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Miscarriage – surgical management

Read our guide below about surgical management of a miscarriage for women under 13 weeks of pregnancy.

You can also download a PDF version of this patient information by following the link on the right.

We’re very sorry that you or someone close to you has had a miscarriage. This guide will help you choose what treatment to have.

What this guide includes

It will help you explain what is going to happen next and how we will manage the miscarriage by surgical treatment. This information will guide you so that you can make an informed decision.

Research comparing the management of miscarriage by surgical intervention, medication or natural miscarriage found that:

  • the risks of infection or other harm are very small with all three methods
  • your chances of having a healthy pregnancy next time are equally good whichever method you choose
  • women cope better when given clear information, good support and a choice of management methods.

This information will help you prepare for your admission and operation if you choose surgical procedure.

What is surgical management of miscarriage?

It’s a minor operation to remove the pregnancy tissue under a light general anaesthetic which puts you to sleep.

What should I do before coming to hosiptal for my operation?

You must:

  • not eat from midnight the night before your operation. You may drink water up to 6am on the day of your operation. This will reduce your risk of vomiting while you are under anaesthetic
  • Bring a dressing gown and slippers. You will need to wear a sanitary towel and appropriate underwear.
  • remove make-up, nail varnish, false nails and all jewellery (except a wedding ring)
  • not bring valuables into hospital
  • arrange for a responsible adult to accompany you home and stay with you for at least 24 hours.

Where will the operation happen and what time do I need to arrive?

The Day Surgery Unit at Stoke Mandeville Hospital at 7.30am.

What happens on the day of my operation?

You may have someone with you during your stay on the pre-operative ward until you go to theatre. Your visitor can stay on the ward if they want until you return
from theatre/recovery until you are ready to go home. If you are being collected we’ll give you an approximate time for when you’ll be ready to leave.

Before your operation, the doctor will have explained what is going to happen, including the risks, so you can provide your written consent for the procedure.

You’ll be given some vaginal tablets (pessaries) to insert into the vagina before the operation. These tablets soften the cervix (neck of the womb) and help reduce the risk of any damage to it or the womb.

How is the operation done?

It’s done through the cervix so there are no cuts or stitches. The pregnancy tissue is removed by suction or gentle scraping and takes 5 to 10 minutes.

The operation is usually early in the morning. If it’s delayed in the case of an emergency, there’s a small risk you may start to feel some crampy abdominal pain with or without vaginal bleeding whilst waiting.

You may also feel some side effects of the vaginal pessaries, for example nausea, vomiting, diarrhoea, dizziness, fever and chills.

What are the most common complications of the operation?

These include:

  • bleeding
  • infection in the uterus (womb)
  • a rare (less than 1 in 200) risk of injury to the cervix or the uterus
  • damage to the uterus (very rarely). This may involve a laparoscopy to look into the tummy through the belly button. Even more rare is the need for a laparotomy, which is making a bigger cut on your tummy to repair damage to any organs
  • risk of adhesions in the lining of the womb. These adhesions are usually mild and the significance of these is uncertain. The risk increases with the greater  number of procedures performed
  • anaesthetic complications
  • missed retained tissue (small chance) with a further operation needed to remove it.

The surgical team will take appropriate measures to reduce the risk of any complications.

What happens after your operation?

After the operation you’ll feel sleepy.  You may experience some abdominal cramping but will be physically well.

You may have a drip or venflon cannula (plastic tube into your vein in your arm/hand) in place. We’ll remove this when you’ve had a drink, some biscuits or a sandwich and have passed urine. Once you’re fully recovered, after about 2 hours, you can usually go home.

If you have a Rhesus negative blood group you’ll need an injection of Anti D (immunoglobulin antibodies) before you go home.

Don’t forget to arrange for someone to stay with you for the first 24 hours after the operation.

After an anaesthetic

Because you’ve had a general anaesthetic, the effects of the anaesthetic drugs may not have completely gone. You may feel some side effects in the first 24 hours.

These include:

  • headache
  • dizziness
  • nausea (a feeling of sickness)
  • drowsiness
  • a dry or sore throat.

Even if you feel perfectly well, do not do any of the following for 48 hours:

  • drive a motor vehicle, motorcycle or a bicycle, as you may not be covered by your insurance
  • drink alcohol
  • return to work
  • risk scalding/burns/spills whilst using your own cooking appliances
  • use electrical tools (for example, a lawn mower, a drill)
  • sign any important documents.

You can eat and drink normally after discharge from the hospital.

What to expect

You may bleed after the operation, but the amount varies from person to person. It may last up to 3 weeks (perhaps on and off) just like a period which usually turns a brownish colour.

Provided you don’t bleed very heavily with bright red blood, don’t worry.

You may get cramp-like pains for a few days. Simple pain relief such as one you would normally take for a headache should relieve this, for example paracetamol.

To help avoid getting an infection during this time, you should:

  • use sanitary towels rather than tampons
  • avoid sexual intercourse for two weeks after the operation
  • you should avoid bathing or swimming until the bleeding stops. You may have showers as usual

What symptoms should I be worried about?

See your GP urgently if you have:

  • severe or continuous pain
  • heavy bright red vaginal, or prolonged bleeding
  • a high temperature
  • a feeling of generally unwellness, have flu like symptoms or a smelly vaginal discharge
  • a feeling of fainting
  • a red inflamed patch on either breast.

Very occasionally you may:

  • get some milk from your nipples 2 to 3 days after the operation
  • have painful and tender breasts for a few days.

You won’t need a specific treatment but you should support your breasts with a well-fitting bra. You may need to take simple pain relief, for example, paracetamol.

How long should I wait to become pregnant again?

Your first period should come in around 3 to 6 weeks’ time. We advise you to wait until you have had at least one ‘normal’ period before you attempt to conceive. This will allow your body to recover physically but psychologically, you may need much longer.

We advise you to continue taking folic acid if you’re planning another pregnancy.

What will happen to your baby?

On most occasions we don’t see a recognisable baby as it’s usually very small. We send any tissue obtained to the histology laboratory for microscopic inspection to check that it’s normal pregnancy tissue.

After histological inspection, we treat all the remains of the pregnancy tissue with the greatest respect. We bury it in an area shared by other babies at Aylesbury cemetery in the presence of the hospital chaplain and funeral director.

We perform this service once a month. Many parents find it comforting to know that their baby is buried beside other babies.

Please be aware this is not a service attended by parents. It’s not possible to locate exactly where the grave is as there are no headstones.

If you’d like to consider more personal options or arrange a burial yourself, please speak to staff in the Early Pregnancy Unit or Gynae staff. If you’re considering a home burial, there’s more information below about burying your baby at home.

Contact us

Call us for advice, if you’re concerned or unsure what to do.

Early Pregnancy Unit

01296 316469 (8am to 5pm, Monday to Friday).

At all other times call Ward 15 on 01296 316500 or 01296 316365

Further information and support

Miscarriage association

Charity bears

About this guide

This guide explains some of the most common side-effects that some people may experience. But it’s not comprehensive. If you experience other side-effects and want to ask anything else related to your treatment, please speak to the Early Pregnancy Unit on the numbers above.

Information about burying your baby at home

If you want to take your baby home for burial, please remember:

  • you may not always live at that address
  • the baby should not be buried near a water supply
  • the baby must be buried at least 90cm deep
  • if you do not own the land, permission must be sought from the landowner
  • others using the land should be informed of the burial
  • keep a note of the exact place of burial with the deeds in case you want to take your baby with you if you move.

You may prefer to bury your baby in a simple casket or box, in case you do want to move.

If you bury your baby in a designated place, for example, the Aylesbury Cemetery or Snowdrop Garden, High Wycombe, you will always be able to visit.

For more  contact the Institute of Cemetery and Crematorium Manager (Inc.) on 0208 9894661.