Early Miscarriage Options

Monday, June 9th, 2014 by Early Options

Having an early miscarriage can be a very emotional experience.  On the one hand, you knew that the chances of failure were high in early pregnancy.  On the other hand, you hoped it wouldn’t happen to you.  You were excited when the pregnancy test turned positive.  Perhaps you already started feeling pregnant.  You were excited to go to your first prenatal visit.  You already started making plans for how your life would change during your pregnancy, and after the baby was born.  You may have told your family and friends.  Then, you may have started bleeding.  Or, you may have gone to get an ultrasound and then were told that the pregnancy wasn’t viable.

Unfortunately, most women in the situation of having an early miscarriage get offered outdated options for treatment.  This can make an already difficult experience much worse. You were probably offered the option of a surgical D&C procedure, to be scheduled in an operating room.  This option can be frightening, especially when they explain that one of the risks can be scarring and fertility problems.  You may have also been given the option to “watch and wait” for the pregnancy to pass naturally.  This can involve unexpected heavy bleeding.  It can take weeks to occur, and in the mean time you may still experience pregnancy symptoms.  Emotionally, it can be upsetting to “wait” for the pregnancy you wanted to pass.  It can be hard to conduct your normal activities at work or with your family.  It can be hard to emotionally “move on.”

There are options that are safer and easier to complete.  We recommend two non surgical options for treating early miscarriage: the Manual Vacuum Aspiration Procedure (MVA), and misoprostol pills.  Most women are happy to learn about the MVA Procedure and choose this option.  This method only takes a few minutes to complete, and is offered in a private examination room.  The doctor simply inserts a thin tube, through the natural opening of the cervix.  She attaches a small handheld device.  This aspirator creates a soft and natural suction, that releases and removes early pregnancy tissue.  Within minutes, the procedure is over.  There is immediate recovery, and women can leave the office and resume their normal activities.

Some women are also offered the option of taking misoprostol pills.  The doctor will assess whether the pills are a good option by doing an ultrasound. These pills are best used in very early pregnancy and when bleeding has already started.  They work better than “watching and waiting” because the bleeding is more predictable.  Usually the failed pregnancy tissue passes within hours of taking the pills.

These non surgical methods are both physically and emotionally easier than surgical D&C or watching and waiting.  The MVA Procedure causes pregnancy hormones to drop immediately, so that pregnancy symptoms start to resolve within 24 hours.  Nausea goes away within hours.  Mood swings can take several days to go away  Breast tenderness may take a week or two to resolve.

Emotionally, it is much easier to move forward after getting an MVA or taking misoprostol pills.  These methods are less traumatic, and more natural, making it easier to move forward and put the hard experience behind you.  WIth either of these options, there is no scarring of the uterus, so there is no need to heal.  You can start trying again as soon as you are ready.  You don’t need to use birth control for a several months and can start trying right away.

Early miscarriage is common.  It is estimated that one out of three early pregnancies may end in miscarriage.  While it is emotionally difficult, it is important not to make your medical care any more complicated than it needs to be.  We want to you to take care of the failed pregnancy in a respectful and natural way, so that you do not focus on the failure.  This way, you can get excited about trying again.

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