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                    • Facing a miscarriage »
                    • Spontaneous miscarriage

                    Spontaneous miscarriage

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                    A miscarriage is your body’s natural response to a pregnancy that has stopped growing. Spontaneous miscarriage is called expectant management, watchful waiting or natural miscarriage.

                    Many people safely miscarry at home with support from family, friends, and early pregnancy loss program nurses. It may take a few days to several weeks for a miscarriage to begin. A small number of women will have very heavy bleeding and need to go to the hospital for care.

                    Caring for yourself

                    It is important to take care of your body during and after a miscarriage. You can support your body by:

                    • drinking extra water to stay hydrated
                    • eating healthy meals
                    • avoiding vigorous exercise until your bleeding has completely stopped for 2 weeks. After two weeks of no bleeding you can increase your activities.

                    While you are bleeding:

                    • use pads instead of tampons
                    • shower instead of having a bath
                    • do not use hot tubs or swimming pools
                    • do not have sexual intercourse until your bleeding has completely stopped for 2 weeks

                    What to expect during a miscarriage

                    You may have small amounts of bleeding and cramping or lower backache for a few days or weeks before the miscarriage happens. When the pain and bleeding increase, it may mean the miscarriage will happen soon. Have a support person with you during the miscarriage.

                    Bleeding, tissue and cramping

                    A miscarriage happens as the uterus contracts and the cervix opens. You may feel lower pelvic pressure and blood clots may come out. Clots are usually dark red, flat and break apart easily.

                    At the peak of the miscarriage, the cramping will be the worst and the bleeding will probably be heavier than your normal period for two to three hours. You may have some gushes of blood that fill one or two large pads within an hour. You will likely pass some clots. They may vary from the size of a coin to the size of the palm of your hand. Try to assess the amount of your bleeding on a pad and not in the toilet.

                    Tissue may also come out and appear red with white or grey parts and feel firm. You may see a small sac with fluid inside. The size of the tissue will vary with how far along your pregnancy is. The tissue may be as small as a coin or as large as the palm of your hand. It may come out all at once or a bit at a time.

                    Managing pain

                    Controlling your pain is important. You can choose to rest, change positions and apply heat for the cramping. 

                    You may also wish to take pain medication such as ibuprofen (Advil or Motrin) or acetaminophen (Tylenol). You may alternate between these pain medications. It is important to follow the recommended dose listed on the package.

                    Nausea and diarrhea

                    You can take medication for your nausea such as dimenhydrinate (Gravol). Follow the recommended amount listed on the package.

                    Nausea and diarrhea should stop in 24 to 48 hours.

                    After the miscarriage

                    Once most of the pregnancy tissue has passed, your pain should decrease. You may have some milder cramping for 24 to 48 hours.

                    Bleeding can vary from a moderate amount to spotting for a few days or weeks, and you may pass small clots for a few days.

                    Collecting pregnancy tissue

                    You may wonder if you should collect the pregnancy tissue, and there is no right or wrong answer to this question. There is no testing of the remains to determine the reason for the miscarriage. 

                    If it is important for you to commemorate your pregnancy by burying the remains, there are several options to consider. You may bury the remains yourself, have a hospital burial or choose cremation. Collect any solid pieces you pass and place them in a plastic container with a lid. Store them in a cold place (refrigerator) and contact the early pregnancy loss program to discuss your options. 

                    Contraception

                    Use contraception to prevent pregnancy until after your first period following the miscarriage. Wait one menstrual cycle before trying to get pregnant again. Talk to your primary healthcare provider about this at your follow-up appointment.

                    Tender breasts

                    It is normal to have tender breasts, and this should go away in a few days.

                    You may also see fluid leaking from your breasts. Wear a well-fitted bra that is not tight and put a cotton pad inside, if needed.

                    Tiredness

                    It is important to get plenty of rest.

                    Make sure you eat healthy foods, drink lots of water and continue your prenatal vitamins until the bottle is finished.

                    You can go back to work, school and driving as soon as you feel ready. Our team can give you a note for time off work if you need one.

                    Coping with loss

                    There are a wide range of feelings you may have after your pregnancy stops growing. You may feel fear, relief, guilt, anger, shock or even numbness. All feelings are normal and okay to have, and your partner’s feelings may be very different from your own.

                    Often, no reason for a miscarriage can be found. Give yourself time to feel sad, cry and talk about your feelings and what happened. It is hard to know how long it will take for you to feel better, but it may help to:

                    • talk to someone who will listen and understand
                    • be kind to yourself. Do not expect too much of yourself and try to be with people who are caring
                    • get in touch with a support group or talk with other people who have experienced a miscarriage

                    When to get help

                    Emergency department

                    Go to the nearest emergency department if you:

                    • have very heavy vaginal bleeding (soaking through four large pads in two hours)
                    • have dizziness that does not go away with rest or causes you to faint
                    • do not get better as expected or you cannot manage at home

                    Primary healthcare provider 

                    See a primary healthcare provider, such as a family doctor, if you:

                    • have signs of infection: 
                      • new, increasing or foul-smelling vaginal discharge 
                      • a fever over 38 degrees Celsius or chills
                    • are not able to drink fluids
                    • have pain that does not get better after you take pain medication
                    • have bleeding and cramping for more than two weeks

                    Follow-up care

                    The nurses at the early pregnancy loss program will contact your regularly to monitor your symptoms and provide emotional support. We will arrange follow-up care and tests based on your symptoms.

                    Use contraception to prevent pregnancy until after your first period following the miscarriage. Wait one menstrual cycle before trying to get pregnant again. 

                    We will ask you to see your primary healthcare provider four weeks after your miscarriage, or sooner if you wish.

                    Emotional support and bereavement care are part of the healing process. Call the early pregnancy loss program for support or to ask questions.

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                    We acknowledge that what we refer to as Alberta is the traditional ancestral territory of a diversity of Indigenous peoples and home to Treaty 6, 7 and 8. We recognize and give thanks to the many First Nations, Métis and Inuit who have lived in and cared for these lands for generations, all who continue to grace these lands and all future generations. We make this acknowledgement as an act of reconciliation and gratitude.

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