What is surgical management of miscarriage?

The surgical management of miscarriage is a small operation to remove pregnancy tissue. It’s also called a dilatation and curettage, or D&C.

Miscarriage is the loss of a pregnancy before 20 weeks.

What does the procedure involve?

After the surgery, you’ll be taken to the recovery area to rest for a few hours before going home.

You should ask your partner, a friend or a family member to drive you home after the surgery. You should not drive home yourself as you may still be sleepy after the anaesthetic.

How can I prepare for the procedure?

You may be told to fast for 6-8 hours before going to the hospital for the D&C.

You may want to take a bag with the following items to hospital:

• your Medicare card
• sanitary pads and toiletries
• your phone and charger
• something comfortable to wear for when you go home
• a water bottle
• a book or magazine

Ask your doctor what you need to do before the surgery.

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How soon will I recover?

You will have some light bleeding and cramps for the first 7 to 14 days after your miscarriage. During this time, you should use sanitary pads instead of tampons.

Paracetamol and ibuprofen are often enough to help manage the pain after surgery.

Until the bleeding stops, you should not:

• have sex
• take a bath
• go swimming

You should have a follow-up appointment with your doctor 4 to 6 weeks after your miscarriage. This is to see how you are going.

You can expect your period to come back around 4 to 6 weeks after your miscarriage. Your first period after the miscarriage may be heavier than usual.

It’s advised that you wait a few months to allow your menstrual cycle to re-establish before trying for a new pregnancy.

If you have a Rhesus negative blood type you may be offered an anti-D injection. This helps to stop problems in future pregnancies.

The emotional effects of miscarriage

It’s normal to feel lots of emotions after a pregnancy loss. It’s important to recognise that there is no right or wrong way to feel.

When you have a miscarriage, there are services that can help support you.

What will I need at home?

It’s a good idea to have the following at home:

• sanitary pads
• pain-relief medicines, such as paracetamol or ibuprofen
• time to rest
• a support person

When should I see a doctor?

If you are still bleeding or in pain after 2 weeks, it’s important to see your doctor.

You should also see your doctor or go to the nearest emergency department if you:

• are soaking 1 to 2 sanitary pads per hour
• are passing large blood clots (golf-ball size)
• have severe abdominal (tummy) pain
• have a fever (a temperature of 38°C or higher) or chills
• feel dizzy, lightheaded or faint
• have unusual or smelly vaginal discharge

What complications can happen?

The risks of having a D&C are very low.

• Up to 3 in 100 women get an infection that needs antibiotics.
• Sometimes, pregnancy tissue may be left in your uterus. This can cause ongoing or heavy bleeding. You may need another operation to remove it.
• Very rarely, the operation can damage your cervix or uterus. This happens to about 1 in 1,000 women. When it does happen, it will usually heal itself. The chance of damage to other organs is even rarer.
• It’s very rare to haemorrhage (have very heavy bleeding) or have adhesions (scarring) on the lining of your uterus.
• There is a risk of reacting to the anaesthetic during any operation. But this risk is very low for most people.

Are there alternatives to surgical management of a miscarriage?

Depending on your circumstances, you may be able to:

• wait for the miscarriage to happen naturally
• choose a medically managed miscarriage

Resources and support

You can talk to your doctor or midwife about where to get support after a miscarriage.

Grief Australia provides support and counselling for people grieving any type of loss.

Miscarriage Australia has resources on what you can expect physically and emotionally after a miscarriage.

Pink Elephants Support Network provides information and support for people who have had a miscarriage.

Red Nose Grief and Loss provides support for miscarriage, stillbirth and newborn death. Call their support line on 1300 308 307.

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