How does medical management of miscarriage work?

A clinician first confirms the miscarriage and discusses whether medicine is suitable. Misoprostol softens and opens the cervix and stimulates uterine contractions. Cramping and bleeding are expected as tissue passes; bleeding may be heavier than a usual period and clots can occur. Nausea, diarrhoea, chills or a temporary fever may also happen. The pregnancy tissue may pass over several hours, although timing varies.

A follow-up check confirms whether the uterus has emptied. If tissue remains or bleeding continues, the options may include another dose, observation or surgical management. Medical treatment does not involve an operation, but it can be physically and emotionally demanding.

Take the medicine exactly as prescribed and arrange a way to contact your care team. Use sanitary pads while bleeding so you can observe the amount; avoid tampons until advised otherwise. Rest, drink fluids and use only pain relief recommended for you. Keep any follow-up appointment, even if the bleeding settles, because symptoms alone cannot confirm that all tissue has passed.

You can read about [Medical Management of Miscarriage](/treatments/medical-gynaecology/medical-management-of-miscarriage/) and [Misoprostol](/materials/misoprostol/). Surgical treatment is another option in some circumstances: [Surgical Management of Miscarriage](/treatments/gynaecological-surgery/surgical-management-of-miscarriage/).

Seek urgent medical help for very heavy bleeding, faintness, severe or worsening pain, difficulty breathing, or feeling seriously unwell. Contact your care team promptly for a fever that persists, foul-smelling discharge or pain that does not improve. These symptoms can signal infection, substantial blood loss or tissue that has not passed. If you are unsure whether your bleeding is within the expected range, call the service that prescribed the medicine.

Ask when to take the dose, which pain medicines are appropriate, how bleeding will be assessed, and when pregnancy testing or an ultrasound is needed. Ask what to do if tissue does not pass and how to access emotional support.