What are the alternatives to surgical management of miscarriage?

Expectant management involves waiting while the body completes the miscarriage. Bleeding and cramping may begin without treatment, and follow-up is used to check that the uterus has emptied. Medical management uses medicine to encourage the uterus to contract and pass the tissue. It can be useful when waiting has not worked or when you prefer a planned approach.

The suitable option depends on the pregnancy stage, ultrasound findings, bleeding, infection risk, pain, and your preferences. A molar pregnancy, heavy ongoing bleeding, or retained tissue may require a different plan. Ask about follow-up testing and what happens if the first option does not complete the miscarriage.

Discuss the options after your diagnosis is confirmed. Ask how to manage cramps, what bleeding pattern to expect, and how you will know the miscarriage has completed. Keep any arranged review appointment, because symptoms alone cannot always confirm that tissue has passed. Use sanitary pads if you need to monitor bleeding, and take only pain relief that your clinician considers suitable.

Seek urgent medical help for very heavy bleeding, faintness, severe or worsening pain, fever, chills, or foul-smelling discharge. One-sided pain or shoulder-tip pain with dizziness can signal an ectopic pregnancy and needs immediate assessment. Contact your maternity or gynaecology service if bleeding continues unexpectedly or you feel unwell.

Ask: Which option fits my scan and symptoms? How long should I wait before review? What medicine will I use and what side effects should I expect? When can I try to conceive again, and do I need treatment if tissue remains?