When I lost my little River died at around 12 weeks I didnt find out till I was 16 weeks. I had started spotting and some mild cramping before the scan showed bubs was gone so I decided to wait to see if it would happen naturally and nothing. I got constant mild pain that I normally get for a week before AF and spotting that stopped and started. Two weeks after the first scan they admitted me to give me misoprostal to see if my body could push it out with help. It worked. They admitted me simply because I was futher along and they were worried about me bleeding too much.
After going through this and discovering lots of things that stressed me out at very unfortunate points in time I thought that maybe it would help other women if it were all written down in simplistic black and white. Knowing what if going on takes a lot of the fear away and helps you when you need to make these choices later on. If anyone has anything to add, feel free as my information if solely coming from my experience so I dont pretend to know everything.
Spontaneous Miscarriage - Natural, Unassisted
If it does happen spontaneously you can expect a decent amount of pain and some bleeding but if after you pass the majority of the tissue you are soaking through a pad in an hour, you are probably bleeding too much so get help asap. Your bleeding should start to taper off to normal AF levels along with your pain as soon as you pass the main tissue and bubby, though the cramping contraction type pain did continue infrequently all day for me at much more manageable levels. The pain came in contraction form for me (what a depressing first taste of labour that was). When the pain was really strong and I had a strong desire to go to the toilet, that was the signals that everything was going to come out so go sit somewhere where you can let it all go and not worry about a mess like the toilet. The contractions not only push the tissue out, they also serve to stop the bleeding afterwards so while pain killers are ok, try not to take things that will slow or stop them.
The benefits to doing it naturally is that it carries the least risk of side effects and the least risk of damage to your uterus. The risks associated with this way are as follows:
1) If you are not close to a hospital and on your own then hemmorrhaging can be very dangerous. If after the main tissue has passed you are soaking through a pad in an hour then call someone asap and get to emergency. The further along you are the greater the danger is.
2) There is the chance of some tissue being retained and this can cause infection later on so get an ultrasound done a few days after to ensure you are all clear. Keep an eye out for signs of infection like dizziness, nausea, temperatures, unusual or smelly discharge and the rigors (shaking and feeling cold when you are hot). If you do have retained tissue you will need a D&C. The further along you are, the greater the danger is.
3) The longer you wait for it to happen naturally, the higher the chance of tissue adhering to the uterus causing scarring and possible retained tissue. Doctors normally consider up to 6 weeks to be the safe zone before they start to try getting you to try other options.
4) The further along you are and the longer you wait, the more chance is that things will get stuck on the way out. Tissue that is stuck in the cervix will cause large amounts of pain and if left there can send you body into a form of shock. It is a rare and unusual situation where your heart rate and blood pressure both drop at the same time and if the tissue is not removed the chances of you becoming unconscious are high. This is rare but is also serious.
Walking away from the horrible clinical description now. . It is an incredibly emotional time. I lost it so bad when the worst was over. Be kind to yourself and do whatever you need to do to get through this. If it starts and you feel like you cant cope then get to emergency and they will help, at the very least with pain medication and someone to talk to if you need it. They sent a social worker to me before they gave me the drugs to make sure I was in a good headspace under the circumstances. Depending on how you are, it may help to have someone stay with you or visit frequently if you are really worried about it happening at home.
The wait is horrendous. A constant reminder that you cant get away from but hang in there. You are strong and you can get through this.