You Are Not Alone, and It Is Not Your Fault
Walking into an ultrasound room full of hope and hearing that a pregnancy has stopped growing is one of the most devastating moments a person can experience. The shock is immediate, the grief is profound, and the silence surrounding miscarriage in our society only makes the isolation worse.
We want to say this clearly and immediately: You did not cause this.
At MomDoc, we sit in our living rooms with women experiencing this heartbreak every single day. About 25% of all pregnancies end in early pregnancy loss (typically within the first 10 weeks) [2]. Going to work, having coffee, exercising, or being stressed did not stop your pregnancy from growing. In the vast majority of cases, early pregnancy loss is simply the result of a random, microscopic genetic error that occurred at the very moment of conception [1].
There is no "right" way to feel right now. But there is a right way to be medically cared for. We are going to give you absolute clinical clarity and put the control back in your hands regarding your physical recovery.
What Are Your Treatment Options?
When a pregnancy stops growing, the tissue must eventually leave your uterus. If this does not happen on its own immediately, you have safe, clinical choices.
MomDoc fully supports the American College of Obstetricians and Gynecologists (ACOG) guidelines, which state that patients should be empowered to choose between expectant management (waiting), medical management (pills), or surgical management based on their physical health and emotional needs [1].
Below is a breakdown of your three options.
<div className="overflow-x-auto my-8"> <table className="w-full text-left border-collapse min-w-[600px]"> <thead> <tr className="bg-primary-50"> <th className="p-4 border-b border-primary-200 font-serif text-lg text-primary-800">What Are My Choices?</th> <th className="p-4 border-b border-primary-200 font-semibold text-primary-700">Watch & Wait<br/><span className="text-sm font-normal text-muted-foreground">(Expectant Management)</span></th> <th className="p-4 border-b border-primary-200 font-semibold text-primary-700">Medication<br/><span className="text-sm font-normal text-muted-foreground">(Medical Management)</span></th> <th className="p-4 border-b border-primary-200 font-semibold text-primary-700">Procedure<br/><span className="text-sm font-normal text-muted-foreground">(Surgical Management)</span></th> </tr> </thead> <tbody> <tr className="border-b border-primary-100"> <td className="p-4 font-semibold text-foreground">What will happen?</td> <td className="p-4 text-sm">You wait for the pregnancy tissue to pass naturally. This happens with cramping and bleeding that may include clots.</td> <td className="p-4 text-sm">Your clinician prescribes a medication (Misoprostol) to induce cramping and help the tissue pass quickly at home.</td> <td className="p-4 text-sm">A clinician removes the tissue during a brief outpatient surgical procedure (Suction Dilation & Curettage), usually with sedation.</td> </tr> <tr className="border-b border-primary-100 bg-white"> <td className="p-4 font-semibold text-foreground">How does it work?</td> <td className="p-4 text-sm">You wait for bleeding to begin. When it does, it will be heavier than a period. Lighter bleeding often continues for 1 to 2 weeks.</td> <td className="p-4 text-sm">Heavy bleeding and cramping usually begin 2 to 6 hours after taking the pills. Lighter bleeding persists for 1 to 2 weeks afterwards.</td> <td className="p-4 text-sm">The uterus is gently emptied via suction. You will have light bleeding and cramping for 3 to 7 days afterward.</td> </tr> <tr className="border-b border-primary-100"> <td className="p-4 font-semibold text-foreground">How painful is it?</td> <td className="p-4 text-sm">You may experience intense cramps when the tissue passes. Ibuprofen and a heating pad will help.</td> <td className="p-4 text-sm">You will experience intense cramps. We will prescribe strong pain medication to take beforehand to manage it.</td> <td className="p-4 text-sm">You will be sedated/numbed during the procedure. Afterward, you may have mild to moderate cramping.</td> </tr> <tr className="border-b border-primary-100 bg-white"> <td className="p-4 font-semibold text-foreground">How well does it work?</td> <td className="p-4 text-sm">Successful 70-80% of the time.</td> <td className="p-4 text-sm">Successful 80-90% of the time (often within 8 days).</td> <td className="p-4 text-sm">Successful 99-100% of the time in a single visit.</td> </tr> <tr className="border-b border-primary-100"> <td className="p-4 font-semibold text-foreground">What if it fails?</td> <td className="p-4 text-sm">If it takes too long, you can switch to the Medication or Procedure options at any time.</td> <td className="p-4 text-sm">You can take a second dose of medication, or schedule the surgical procedure to complete the process.</td> <td className="p-4 text-sm">In extremely rare cases, a second brief procedure may be required.</td> </tr> </tbody> </table> </div>When to Seek Emergency Care
Regardless of which option you choose, you will be passing tissue and blood at home. It is critical that you know the difference between normal miscarriage symptoms and an emergency.
Go to the nearest Emergency Room immediately if you experience:
- Bleeding so heavy that you soak completely through more than two maxi pads an hour for two hours in a row.
- A fever of 100.4°F or higher.
- Severe, sudden abdominal pain that is not relieved by pain medication.
- Dizziness, fainting, or severe lightheadedness.
Healing and Moving Forward
A core tenet of our practice is that there is no timeline on grief. Your body will likely physically recover from an early pregnancy loss within a month, but emotional recovery is entirely your own. If you are struggling to return to your normal life, please tell your MomDoc clinician. We can connect you with compassionate counselors and support groups.
When you feel emotionally and physically ready to try for a pregnancy again, we are right here to guide you. You do not have to wait a specific number of months to try again unless directed by your provider.
We are so sorry for your loss. We are here to support you safely through it.