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Pregnancy Loss

Firstly, we would like to extend our deepest sympathies to you and your family if you have experienced a pregnancy loss. Losing a baby, no matter the gestation, is a heartbreaking and difficult journey.

The staff at South West Healthcare are here to provide you with support and guidance.

Pregnancy loss less than 20 weeks gestation

Early pregnancy loss is the loss of a pregnancy prior to 20 weeks gestation. It encompasses many different definitions such as miscarriage and ectopic pregnancy. Unfortunately, it is reported that 1 in 4 women will experience a pregnancy loss. Although women will often blame themselves, it is very rare that a miscarriage will occur because of something they either have or haven’t done. Sadly, miscarriage is a tragic and common event.

Symptoms of a miscarriage may include bleeding and pain. Whilst some spotting is common in early pregnancy, it is important to tell your doctor or midwife if you experience any bleeding. Heavier bleeding that is usually accompanied by cramping pain, similar to period cramping, could indicate the start of a miscarriage. If you experience this, or think you are having a miscarriage, you should contact your GP or attend to hospital for assessment. Investigations for a suspected miscarriage may include history taking of your symptoms, an examination, ultrasound and blood tests.

Creating memories

The way in which families grieve and choose to remember their baby is very individual. Creating memories is a way to provide comfort and healing to parents during a difficult time. The staff at South West Healthcare encourages and assists parents in creating special memories and keepsakes. These can include:

  • Creating a memory booklet
  • Cot card, name bands and tape measure with the baby’s information
  • Hand/footprints (if possible)
  • Photographs
  • A Bears of Hope care package
  • Clothing/blanket/cocoon
  • Assisting parents to bathe/dress/hold their baby

For more ideas or information https://sands.org.au/creatingmemories

Commemorative Certificate – A pregnancy loss less than 20 weeks gestation is not required to be legally registered. Therefore, you will not receive an official birth certificate. However, an early pregnancy loss commemorative certificate is available through Births, Deaths and Marriages Victoria.

Care of your baby after birth

A baby born prior to 20 weeks gestation is not registered so is legally not required to be buried or cremated. There is no law in Victoria to state that a Funeral Director is required to arrange a burial or cremation for a baby under 20 weeks gestation. Therefore, there are a number of options available to you.

Option 1: You may take your baby home for burial. The Maternity Unit can supply you with an Angel Box/Cocoon to place your baby in.

Option 2: You can choose a Funeral Director for burial/cremation. (This option will incur costs to you)

Option 3: You can arrange your own burial/cremation/service with the Cemeteries Trust. (This option will incur costs to you)

Option 4: You can request that South West Healthcare will dispose of the baby in a respectful and dignified manner.

Guyetts Funerals (03) 5562 2622
John O’Sullivan and Family Funeral Directors (03) 5561 1199

Miscarriage

If a miscarriage has begun, unfortunately there is nothing that can be done to stop it. Treatment options will be recommended based on a number of factors, including how many weeks pregnant you are (gestation), amount of bleeding you are experiencing and any signs of infection. The aim of any treatment is to limit the amount of bleeding you experience as well as reduce your chances of developing an infection.

At South West Healthcare, treatment options will be discussed once a miscarriage is confirmed at the appointment by an Obstetrician. Depending upon which treatment option is decided, an appointment may be scheduled for two weeks post treatment at the Women’s Clinic. This appointment may be necessary to perform a follow up ultrasound to exclude any remaining products.

Treating a miscarriage

  • No treatment (expectant management)

    Waiting to see what will happen naturally is called ‘expectant management’. The pregnancy tissue can pass naturally anywhere from a few days to a number of weeks depending on the classification of miscarriage experienced.

    While you are waiting you may experience some spotting or bleeding, very similar to a period. As the pregnancy tissue is passed, you are likely to experience heavier bleeding with some cramping pain.

    If expectant management is unsuccessful or you develop signs of infection, a recommendation will be made to have surgical intervention (curette).

  • Treatment with medicine

    Medication is available in order to speed up the process of passing the pregnancy tissue. This process is usually complete within a few hours and occasionally may take a day or two.

    Medication is not suitable for all women. There are a few instances when this treatment option is not available, such as in the case of heavy bleeding or when there are signs of infection.

    If medication is unsuccessful or you develop signs of infection, a recommendation will be made to have surgical intervention (curette).

  • Surgical intervention (curette)

    Dilatation and curettage, also known by the shortened version of D&C or curette.

    This procedure is performed in the operating theatre, usually under general anaesthetic. It is a relatively quick procedure and patients will generally only be in hospital the one day.

    The cervix is gently opened and the remaining pregnancy tissue is removed, leaving the uterus empty.

    Choice of management if you are experiencing:

    • Heavy bleeding
    • Pain
    • There is a large amount of pregnancy tissue present
    • Signs of infection

    Like all medical procedures there are risks associated with a D&C, but the risks are considered very low. Your doctor will discuss these risks with you when discussing your options.

After a miscarriage

Following a miscarriage, it is usual to have pain and bleeding, very similar to a period for about 2 weeks, but the bleeding should get less and less each day. If it is worsening or offensive, please notify us. Management at home can include taking simple analgesia such as paracetamol and using heat packs for comfort.

If you experience any of the following you should seek medical treatment from your GP or hospital emergency department:

  • Increasing abdominal pain or shoulder pain
  • Increasing bleeding (soaking two pads per hour) or passing clots
  • Fever or chills
  • Dizziness or fainting
  • Abnormal vaginal discharge, particularly if it has an unpleasant odour
  • Diarrhoea or pain when you open your bowels

Other information:

  • Your next period should return in four to six weeks following a miscarriage.
  • Avoid inserting anything into your vagina (sex or tampons) until the bleeding stops and you feel comfortable
  • All contraceptive methods are safe following a miscarriage
  • See your GP/Women’s Clinic in four to six weeks for a check up (or as advised)
  • If you have a negative blood group, you may require and injection

Misoprostol

  • What is misoprostol?

    Misoprostol is a synthetic (manufactured) form of the hormone prostaglandin. It is used to soften and dilate the cervix, cause uterine contractions and aid in the passing of pregnancy tissue.

  • Who should not use misoprostol?

    If you have:

    • An allergy to any prostaglandins
    • Previous caesarean section or uterine surgery
    • An intrauterine device (IUD) inserted
    • Been taking medications to thin your blood
    • Severe high blood pressure
  • How should I use misoprostol?

    Your doctor will advise on the most appropriate dose of Misoprostol based on the intended purpose and outcome. Misoprostol tablets may be used in the vagina, under the tongue (sublingual) or between the gum and cheek (buccal).

  • Using misoprostol in the vagina

    The tablets should be placed deep in the vagina 2 hours prior to hospital admission

    1. Empty your bladder
    2. Wash your hands
    3. Remove Misoprostol tablets from the foil packaging
    4. Adopt a comfortable position to insert the tablets (squatting or lying on your back/side).
    5. Using your finger, push Misoprostol tablets into the vagina one at a time
    6. Lie down for around 30 minutes to allow the tablets to dissolve (If the tablets begin to fall out you may push them back in again)
    7. Wash your hands
  • Using misoprostol sublingually or buccally

    The tablets should be placed either under the tongue or between the gum and the cheek 2 hours prior to hospital admission

    1. Wash your hands
    2. Remove Misoprostol tablets from the foil packaging
    3. Place 2 tablets as directed by your doctor (either under your tongue or between your gum and cheek)
    4. Allow the tablets to dissolve. The tablets may make your mouth dry and have a chalky taste
    5. After 30 minutes, if any of the tablets are left in your mouth, you may swallow with a sip of water
  • Possible side effects of misoprostol

    Common side effects may include:

    • Nausea and/or vomiting
    • Diarrhoea

    Rare side effects may include:

    • Chills and/or fever
    • Abdominal pain/cramping
    • Bleeding

    If you experience any of these rare side effects or have any concerns please contact Maternity Unit (03) 5563 1441

Page last updated: 18 July 2022

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