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.
Early pregnancy loss is the loss of a pregnancy prior to 12 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.
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. Your healthcare provider will also need to rule out the potential for an ectopic pregnancy. This is usually determined by an assessment performed by your doctor that usually involves an ultrasound. See link for more information on ectopic pregnancy – The Royal Women’s.
At Southwest Healthcare, treatment options will be discussed with a doctor once a miscarriage is confirmed. Depending upon which treatment option is decided, an appointment may be scheduled for two weeks post treatment at the Women’s Health Service. This appointment may be necessary to perform a follow up ultrasound to exclude any remaining products.
No treatment (expectant management)
Treatment with medicine
Surgical intervention (curette)
Miscarriage – Better Safer Care Victoria.
You will be admitted to the hospital for the birth of your baby so we can provide the necessary medical care and emotional support during this difficult time.
Initial management includes the use of 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.
Common side effects may include: Nausea and/or vomiting, Diarrhoea, chills and/or fever, bleeding, abdominal pains/cramping
Misoprostol is a small tablet that can be administered by placing it between your cheek and gum and waiting for it to absorb (unpleasant taste), or it may be given by inserting the tablet into the vagina and positioned close to the cervix by yourself or your midwife.
Misoprostol will be administered every 4hrs until birth. Misoprostol is used to cause cramps leading to contractions. It may cause vaginal bleeding and nausea.
Medication to help soften the cervix and induce contractions. It can take time for contractions to begin and they may be irregular at first. The induction process could take between 3 hours- 3 days. Every birth is different.
You will remain in the Birth Suite for the duration of your stay, in a private room. A support person is welcome to stay overnight also.
You will be met by a midwife and doctor and they will review the plan for your care. This is a good opportunity to discuss any questions or concerns you or your support person may have, and any preferences you would like staff to respect or facilitate during the labour and birth of your baby.
An IV drip will be placed into your arm and blood tests will be taken, with your consent. The doctor may also discuss swabs being collected to test for infection.
The first dose of the medication that starts your labour, Misoprostol will then be administered. Your midwife may not be present in the room the entire time during the early phase of labour, but if you feel vulnerable or anxious, please talk to your midwife.
Often staff leave parents because they feel they need privacy or are managing fine on their own. It’s all about communication and you will be provided with the support you need during your labour.
As labour progresses and contractions become more intense, you may want to use some pain relief. Options available include:
Following the birth of your baby, you may be given an injection of a medication called oxytocin in your arm/leg, with your consent, to help deliver your placenta depending on your gestation. It can be difficult at this point because you might just want to be left alone with your baby. However, the midwives need to continue caring for you until your placenta is delivered.
If the placenta doesn’t come away from the uterus or there are complications, you may be taken to theatre so the doctor can perform a small operation to remove the placenta. Placental tissue that is left inside the uterus can cause bleeding and infection.
Testing options:
Post-mortem:
Post-mortems are performed at The Women’s Hospital Melbourne, and may provide further insight into why your baby died. However, findings may be inconclusive. A doctor will discuss this option further with you.
We will provide you with The Women’s Hospital post-mortem information sheet to help you make an informed choice about this process.
If your baby is born before 20 weeks gestation, you are not legally required to register your baby with Births, Deaths and Marriages, or arrange a funeral.
Births Deaths and Marriages Victoria have recently developed an Early Pregnancy Loss Commemorative Certificate to recognize the importance of an early pregnancy loss which parents can apply for, for free.
We understand how difficult and upsetting this can be for some parents who feel their baby has not been legally recognised. We do have some options for you to consider when saying goodbye to your baby, please speak with your midwife and doctors.
Pregnancy loss greater than 20 weeks gestation is called a stillbirth or neonatal death. In Australia, a stillborn baby is defined as a baby that shows no signs of life at birth at or after 20 weeks’ gestation or weighing 400 grams or more.
Many people may blame themselves for this happening, it is rarely anything they have done, or not done that has caused this to happen. Please speak to your doctor, nurse or midwife if you have any further questions or concerns.
You will be admitted to the hospital for the birth of your baby so we can provide the necessary medical care and emotional support during this difficult time.
Initial management includes the use of 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.
Common side effects may include: Nausea and/or vomiting, Diarrhoea, chills and/or fever, bleeding, abdominal pains/cramping
Misoprostol is a small tablet that can be administered by placing it between your cheek and gum and waiting for it to absorb (unpleasant taste), or it may be given by inserting the tablet into the vagina and positioned close to the cervix by yourself or your midwife.
Misoprostol will be administered every 4hrs until birth. Misoprostol is used to cause cramps leading to contractions. It may cause vaginal bleeding and nausea.
Medication to help soften the cervix and induce contractions. It can take time for contractions to begin and they may be irregular at first. The induction process could take between 3 hours- 3 days. Every birth is different.
You will remain in the Birth Suite for the duration of your stay, in a private room. A support person is welcome to stay overnight also.
You will be met by a midwife and doctor and they will review the plan for your care. This is a good opportunity to discuss any questions or concerns you or your support person may have, and any preferences you would like staff to respect or facilitate during the labour and birth of your baby.
An IV drip will be placed into your arm and blood tests will be taken, with your consent. The doctor may also discuss swabs being collected to test for infection.
The first dose of the medication that starts your labour, Misoprostol will then be administered. Your midwife may leave you on your own during the early phase of labour, but if you feel vulnerable or anxious, please talk to your midwife.
Often staff leave parents because they feel they need privacy or are managing fine on their own. It’s all about communication and you will be provided with the support you need during your labour.
As labour progresses and contractions become more intense, you may want to use some pain relief. Options available include:
Following the birth of your baby, you may be given an injection of a medication called oxytocin in your arm/leg, with your consent, to help deliver your placenta depending on your gestation. It can be difficult at this point because you might just want to be left alone with your baby. However, the midwives need to continue caring for you until your placenta is delivered.
If the placenta doesn’t come away from the uterus or there are complications, you may be taken to theatre so the doctor can perform a small operation to remove the placenta. Placental tissue that is left inside the uterus can cause bleeding and infection.
Testing options:
Post-mortem:
Post-mortems are performed at The Women’s Hospital Melbourne, and may provide further insight into why your baby died. However, findings may be inconclusive. A doctor will discuss this option further with you.
We will provide you with The Women’s Hospital post-mortem information sheet to help you make an informed choice about this process.
How parents and their families would like to remember their baby is a personal choice and is based on what’s important to them. For many people, the loss of a baby leaves them feeling shocked, isolated and empty.
Creating memories is a way to provide comfort and healing to parents and honour their baby’s memory.
Babies born after 20 weeks gestation are considered a registered birth, and are legally required to be buried or cremated. In Victoria, the law states that a Funeral Director is required to arrange a burial or cremation for any baby over 20 weeks gestation.
Planning a funeral or memorial can be a way for you to celebrate the life of your baby and to say goodbye.
You may also decide to bless or baptise your baby in the hospital. You can contact your own religious organisation or staff at South West Healthcare can contact spiritual care at your request.
It is your decision whether you have a small, private funeral for immediate family, or whether you decide to have a bigger funeral ceremony for your baby and invite friends and extended family.
The hospital will provide information on Funeral Arrangements Stillbirth and Loss of a Baby after 20 Weeks Gestation. It is important to do what is right for you and your family.
Please speak with your midwife about ways you can be supported.
Deepest sympathies to you and your family on the loss of your baby.
Neonatal death is the death of a baby in the first 28 days of their life.
You may wonder why this has happened to your baby and family, the doctor will discuss with you investigations that you may wish to consider to find a cause of death.
The most common causes of neonatal death are premature birth, low birthweight and birth defects.
When a baby passes away, it is a very sad and emotional time for the parents, siblings of the baby and extended family. It is important that you seek support from family and friends or through a range of support networks that can help you through the grieving process.
We also will help create memories of your baby for you to help remember the time you spent with your baby.
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.
If you have:
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).
The tablets should be placed deep in the vagina 2 hours prior to hospital admission
The tablets should be placed either under the tongue or between the gum and the cheek 2 hours prior to hospital admission
Common side effects may include:
Rare side effects may include:
If you experience any of these rare side effects or have any concerns please contact Maternity Unit (03) 5563 1441
After a miscarriage, stillbirth or death of a baby the emotional trauma, grief and shock can be all consuming and devastating.
At the same time, women will experience a number of physical changes post birth and will need to allow time for their body to recover from the birth.
Following pregnancy loss it is usual to have pain and vaginal bleeding for 7-10 days post-delivery. If your baby was born closer to the due date this may continue for longer.
If it is worsening or if you have prolonged /heavy bleeding, pass clots, have severe lower abdominal pain or develop flu-like symptoms, please notify or GP.
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:
Your first period after the loss of your baby usually happens around four to six weeks after giving birth. Allow yourself time to process the return of your period as this can commonly be a very upsetting and difficult time.
Watch your breasts for any breast changes as it’s possible that milk production could commence.
Prescription medication can be taken to suppress lactation. Please talk with your midwife, obstetrician or GP for further information.
Within the first couple of days following your miscarriage, stillbirth or the loss of your baby a midwife will contact you by phone or visit you at home at a time convenient to you.
This follow up is to discuss your physical and emotional recovery after your discharge from hospital and to ensure community support service links have been made. A further follow up visit or phone call can be arranged.
Postnatal Check – GP
Your six-week postnatal check-up is usually held at your GP’s clinic.
Your GP will have received a summary from the hospital regarding the birth and loss of your baby. At this appointment you can expect the doctor to check on your physical recovery after giving birth.
You may want a support person to attend this appointment with you. This can be an opportunity to discuss how you are coping and discuss additional community supports that you may find helpful in the community.
An appointment may be made for you with the obstetric consultant six weeks after your loss.
This appointment is to discuss your baby and birth. There may also be discussion at this appointment about future pregnancies, their care and management.
You may wish to bring your partner and/or another support person with you to this appointment as it can be difficult and upsetting.
Other information
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
If you have a negative blood group, you may require an injection.
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:
Sometimes babies leave us too soon and therefore it isn’t possible to get physical memories or parents may simply wish to continue making memories when they get home.
The following ideas are from SANDS and further information can be found here (Sands – Creating Memories).
They include:
Remember, there is no right or wrong way to grieve or make memories and every journey will be unique. Some parents decide to mark anniversaries.
Mother’s Day, Father’s Day, your baby’s due date, birth date – these can all become particularly difficult days. You might want to think about taking time off work or marking important dates in some way such as lighting a candle or if you have other children, they may want to celebrate their sibling’s birthday.