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Surgical managment

This is sometimes called ‘evacuation of retained products of conception’.

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Surgical management

If you choose surgical management you will not need a follow-up appointment. You will be told what is expected as you recover and how to contact us if you have any problems.

We offer these type of procedures

You should plan to be at the clinic for 3 hours.

Vacuum aspiration uses gentle suction to remove the pregnancy and takes about 5-10 minutes. You will need to rest for about 30-45 minutes before going home. This treatment can be done up to 12-14 weeks of pregnancy and you will be awake. When you arrive, a healthcare professional will talk with you and answer your questions. You will take pain relief tablets if you have not had any before coming to the clinic.

You will be shown into a treatment area and asked to lie on a treatment couch which supports your legs. A healthcare professional will stay with you to provide comfort and support. The doctor will examine your uterus (womb) and a speculum is inserted into your vagina. The doctor will then inject a numbing medication (local anaesthetic) into or near your cervix (neck of the womb).

The opening of your cervix may be stretched with thin rods called dilators. A tube is then inserted through the cervix into the uterus. Either a hand-held suction device or a suction machine gently empties your uterus.

You will feel cramping, similar to period pains, during the procedure. For some women the procedure can feel uncomfortable. Gas and Air will be available to you as needed for extra pain relief.

With your permission we will place some antibiotics in your bottom and you will be given some to take home.  If you prefer you can take the antibiotics orally. 

If your blood group is Rhesus-negative you will also have an Anti-D injection directly after the procedure.

You should plan to be at the clinic for the whole day.

Vacuum aspiration uses gentle suction to remove the pregnancy and takes about 5-10 minutes. This can be done up to 12-14 weeks of pregnancy and you will be asleep or sedated.

When you arrive, a healthcare professional will talk with you and answer your questions. You will change into a gown and be asked to lie down on a trolley. Your anaesthetist will meet you, answer your questions and take you into theatre.

A small cannula (a fine plastic tube) is placed in a vein, normally on your hand. Medication is given through the cannula to put you to sleep (general anaesthetic) or make you drowsy (conscious sedation).

Once asleep or sedated, your legs are placed in supports. The doctor examines your uterus (womb) and a speculum is inserted into your vagina. The opening of your cervix (neck of womb) may be stretched with thin rods called dilators. A tube is then inserted through the cervix into the uterus.  Either a hand-held suction device or a suction machine gently empties your uterus.

You will not feel any pain during the procedure.  You will wake up in the recovery area to be observed for about 1-2 hours before going home.

With your permission we will place some antibiotics into your bottom and you will be given some to take home. If your blood group is Rhesus-negative you will have an Anti-D injection directly after the procedure.

After a general anaesthetic or conscious sedation, you should not drive for 24 hours. Read more about general anaesthetic.

You should plan to be at the clinic for the whole day.

Instruments and suction are used to remove the pregnancy. It is usually performed between 15 and 24 weeks of pregnancy. In addition to the procedure described below you will need cervical preparation on the day of surgery, or the day before. Read about cervical preparation here.

When you arrive, a healthcare professional will talk with you and answer your questions. You will change into a gown and be asked to lie down on a trolley. Your anaesthetist will meet you, answer your questions and take you into theatre.

A small cannula (a fine plastic tube) is placed in a vein, normally on your hand. Medication is given through the cannula to put you to sleep (general anaesthetic).

Once asleep, your legs are placed in supports and the doctor examines your uterus (womb). A speculum is inserted into your vagina. The opening of your cervix (neck of womb) may be stretched with thin rods called dilators. The pregnancy is removed using narrow forceps passed through the neck of the womb. A tube is inserted through the cervix and a suction machine is used to gently complete the evacuation.  

You will not feel any pain during the procedure, which takes about 10-20 minutes. You will wake up in the recovery area to be observed for about 1-2 hours before going home.

We will give you antibiotics to prevent infection. If your blood group is Rhesus-negative you will have an Anti-D injection directly after the procedure.

Do not drive for 24 hours after a general anaesthetic.  Read more about general anaesthetic here.

Miscarriage follow-up instructions

You should start to feel better each day after the pregnancy has been passed.

Surgical or medical management in the clinic

If you choose surgical management or have medical management in the clinic where we can be sure the pregnancy has passed, you will not need a follow-up appointment.

You will be told what is expected as you recover and how to contact us if you have any problems.

Miscarriage recovery

What to expect

You should start to feel better each day after the pregnancy has passed - please call your BPAS Clinic (during opening hours) or the Aftercare Line 0300 333 68 28 (at any time) if you are unsure about anything.

Most women bleed for around 1-2 weeks after treatment for miscarriage or if they have chosen expectant management. It is best to use sanitary towels during this time. You should expect the bleeding to be like a normal menstrual period, but you may pass some small blood clots. Your bleeding should lessen over time, but you may have some spotting until your next period.

If your bleeding soaks 2 or more sanitary towels per hour for 2 hours in a row, then you should contact the clinic or Aftercare Line urgently for advice. If you cannot call, go to A&E.

Most women experience cramping on and off for about a week after the procedure. Take ibuprofen and paracetamol if needed. These can be bought over the counter without a prescription, from pharmacies, supermarkets and other shops.

There are 2 strengths of ibuprofen tablets - follow the directions for the one you have. Always read the patient information leaflet that comes with these medicines and take them as directed.

You can take paracetamol and ibuprofen together if the recommended dose of either medicine alone is not controlling your pain.

If the medicines do not control your pain - call the clinic or Aftercare Line on 0300 333 68 28 (or +44 01789 508 210)

You may experience a variety of emotions regarding the miscarriage and this is normal. You may feel like talking to someone if these feelings remain for a long time. The Miscarriage Association and Relate can provide information about counselling.

If you have any of the above symptoms, you should phone the BPAS clinic where you had your treatment, or the Aftercare Line on 0300 333 68 28 (or +44 1789 508 210) immediately. Alternatively, you should go to A&E.

If you have pregnancy symptoms such as nausea or fatigue, these will go away within a few days of treatment. If you lost a pregnancy after 12 weeks, your breasts may feel firm and tender and leak milk after your procedure. Your breasts will return to normal after 3-4 days of swelling. You will feel more comfortable if you wear a supportive bra and apply cold ice packs to your breasts. Take ibuprofen or paracetamol if necessary for the pain.

Unexpected or unusual symptoms
  • heavy bleeding that soaks through 2 sanitary pads an hour for 2 hours or more in a row
  • abdominal tenderness, pain or discomfort which is not helped by medication, rest, a hot water bottle or heating pad
  • a fever of 38°C or higher
  • an unpleasant smelling discharge from your vagina
  • no bleeding at all after 24 hours of taking the medication
  • a general feeling of being unwell or still feeling pregnant

Bathing

You can have a bath or shower as normal. Take care if you have a bath in the 24 hours after a general anaesthetic - make sure someone is around to keep an eye on you in case you still feel drowsy.

Work and other activities

Most women are fit and well enough to return to normal activities within a day or two. Rest until you feel able to return to your usual routine.

Sex

You may resume sexual activity when you feel ready. You can get pregnant almost immediately following miscarriage, so it is important to use contraception if you do not want to get pregnant.

Travel

It's best not to travel within 24 hours of treatment. If you must travel, make sure you know how to get emergency treatment at your destination in case of complication. Please be aware that, if you are having medical management and choose to travel soon after taking the second medication (misoprostol), you could start to have cramps and bleed heavily whilst you are travelling.

Your next period should come about 4 weeks after miscarriage. If it hasn't or you are concerned, contact us. Remember that any bleeding immediately after treatment is not a period.

Important

Serious complications may have warning signs.

Contact your BPAS clinic or our Aftercare helpline 0300 333 68 28 straight away if you have:

  • heavy bleeding that soaks through 2 sanitary pads an hour for 2 hours or more in a row
  • abdominal pain or discomfort which is not helped by medication, rest, a hot water bottle or heating pad
  • a fever of 38°C or higher
  • an unpleasant smelling discharge from your vagina
  • no bleeding at all after 24 hours of taking medication (medical management)

How we can help ?

We are an independent healthcare charity which for more than 50 years, has been advocating and caring for women and couples who decide to end a pregnancy.