Non-viable pregnancy

There are various terms used for a pregnancy which is no longer viable (has not survived):

Delayed miscarriage (also called missed miscarriage or sometimes missed abortion)

This is where the baby has died or failed to develop but your body has not miscarried him or her. There may have been little or no sign that anything was wrong.

Blighted ovum or anembryonic pregnancy (which means a pregnancy without an embryo)

This is the name given to a fertilised egg that does not divide and develop as it should. The normal pregnancy sac develops but the baby does not develop within the sac. The scan picture usually shows an empty pregnancy sac. You can read more about this.

Incomplete miscarriage

Sometimes when a miscarriage occurs, not all the pregnancy tissue in the uterus (womb) comes away. Although the pregnancy is over, symptoms of pain and heavy bleeding continue.

Managing the miscarriage

In all of these situations, the pregnancy will fully miscarry with time, but there are several ways of managing the process. You may be offered a choice, or the hospital might make a recommendation. In most cases, you should be able to have time to think about what you would prefer.

ERPC or D&C (Surgical management)

This is an operation to remove the remains of your pregnancy and it is done under general anaesthetic. ERPC is an abbreviation for Evacuation of Retained Products of Conception, which means the removal of the remains of the pregnancy and surrounding tissue. Some people still call it a D & C, which is a slightly different procedure. You can read more about this.

Medical management

Some hospitals offer a combination of pills and vaginal pessaries which can “kick-start” the process of a delayed or missed miscarriage. Some women experience quite severe abdominal cramps as well as heavy bleeding with this option, but they may prefer this to an operation. Not all hospitals offer this option and those that do sometimes differ in the way they give the treatment. You may want to ask for written information about this kind of management.

Expectant or conservative management: letting nature take its course

Some women prefer to wait and let the miscarriage happen naturally – and hospitals may recommend this too, especially in the first 8 or 9 weeks of pregnancy. It can be difficult to know what to expect and when (it may take days or weeks before the miscarriage begins) but most women will experience abdominal cramps, possibly quite severe, and pass blood clots as well as blood.

After the miscarriage

Physical recovery

Everyone is different, but many women find that it can take them a few days to recover physically from a miscarriage. (See ectopic pregnancy and molar pregnancy for information on these conditions.) Most women will get their next period somewhere between four and six weeks after their miscarriage, and it may be heavier and longer than usual.

After the miscarriage: what happens to your baby

Some women and their partners do not know what happened to their baby or the remains of their pregnancy and many want to find out.

The bodies of babies who are stillborn (that is, born dead after 24 weeks of pregnancy), or who are born alive but then die, must by law be buried or cremated. For babies who die during pregnancy before 24 weeks, the situation is different because there is no law that governs what happens to these babies.

After a late miscarriage, most hospitals offer a simple funeral and either burial or cremation. Some hospitals offer this for all babies, no matter how early the loss and whether or not there is a fully formed body. Hospital practice is improving all the time, but sadly some hospitals may still treat the remains of an early loss as clinical waste.

If you want to find out about the arrangements at your hospital, ask a nurse or midwife on the ward or unit where you were cared for, the hospital chaplain, the PALS (Patient Advice and Liaison) officer, or the hospital bereavement service.

You may want to make your own arrangements for burying or cremating the remains of your baby, whether you use a funeral director or choose to bury the remains at home. There are some things to think about and you may want to contact us for further information.

A certificate for your baby

Although there is no legal certificate after a pregnancy loss before 24 weeks, some hospitals provide a certificate for parents which acknowledges what has happened. For many parents, this is an important memento.

If you have not been given a certificate but would like to have one, contact a nurse or midwife on the ward or unit where you were cared for, the hospital chaplain, the PALS (Patient Advice and Liaison) officer, or the hospital bereavement service.