Recovering from Surgical Management of a Miscarriage

Q 1. What is the usual length of stay in hospital?

A. This operation is usually done as a day case, which means that you can go home on the same day.

Q 2. How long will the after-effects of anaesthesia last?

A. Most modern anaesthetics are short lasting. You should not have, or suffer from, any after- effects for more than a day after your operation.

During the first 24 hours you may feel more sleepy than usual and your judgement may be impaired. If you drink any alcohol, it will affect you more than normal.

You should have an adult with you during this time and you should not drive or make any important decisions.

Q 3. How long will the Vaginal bleeding last?

A. You can expect to have some vaginal bleeding for one to two weeks after your operation.

This is like a heavy period for the first day or so. This should lessen and may become brown in colour.

You should use sanitary towels rather than tampons as using tampons could increase the risk of infection.

Q 4. How long will I be in discomfort?

A. You can expect some cramps (similar to strong period pains) in your lower abdomen on the day of the operation.

You may get milder cramps or an ache for a day or so afterwards.

When leaving hospital, you would be provided with simple painkillers to reduce any discomfort.

Q 5. When can I start to eat and drink?

A. Once you have woken up from the anaesthetic and are not feeling too nauseous, you will be offered a drink of water or cup of tea and something light to eat.

Once you are home, you can eat and drink as normal.

Q 6. Can I take a bath?

A. You should be able to have a shower or bath as normal after the operation. It is advisable to have someone at home with you initially so that they can help you if you become dizzy or feel faint.

Q 7. What is the risk of blood clot formation? How to reduce the risk?

A. There is a small risk of blood clots forming in the veins in your legs and pelvis (deep vein thrombosis) after any operation.

These clots can travel to the lungs (pulmonary embolism), which could be serious. You can reduce the risk of clots by:

  • Being as mobile as you can as early as you can after your operation
  • Doing exercises when you are resting, for example:
    • Pump each foot up and down briskly for 30 seconds by moving your ankle
    • Move each foot in a circular motion for 30 seconds
    • Bend and straighten your legs – one leg at a time, three times for each leg.

You may also be given other measures to reduce the risk of a clot developing, particularly if you are overweight or have other health issues. These may include:

  • Daily heparin injections (a blood thinning agent) – you may need to continue having these injections daily when you go home; your doctor will advise you on the length of time you should have these for
  • Graduated compression stockings, which should be worn day and night until your movement has improved and your mobility is no longer significantly reduced
  • Special boots that inflate and deflate to wear while you are in hospital.

Q 8. What can help after an operation for miscarriage?

A. The following may be helpful in your recovery:

Support from your family and friends: Your family and friends may offer support in lots of different ways. This could be in terms of practical support with things such as shopping, housework or preparing meals. Most people are only too happy to help.

Having company can help lift your mood as well as bring comfort. If you live alone, you may wish to have someone stay with you for the first few days after you go home.

A daily routine: Establish a daily routine and keep it up.

For example, try to get up at your usual time, have a wash and get dressed, move about and so on.

Eat a balanced healthy diet: Ensure that your body has all the nutrients it needs by eating a healthy balanced diet. A healthy diet is a high fibre diet (fruit, vegetables, wholegrain bread and cereal) with up to two litres per day of fluid intake, mainly water.

Remember to eat at least five portions of fruit and vegetables each day.

Stay active: It is important to get back to full activity soon, as this will help with your recovery and help you feel better in yourself.

If you want to exercise, this will not do you any harm.

If the exercise you are doing is causing you pain, stop and try something less active for a few days. If you are not experiencing any problems, you can soon increase the number and distance of your daily walks.

Doing this will help to keep you fit.

Stop smoking: Stopping smoking benefits your health in all sorts of ways.

Q 9. Why and when might it take longer to recover?

A. It can take longer to recover if:

  • You had health problems before your operation; for example, women with diabetes may heal more slowly and may be more prone to infection
  • You smoke – smokers are at increased risk of getting a chest or wound infection during their recovery, and smoking can delay the healing process
  • You were overweight at the time of your operation – if you are overweight, it can take longer to recover from the effects of the anaesthetic and there is a higher risk of complications such as infection and thrombosis
  • There were any complications during your operation
  • You have had previous miscarriages
  • You have taken a long time to get pregnant

Q 10. When should I seek advice after an operation for a miscarriage?

A. As with any operation, complications can occur after an operation for a miscarriage. You should seek medical advice from your doctor if you experience:

  • Heavy or prolonged vaginal bleeding, smelly vaginal discharge and abdominal pain: If you also have a raised temperature (fever) and flu-like symptoms, this may be due to an infection of the lining of the uterus (womb). This occurs in two to three women in 100 (2-3%).

Treatment is with antibiotics. Occasionally, there is still pregnancy tissue remaining in the uterus and you may need another operation to remove it from the uterus.

  • Increasing abdominal pain and you feel unwell: If you also have a temperature (fever), have lost your appetite and are vomiting, this may be due to damage to your uterus.

You will be readmitted to hospital.

  • Burning and stinging when you pass urine or pass urine frequently: This may be due to a urine infection. Treatment is with a course of antibiotics.
  • Painful, red, swollen, hot leg or difficulty bearing weight on your legs: This may be due to a deep vein thrombosis (DVT). If you have shortness of breath or chest pain or cough up blood, this could be a sign that a blood clot has travelled to the lungs (pulmonary embolism).

If you have any of these symptoms, you should seek medical help immediately.

Q 11. When can I start house hold work and driving?

A. You should be able to start doing light everyday activities within a day or two. You might need some help early on, but you will not be harmed by doing normal household activities.

Most women are back to normal daily activities, including domestic work, within a week.

You should not drive for 24 hours after a general anaesthetic, nor until you are free from the sedative effects of pain relief.

Q 12. When can I start having sex?

A. You can have sex as soon as you both feel ready. It is important that you are feeling well and any pain and bleeding has significantly reduced.

It is possible to conceive a few weeks after your operation, even before you have a period. You may wish to talk with your obstetrician about contraception.

If you wish to be pregnant, trying again soon, whenever you feel ready, does not increase your risk of miscarrying next time.

Q 13. When Can I return to work?

A. When you return to work depends on you and how you feel. It is advisable to rest for a few days after your operation – then start your routine activities