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Once a physician determines that a miscarriage is inevitable or is already occurring, there are several treatment options available depending on the stage of the miscarriage and the condition of the mother, among other factors. These may include:

• Observation. In most cases, women who miscarry do not need further medical treatment because the uterus usually empties itself (similar to a heavy menstrual period) within a couple of weeks, although sometimes it can take as long as three to four weeks. Once the contents of the uterus have been expelled, an ultrasound is performed to ensure that the miscarriage is complete. Any remaining pregnancy tissue is removed to prevent infection.
  
  
• Medication. Sometimes, medications (e.g., mifepristone, methotrexate, misoprostol, or a combination of the three) may be administered by the physician to stimulate the uterus to expel remaining pregnancy tissue. However, these medications may produce side effects, such as prolonged vaginal bleeding, nausea, diarrhea, fever, headache and/or pelvic pain. Also, another potential downside (although rare) is that pregnancy tissue might still remain after use of these medications and surgery may be needed to remove it.
  
  
• Surgery. The conventional treatment for early miscarriage with incomplete dispelling of the uterus is a surgical procedure called dilation and curettage (D&C). In a D&C, the cervix is dilated (widened), and an instrument is inserted that uses suction and/or gentle scraping motion to remove the contents of the uterus. This procedure is performed in women who do not want to wait for spontaneous passage of the pregnancy, and in women with heavy bleeding or infection. However, risks involved with D&C include perforation of the uterus, formation of scar tissue in the uterus, trauma to the cervix and infection, which could lead to infertility.

If a woman experiences recurrent miscarriage, a physician may recommend further treatment, such as:

• Surgery. Surgical procedures may be performed to correct any uterine and/or cervical abnormalities. Sometimes, a cervical cerclage procedure that stitches the cervix shut in women with incompetent cervix is helpful in preventing pregnancy loss resulting from this abnormality.
  
  
• Hormone therapy. Human menopausal gonadotrophin (hMG) hormone, which stimulates ovulation, may be useful in treating women who experience recurrent miscarriage due to low levels of the hormone progesterone (luteal phase deficiency). This hormone promotes the formation of a thicker endometrium, thereby leading to better implantation of the embryo.
  
  Also, studies have shown that treatment with clomiphene citrate, a type of ovulation drug, may promote pregnancy in some women with recurrent miscarriage due to a luteal phase deficiency.
  
  Another type of treatment is the administration of the hormone progesterone, either via injections or vaginally (to achieve higher concentration in the uterus), to prevent miscarriage due to luteal phase deficiency. However, some studies suggest an association between mothers who undergo progesterone therapy during the first trimester of pregnancy and genital abnormalities in male and female babies.
  
  In addition, it should be noted that there is no conclusive evidence to support the effectiveness in treating recurrent miscarriage with any of these types of hormonal treatments.   
  
  
• Medical treatment of chronic illness. Women with chronic diseases, such as diabetes mellitus, thyroid dysfunction and polycystic ovarian syndrome (PCOS), among others, should be treated medically to get their illness under control prior to attempting pregnancy. This will reduce their chance of miscarriage.
  
  
• Treatment for immune system problems. Treatment administering a combination of low dose aspirin and low dose heparin (an anticoagulant drug) may be effective in improving pregnancy outcome in women with recurrent pregnancy loss due to lupus or antiphospholipid antibody syndrome (APS). However, this treatment is not effective in women with unexplained recurrent miscarriage. Also, aspirin alone does not reduce risk of miscarriage.
  
  
• In-vitro fertilization (IVF) and preimplantation genetic diagnosis (PGD). A combination of IVF and PGD is often successful in preventing recurrent miscarriage due to chromosomal abnormalities in the embryo. This is because PGD can identify and transfer only chromosomally normal embryos to the uterus.
  
  
• Donor eggs. Even though use of donor eggs for assisted reproduction may increase the risk of miscarriage, it is still a good alternative in cases where recurrent miscarriage is occurring due to problems with a woman’s own eggs. This may help prevent recurrent miscarriage in women over age 40.

Following a miscarriage, a physician will advise a woman to maintain “pelvic rest” for up to two weeks. This involves not having sexual intercourse or inserting anything (e.g., tampons) into the vagina. It is also customary for a physician to advise a woman to wait two to three months before attempting to become pregnant again.

Medications may also be prescribed to help decrease bleeding and reduce infection. In the case of Rh incompatibility, women are prescribed a drug called Rh (D) immune globulin. This medicine helps protect future pregnancies against problems that can occur if a mother’s Rh factor is incompatible with that of the fetus, such as miscarriage.

It may take weeks to a month or longer for a woman to physically recover from a miscarriage. In addition, parents often experience grief or depression after a miscarriage. Sometimes these feelings are severe and long-lasting. In such cases, a physician may recommend a psychologist or grief counseling group for emotional support.

The majority of women who experience a miscarriage go on to have successful pregnancies.