Natural or expectant management is when you wait for your body to miscarry naturally without the use of medicines or physical treatment.
The first signs you will notice are spotting and cramping, which will progress to heavy bleeding and more painful cramping or contractions. Depending on how far along you are in your pregnancy, you may pass large clots of tissue.
At a glance
- Natural/expectant miscarriage is when you wait for your body to miscarry naturally
- You can expect heavy bleeding and abdominal pain to begin within 7-14 days
- Pain and bleeding should stop after 2 weeks
- If pain and bleeding persists its important to go back to your doctor or specialist.
- You can download our printable Natural/Expectant Fact Sheet.
What to expect
Pain and Bleeding
For most women, if not already, spotting and cramping will start within 7-14 days. The spotting and cramping will progress to heavy bleeding and more painful cramping or contractions. Depending on how far along you are in your pregnancy, you may pass large clots of tissue.
The pain should improve within 24 to 48 hours when the bleeding will begin to reduce. It could take up to 2 weeks before the bleeding or spotting stops completely.
If you are experiencing any of the following symptoms, please go to emergency or call 000 immediately
- You are soaking 1 to 2 pads in an hour
- You are passing large blood clots (golf ball size)
- You have severe abdominal pain
- You have a fever or chills
- You are feeling dizzy or fainting
- You have signs of infection e.g. a fever or a vaginal discharge that is smelly
Pain relief and anti-sickness medication can assist with the symptoms. In most cases, over-the-counter pain medications such as paracetamol (‘Panadol’) or Ibuprofen (“Nurofen” or “Rafen”) will be enough to help manage the pain.
Recovery at home
What should I have at home?
We suggest having the following at home:
- Pads (not tampons) – you may want to purchase a few packs as you may be changing your pad regularly.
- Pain relief medication such as paracetamol or ibuprofen.
- Time to rest
- Someone to support you if possible – it can be a very emotionally and physically difficult time for you. Having someone with you to help you with practical things such as cooking or going to the supermarket or chemist can be helpful. But we understand that this is not always possible.
Recovery at home
Your doctor will advise you on how to take care of yourself after your miscarriage. Generally, you will be informed you need to:
- Avoid sex for 2 weeks until the bleeding stops
- Avoid swimming or taking a bath until the bleeding stops
- Use sanitary pads instead of tampons.
When to see your doctor
In some cases, natural management may only partially work; some pregnancy tissue may be left behind. It is important you go back to your doctor or specialist if you:
- Have a fever which may indicate an infection
- Are experiencing heavy bleeding for more than two weeks
You should have a general follow up appointment with your doctor or specialist 4-6 weeks after your miscarriage to check how you are going.
What happens if I haven’t passed all the pregnancy tissue?
Your doctor or specialist will order further tests to work out whether you may still have pregnancy tissue in your body causing the continued bleeding and/or pain. They will discuss with you the options of continuing natural/expectant management or having medical or surgical management.
This section contains some graphic descriptions of what you might see during a miscarriage.