If there's no pregnancy tissue left in your womb, no treatment is required. However, if there's still some pregnancy tissue in your womb, your options are: The risk of complications is very small for all these options. It's important to discuss them all with the doctor in charge of your care. If you have a miscarriage in your first trimester, you may choose to wait 7 to 14 days after a miscarriage for the tissue to pass out naturally. This is
called expectant management. If the pain and bleeding have lessened or stopped completely during this time, this usually means the miscarriage has finished. You should be advised to take a home pregnancy test after 3 weeks. If the test shows you're still pregnant, you may need to have further tests. If the pain
and bleeding have not started within 7 to 14 days or are continuing or getting worse, this could mean the miscarriage has not begun or has not finished. In this case, you should be offered another scan. After this scan, you may decide to either continue waiting for the miscarriage to occur naturally, or have drug treatment or surgery. If you choose to continue to wait, your healthcare professional should check your condition again up to 14 days later.Expectant management
Contact your hospital immediately if the bleeding becomes particularly heavy, you develop a high temperature (fever) or you experience severe pain.
Medicine
You may choose to have medicine to remove the tissue if you do not want to wait, or if it does not pass out naturally within 2 weeks. This involves taking tablets that cause the cervix to open, allowing the tissue to pass out.
In most cases, you'll be offered tablets called pessaries that are inserted directly into your vagina, where they dissolve.
The tablets usually begin to work within a few hours. You'll experience symptoms similar to a heavy period, such as cramping and heavy vaginal bleeding. You may also experience vaginal bleeding for up to 3 weeks.
In most units, you'll be sent home for the miscarriage to complete. This is safe, but ring your hospital if the bleeding becomes very heavy.
You should be advised to take a home pregnancy test 3 weeks after taking this medicine. If the pregnancy test shows you're still pregnant, you may need to have further tests.
You may be advised to contact your healthcare professional to discuss your options if bleeding has not started within 24 hours of taking the medicine.
Surgery
In some cases, surgery is used to remove any remaining pregnancy tissue. You may be advised to have immediate surgery if:
- you experience continuous heavy bleeding
- there's evidence the pregnancy tissue has become infected
- medicine or waiting for the tissue to pass out naturally has been unsuccessful
Surgery involves removing any remaining tissue in your womb with a suction device. You should be offered a choice of general anaesthetic or local anaesthetic if both are suitable.
After a miscarriage
A miscarriage can be very upsetting, and you and your partner may need counselling or support. You may also have questions about trying for another baby and what happens to the miscarried foetus.
For more information, read what happens after a miscarriage.
Page last reviewed: 09 March 2022
Next review due: 09 March 2025
Although our patients usually have a pretty good idea about the outcome of their True Care pregnancy test (since they already took 10 at home), occasionally a woman will be shocked by the news our True Care nurses provide. Sometimes a woman is certain she is pregnant, but the test comes out negative. To understand what might be going on, it is important to understand how a pregnancy test works.
How Do Pregnancy Tests Work?
There are two main types of pregnancy tests: urine and blood tests. Both types of tests work by detecting a hormone called human chorionic gonadotropin (hCG) which is produced after the baby implants into the uterus.
Urine tests: Urine tests can be purchased over the counter in stores and are often used at home. There must be a certain level of pregnancy hormone present in the urine before the tests will turn positive. And though they are a great indicator that hCG is present in a woman’s urine, these tests cannot tell how much hormone is in the urine.
Blood tests: An hCG blood test must be ordered by a physician. The lab will draw some blood and check the actual level of hCG present. This test is much more accurate, and if done a few days in a row, can help a doctor determine if an early pregnancy is progressing properly or if s/he needs to be concerned about a complication, such as ectopic pregnancy or miscarriage.
What Causes a Negative Urine Pregnancy Test?
There are a couple of reasons a woman may have a negative test.
- Not Pregnant: The most common reason for a negative test is that there is no pregnancy. Because she is not pregnant, she is not producing the hCG hormone.
- Too Early: Sometimes a woman will test too early, before there is an adequate level of the hCG hormone to turn the test positive. Most store-bought pregnancy tests can detect a pregnancy up to 5 days before a missed period. If a woman tests too early, she may have a negative pregnancy even though she is really pregnant. She can retest in a week (preferably she should wait until her missed period to retest) to be sure she really has a negative test.
- Urine is dilute: When a woman’s urine is dilute (she has been drinking a lot of fluid and her urine is very light in color), her test may show up negative early in the pregnancy. Usually the highest hCG levels in the urine will be in the morning when the urine is most concentrated. This can help explain why a woman may have a positive test that morning and then a negative test later that afternoon. After a few days the hormone level should be high enough to turn the test positive even in more dilute urine.
- Pregnancy complications: If a woman is having a pregnancy complication, such as an early miscarriage (implanted pregnancy loss) or an ectopic pregnancy, she may have lower than expected hormone levels and may have a negative pregnancy test when she previously had a positive home test. In the case of pregnancy complications, it is important to see a physician who can monitor blood hCG levels and manage any complications a woman may have.
So what do I do if my Home Test is Negative but I think I’m Pregnant?
If you have a negative pregnancy test but really feel like you are pregnant, re-check in a few days to a week to see if your test is still negative. If you miss more than one period and have a negative test, be sure to check with your physician. He or she can check your blood to see if you have any hCG present and help you to determine what might be going on.
True Care Women’s Resource Center in Casper, Wyoming is available for women experiencing an unplanned pregnancy. We do medical quality urine pregnancy testing and if positive, we offer a free pregnancy confirmation ultrasound. If you or someone you know suspect being pregnant, our nurses can help determine if you’re pregnant or not. Call for an appointment today: 307-215-9684.