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We are sorry that you have had a miscarriage.
To help you get through this difficult time, you should have already received information on different treatment options.
This leaflet gives you information about a surgical option called Manual Vacuum Aspiration (MVA), which can be done using local anaesthetic.
MVA is a way of emptying the uterus (womb) while you are awake. It uses a narrow tube to enter and empty the womb using gentle suction. Anaesthetic is applied to the cervix (neck of the womb) to numb any physical sensations felt, including pain.
Research has found MVA to be:
MVA is offered to women in the following situations:
You will be admitted to our ward for a few hours. Before the procedure we will give you some medication for pain relief to take and we may insert vaginal tablets (misoprostol) to help soften and open the neck of the womb (cervix). This helps make the MVA procedure easier and safer. These tablets can sometimes cause cramping pain and bleeding. We would also insert a cannula in your hand / forearm so we can give you fluids or medications if required.
The MVA will be performed in a private clinic on the ward where a doctor will use a speculum (similar to that used in a smear test) to look at the neck of the womb. Local anaesthetic may be injected into the neck of the womb to numb this area, and then, using a tube and syringe the tissue remaining from the miscarriage will be removed. A nurse will be with you at all times to monitor the need for pain relief and extra support. Your partner will be able to be present during the procedure.
The actual procedure itself should take only a few minutes although you will be on the couch for longer. During this time you will experience some cramping, abdominal pains, which should settle after the procedure.
We want you to be as comfortable as possible during the procedure. Nitrous oxide (known as gas and air) is also available for pain relief and clinical staff will help you to use this if this is what you choose. If you needed medication for pain relief you will be offered some at the end of the procedure.
We would ask you to stay for a short while after the procedure to ensure you are well enough for discharge. We would like someone to accompany you home, as you should not drive yourself.
Misoprostol is the medicine inserted into the vagina before the procedure to help soften the neck of the womb. Possible side effects include:
We will monitor you for a couple of hours after the procedure. This will include taking your blood pressure, your pulse and checking if you are in pain. You can go home once you have passed urine and feel well enough. We recommend someone escorts you home after the procedure.
You can expect some bleeding after the MVA which will usually settle within seven days. We recommend using sanitary towels instead of tampons and advise you not to have sexual intercourse until the bleeding has stopped. This reduces the risk of infection. You may return to work in 48 hours, or when you feel able.
If your blood group is rhesus negative we would offer an injection of Anti-D.
There are several alternatives to managing your miscarriage and these should already have been discussed with you. These include:
Further details on all these options can be found in patient information leaflet on miscarriage.
Please feel free to take as much time as you feel necessary. Please do not feel like you have to choose this option, or be rushed into a decision. We understand that this choice may be difficult, but previous research has found that women generally coped better when they were able to choose the management method that they felt best for them at that time. Please feel free to contact us if you have any questions.
Further resources you may find useful: www.miscarriageassociation.org.uk
If you want to discuss any of the options for the management of your miscarriage further, please contact the Early Pregnancy Assessment Unit.
The risks of complications are very small but if you have heavy bleeding, severe abdominal pain, a fever or vaginal discharge, please:
It is normal for your body to take a couple of weeks to return to pre-pregnancy. It is normal to experience fear, sadness and anxiety after an MVA. These feelings should subside, but if you have any concerns please contact your GP. It is important to take care of your body after the procedure. This includes eating well, drinking lots of water and resting for a couple of days. We advise you not to have sexual intercourse until the bleeding stops.
Several national organisations can provide support and information:
Babyloss. A UK based resource of information and support for bereaved parents and their families who have lost a baby at any stage of pregnancy.
This information is intended for patients receiving care in Brighton & Hove and Haywards Heath.
The information in this leaflet is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.
Publication Date: March 2021
Review Date: December 2023