I had three losses before going on to have my daughter. I ended up studying them intensively in depth, so here's what I know:
Firstly, I learned that miscarriage is extremely common. One in four pregnancies is known to end in miscarriage, but the number is thought to be much higher - probably about 50% - because many women don't even realize they are having a miscarriage and think that they are only having a late or heavy period.
Miscarriage is completely normal and extremely common. Just that knowledge helped me cope a lot because when you have one, you feel like it's somehow your fault. It's not. A billion little things have to happen just perfectly to make a baby and if even one of them doesn't go right, it may not happen. Our bodies were made to miscarry as much as they were made to give birth or have periods, so it's not something to be scared of, just understood.
Having a few miscarriages in a row does not necessarily mean that you cannot have a baby or that there is anything wrong with you. Many doctors insist on doing invasive examinations after two miscarriages. I had three and ended up with a very healthy baby and pregnancy. Because miscarriage chances are literally the same as flipping a coin, you may have a few in a row before conceiving a viable pregnancy.
There are some safety procedures for unassisted miscarriage, but nothing major. Usually everything goes just fine, but for a small percentage of women, there are life-threatening emergencies (just like with anything else, right?
1. Watch for signs of hemorrhage. Soaking more than one large heavy pad in an hour can be a sign of a problem, but not always. Miscarriage is usually like a very heavy period. If you are losing a large amount of blood quickly or if you are pale and feel shaky and light-headed, you may need to get to the ER.
2. Miscarriage is like birth. You have what is essentially like an open wound inside of your body which can become infected. Never insert anything into your vagina during a miscarriage or after. Don't feel for dilation and don't have sex. It is the best way to be sure you are not introducing bacteria to the placental site. This normally isn't a problem because the body keeps itself so clean, but sometimes some of the (non-living) birth products are retained and these can grow bacteria which can lead to infection.
3. If you develop an infection, you must get to the ER immediately for a D&C and a course of antibiotics. Infection can be almost immediately life-threatening. Signs of infection include fever, flu-like symptoms, green, yellow, or whitish discharge, tenderness in the abdominal area when pressed, and foul odor coming from the vagina. Uterine infection can also cause scarring which can prevent you from carrying to term or getting pregnant in the future.
4. Bleeding from an early miscarriage lasts about as long as a normal period with maybe a couple of additional days. Bleeding from a late miscarriage can last longer and be a bit heavier. You may or may not experience birth-like lochia. Bleeding that starts and stops (ie: you bleed for five days, stop for a whole day, bleed two days, stop two days, bleed again) can be a sign of retained tissues.
5. Cramping usually lasts one to two days. If you are having cramping for more than two days and you are experiencing heavy bleeding for more than two days, it is a sign that you could have retained some of the tissues. In this case, it is absolutely imperative that you do not insert anything into your vagina. In some cases, the retained product will come out in the next couple of days, but this is not always the case. If the retained tissues do not come out on their own, you should see a doctor about having a D&C to prevent infection.
Self-care during miscarriage is not difficult. Don't exert yourself and be sure to remove yourself from stressful situations. Stay home if you want to. Get plenty of rest and eat as you normally would. To replenish yourself from the blood loss, you can drink nettle tea or take Floradix.
Cramping during miscarriage can be very strong and for some women, painful. You can take pain relievers for this, but I prefer to tough it out. The reason for this is because it is not uncommon to have false miscarriages or miscarriages in which a non-viable twin is expelled, leaving the second twin alive and well. I would not want to chance harming a viable baby, so I deal with the pain as much as I can.
Red raspberry leaf tea is excellent for miscarriage. I drank at least two cups a day while miscarrying.
Taking a pregnancy test after having a miscarriage will not tell you whether or not you are still pregnant. The HCG in your urine can give a positive reading up to three months after having a miscarriage, so if you want to take a test, get two blood tests a number of days apart to see if your HCG levels are decreasing or still increasing. (Edited to add: if you think you had a miscarriage but your HCG levels are still increasing, but at a very very slow rate - not enough for a viable pregnancy, there is a possibility of ectopic pregnancy so you should always take a trip to the emergency room to have a look at what is going on.)
I personally do not recommend getting ultrasound after a miscarriage to check for viability of pregnancy. I cannot tell you how many stories I have heard of women who went to the doctor's office during what they thought was a miscarriage and the doctor found no heartbeat. These women then went home planning to have an unassisted miscarriage rather than agree to the doctor's advice of an immediate D&C. These women went on to discover that their babies were fine and if they had consented to the D&C, they would have been terminating a viable pregnancy. I wonder, after hearing their stories, how many healthy pregnancies were terminated by incorrect diagnosis using ultrasound (which is HIGHLY inaccurate). If you want to check for viability of pregnancy after a miscarriage, I suggest HCG quant. blood checks instead unless you or your doctor suspect infection or other problems.