People experiencing miscarriage are advised to seek medical help - but it's not always clear who can provide that help.

"If a patient is pregnant and starts bleeding, they must seek medical attention," says gynaecologist Reshma Desai. "If they do have a midwife by then, they should go and see the midwife, or a general practitioner. And if it's not possible and the GP practice is closed, they should go to the nearest A&E or emergency department."

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Those with severe symptoms are advised to seek help immediately, says GP Cathy Stephenson.

"If you get pain, bleeding, and particularly dizziness or a feeling of faintness like you might collapse, and you haven't known the pregnancy was within the womb, then you do need to contact a doctor relatively urgently just in case you're having an ectopic pregnancy," says Stephenson. "And if you get extremely heavy bleeding or pain at any stage, you're going to want to seek help."

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Many miscarriages finish on their own, but sometimes tissue remains in the uterus (an "incomplete miscarriage") and sometimes there are no miscarriage symptoms at all (a "missed miscarriage").

In these cases, the miscarriage can be managed in three ways:

• Conservatively (also known as expectant, or natural management) - by waiting for the miscarriage to complete on its own. This may take days or weeks.

• Medically - by taking medication such as misoprostol to bring on the process of miscarriage.

• Surgically - by having a procedure called a dilation and curettage (D&C) which clears the uterus.

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There is no 'right' choice, and each of these methods has pros and cons.

And, as none of the options are failsafe, some people end up using a combination of them.

That's what happened to Hilaire Cornelius. "I first of all chose the pills," she says. "I thought they worked, but they didn't. I went to the hospital and I ended up having to have the D&C."

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Having to make unexpected decisions about surgery and medication can feel overwhelming. Kathryn Stothers, who had a missed miscarriage, had to make a sudden mind-shift from expecting a baby to preparing for an operation.

"We found out on the Thursday that our baby had no heartbeat, and on the Friday we were going in for surgery, so there was no time to really adjust to emotions," she says.

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Need support?

• If you think you may be having a miscarriage, contact your lead maternity carer - this may be a midwife or your GP. Alternatively, call Healthline free on 0800 611 116, or visit your local Urgent Medical Centre or hospital

• Visit the Miscarriage Support website or join the Facebook group.

• Visit the Sands website. Sands supports parents and families who have experienced the death of a baby.

• Free call or text 1737 to talk to a trained counsellor.

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