Miscarriage is common: one in five women who know they are pregnant will miscarry before 20 weeks. However, the rate is higher than this because some women miscarry before they even realize they are pregnant. Often, there is no clear reason for miscarriage, though around half of all miscarriages are thought to be due to a chromosomal problem with the embryo.
Having a pregnancy confirmed is often a time of joy, especially if a couple has been trying to conceive. Emotions, dreams, planning, and excitement all start building from the moment of a positive pregnancy test. But just as quickly, this can all turn to disappointment and sadness when a miscarriage occurs.
Medical management of a miscarriage depends on the gestation. If the miscarriage happened early in pregnancy and is complete, a dilatation and curettage (D&C) may not be needed. If a miscarriage is incomplete, this means some of the products are still inside the uterus.
A D&C is often done to clear the uterus of all products of conception. It also helps to reduce the risk of prolonged bleeding and infection.
It can take a few months for hormones to return to normal after a miscarriage. Some women find their pregnancy symptoms continue for a while after they miscarry, and their breasts may even produce milk. Emotional ups and downs are also common.
Some couples start trying for another baby soon after a miscarriage. Others choose to wait a while. There is no one right time to plan for another pregnancy.
Partners and miscarriage
Your partner’s response to miscarriage is an area of increasing awareness as we learn to recognize the importance of supporting partners as well as mothers. Partners and fathers are often overlooked when a miscarriage happens. Generally, the early focus is on the mother's medical management and making sure she is alright. But fathers and partners can feel intense sadness over the loss of a pregnancy. Some find it difficult to express their emotions and feel they need to be strong for the sake of their partner.
As your baby's other parent, you have a right to grieve for your own unique baby in your own unique way. Avoid feeling you need to justify this to anyone, even yourself. Grief has an emotional as well as biological basis and is deeply influenced by our life experiences and expectations.
If you feel you need to talk with someone, speak with your healthcare provider about options. Your workplace may also have counseling availability through employment services.
After a miscarriage
It may sound like an old cliche, but time really does heal. When feeling very sad, it can be difficult to feel there are better days ahead. Talking to friends and family about the baby and what you are experiencing may help.
Check with your health care provider about any health issues you need to be aware of after a miscarriage
When do I need to speak with someone?
Every woman's experience of miscarriage is different. Some don’t feel they need to talk with anyone, while others benefit enormously. It is normal to feel a state of shock and just needing to get through what must be done in the early days after miscarriage.
Symptoms of miscarriage can vary. If you experienced pain and bleeding during a pregnancy which ended in miscarriage, this may have been very frightening. Some women describe feelings of intense shock, confusion, and even trauma after miscarriage.
There are likely to be days when you feel fine and others where you feel overwhelmed with sadness. Trying to force yourself into just getting over it may well create feelings of unresolved loss later. Be kind to yourself and don’t overlook the basics.
Eat and sleep well, look after your hygiene and grooming. Making the effort to get out of bed and shower, changing into clean clothing, and eating may all seem like insurmountable hurdles, but are likely to help you feel better.
Where has everyone gone?
When a miscarriage happens, you'll find that many people are involved in decisions around your life. Doctors, ultrasound technicians, hospital staff and even pathology services become very important. When things settle down after a miscarriage, there can be a sense of loneliness and no longer being the focus of anyone's attention. Aim to see this as a quiet oasis of time to help you recover.
Frequently asked questions about miscarriage
Is it normal to feel so sad?
Give yourself permission to grieve. How you do this will be very individual; perhaps you have never felt grief or lost someone close to you before. Remember, coping with miscarriage is not proportional to the weeks of gestation.
When should I go back to work?
Even if you feel you are fine and on top of things, a few days off just to recover physically will be beneficial. Speak with your provider about getting a work release.
The information of this article has been reviewed by nursing experts of the Association of Women’s Health, Obstetric, & Neonatal Nurses (AWHONN). The content should not substitute medical advice from your personal healthcare provider. Please consult your healthcare provider for recommendations/diagnosis or treatment. For more advice from AWHONN nurses, visit Healthy Mom&Baby at health4mom.org.