The guide to miscarriage aftercare - Ruth Health

The guide to miscarriage aftercare

Fast facts:

  • 10-20% of known pregnancies end in miscarriage.
  • Most miscarriages aren’t caused by anything a pregnant person does and occur because of an underlying problem with the pregnancy.
  • The majority of miscarriages happen before the 12th week of pregnancy.
  • If there is any pregnancy tissue remaining in your uterus, a first trimester miscarriage may require additional treatment such as a dilation and curettage or medication.
  • Beyond recovering physically, a miscarriage can bring many intense emotions to the surface. It may be difficult to talk about your feelings with friends or family, but sharing your experience is an important part of processing your loss.

Many women experience pregnancy loss each year, with 10-20% of known pregnancies ending in miscarriage. While it is a fairly common experience, it is by no means an easy one. And yet we as a society don’t talk nearly enough about the challenges of recovering from a miscarriage.

Healing after pregnancy loss is both an emotional and physical process. Allow yourself to grieve however you need to.

Though it can be difficult to talk or think about, it’s important for your health and well-being to learn how a miscarriage affects your body. Here’s an overview of what happens during and after a miscarriage.

What is a miscarriage?

A miscarriage is the loss of your baby before the 20th week of your pregnancy. (Pregnancy loss after 20 weeks is typically referred to as stillbirth.) The majority of miscarriages happen before the 12th week.

With the caveat that no two bodies or pregnancies are the same, and that it’s possible to have a miscarriage without experiencing any common symptoms, here are some of the primary changes that happen during a miscarriage in the first trimester.

  • Back pain that usually feels worse than typical menstrual cramps
  • A white-pink mucus coming from your vagina
  • Pelvic contractions, the intensity of which can vary significantly from one woman to another
  • Diarrhea and abdominal pain
  • Brown, textured discharge, akin to coffee grounds

There are several signs associated with a miscarriage that also can happen during healthy pregnancies. For example, brown or red bleeding with or without cramps can be a symptom of an early pregnancy miscarriage, but it isn’t uncommon in healthy pregnancies.

Similarly, some women who have a miscarriage experience a sudden decrease in pregnancy signs like nausea and breast pain. These symptoms often become less noticeable as pregnancy progresses.

Can a miscarriage be prevented?

Most miscarriages aren’t caused by anything a pregnant person does. Contrary to what many people assume, engaging in everyday physical activities like sex and exercise does not cause miscarriage.

While some major injuries and serious illnesses can cause a miscarriage, most minor injuries do not. In the majority of cases, a miscarriage occurs because of an underlying problem with the pregnancy, often a chromosomal abnormality in the baby’s DNA.

You may be more likely to have a miscarriage if you are in your early 40s or older or have specific health conditions. This includes diabetes, high blood pressure, hormone imbalances, or autoimmune or thyroid issues.

If you have one of these conditions, working with your healthcare provider to manage symptoms can help keep both you and your baby healthy during pregnancy.

What are the next steps after a miscarriage?

Many miscarriages require medical treatment. It’s important to contact your doctor right away if you have experienced any symptoms of a miscarriage.

Your doctor will likely recommend tests to confirm that you’ve had a miscarriage, including:

  • A pelvic exam, to see if your cervix has begun to dilate
  • An ultrasound, to check for your baby’s heartbeat
  • Blood tests, to check for levels of pregnancy hormones as well as anemia, which may contribute to heavy bleeding

Miscarriage aftercare depends on what type of miscarriage you have. A complete miscarriage, in which all of the pregnancy tissue is emptied from your uterus, typically does not require additional treatment.

If there is any pregnancy tissue still inside of your uterus, you may need a dilation and curettage (D&C) procedure, also known as an abortion. During which your doctor will gently remove the tissue that's remaining.

Some individuals take medications that cause the pregnancy tissue to pass through the body instead of having a dilation and curettage.

Taking medication may sound less invasive than having a procedure, but it’s a physically taxing process. It often results  in severe cramping and hours or even days of contractions and labor pains.

Second trimester miscarriages

If you have a miscarriage between weeks 13-20, your doctor may induce labor and delivery. This is typically done through the use of medications that dilate the cervix and allow for vaginal delivery of the fetus and placenta. These medications are usually administered in the hospital.

Discomfort often increases when a miscarriage happens at a later stage of pregnancy. You can discuss pain management options, including epidural anesthesia, with your healthcare provider.

Many women continue to bleed for several weeks after a labor induction. You should contact your doctor as soon as possible if the bleeding becomes heavier.

While some people jump back into work or regular activities within a week or two, recovery looks different for each individual.

Check with your doctor or a trusted healthcare professional if you have concerns about resuming physical activities after a second trimester miscarriage.

The importance of miscarriage support

Whether you have a D&C (abortion) or take medications, make sure someone is there to support you through the recovery process. Along with your friends and family, doulas can help women navigate the physical and emotional aspects of miscarriage.

Ask A Doula by Ruth Health is a new service that offers unlimited texting access to a doula. You can get personalized support with postpartum planning, feeding, and anything else pregnancy or postpartum-related. Spaces are limited, so sign up today!

Beyond physical healing, a miscarriage can bring many intense emotions to the surface. This includes sadness, grief, guilt, shame, and anxiety about future pregnancies.

It may feel difficult to talk about your feelings with friends or family. But sharing your emotions is an important part of processing your loss. It often helps to reach out to others for support.

You can also ask a healthcare provider or trusted professional about pregnancy loss support groups or a referral for therapy.

In addition, the nonprofit Life Perspectives supports those facing pregnancy loss through the website Miscarriage Hurts. On their site, you can share your story and find additional resources related to grief and coping.

Will a miscarriage affect future pregnancies?

After grieving a miscarriage, many people are reasonably worried that it will happen again. There is reason to be optimistic, however. At least 85% of women who have had a miscarriage go on to have a healthy pregnancy and give birth.

Some women experience repeated miscarriages, often defined as three or more. If you’ve experienced two miscarriages in a row, contact your doctor about potential tests to determine the cause.

When it comes to trying again after a miscarriage, there’s no universal rule of thumb about how long to wait. It’s best to check with your healthcare provider about your individual needs.

If you have any scarring in your uterus or pieces of placenta remaining, they may suggest that you wait longer than one menstrual cycle. 

Of course, readiness involves not only the body but the mind as well.

Listen to your needs and remember that there’s no right way to grieve and heal.

Ruth Health is here to provide you with expert, evidence based maternal care and advice.

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