A miscarriage is when an embryo is expelled from the uterus before it can survive outside on its own. Often, the first sign this is happening is heavy bleeding accompanied by abdominal or back pain and cramping. Depending on how far along your pregnancy was, these symptoms can last for just a few days — like a normal period — or up to three or four weeks. If you experience any of these symptoms, see your doctor so he can diagnose the miscarriage and help you with the next steps.
By the time you learn that you had a miscarriage or ever see a doctor, the process might be mostly over (the physical part at least) or not even begun. If you suspect a miscarriage, see your practitioner right away. She will confirm the miscarriage using an ultrasound to check if the pregnancy is growing normally or whether there’s a heartbeat, and she’ll possibly perform a pelvic exam to see if your cervix is dilated. She may also draw blood to check your hCG levels, your blood count (to determine how much blood was lost), and your blood type (to check for Rh incompatibility).
If your blood type is Rh negative, you may also receive a shot of Rh immunoglobulin (it’s possible for your blood to come into contact with fetal blood cells during a miscarriage — and this shot can prevent serious problems in later pregnancies).
Resuming normal activities after a miscarriage
Whether or not you had a surgical procedure to treat your miscarriage, your doctor will let you know when it’s okay resume normal activities (like exercise and sex). While you may be able to get back to your usual routines right away, your practitioner may recommend that you don’t put anything in your vagina (which means abstaining from sex and avoiding using tampons) for two weeks to avoid infection. Make sure to see your healthcare provider for a follow-up appointment a few weeks after your miscarriage.
Even if your miscarriage progresses naturally and is relatively pain-free, your healthcare practitioner will likely want to check in with you for a few weeks or months to make sure you don’t develop any complications (don’t worry, these are all very rare). If you keep bleeding for more than seven days, this excessive bleeding can be a sign that there’s still placenta in the uterus, or that you’ve developed an infection. Other signs of an infection can include foul-smelling discharge, fevers, chills and abdominal pain. If your health care provider suspects an infection, she’ll likely treat it with a course of antibiotics. In extremely rare cases, retained products of conception (the technical term for an embryo or placenta left in your uterus) can start abnormally growing and form a type of tumor called a choriocarcinoma.
After a D&C, you’ll also have a slight risk of complications from the surgery. In around 16 percent of first D&Cs, women develop scarring, called Asherman’s Syndrome, inside their uterus or around their cervix. It can take a second surgery to get rid of those scars, but luckily, you’ll likely recover and be able to get pregnant again.
Your emotions after miscarriage: The stages of grief
Whenever a pregnancy loss happens, you’re likely to experience many feelings and reactions. Though you can’t wish them away, understanding them will eventually help you come to terms with your loss. Many people who suffer a loss of any type go through a number of steps on their road to emotional healing. These steps are common, though the order in which the first three occur may vary; so too, may the feelings you experience.
- Shock and denial. There may be numbness and disbelief, the feeling that “this couldn’t have happened to me.” This is a mental mechanism designed to protect your psyche from the trauma of loss.
- Guilt and anger. Desperate to pin the blame for such a senseless tragedy on something, you may blame it on yourself (“I must have done something wrong to cause the miscarriage” or “If I’d been happier about the pregnancy, the baby would still be alive.”). Or you may blame others — God, for letting this happen, or your practitioner (even if there is no reason to). You may feel resentful and envious of those around you who are pregnant or who are parents and even have fleeting feelings of hatred for them.
- Depression and despair. You may find yourself feeling sad most or all of the time, crying constantly, unable to eat, sleep, be interested in anything or otherwise function. You may also wonder if you’ll never be able to have a healthy baby.
- Acceptance. Finally, you’ll come to terms with the loss. Keep in mind that this doesn’t mean you’ll forget the loss — just that you’ll be able to accept it and get back to the business of life.
Coping with grief after miscarriage
The grief you’re feeling is real — and no matter how early in pregnancy you experienced the loss of a baby, you may feel that loss deeply. Some well-intentioned friends and family may try to minimize the significance of a loss with a “Don’t worry, you can try again,” not realizing that the loss of a baby, no matter when it occurs during a pregnancy, can be devastating. And the fact that there is no possibility of holding the baby, taking a photo, having a funeral and burial — rituals of grieving that can all help offer some closure for parents of stillborn infants — may complicate the recovery process.