According to World Health Organization (WHO) statistics, about 12-15% of clinical pregnancies result in miscarriage, with 17-22% of miscarriages occurring within the first trimester or the early stages of pregnancy (1). However, taking some precautions after miscarriage could help you plan a family again. While you eventually recover from the loss of your baby, it is important to know that you can be pregnant again. So, read this post to know about things to do and avoid after a miscarriage and ways to physically and emotionally recover from this tragic incident.
What Is A Miscarriage?
Miscarriage is defined as a spontaneous loss of pregnancy before the 20th week (in the US) or 24th week (in the UK) (2). Medically, it is termed as spontaneous abortion. It involves expelling the fetus from the uterus.
Why Do Miscarriages Happen?
Primarily, miscarriages happen due to genetic reasons and chromosomal abnormalities. These factors inhibit the growth of the fetus. Besides the above, hormonal levels, uncontrolled diabetes, exposure to toxic agents, uterine abnormalities, medications, smoking, alcohol and drug abuse can also lead to miscarriages. A blood condition called thrombophilia can also lead to miscarriage.
What Are The After-Effects Of Miscarriage?
Physical health after miscarriage:
The body takes about a few weeks to months to ease symptoms and restore its strength.
Since miscarriage happens with the detachment of fetus from the uterine lining, bleeding after miscarriage is inevitable. Miscarriage bleeding begins as a light spotting and progresses to a heavier flow with clots. While it does taper off within a week or two, the duration of bleeding depends on whether it was a medical or surgical miscarriage. In case the bleeding lasts for more than two weeks, you should contact your doctor immediately (4).
You should have regular showers at home and ensure that you do not use public pools or showers to minimize the risk of infection.
A D&C (dilation and curettage) surgery is done to remove the fetal tissue remains from the uterus to prevent bacterial infection from the vagina to the uterus. They can be treated with antibiotics or surgery (5). If the fetal remains go unnoticed and are not surgically operated, then they result in vaginal discharge and pelvic pain after miscarriage. If there is severe pain, cramping, prolonged bleeding and fever, you should see a doctor.
Pains after a miscarriage are common due to contractions. The series of events inside the uterus affect the abdomen causing severe abdominal pain. The contractions that develop from a miscarriage also cause intense pain. These pains radiate to the other body parts with the lower back being affected the most (6).
The hCG hormone remains in the blood for a couple of months after a miscarriage and the levels come to zero only after the placental tissue is completely separated. In most cases, the levels drop below 5mlU/ml. If you have an early miscarriage (around the eighth to tenth week), then it takes more time for the hCG levels to return to normal as the hormone is at its peak during these weeks. Your healthcare provider will continue to check the levels by taking your blood sample.
5. Uterus after miscarriage:
It takes at least two weeks post miscarriage for the cervix to close and the uterus to shrink back to its normal size. But in some cases, the uterus is unable to empty its contents. This situation is referred to as an incomplete miscarriage. This miscarriage is very painful and is associated with severe cramps, and lasts for two or more weeks. In this case, the body will go into a mini labor with profuse bleeding and intense pain. The bleeding only stops once the uterus returns to its normal size. Massaging the uterine area helps the uterus return to its pre-pregnancy size.
Depending on how long you were into pregnancy, you will experience leaking breasts or milk letdown after the miscarriage. Your breasts may feel full, but the pressure lessens gradually. In some cases, your doctor may prescribe medications for quick healing after miscarriage.
Physical care after a miscarriage:
The body heals rather quickly after a miscarriage (whether early or late). Usually, a woman ovulates in two to four weeks following a miscarriage, and has a normal menstrual period after two weeks of ovulation. Below are a few ways to take care of yourself after a miscarriage.
You have gone through a traumatizing experience, and need time to heal. So, rest as much as you can. You may find it difficult to sleep as it can be mentally taxing. You could have warm milk to induce sleep. You should also do light exercises whenever you can (7).
A miscarriage pain may vary depending on the nature of the miscarriage. You can take antispasmodics painkillers such as cyclopam and buscopan. But you must consult your doctor before using them. But in case your pain increases with time, you need to seek medical attention.
3. Monitor your temperature:
For the first five days after a miscarriage, you must record your body temperature. If you see the numbers on the thermometer creep past 99.7ºF, contact your doctor. A fever after a miscarriage may indicate an infection in the body.
4. Maintain proper hygiene:
Use cotton sanitary napkins when you bleed after miscarriage, and change them every 4-6 hours. You also need to shower once or twice a day (weather permitting), to regulate your body temperature. Do not douche or use disinfectants to clean your vaginal area as it may lead to infections.
5. Hot and cold compresses:
Many women experience headaches after a miscarriage. Using hot and cold compresses can give you some relief and ease abdominal cramping.
6. Healthy diet after miscarriage:
Your body needs to rebuild and refuel after a miscarriage, so have a healthy diet. Make sure your meals contain portions of protein, carbohydrates, fiber, fat, and essential minerals and vitamins.
For healthy fats, you could have coconut oil, butter, and olive oil.
Rebuild your body with proteins such as eggs, cheese, poultry, red meat, organ meat, and seafood (sardines and salmon).
Whole fruits and vegetables are high in nutrition and require no prep time. Leafy greens, beans, Brussels sprouts, lentils, soybeans, and fruits such as papaya, strawberries, and grapefruits are good for you.
Calcium levels plummet during pregnancy making it necessary to have calcium-rich foods (8). Therefore, it is important to consume calcium-rich foods such as milk, dairy products, dry fruits, soya, and leafy greens.
7. Stay hydrated:
Your body requires water to recover from the loss. So, drink at least eight glasses of water every day. You can try including fruit juices, herbal teas (mint or chamomile), and warm broths. Stay away from caffeinated drinks as caffeine is a diuretic and will not work on healing the body.
8. Sex after miscarriage:
Try to avoid sex in the first two weeks after miscarriage as you should allow your body to heal. Wait for the bleeding to stop and give your cervix enough time to contract and close. Talk to your doctor before you begin to plan a family again. Use a contraceptive if you are not looking to become pregnant anytime soon (9).
Mental health after miscarriage:
Pregnancy loss brings with it a tide of emotions (10):
1. Shock and denial:
Since the time you undergo a miscarriage and throughout the healing process, your body will be in a shock. You may refuse to believe that you have lost the fetus.
2. Guilt and anger:
You might blame yourself for the mishap. You may also be tempted to blame others though it might seem senseless. You may feel envious and get irritated by other pregnant women and could harbor hatred against them.
3. Depression and distress:
Some women may go into depression, also referred to as major depressive disorder. It causes intense and persistent feelings of sorrow for longer periods, and women may lose interest in everything. For the next few weeks, you may be feeling:
Irritable or frustratedHopeless, empty or sad
Sleepy or insomnia
Very hungry or not hungry at all
Distressed, anxious, worthless
Lack focus on making decisions, remembering things
Suicidal tendencies and random pains (11).
Do not be hard on yourself as there is a way out and you can recover to start a family again.
Mental Recovery After A Miscarriage:
A miscarriage not only ravages your body but also leaves you emotionally fragile. You can effectively deal with miscarriages but first, you must understand and believe that whatever happened wasn’t your fault (12):
1. Do not blame yourself:
Miscarriage is often a chromosomal abnormality and is not just the negligence of the mother. You must move past it to plan your family in the future.
2. The doctor can help:
Your doctor is the first person to help you understand the tragedy. He will explain to you the reasons, (such as cysts in ovaries, tilted uterus, too much stress, smoking, etc.) that you can avoid in your next pregnancy.
3. Stay away from stress:
Stop focusing too on the physical and mental pain. Remember that your hormones are already imbalanced and they take some time to normalize. You will be irritable and moody. Understand that the body is on its path to recovery and will take some time.
4. Identify the reason for your emotions:
Identify the reason – Have you had an earlier miscarriage? Were you desperate about having a baby? Are you over 35 years old? Are you freaked out about the unsuccessful pregnancy? Whatever it is, be honest with yourself to know what triggered you the most. You must understand that you cannot solve the problem until you know the reason.
5. Talk to others:
When you are dealing with something as big as a miscarriage, you need to vent out your feelings. Talk to somebody – be it your friend, family, or a professional. It is normal to feel alienated, but don’t shut yourself out, especially from your partner. Remember, he too has lost his child. Talking about it will help take a little burden off and help you move on better.
Once you are physically up to it, try and exercise. A good workout releases the happy hormones endorphins in the body, and can help you deal with stress. Begin with mild exercises such as walking, and move on to running and other vigorous exercises. But be sure that you talk to your doctor before beginning any exercise.
7. Medication and treatments:
If you are having a tough time dealing with depression, your doctor may suggest treatment for miscarriage such as:
Antidepressant medications lessen depressive symptoms
Psychotherapy to helps cope with grief
Electroconvulsive therapy (ECT) to treat severe cases by sending electric currents to the brain (13)
You should not let yourself continue to be depressed. Instead, make every effort to come out of those feelings and lead a normal life again. Also, you need to take care of your health.
Precautions After Miscarriage:
You should follow certain safety precautions to remain physically and mentally fit after miscarriage. In many cases, these precautions would avoid future mishaps and recurrent pregnancy losses (14):
- Do not try to conceive until you complete at least two menstrual cycles.
- Have a healthy and balanced diet, and avoid foods such as raw meats, soft cheese, processed foods, etc., that can damage your baby.
- Exercise regularly and keep your weight consistent.
- Avoid alcohol and smoking during pregnancy. Limit caffeine consumption.
- Take prenatal vitamins and folic acid supplements every day, after consulting your doctor.
- If you have high temperature, do not ignore as it can be a sign of infection after miscarriage which could cause infertility.
- Do not neglect any abnormal vaginal discharge.
- Avoid sexual intercourse for some time until you get off from the after-effects of miscarriage.
How Long Does Your Body Take To Heal From A Miscarriage?
It takes about a few days to several months for the body to heal after a miscarriage. However, vaginal bleeding may last up to a week, and lower abdominal pain up to two days (15).
The healing period also depends on the emotional bond the woman shares with the fetus (16).
Frequently Asked Questions
1. What should you not do after a miscarriage?
Avoid the following activities after a miscarriage (16):
Inserting anything into your vagina
Strenuous activities such as swimming, horse riding, bicycling, and lifting
2. Are you more fertile after a miscarriage?
It may not be possible to ascertain if fertility increases after a miscarriage. However, research shows couples who try to conceive within three months of a miscarriage may have a better chance of a successful pregnancy than those who wait for longer (17).
3. Why do you have to wait three months after a miscarriage to conceive?
The waiting time is recommended to allow yourself to heal physically and mentally so that your uterus can be strong enough to conceive and carry out a healthy pregnancy (18).
Miscarriage can affect both your mind and body. While you may mentally feel depressed, lost, and distant, you are bleeding, in pain, and susceptible to various illnesses. Therefore, it is critical to take the required precautions after a miscarriage. Take adequate rest, maintain proper hygiene, take your medicines on time, and eat a balanced diet to heal physically from this traumatic experience. Also, share your grief, exercise, avoid stress, and surround yourself with your loved ones to help you recover mentally. Remember that being mentally and physically strong can help you improve faster.
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- Previous Prenatal Loss as a Predictor of Perinatal Depression and Anxiety.
- Ectopic Pregnancy and Miscarriage: Diagnosis and Initial Management in Early Pregnancy of Ectopic Pregnancy and Miscarriage.
- J. H. E. Promislow et al; Bleeding Following Pregnancy Loss Prior to Six Weeks Gestation.
- Jennifer Lohmann-Bigelow et al; Does Dilation and Curettage Affect Future Pregnancy Outcomes?.
- Alexandros Sotiriadis et al; Threatened miscarriage: evaluation and management.
- L D Ritchie et al; A longitudinal study of calcium homeostasis during human pregnancy and lactation and after resumption of menses.
- How soon after a miscarriage can you have sex?.
- Anne Nordal Broen et al; The course of mental health after miscarriage and induced abortion: a longitudinal five-year follow-up study.
- Jessica Farren et al; Post-traumatic stress anxiety and depression following miscarriage or ectopic pregnancy: a prospective cohort study.
- Fiona A Murphy et al; Follow-up for improving psychological well being for women after a miscarriage.
- Anette Kersting; Complicated grief after perinatal loss.
- Abortion (Termination of Pregnancy).
- Pregnancy after miscarraige: The sooner the better study says
- Pregnancy after misccariage