Important COVID-19 Updates: Office Guidelines | Vaccine and Pregnant Women

Wednesday, July 3, 2019

Miscarriages take both a physical and emotional toll on a woman’s health

Anne Vaillant, CNM

Woman sitting on a rock by the beach
Miscarriages are far more common than many people realize. In fact, up to 20 percent of pregnancies end in miscarriage, defined as the loss of a fetus before the 20th week of pregnancy (after 20 weeks, it is called a stillbirth). Just because they are common, however, does not make them easy.

Most miscarriages occur before the seventh week of pregnancy. This means that you may miscarry before you even realize you are pregnant and think you are just having a heavier than normal period. But if you know you are pregnant or are further along in the pregnancy, a miscarriage may feel like a devastating loss.

Physical experience
Typically, most miscarriages, especially those early in a pregnancy, do feel like a heavy period, including cramping and discomfort. The duration is typically longer, as it can take a few days to a few weeks for the body to clear the uterus.

Physically, this is a very important part of the process. In order to resume your normal menstrual cycle and for your overall health, we need to make sure the miscarriage is complete. Sometimes this means allowing nature to take its course; other times, we may prescribe medication to move things along, or recommend dilation and curettage, commonly called a D&C, a procedure in which we gently remove the contents of the uterus. There are several factors we consider with you before recommending how to proceed.

If you’ve miscarried, we’ll typically advise you to avoid strenuous activity, intercourse, and insertion of anything into the vagina, such as a tampon, for a couple weeks afterward. We’ll want to see you for a follow-up appointment a few weeks after the miscarriage, or sooner if you experience signs of an infection including excessive bleeding or abdominal pain, fever and chills, or a foul-smelling discharge.

If you have a D&C, it may be possible to tell the miscarriage happened. Even if this is not the case, a miscarriage or two is not a sign in and of itself that you can’t successfully carry a pregnancy. If you experience multiple miscarriages without a clear cause, we can run tests to determine if there is an underlying issue.

Emotional experience
Beyond the physical outcome of a miscarriage, you can expect a range of emotions, including denial, anger, guilt and depression. It’s normal to undergo all the stages of the grieving process, even if the pregnancy wasn’t planned. Every woman experiences this loss differently. There is no one way or right way to feel. The passing of time often helps, but if you find yourself struggling with depression, let us know as we may be able to help or provide a referral for counseling.

The good news is that most of the time, having a miscarriage does not indicate a problem with your ability to carry a pregnancy to term. Often, women experience a loss between other perfectly healthy and successful pregnancies.