Care for Yourself After a Miscarriage
Having a miscarriage can be very emotionally distressing for both you and your partner, while also taking its toll on your body. A miscarriage is defined as losing a fetus — spontaneously or otherwise — before 20 weeks of pregnancy. Start with Step 1 below for some helpful information on how to take care of yourself, both physically and emotionally, following a miscarriage.
Contents
Steps
Taking Care of Yourself Physically
- Rest as much as possible during the first 24 hours. It is essential that you rest as much as possible in the 24 hours immediately following a miscarriage, as this gives your body time to adjust to its new condition and recover from the loss.
- Sleep as much as possible — if you are having difficulty in getting to sleep, try drinking a glass of warm milk. The warm fluid will relax your body and help to induce sleep.
- Between resting periods, try stretching your arms and legs for ten minutes each. You can also take daily 20 minutes walks — the exercise is good for you and will help you to sleep better.
- Take painkillers to relieve abdominal cramping. Abdominal cramping is very common following a miscarriage and is usually accompanied by bleeding. The pain varies from person to person, and can depend on whether the fetus was expelled naturally, or removed surgically.
- Taking drugs like ibuprofen help to relieve the pain, while drugs like cyclopam and buscopan are antispasmodics which lessen pain by reducing the strength of the contractions in the muscles of the uterus.
- The pain of the cramping should reduce naturally over time. If the pain increases over time, it is advisable to seek medical attention, as there may be more tissue left in the uterus that will need to be removed.
- Monitor your temperature, as it could be a sign of infection. For the first five days following a miscarriage, it is recommended that you check your temperature everyday. Any temperature over 37.60 degrees C (99.7 degrees F) should be reported to your doctor, as a high temperature may be a sign of infection in your uterus or elsewhere.
- Use sanitary towels or tampons to control bleeding. Heavy to moderate vaginal bleeding is expected following a miscarriage, as the uterus expels tissue leftover from the pregnancy. Sanitary towels should be used to absorb the heavier bleeding, but you can switch to tampons once it eases off a little. Both sanitary towels and tampons should be changed every 8 hours, at the very minimum.
- You should also make an effort to shower at least once a day (and preferably twice). This helps to maintain good hygiene and reduces your chances of developing an infection.
- Avoid douching and don't use any strong disinfectant soaps or chemicals around the vagina. This can irritate the area and cause an infection.
- Use hot and cold compresses to ease cramping and headaches. Hot and cold compresses can be used to relieve the pain of headaches, along with abdominal cramps and back pain. Alternating between hot and cold compresses is a good idea, as heat helps to relax the muscles, while cold helps to numb any pain.
- You can buy special hot and cold packs for this very purpose, or you can make your own by soaking a washcloth in hot or cold water and wringing it out before using. You could also use a bag of frozen peas for a cold compress and a hot water bottle for a hot compress.
- Press the hot compress against the painful area for 20 to 25 minutes at a time, then switch to the cold one, or vice versa.
- Follow a healthy diet, as it will help your body to heal. Following a healthy diet is essential after a miscarriage, as healthy foods will help the body to heal itself and allow it function normally. It will also give you more energy, which will help you to feel better overall. Eating poorly will only make you feel worse.
- Follow a balanced diet that contains healthy portions of protein, carbohydrates, fiber and fat. Try to drink at least 8 glasses of water per day.
- Increase your calcium intake to about 200mg per day. Any calcium is absorbed by the baby during pregnancy, so you may be deficient following a miscarriage. Drink milk, eat dairy products and eat fish such as sardines and salmon.
- Increase your folic acid intake. Folic acid is necessary in blood formation and you tend to lose a lot of blood following a miscarriage. Get more folic acid in your diet by taking a supplement and eating leafy green vegetables and fruits.
- Avoid having sex for the first 1 to 2 months following a miscarriage. It is advisable to avoid having sexual intercourse for the first 1 to 2 months following a miscarriage — this gives the vagina time to heal.
- Once you begin having sex again, it is recommended that you use contraceptives because there is an increased likelihood of becoming pregnant again before your normal period is due (usually one month to six weeks after the miscarriage).
- This is particularly important if you and your partner do not want to conceive again so soon.
Taking Care of Yourself Emotionally
- Grieve the loss of your baby. Different people react to miscarriage in different ways, but everyone — regardless of the circumstances of the miscarriage — needs time to heal. It is important to grieve the loss of your baby as much as you need, as this helps you to accept the loss and begin the healing process.
- If you are feeling constantly down and can't seem to recover from your miscarriage, it might be a good idea to seek the help of a counselor. They can help you to work through your feelings and allow you to make sense of what you're going through.
- It is important to find a counselor that you feel comfortable around, so you feel comfortable opening up about your sadness, fear and anxiety.
- Discuss your feelings with a close friend or family member. The hormonal changes that take place in the mother’s body following a miscarriage can heighten feelings of sadness or anger, which your partner may not be able to fully understand. Therefore, finding a friend, a close relative or even a support group to whom you can express your feelings is very important. This helps to promote healing and prevent depression.
- However, it's important to be be conscious of the fact that a miscarriage is a distressing experience for both the mother and the partner. Both experience the emotional strain of losing the baby, so don't shut your partner out — it is essential that you support each other throughout the grieving process.
- Also try to keep in mind that both partners may grieve differently. For example, you may cry out loud, while your partner keeps their grief to themselves. This does not mean that their pain is any less real, so try to be understanding.
- Do some light exercise and meditation. Once you get over the initial physical symptoms of a miscarriage, it's recommended that you work out as much as possible. Any form of exercise is good, as it reduces the levels of androgens (stress hormones) in our body and releases endorphins (happy, relaxing hormones) instead.
- Start out by going for a daily 20 minute walk to get the blood flowing — the fresh air will do you good. After that, you can move on to more strenuous activities, like running, biking or rowing.
- Find a type of exercise that you enjoy doing — anything from dancing to rock climbing to horseback riding. The months following a miscarriage are a difficult time, so it's important to indulge in activities that bring you happiness
- Do yoga. Doing yoga everyday is highly recommended for women recovering from a miscarriage, as it provides a form of light exercise and helps to calm the mind and relieve tension.
- Yoga involves a series of breathing exercises, which promote feelings of calmness and relaxation while also delivering more oxygen into the blood stream, relaxing the muscles and helping you to feel better physically.
- Yoga can be practiced in the comfort of your own home, with the help of a yoga mat and DVD, or you can find out about classes in your local area. For more detailed instruction on how to do specific yoga breathing exercises, see this article.
- Ask your doctor about antidepressant drugs, if necessary. Anti-anxiety and antidepressant drugs are available to help with depression and anxiety if these feelings become overwhelming. These medications work by inhibiting the serotonin receptors that cause more depression and grief.
- These medicines can take up to 3 weeks before you feel a noticeable difference, but over time they tend to produce good results.
- Talk to your doctor about getting a prescription.
- Go back to work when you feel ready. The time it take to returning to work and resume normal, everyday activities following a miscarriage varies from one person to another.
- Some people will return to work early as a way of dealing with the emotional trauma associated with the loss of their baby. Other people take more time because they don't feel ready to face the real world just yet.
- How much time you take off after a miscarriage is a completely personal choice, which should be informed by how you feel both mentally and physically. Take as much time as you need — there's no need to rush the decision.
- Plan future pregnancies with the help of an obstetrician. Following a miscarriage, it is recommended that you plan any future pregnancies with the help of an obstetrician.
- The obstetrician will advise you on any precautions you can take to avoid future miscarriages — this may include instructions to rest enough during pregnancy and follow a balanced diet.
- He or she may also prescribe you drugs to minimize the chances of miscarrying. This can help you to feel more relaxed and secure during your next pregnancy.
- For more detailed information on how to prevent a miscarriage, see this article.
Understanding Miscarriages
- Understand that there are different types of miscarriages. A miscarriage is defined as losing a fetus before 20 weeks of pregnancy. However, within this definition, there are several terms used to describe the exact nature of the miscarriage:
- Spontaneous abortions: These occur when the fetus is aborted naturally in before 20 weeks of pregnancy, due to factors like genetic abnormalities, drug or alcohol abuse, infections or hormonal problems which make it impossible for the fetus to survive.
- Incomplete abortion: This is when the fetus gets aborted but part of the tissue is still left in the mother's womb. This tissue needs to be removed by a doctor, or it could lead to infection.
- Complete abortion: This is when the fetus is expelled with all of the accompanying tissues (also known as products of conception).
- Inevitable abortions: These are a class of abortions where the symptoms cannot be prevented or stopped and will eventually lead to a miscarriage. Symptoms include vaginal bleeding and dilation of the cervix.
- Know if you are at risk. Some women are at higher risk of having a miscarriage than others. In some cases these risks can be avoided, but in others they are inevitable. Women who are at risk include:
- Those who smoke, drink alcohol or take drugs during their pregnancy. These behaviors are known to reduce the amniotic fluid in the body, which induces labor-like symptoms in the body and can lead to miscarriage.
- Those who are over the age of 35 upon conceiving their first child.
- Those who have a history of miscarriage.
- Learn to recognize the symptoms of a possible miscarriage. If you are pregnant, it's important to learn how to recognize the first signs and symptoms of miscarriage. If you notice any of the following symptoms, you should call your health care provider immediately to get checked out.
- Vaginal bleeding: Vaginal bleeding (often accompanied by cramping) is one of the most obvious signals that you are about to miscarry (or that you have already). Please visit the nearest physician if you should notice any vaginal bleeding. The bleeding occurs when the placenta starts to separate due to various factors, such as decreased HCG levels in the blood or drug and alcohol use leading to spontaneous contractions.
- Passage of clots: In some cases, there may not be any bleeding (at least at first) but you may notice clot-like tissues coming out of the vagina. These occur due to low levels of HCG in the blood, which means that the mother's body is unsuitable for carrying a baby to full term and will naturally self-abort.
- Abdominal or back pain: Any form of abdominal or low back pain should raise suspicion of a miscarriage. These kinds of pains are often the initial sign that the uterus is contracting due to decreased levels of estrogen and HCG in the blood.
- Understand how the doctor determines whether a miscarriage has occurred. In some cases, it is not immediately obvious whether or not a miscarriage has occurred, even if symptoms such as vaginal bleed and cramping are present. In these situations, doctors need to run several tests to find out if the pregnancy is still valid. These tests include:
- A routine CBC (Complete Blood Count) test is carried out to determine the levels of haemoglobin in the blood and how much has been lost.
- Blood grouping is done to find out the Rh compatibility. Rh compatibility indicates whether the mother's blood group and the fetus's are the same or different.
- Ultrasound of the abdomen and/or the pelvis may be advised.
- Blood HCG levels are tested to find out if they are low or normal. Low levels of HCG increase the probability of a miscarriage.
- Understand how tissues are removed following an incomplete abortion. Following an incomplete abortion — where the fetus is expelled but products of conception remain inside the womb — it is necessary to remove these products of conception to prevent the uterus from becoming infected. This is done with a procedure known as dilatation and curettage.
- During the dilatation and curettage procedure, the patient is given an anesthetic and put to sleep so they won't feel any pain. The cervix is then dilated and an instrument called a curette is used to remove the content of the womb through the opening of the vagina.
- Once the tissues are removed, the uterus is cleaned with an antiseptic betadine solution, which helps to prevent infection.
Tips
- Wear a well-fitting bra to reduce breast discomfort.
- Get a massage to relieve tension in the neck, back and shoulders.
- Any sort of vaginal bleeding before 20 weeks is called a miscarriage. Anything beyond 20 weeks is known as a preterm delivery.
Sources and Citations
- Barrett, E. E. (2010). What was lost: A Christian journey through miscarriage. Louisville, Ky: Westminster John Knox Press.
- Rehmann-Sutter, C., & Müller, H. (2009). Disclosure dilemmas: Ethics of genetic prognosis after the 'right to know/not to know' debate. Farnham, England: Ashgate Pub.
- Perkins, S., & Meyers-Thompson, J. (2007). Infertility for dummies. Hoboken, NJ: Wiley Pub.
- Katz VL. Spontaneous and recurrent abortion: etiology, diagnosis, treatment. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 16.
- Laurino MY, Bennett RL, Saraiya DS, et al. Genetic evaluation and counseling of couples with recurrent miscarriage: Recommendations of the National Society of Genetic Counselors. J Genet Couns. June 2005;14(3). Reaffirmed April 2010.
- Simpson JL, Jauniaux ERM. Pregnancy loss. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 26.
