Your emotions
Everybody is different, so no two people will cope with miscarriage in exactly the same way. Even though the baby has been lost at a very early stage, it is natural that most people feel upset. There is nothing wrong with this reaction. Not everybody will feel upset to the same degree and it depends on how you see your miscarriage. You may regard it as a late period. Alternatively, you may see the developing fetus as a baby from very early on and feel that this is what you have lost.

After a miscarriage you may go through the same grief reactions as you would for a normal bereavement. It can be hard to accept that such deep feelings can occur for something that you never saw or even felt move. However, it is quite normal and you should not feel guilty or try to suppress it.

You may experience various changes of mood. This is part of the grieving process. These changes may often be unpredictable and of variable duration. They are partly due to the changes in your hormone levels as your body readjusts to its non-pregnant state.

At first you may feel very shocked and unable to believe what has happened. You may also briefly feel relieved once the physical trauma of the miscarriage, which can be quite frightening, is over. Some people feel they need company while others may need solitude and want to be alone. Sometimes you may feel angry, either with your doctor, your partner, pregnant women, yourself or even the world in general for letting this happen to you.

A common thought is ‘Why me?’. It may seem important for you to find a cause and blame something or someone for the miscarriage. You may blame yourself for causing it and feel guilty for what you have lost for your partner. You may feel a failure as a woman and lose self-confidence. If it is your first pregnancy you may feel that your body has let you down. This can be a vicious circle. Failing to cope with the emotions that miscarriage has brought may lead to failure to cope properly with your job or everyday tasks and increase any loss in self-confidence. With the loss of the baby and your future plans, you may feel depressed at various times.

All these reactions to your loss are normal and others will have felt as you do before getting over it. Knowing this should be reassuring at this time. If you feel that you cannot cope you should not be afraid to see your doctor and discuss the situation.

How long does it take to get over it emotionally?
There is no one answer to this as everybody is different. The initial deep sadness will usually pass during the following few weeks, but it may be months before it fully resolves. In the long term you may never completely forget your miscarriage and it may remain an important part of your life, affecting you and the way you view things. There are of course particular times in the future when you may feel more upset, such as the date the baby would have been born or the anniversary of the miscarriage. Such reactions are natural and as time passes these occasions will become less distressing.

If you are worried that you do not seem to be getting over it or feel you cannot cope, do not hesitate to see your doctor.

Helping yourself to get over it
It is important that you give yourself time and do whatever you want to do. If you feel like crying, then cry. Do not be ashamed and do not blame yourself. It is often helpful to talk to people who have been through the same experience, or who are involved in health care. There may be a counselling service set up at your hospital, or health visitors may be available. Alternatively, support organisations such as the Miscarriage Association may be useful. The addresses of some of these organisations are given at the end.

It may be helpful to mark the loss of the baby in some way. For example, some hospitals and churches have a remembrance book and you may wish to make an entry in the book. Sometimes services are held to mark the loss of those babies who were miscarried. Alternatively, you may feel you would like to mark the loss in some more permanent way, such as planting a tree in the garden.

Meeting other people again may seem like a big hurdle, but there are things you can do to make this easier. Take your time and make sure you are ready before you try. If people knew you were pregnant it may be helpful to ensure they know in advance about your miscarriage, for example, before you return to work. This will avoid you being asked how your pregnancy is going, which would obviously be upsetting and embarrassing for both of you. People will react to the knowledge in different ways. Some may be very sympathetic and understanding. Others may be less able to deal with other people’s emotions and they may be less forthcoming or even ignore what has happened. It will therefore soon be obvious to you who you can most easily talk to and share your feelings with, knowing that they will not be surprised or embarrassed if you are upset or cry at this time.

Your husband or partner
Some men will feel the loss just as much as women and will show this. However, many men may not feel the same sorrow, partly because they have not physically experienced any of the changes of pregnancy. Not having felt or seen any changes at this early stage sometimes makes it difficult for them to realise what they have lost. At the time of your miscarriage your partner may have been so worried about you that he has not yet felt deeply about the loss of your baby. In addition to this, people’s expectations of men are often different. They may feel they must be strong and support you. Your partner may therefore be just as upset without actually showing it and so it is important that you talk to each other about how you both feel.

Your family
Your sadness is likely to affect all your family. Children may sense grief or may be frightened by your emotions. It is important that they do not feel excluded, so you probably need to tell them honestly in some way. Grandparents may also grieve over the loss of a potential grandchild.

Your physical recovery
Physically you will recover very quickly and your body will soon be back to normal. If you have had a D and C, which is a very short operation, the effects of the anaesthetic soon wear off and you will probably return home the following day. You should certainly take things easy for the first few days at home, but return to your normal level of activity as and when you feel able.

It is likely that bleeding will continue when you are at home. Women vary in how much bleeding they have after a miscarriage, what it looks like and how long it goes on for. It may be red or brownish in colour and there may be some small blood clots at first. Each day it should gradually lessen and after two weeks it has usually stopped completely. If you experience a sudden increase in the amount of bleeding it is important to see your doctor for advice. Similarly, if at any time the loss becomes unusually smelly this could be a sign of infection and you should see your doctor. Using tampons is not advisable, as inserting a tampon may introduce an infection. You should use sanitary towels until the loss stops.

If your periods normally occurred every month, the first period after miscarriage will usually occur within six weeks. It is safe to use tampons at this time if you wish. Your periods will return to their previous pattern, although it may take a few cycles for this to happen.

Your six-week check
Sometimes this may be done at the hospital, but you may be asked to see your own doctor instead. The reason for this visit is for the doctor to ensure that you have recovered physically and that you are coping emotionally. It is also an important opportunity for you to ask any questions you may have about what has happened. You should not be afraid to ask. If you did have a D and C the doctor will have a report on the results of some simple tests that will have been done on the tissues that were removed. These are to ensure that there was no obvious cause for what happened.

When can I try again?
You can technically try again after one normal period. However, it is best not to have intercourse until the bleeding has completely stopped after the miscarriage. Then it is safe to do so if you wish. However, many women (and their partners) find that they have less interest in sex after a miscarriage. This can last for several weeks, but your interest will return.

You may feel that you want to become pregnant again as soon as possible. For several reasons it is better to wait for two or three months before trying again. This is an important breathing space. It gives your body time to recover and allows you to get in the best possible shape for the next pregnancy, both physically and emotionally. There are many things you can do in this time to help your recovery, such as:  

• stopping smoking,
• reducing alcohol consumption,
• eating a sensible diet,
• taking exercise,
• talking to your family and others (such as your doctor) about your plans and concerns for your next pregnancy.

This positive action for a future pregnancy is called ‘preconception care’. In some hospitals and occasionally in doctors’ surgeries there are clinics where such advice about preparation for pregnancy is available. It is worth finding out whether a ‘preconception service’ exists at your hospital or doctor’s surgery.

It is possible to get pregnant very soon after a miscarriage (even before your next period). Therefore if you do choose to wait for two or three months, some form of contraception is necessary. There are several alternatives and it is worth discussing the situation with your doctor to decide which is the most sensible method for you at this time.

Will it happen again?
The chance of having a successful pregnancy next time is very high. Even if you have had two or three miscarriages and feel despondent, the chances of success are still strongly in your favour.

As soon as you think you are pregnant again, arrange to see your doctor. He or she can then refer you to the hospital clinic at this early stage and a scan can be arranged. Once a pregnancy is confirmed by scan the chances of it continuing successfully are very high. This will be important reassurance for you at a time when you will be understandably anxious.

Meaning of medical terms used
abortion: medical term used for termination of a pregnancy, whether miscarriage or induced

dilatation and curettage (D and C): scraping away of the womb lining which also removes any pregnancy tissue that may remain after miscarriage

evacuation of retained products of conception (ERPOC): a D and C operation carried out to ensure the womb is emptied of any remaining pregnancy tissue after miscarriage

retained products of conception (RPOC): pregnancy tissue that remains in the womb after miscarriage

Related posts:

1. Miscarriage In Pregnancy
2. Causes Of Miscarriage In Pregnancy
3. Treatment For Miscarriage In Pregnancy