Miscarriage Recovery

Recovery after a miscarriage can be extremely difficult.  There are physical changes your body goes through as well as emotional symptoms, some of which can last long after the physical recovery has taken place.

You may have been extremely happy to become pregnant and may have rejoiced over finally having a positive pregnancy test.  This makes it doubly more difficult to recover from a miscarriage.  Even though you weren’t ever able to see your child except on an ultrasound, the baby may have become real to you so that, when the pregnancy is lost, it can be devastating to have to break a bond that may have begun as soon as the pregnancy test became positive.

When a woman becomes pregnant, she often dreams of the future she imagines will happen.  She might go out and buy some baby things right away or may tell the entire family that she is pregnant only to have the onset of miscarriage symptoms and the inevitable loss of the pregnancy.

When this happens, there can be a variety of emotions you will need to recover from.  This includes being angry that your body (or something else) betrayed you and caused a miscarriage.  You may resent other women who have become successfully pregnant.  You may find yourself withdrawing from friends or relatives who are already pregnant or who have just had their baby.

Physically, you may have difficulty sleeping, staying awake thinking about your sudden loss.  Eating may also be difficult as you can’t imagine enjoying anything again after the sudden loss you have just incurred.  You may find yourself crying or you may find it difficult to cry.  All of these emotions are completely normal and are a part of the normal grieving process.

It may be difficult to know what to expect after having a miscarriage and you may not know what you need to do next to recover from the miscarriage and hopefully go on to having a healthy baby.  It is a good idea to be open and ask questions of your doctor as to what you can expect after the miscarriage has occurred.  You will get over the miscarriage more effectively if you remain positive and share your feelings with your partner, loved ones, and doctor.

Understanding What it Means

A miscarriage can happen whenever the embryo dies and is expelled from the uterus prior to 20 weeks’ gestation.   You may have no symptoms in the beginning but, when the hormones of pregnancy have decreased to some degree, the uterine lining breaks down and is shed from the body along with the products of conception (the embryo and placental tissue).  The symptoms may last for just a few days or can drag on for weeks if the products of conception are not easily expelled.

What Happens Physically

You may begin to have symptoms even before you discovered you were pregnant or saw a doctor.  The typical symptoms are heavy bleeding, cramping of the abdomen and back, and the loss of the tissue that was once the products of conception.  The bleeding can last as long as a period or can be longer than that, especially if you suffer your miscarriage in the latter half of the first trimester.

If you have a blood HCG level drawn, it will likely be low and will not double in 48-72 hours as is typical in a normal pregnancy.  If you have had or are having a miscarriage, you need to have a CBC drawn to make sure the bleeding didn’t make you anemic and you need to have a blood type drawn.  If you are Rh negative, you should have a shot of Rhogam (Rh immunoglobulin) to prevent sensitization against the Rh receptor on the fetus in future pregnancies.

The miscarriage may take care of itself completely and you won’t have to see the doctor.  If the bleeding lasts just a few days, the uterus will empty itself out and will expel both the uterine lining and the products of conception.  You can expect your body to pick up where it left off and you will start a menstrual cycle that may be normal or may be longer than a normal cycle as you need to wait until the ovaries ovulate again after the miscarriage.

If the miscarriage was incomplete and the products of conception did not empty the way it was supposed to, the doctor may provide you with medications that help the products of conception to pass without having to have any type of surgical or gynecological intervention.  There are specific medications, such as misoprostol or mifepristone, that can be given to help the products of conception empty out more completely.  This can shorten the length of bleeding but will have side effects, such as nausea, cramping, diarrhea, and bleeding.

The dilatation and curettage (D and C) is the procedure you’ll have to undergo if medical management failed or expectant waiting didn’t allow for complete passage of the products of conception.  The doctor will dilate the cervix and scrape out the inner lining and the products of conception.  There is a minimal risk of infection when you have this procedure done so, if you develop a fever or foul-smelling discharge after a D and C, see your doctor about getting treatment for this complication.

Resuming Normal Activities

Regardless of whether you had a spontaneous miscarriage or a surgical miscarriage (with a D & C), you will want to know when it is okay toreturn to the activities you were used to before becoming pregnant. Ask your doctor when it is safe to return to normal sexual activities and when you can begin exercising.  You may wish to stay away from work for a few days so you can both physically and emotionally be ready for a normal work life.  Pay attention to your emotional state and allow yourself time to grieve before returning to your regular activities as though nothing had happened.

Your doctor will want to avoid having sex or using tampons for at least two weeks after you have your miscarriage.  This is because there is a risk of infection anytime something is introduced into the vagina while the cervix is still open enough to allow bacteria to enter the uterus.

Miscarriage Complications

Even if you think you are having a normal miscarriage and are relatively free of much pain, your doctor may wish to re-examine you in just a few weeks to make sure that you didn’t develop any type of uterine infection and t make sure the bleeding has stopped.  Your doctor may ask you about your emotional state and may give you advice as to when you can try to become pregnant again.

Typical complications the doctor is trying to make sure aren’t happening include blood loss anemia (from hemorrhaging) and infection of the uterus (from bacteria entering the uterus after the miscarriage).  If these complications occur, they can be easily managed by you and your doctor so you can recover from the miscarriage and return to normal activities, including trying to become pregnant again.

 References:

• After a Miscarriage: Physical Recovery. http://americanpregnancy.org/pregnancy-loss/physical-recovery-after-miscarriage/
• After a miscarriage: What happens and how to cope. http://www.whattoexpect.com/pregnancy/after-miscarriage/