Dealing with Miscarriage
First of all, I’m so so sorry this has happened to you. I know from personal experience how heart-wrenching it can be. I hope you eventually find healing & solace <3
Dealing with Miscarriage Physically
If you are already undergoing a miscarriage (i.e. bleeding/passing tissue), you should continue at home until the pain/bleeding has subsided, which can be up to two weeks
If you have severe pain or bleeding (e.g. soaking through 2 pads per hour, or passing golf ball sized clots), you should go to the ER
If the miscarriage is taking over 2 weeks to be “complete”, or you are still showing up as positive on a pregnancy test, you may need to consider further treatment (the below options) to ensure that no fetal tissue remains in the uterus
If you have been diagnosed with an unviable pregnancy (e.g. no heartbeat) but haven’t yet begun to show signs of miscarrying, you have 3 main options:
Waiting for miscarriage to occur spontaneously: this is called “expectant management” and is basically just waiting for your body to naturally expel the fetal tissue
Benefits: avoids hospital; feels more natural
Downsides: this can take a long time and prolong what is already a difficult experience; if it is incomplete, surgery may still be required
Medicine: this involves taking misoprostol either orally or vaginally, which causes your cervix to soften, dilate and to shed the uterine lining and fetal tissue
Benefits: more predictable and starts sooner than natural option
Downsides: can be more painful than natural or surgical route, and in about 16% of cases where it is incomplete, surgery is still required
Surgery: called a D&C (dilation and curettage), this procedure is usually done under general anesthesia. A suction or a sharp device is used to remove the fetal contents from the uterus. This is the recommended route for women who miscarry after 10 weeks.
Benefits: quick and relatively painless; ensures all fetal tissue is removed
Downsides: small risk of scarring the uterus, which could affect future fertility (risk goes up with age); you can reduce this risk by asking for an ultrasound-guided D&C (rather than the standard “blind”) and asking for suction rather than sharp curettage
All three options are safe and low risk, so it’s really a personal choice based on things like how eager you are to move on, how comfortable you are with anesthesia, etc.
Personally, I would have preferred to miscarry naturally after learning we had lost the heartbeat. But after waiting many long weeks with nothing happening, I ended up having a D&C (and in retrospect wished I had done it sooner)
Some doctors may tell you to wait at least 3 months before trying again, but the data actually suggests that the period immediately after a miscarriage may be the most conducive to getting pregnant again. So as soon as you feel emotionally ready, you can start trying again.
Dealing with Miscarriage Emotionally
Letting go of blame:
While it’s natural to worry if it was something you did or didn’t do, the reality is that 90% of miscarriages are caused by chromosomal problems that are completely out of your control (e.g. not the right number of chromosomes in either egg or sperm, or a defect that prevents it from developing normally)
And most of these are not part of a broader fertility issue, and should not have any bearing on your future pregnancies. Usually it’s impossible to know what the cause was - unless you have recurrent miscarriages, the doctors are unlikely to do special followup testing.
Grieving your loss:
While it might seem strange to others that you are grieving a being you never met, it is completely understandable. It’s incredible how in a short time, you can already form an attachment to this baby, even if it’s more of a concept/idea.
And most of all, it was a hope and vision for the future that has been lost, or at least that you will have to start rebuilding again
I found this 15 minute meditation very helpful when I was grieving my miscarriages: Soften, Soothe, Allow
Know that in addition to having gone through a traumatic experience, your hormones are also wonky after a miscarriage, further heightening your emotions
Connecting with others:
15% of pregnancies end in miscarriage, but since women often have multiple pregnancies, that means an even greater proportion of women have experienced miscarriage at some point in their lives
Chances are you know a handful of people who have suffered the same experience, so this might be a moment to reconnect. You may end up having a very poignant, and likely hopeful, conversation.
Future anxiety and joy:
When you next get pregnant again, you will likely feel extra nervous especially until you pass the point where you miscarried last time. I remember my heart pounding so hard as I awaited confirmation of my “rainbow baby’s” heartbeat (since that was where things went wrong the first time).
This is completely understandable, but at the same time you don’t want to rob yourself of the joy and excitement of being pregnant again. See if you can find space for both.
Another way to think of it: if things end up going well with this new pregnancy, all that worry will have been unnecessary. And if things don’t go well again, the worry along the way won’t make it feel any less terrible.
