Coping with the physical impact, the emotional turmoil and understanding the possible causes – advice from the Miscarriage Association.

‘I’ve never cried so much in my whole life. I was walking about with an empty feeling where I should have been holding my baby.’ The feelings expressed by one woman after miscarriage show what a distressing experience it is. Apart from the emotional trauma of expecting a baby and then losing it, your body has been adapting to the changes of pregnancy and has to return to normal. Many women are left with feelings that are difficult to cope with and talk about. Emotions range from anger to jealousy, isolation, loneliness, guilt, depression and tiredness. These emotions may resurface months afterwards, perhaps at the time the baby was due.

Your partner is likely to feel upset because of the trauma you’ve been through, as well as the loss of your baby. His grieving pattern may be different from yours and he may find it hard to show his feelings.

It can be hurtful if friends and relations avoid talking about your loss, but they may be afraid of saying the wrong thing and upsetting you further. You can help them by talking openly about what has happened.

Even though one in four pregnancies ends in miscarriage, it is usually difficult to find the cause. It can happen at any time from the date of the first missed period to twenty-four weeks of pregnancy. Miscarriage is very rarely anyone’s fault.

The main causes are thought to be:

• Genetic – about half of early miscarriages occur because of chance chromosome abnormalities.
• Hormones – women with hormonal irregularities find it harder to conceive and when they do, are more likely to miscarry.
• Immune system – problems in the blood vessels which supply the placenta can lead to miscarriage.
• Infections – minor infections like colds are not harmful, but a very high temperature and some specific infections such as German measles, may cause miscarriage.
• Anatomical problems – if the cervix is weak, it may start to open as the uterus becomes heavier in late pregnancy and this may lead to miscarriage. An irregular shaped uterus can mean there is not enough room for the baby to grow in later pregnancy.
• Some pregnancies are lost through ectopic pregnancy. This is when the egg implants outside the womb, usually in the fallopian tubes.

Physical impact

Some miscarriages are ‘complete’ and no surgery is needed. In other cases a small operation is necessary to empty the womb and prevent infection. This is done under general anaesthetic with no cutting or stitching.

You may have some cramping pains and bleeding for up to two weeks. It is better not to have sexual intercourse until any discharge has stopped. You should have your next period between four to six weeks after the miscarriage. It may be heavier than normal.

If you miscarried late in pregnancy, your breasts may stay larger and leak milk for several days.

Returning to normal

You may feel physically low for at least a week, perhaps longer. Some women find it helps to return to work when they have recovered, to have the support of friends and colleagues. Others find it difficult to face people and harder still to concentrate on work.

After one miscarriage, most women will go on to have a normal pregnancy. Statistics indicate that even after several miscarriages, you still have a good chance of having a baby. The most important thing is to give yourselves the chance to recover emotionally. Doctors usually advise waiting until you have had one period before you try to conceive again.

When they get pregnant, many women feel anxious about miscarrying again. Try to take the pregnancy one day or one week at a time. Sharing your fears with someone else can help. The Miscarriage Association run support groups in different parts of the country with people who have been through similar experiences.

For more information contact:

The Miscarriage Association,
C/O Clayton Hospital, Northgate, Wakefield WF1 3JS.
Tel 01924 200799.