The Emotional Impact
When a woman suffers a miscarriage, she and her partner may have a range of emotional reactions.
Just as every person is unique, every person's response to pregnancy loss is also unique to that person and her way of coping. It is important to note that there is no "right" way to feel. Some women have feelings that include disbelief, anger, guilt, and sadness. Others may feel tired or have trouble sleeping or concentrating. Frequent crying, irritability, changes in appetite, or loss of interest in one's normal activities may also be experienced. Women may have questions or concerns that something they did cause the miscarriage. Many are surprised at how intense their feelings are, even when the pregnancy is lost at an early stage.
All of these feelings and thoughts are normal responses to grief and loss and to events happening beyond one's control. Hormone levels that change after a miscarriage can also make the feelings more intense. For some, the emotional recovery may take longer than the physical recovery. As noted above, partners may have varying reactions as well. They are not the ones who were carrying the pregnancy, experiencing the hormonal and bodily changes, and so, may feel less upset than their mate.
Some people have all the reactions described above and some have few or none of these. Individuals grieve differently and may have different feelings and needs during this time. It is important that each person affected by the pregnancy loss be allowed to cope in her/his own way.
Emotional Support
We want you and your partner to know that BIDMC has social workers with expertise in helping women and couples cope during and after a miscarriage. They offer information and support around the grieving process, supportive counseling, and guidance around some of the concrete issues, such as help finding a funeral home if you and your partner want tot take responsibility for the remains. They can also provide information and referral to local community mental health/grief resources. Please call the Social Work Department at 617-667-3421 and ask to speak with an OB social worker. Or talk to your obstetrician who can facilitate a referral.
For referral to a religious counselor please call Pastoral Care at 617-667-3030.
Miscarriage Facts
What is a miscarriage?
A miscarriage is the early loss of pregnancy. It is very common. One out of every five pregnancies ends in miscarriage.
What causes miscarriage?
Most often, miscarriage happens when the pregnancy is not developing normally. In the majority of cases, miscarriage is the body's natural response when the pregnancy is not going along as it should. If a woman has multiple miscarriages, her doctor may look for other possible causes and treatments to prevent miscarriage in the future.
What happens during a miscarriage?
When a women's body recognizes that there is something wrong with a pregnancy, a miscarriage can happen. It often starts with bleeding and cramping. The bleeding could be like a menstrual period or it could be heavier.
What is Misoprostol?
Sometimes a medication called Misoprostol is given to help the uterus contract. This helps make sure all the tissue from the pregnancy is expelled. It works effectively within 12 to 24 hours, 80 to 90 percent of the time. If you and your doctor decide on this option, you will be given a prescription and instructions on how to take the Misoprostol. You will also receive a prescription for pain medication to control any discomfort caused by the cramping.
Sometimes, a procedure is needed to help remove the pregnancy tissue. There are different options available, including a D and C and a manual aspiration . Your doctor will let you know if a procedure is recommended for you. Many women do not need a procedure during or following a miscarriage.
What is a D and C?
D and C stands for "dilation and curettage." It is a minor surgery where the entrance to the uterus (the cervix) is opened and the contents of the uterus are removed, including any tissue related to the pregnancy. This is an outpatient procedure and can be performed under local or general anesthesia.
What is a manual aspiration?
Manual vacuum aspiration (MVA) has been proven to be a safe and effective alternative to a D and C. It can be used to clear the uterus of pregnancy tissue following a miscarriage. A thin tube is inserted into your vagina through the opening of your cervix, and the pregnancy tissue is removed using gentle suction. It is usually an outpatient procedure performed under local anesthesia.
What happens to the tissue from the pregnancy?
Your doctor or other health care provider will discuss with you the options for the pregnancy tissue. The hospital can dispose of the remains or, if you prefer, you have the option of disposition through a funeral home. If you wish, we can assist you in finding a funeral home so you can make your own arrangements. In either case, you will be asked to sign a form before you leave the clinical area. The form indicates what choice you made regarding disposing of the pregnancy tissue.
What can a woman expect after a miscarriage?
Physical effects
Most women have some bleeding for several days or weeks after a miscarriage. The bleeding can be like a menstrual period or it could be a little heavier.
Breast tenderness and fullness can also occur and will go away shortly. Ice packs and a tight bra can help with the discomfort.
Most women can go back to their normal activities as soon as they feel able. Sexual intercourse can usually be resumed in one to two weeks if the bleeding has stopped.
You will receive other instructions and information about your care from your nurse or doctor. Please ask us about anything you don't understand.
When is is safe to get pregnant again?
Most health care providers recommend that a woman wait several months before trying to get pregnant again. Please talk with your individual health care provider about his/her recommendations for you. It is normal to feel anxious that another miscarriage might happen. However, women who have had a miscarriage early in pregnancy still have a good chance of having a normal pregnancy in the future.
Suggested Reading Material
- Miscarriage: A Book for Parents Experiencing Fetal Death, Revised, by Joy Marvin Johnson. Centering Corporation. 1992
- Empty Arms, by Sherokee Ilse, Wintergreen Press, Maple Plain, MN 1996
- Unspeakable Losses: Understanding the Experience of Pregnancy Loss, Miscarriage, and Abortion, by Kim Kluger-Bell, Norton, NY, 1998.
- Silent Sorrow: Pregnancy Loss, Guidance and Support for You and Your Family, 2nd Edition, by Ingrid Kohn & Perry-Lynn Moffit, Routledge, 2000
- Surviving Pregnancy Loss: A Complete Sourcebook for Women and Their Families, by Rochelle Friedman & Bonnie Gradstein, Carol Publishing Group, New York, New York, 1996.
- Miscarriage: A Shattered Dream, by Sherokee Ilse & Linda Hammer Burns, Wintergreen Press, Maple Plain, MN, 1985.
- Empty Cradle, Broken Heart, by Deborah Davis, Fulcrum Publishing, Golden, Colorado, 1991.
- Our Stories of Miscarriage: Healing with Words, by Rachel Faldet & Karen Fitton, Fairview Press, Minneapolis, Minnesota, 1997
