How to Cope with the Physical and Emotional Pain of Having a Miscarriage

Then there’s the blame factor. The miscarrying woman may fault her body for failing her; her partner may assign blame (“You shouldn’t have been working out”). Both can breed resentment.

Be aware that you and your partner may process grief differently and may not always be in the same place at the same time. If you are fighting or feel disconnected, or if your sex drive doesn’t bounce back in a month or two, you may want to try couples counseling—even just one session, says Itzkoff. Particularly if you’ve been referred for genetic testing, therapy can be crucial in helping deal with any emotional fallout or the news that one or both parties has a genetic issue.

What to Expect Physically
If an ultrasound confirms that you’ve miscarried, stock up on pads (no tampons or menstrual cups—they can introduce bacteria to your open cervix) and ibuprofen. If you’re around six or fewer weeks along, your body will likely expel fetal and placental tissue on its own. It will look and feel like a very heavy period with cramping that can range from light to labor-like contractions that can last up to three weeks. For later miscarriages, losses that don’t resolve on their own, and miscarriages in which all pregnancy-related tissue doesn’t come out (your doc can figure this out with a blood test), you’ll need a dilation and curettage, known as a DC. During this outpatient procedure, you’ll be given anesthesia, and your OB will dilate your cervix and clean out your uterus. Afterward, unless there’s a rare complication, most women experience a few days of light spotting and minor cramping.

After most pregnancy losses, it’s safe to try again as soon as you get your next period (usually within a month of the miscarriage), with no increased risk of miscarrying again. But as always, get the green light from your OB first.

Source: Jane Frederick, M.D., ob-gyn with HRC Fertility in Orange County, California

How to Deal Emotionally
With miscarriage, there’s no standard “stages of grief.” It’s normal to feel shock, denial, and sadness, in any order, no matter how far along you were. These emotions will likely come in waves that may continue for years, even if you go on to have a healthy pregnancy.

Postpartum depression (PPD) is a real risk: Any time you’re pregnant, for any length of time, the pregnancy hormones that contribute to PPD are there; the sudden drop can leave you feeling depressed. Anticipate emotional triggers that may make this worse, like your would-be due date. If social situations like a friend’s baby shower or a first birthday party spark sadness, explain and bow out or feign a family obligation. Just don’t isolate yourself too much, since it can increase symptoms of depression like fatigue, listlessness, and sadness. If grief impairs your daily functioning (e.g., your ability to work or care for kids or yourself), seek out a therapist with miscarriage counseling experience (try resolve.org). Some women find it comforting to hold a ceremony memorializing the loss. Wait until you’re mentally ready before trying to get pregnant again.

Source: Rebecca Kennedy, Ph.D., psychologist specializing in infertility and loss in New York City

For more information on why miscarriages happen, pick up the March 2016 issue of Women’s Health, on newsstands now.