Coping

Miscarriage is fairly common; one in five women who know they are pregnant will miscarry before 20 weeks. However, the rate is higher than this because some women miscarry before they even realise they are pregnant. Often, there is no clear reason for miscarriage, though around half of all miscarriages are thought to be due to a chromosomal problem with the embryo.

Having a pregnancy confirmed is often a time of joy, especially if a couple has been trying to conceive. Emotions, dreams, planning and excitement all start building from the moment of a positive pregnancy test. But just as quickly, this can all turn to disappointment when a miscarriage occurs.

Medical management of a miscarriage depends on the gestation. If the miscarriage happened early in pregnancy and is complete , a dilatation and curettage (D & C) may not be needed. If a miscarriage is incomplete , this means some of the products are still inside the uterus.

A D & C is often done to clear the uterus of all products of conception. It also helps to reduce the risk of prolonged bleeding and infection.

It can take a few months for hormones to return to normal after a miscarriage. Some women find their pregnancy symptoms continue for a while after they miscarry, and their breasts may even produce milk. Emotional ups and downs are also common.

Some couples start trying for another baby soon after a miscarriage. Others choose to wait a while. There is no one right time to plan for another pregnancy.

Fathers and miscarriage

Fathers and miscarriage is an area of increasing awareness as we learn to recognize the importance of supporting partners as well as mothers. Fathers are often overlooked when a miscarriage happens. Generally the early focus is on the mother's medical management and making sure she is alright. But fathers too, can feel intense sadness over the loss of a pregnancy. Some men find it difficult to express their emotions and feel they need to be strong for the sake of their partner

As your baby's father, you have a right to grieve for your own unique baby in your own unique way. Avoid feeling you need to justify this to anyone, even yourself. Grief has an emotional as well as biological basis and is deeply influenced by our life experiences and expectations.

If you feel you need to talk with someone, speak with your GP about options. Your workplace may also have counseling availability through employment services.

After a miscarriage

It may sound like an old clich , but time really does heal. When feeling very sad, it can be difficult to feel there are better days ahead. Talking to friends and family about the baby and what you are experiencing may help.

Check with your GP about any health issues you need to be aware of after a miscarriage.

When do I need to speak with someone?

Every woman's experience of miscarriage is different. Some don t feel they need to talk with anyone, others benefit enormously. It is normal to feel a state of shock and just needing to get through what has to be done in the early days after miscarriage.

Symptoms of miscarriage can vary. If you experienced pain and bleeding during pregnancy which ended in miscarriage, this may have been very frightening. Some women describe feelings of intense shock, confusion and even trauma after miscarriage.

There are likely to be days when you feel fine and others where you feel overwhelmed with sadness. Trying to force yourself into just getting over it may well create feelings of unresolved loss later on. Be kind to yourself and don t overlook the basics.

Eat and sleep well, look after your hygiene and grooming. Making the effort to get out of bed and shower, change into clean clothing, and eating may all seem like an insurmountable hurdles, but are likely to help you feel better.

Where has everyone gone?

When a miscarriage happens, you'll find that many people are involved in decisions around your life. Doctors, ultrasound technicians, hospital staff and even pathology services become very important. When things settle down after a miscarriage, there can be a sense of loneliness and no longer being the focus of anyone's attention. Aim to see this as a quiet oasis of time to help you recover.

Support

To help with coping after miscarriage, see your General Practitioner, midwife or health care professional. You can also visit http://cope.org.au or http://www.sands.org.au, or call the SANDS helpline on 1300 072 637.

Written and reviewed by Jane Barry midwife and child health nurse on 1/02/20