Although 15-20% of known pregnancies end in miscarriage, according to the American College of Obstetricians and Gynecologists (ACOG), it can be emotionally and physically difficult for everyone involved. This is especially true if you’ve never experienced a pregnancy loss before. Here’s your guide to what happens after a miscarriage, with important information about side effects, bleeding, having sex, and getting pregnant again.
What Happens After Miscarriage?
While some women don’t experience any symptoms of miscarriage, most will have some bleeding and spotting. Other signs of pregnancy loss include pain in your back or abdomen, white-pink mucus, passing tissue or clot-like material, and loss of pregnancy symptoms like nausea or vomiting. See your healthcare provider right away if you experience any of these symptoms; he will likely conduct a fetal ultrasound and blood tests to see if the pregnancy is viable.
Physical healing after a miscarriage may depend on how far along in the pregnancy the loss occurred. Miscarriages that occur early enough during the first trimester may simply require rest and recovery at home, which allows the pregnancy to expel naturally. Some women take medication like Cytotec (misoprostol) to speed things up, and others undergo a dilation and curettage (D&C) to excavate the uterus.
A D&C is most often used if the woman is bleeding heavily without effective passage of the tissue (incomplete miscarriage), says Jennifer Jolley, M.D., Assistant Professor of Maternal-Fetal Medicine at the University of Washington in Seattle. It’s also used for missed miscarriages. During the procedure, doctors will dilate the cervix and remove the contents of the uterus with suction and scraping tools. You can expect postoperative pain, bleeding, and cramping for several days.
How Long Do You Bleed After a Miscarriage?
Whether you had a natural miscarriage or a D&C, you’ll continue bleeding as your body expels the pregnancy. Bleeding after miscarriage will be heaviest within the first several hours, and it’ll probably contain clots and fetal tissue. The flow will eventually lighten up, and it will go away completely after one or two weeks. Always use pads—never tampons—to control the bleeding.
Your Period After Miscarriage
After a miscarriage, your monthly cycle may look different than usual. For example, you might have heavier bleeding, irregularity, or spotting. However, your period should return to normal before two months, says Dr. Zev Williams, M.D., Ph.D., director of the Program for Early and Recurrent Pregnancy Loss (PEARL) at Montefiore Medical Center and Albert Einstein College of Medicine in New York. That’s how long it takes for your uterus to return to its previous state, and for the levels of pregnancy hormone hCG to drop.
Having Sex After Miscarriage?
If you had a natural miscarriage, you can have sex after about two weeks, assuming your OB-GYN gave approval at your follow-up appointment, says Angela Chaudhari, M.D., a gynecologic surgeon and assistant professor in the Department of Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine in Chicago, Illinois. Women who had a D&C might experience more intense bleeding, and they’ll need to wait longer to have sex after miscarriage.
Getting Pregnant After Miscarriage
You may not feel ready to conceive another baby just yet, and that's more than OK. But whether a woman has experienced a spontaneous loss or required surgery, most physicians recommend waiting 1-2 full menstrual cycles before attempting another pregnancy in order to allow full physical healing and hormonal re-balancing. That said, according to the ACOG, ovulation can occur as early as two weeks after an early miscarriage. Always get the green light from your doctor first before trying to conceive again, says Jonathan Schaffir, M.D., an assistant professor of obstetrics and gynecology at Ohio State University College of Medicine.
Will I Have Another Miscarriage?
It may be reassuring to know that your chances of another miscarriage don’t raise after one pregnancy loss. Indeed, your odds of a successful pregnancy after miscarriage are the same as everybody else’s (about 80 percent), says Jani Jensen, M.D., a reproductive endocrinologist and assistant professor at the Mayo Clinic in Rochester, Minnesota. That’s because most miscarriage result from random chromosomal abnormalities in the fetus’s genes, and they aren’t caused by the mother or father.
The risk of subsequent miscarriage does rise slightly after having a second one, and doctors might start testing for “genetic, uterine, or hormonal problems” after your third, says Dr. Schaffir.
Your Emotions After Miscarriage
Dr. Ricardo Huete, M.D., Chief of OB-GYN of Torrance Memorial Medical Center in California, explains that woman have to undergo what he calls an "emotional healing" after a miscarriage. "I think that one of the most difficult facets for a woman to deal with after a miscarriage is the anxiety level that she suffers after such a traumatic episode," he says. "We need to remember that everybody is different dealing in with a stressful situation; everybody needs an individual approach and reassurance."
Miscarriage can cause postpartum depression and other intense emotions. What’s more, "multiple questions arise after (a miscarriage,)" explains Dr. Huete. "A woman may question her capacity of carrying a pregnancy or there may be a strong sense of guilt, often from thinking that she has done something wrong that affected the pregnancy. There are also questions about how she could have prevented it."
For healing, it may be helpful to try some of the following ways to honor your loss:
- Plant something in memory of the loss that will spring new life, such as a tree or flowering bush in your yard.
- Purchase a remembrance item, such as a pregnancy loss statue, necklace, or photo frame.
- Reach out to another mother who has experienced a loss—it can help to talk to someone who is feeling the same way you are. Or simply lean on a friend who will lend a genuinely sympathetic ear and offer encouragement.
- Try journaling to your baby to write out your feelings.
- Choose a special and/or inspirational song to listen to that is meaningful and/or uplifting to you.
- Talk to your doctor if the sadness is interfering with your daily life.
Along with the emotional healing of a miscarriage, Dr. Huete recommends that all women who have suffered a miscarriage follow the known recommendations for physical healing, especially in preparation for any future pregnancies, such as reducing alcohol intake, stopping use of drugs and smoking, taking vitamins, good nutrition intake, and maintaining an exercise regime.