If I start miscarrying, what can I expect?

I’m sorry that you might/or you are miscarrying. No matter how prepared you feel, this will be an emotionally heavy time.

If miscarriage is not for certain, drawing Progesterene and hCG labs can helps know what is going on. Let us know and we can get a lab order set up for you. usually results take 24 hours not counting the weekend. Uusually we redo labs 2 days later to see if levels have changed.

Here is some information on what to expect in case you are having a miscarriage.

Miscarriage is a similar process to labor: cramps/contractions that cause your cervix to open and empty your uterus. Coping or comfort techniques that are used during labor may be useful for working through this process. See the list below for ideas. Keep in touch with me via text or phone call during this process. 

Some items that might be helpful:

  • Maxi Pads 

  • Pain Management for cramping such as Ibuprofen

  • Calming Techniques/Comfort Tools

  • Heating Pad/Tub/Sauna

  • Nourishing Food

  • A container to put the baby in

  • Helpful support people

  • (optional) strainer to use while on the toilet

General recommendations: 

  • Have someone with you at all times once bleeding has begun. 

  • Eat light, nourishing foods

  • Drink fluids regularly, a cup of liquid every 1-2 hours. A homemade or store bought electrolyte drink is good. Coconut water is also good with a shake or two of salt. Bone broth is also light and nourishing.

  • Remember to empty your bladder often enough. A full bladder can irritate the uterus as it tries to cramp. 

  • Keep yourself warm and comfortable.

Any comfort measures which would be used during labor can be used during a miscarriage, such as:

  • Massage or heat on your lower back, feet, or thighs. Avoid putting a heating pad on the uterus during the period of heavy bleeding as it can make bleeding worse. 

  • Relax your body starting with your face and jaw and working your way down: arms, back, butt, thighs, etc. Physical tension leads to pain and eventually to fear; which causes more tension. 

  • Warm water like the shower directed at your back, or a warm (not hot so as to promote more bleeding!) bath can be pain relieving/comforting. 

  • Keep your space calm with dim lights, candles, essential oils, peaceful music, etc. 

Warning signs: When to Go to the Hospital

 Most women who allow nature to take its course at home will miscarry with no complications. But miscarriage at home should also not be taken lightly - it does carry risk of hemorrhage and infection.

  • Fever over 100.4 degrees for more than several hours

  • Severe abdominal pain that is increasing abnormally (more than just cramping)

  • Flu symptoms, such as achiness or chills

  • Severe nausea and vomiting that does not stop

  • Foul-smelling vaginal discharge

  • Bleeding that completely saturates two large maxi pad in 1 hour for more than 2 hours in a row

Below are possible warning signs for shock, and with blood loss, may be life-threatening. If at any time you experience heavy bleeding and notice (or your partner notices) any of the following symptoms, leave for the hospital immediately or call an ambulance.

  • Spaced out, fuzzy, incoherent 

  • Unusually anxious 

  • Excessively sleepy or lethargic

  • Clammy (feeling sweaty but the room is not too hot) or begin to look pale 

Bleeding - What to Expect

The heavy bleeding will generally take 3-5 hours, and may be spread out over a day or 2, as in you may have heaving bleeding for 1-2 hours one day, then it may slow down, and may start again for 1-2 hours the next day. One way to assess blood loss is to keep track of how many large maxi pads you fill per hour. If you fill one large maxi pad in half an hour, (meaning the pad is completely soaked with blood, cannot hold any more liquid) be very attentive for the next hour: two in an hour, for two hours in a row is very heavy for an early miscarriage and may need intervention. Call me after the first hour so we can make a plan for if the bleeding continues at that rate. 

The bleeding will continue at the rate of a period for around 2 weeks after the miscarriage. The pattern may stop and start. Eventually the discharge will change from red to brown to tan. If you continue to bleed more than normal, it may be a sign that there is still something left in your uterus from the pregnancy and may require an ultrasound to determine if the uterus is empty.

Keep the strainer in the bathroom for when you sit on the toilet. Any clots or fetal tissue from the strainer or the pad can be placed in a bowl or jar. Whether you decide to keep it or not, it will be helpful to assess for complete miscarriage (no remaining placenta or lining left in your uterus), especially if the bleeding doesn’t subside naturally.

Recovery

Post miscarriage is like a mini – postpartum. Healing after your miscarriage can have great effects on not just your fertility but also your overall physical and mental health. Be gentle with yourself. Grieve well. Rest. Nourish yourself. Heal.

Do not insert anything into the vagina until you have stopped bleeding. Do not do any heavy labor, strenuous exercise, etc.. Get extra rest, just like you would after giving birth to a full-term baby. Eat nourishing foods and drink lots of hydrating fluids like herbal teas, coconut water, and broth. Take time off work. 

  • Extra rest

  • Prayer

  • Worship

  • Ceremony/Burial

  • Artistic Expression: Write, Paint, Sing, Dance

  • Plant a tree or plant

  • Meditation

  • Chiropractor

  • Acupuncture

  • While honoring your privacy, be mindful not to isolate yourself

Emotional Changes after a Miscarriage

One thing that people are not told to expect is some depression. Obviously, there is the grief from losing your baby, but there are other factors at play. When you deliver, whether at 8 weeks or 40, the hormones that have been very high during pregnancy drop precipitously. This is usually referred to as “the baby blues” or, if more severe or persistent, “postpartum depression.” What most people are not aware of is that women who miscarry are at least as much at risk for postpartum depression as women who deliver live babies and usually more. If you have delivered a living baby you will be distracted by the care of a newborn and you will be surrounded by balloons and flowers and congratulations. After a miscarriage you not only do not have these, but you have the added grief of pregnancy loss. Do not hesitate to get help if this is becoming a problem. You may need some support for the physical causes of depression, and that is not something you should overlook if needed.

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