What happens after miscarriage

What should I do if I've miscarried at home?

If you have miscarried at home, you should see your doctor to confirm that the miscarriage is complete and that you do not need any medical treatment.

You may decide to collect any tissue you pass in a container to take to your appointment. Your doctor may recommend sending the tissue to a laboratory for testing, to try to find a cause, especially if you have had multiple miscarriages. It's important to remember that most miscarriages happen without an identifiable cause.

What will happen if I miscarry in hospital?

If you miscarry in hospital, you may wish to see your baby. This may or may not be possible, depending on:

• the stage of your pregnancy
• when the baby died
• whether you had a dilatation and curettage (also called a D&C or curette)

Sometimes your baby may not be recognisable, and the staff may advise you not to view the remains.

If you think you would like to see your baby, discuss your wishes with the hospital staff.

Are there any legal obligations?

Legal obligations following your miscarriage may vary according to your state or territory. Your health team will inform you of any requirements.

Generally, if you miscarry in the first 20 weeks of pregnancy, the birth and death of your baby cannot be formally registered. This means that you will not receive a birth or a death certificate.

Some hospitals offer a certificate to commemorate your baby. All state and territory governments also offer optional certificates recognising early pregnancy loss to support parents grieving a miscarriage. Red Nose Grief and Loss has information on applying for an early pregnancy loss certificate with your state or territory's Births, Deaths and Marriage Registry.

You are not legally required to have a funeral, burial or cremation, although you may choose to do so.

What services will the hospital offer?

The services offered for miscarriage vary between different hospitals. If you do not make any specific requests, the pregnancy tissue is commonly examined in a laboratory and then cremated according to the hospital protocol.

Some hospitals raise these issues with you. If they do not, and you want your preferences to be considered, it is important to raise these issues yourself.

Some hospitals offer shared memorial services to commemorate pregnancy loss. Your hospital may also offer a social worker or bereavement support.

Can I have a funeral for my baby?

While there is no legal obligation to have a funeral, burial or cremation after a miscarriage, you may choose to make your own arrangements to mark your loss.

You may choose to engage a private funeral director or approach your religious leader for advice about having a funeral, burial or cremation. You may also decide to bury your baby at home.

How long will it take to physically recover from a miscarriage?

Recovery is different for every person. Your physical recovery may be affected by:

• how far along you were in your pregnancy
• if you were treated with any medicines or procedures for your miscarriage
• any complications you experienced

Bleeding and discomfort

You may have discomfort and vaginal bleeding for up to 2 weeks.

Things to consider:

• Do not put anything in your vagina — use pads for the bleeding, not tampons.
• Use medicine such as paracetamol for the discomfort.
• Avoid sex and swimming until the bleeding stops.

See your doctor or go to your nearest emergency department if:

• the bleeding is heavy (soaking 1 to 2 maxi pads in an hour)
• the bleeding started to resolve, and then becomes heavier again
• the bleeding continues for longer than 2 weeks
• you pass large blood clots
• you have severe pain
• you have a temperature
• you have smelly vaginal discharge

Other changes

If you experienced any early pregnancy changes, such as nausea and breast tenderness, these should resolve within a few weeks.

If you have had a miscarriage close to 20 weeks of pregnancy, your breasts may produce milk. Please talk to your doctor or midwife if you have any questions or concerns.

What are the emotional effects of miscarriage?

Having a miscarriage can lead to a many different emotions. It is important you recognise that there is no right or wrong way to feel. When you have a miscarriage, there are support services available to help you and your partner.

Everyone reacts differently to having a miscarriage. You may or may not feel the loss very strongly. Some people feel relieved and may or not feel guilty about this feeling.

Feelings of grief are very common. Grief can be both a physical and emotional experience. Other common emotions include:

• sadness
• numbness
• anger
• denial
• disappointment

Some people wonder if something they did caused the miscarriage. In most cases, it's important to remember that most miscarriages can't be prevented, and occur without an identifiable reason.

Your feelings about your miscarriage may change over time. Important dates such as the expected due date or the anniversary of the miscarriage can be upsetting. Seek support if you feel you need it.

The effect of a miscarriage on your relationship

At the time of a miscarriage, you may find your relationship with your partner is strengthened, but some people find that their relationship suffers.

You may feel angry or frustrated if your partner does not react the way you think they should. Your partner's reaction to the miscarriage may be similar or different to yours. They may express their emotions in a similar or different way to you.

You and your partner can provide valuable support for each other. It is important to talk about how you are feeling with each other and to seek professional help if you are struggling.

Support from family and friends

You may not feel comfortable to discuss your miscarriage with family and friends, especially if you had not yet told them about the pregnancy. Some people feel that their friends and family members do not understand the significance of their loss.

Despite these challenges, many people find it helpful to seek practical and emotional support from their friends and family.

When should I follow up with my doctor or midwife?

You should have a check-up with your doctor or midwife no later than 6 weeks after you miscarry. Your doctor or midwife can provide support, answer questions and advise about contraception or planning future pregnancies.

If you have any symptoms that are worrying you, or need support, see your doctor sooner.

What does this mean for future pregnancies?

Most people who miscarry go on to have healthy pregnancies.

Your chance of miscarrying is influenced by:

• your age
• your partner's age
• lifestyle factors, such as smoking
• any medical conditions you have
• how many miscarriages you have experienced in the past

If you are worried about your risk of miscarriage, discuss this with your doctor.

If you have had 3 or more miscarriages, your doctor may recommend you that you see a fertility specialist.

How soon can I become pregnant again?

Fertility can return very soon after a miscarriage, so it's important to use contraception until you are ready to start trying again. Because ovulation happens before your period, it's possible to become pregnant even before your first period after your miscarriage.

Some research suggests that you have a slightly higher risk of miscarriage if you become pregnant straight after having a miscarriage. For this reason, doctors often recommend that you wait until you have had at least one period before trying to get pregnant again.

How do I plan for another pregnancy?

It can take time to be emotionally ready for another pregnancy after miscarriage, even if you have physically recovered. It is important to discuss how you feel with your partner.

Looking after your physical health is also important as you plan for another pregnancy. Make sure you are taking a preconception supplement and speak to your doctor about whether any medicines you are taking are safe for pregnancy.

Other things you can do to increase your chance of conceiving and having a healthy pregnancy include:

• avoiding smoking
• avoid drinking alcohol
• reducing your caffeine intake
• remaining physically active
• eating a healthy diet
• maintaining a healthy weight
• tracking your cycle and having sex around the time of ovulation

Resources and support

Talk to your doctor or midwife for information and advice on what do and how to look after yourself if you experience a miscarriage. Social workers may be available through your hospital for additional support.

Miscarriage Australia has resources about what to expect physically and emotionally after miscarriage.

Red Nose Grief and Loss provides support for people affected by pregnancy loss, stillbirth, baby or child death. You can call them on 1300 308 307 – 24 hours a day, 7 days a week.

NSW health has a booklet about miscarriage in many community languages.

The Pink Elephants provide information and peer-support for anyone impacted by early pregnancy loss.