If the unexpected happens when you're expecting, you will get through it. We've got some advice to help the process along.
When I decided it was time for baby number two, I stopped using birth control, cozied up to my best beloved, and soon enough found myself staring at a positive pregnancy test—just as planned. But when I went for my first prenatal appointment, at roughly nine weeks, that plan suddenly collapsed. “We'd expect to see a heartbeat at this point,” the ob told me as she squinted at the ultrasound monitor. A few days and another ultrasound later, the bad news was confirmed: The fetus had died between five and eight weeks.
What amazed me was what happened later. Because I'd had no reason to suspect anything was wrong—no bleeding, no problems with my first pregnancy—I'd already spread the good news around; now I had to tell everyone what had happened, and I was astounded by their responses.
“Oh, yeah, a miscarriage. I had one of those between my two kids,” an acquaintance told me.
“I lost a baby at thirteen weeks, the day after I told my extended family I was pregnant,” another friend confessed. (I'd never known!)
“I didn't bleed, either,” a mom I knew from my son's preschool told me. “Like you, I went in for an appointment and they couldn't find a heartbeat.”
And on and on. To my great surprise, it seemed that more people had had miscarriages—the spontaneous loss of a pregnancy before 20 weeks—than hadn't. Henry Lerner, M.D., coauthor of Miscarriage: Why It Happens and How Best to Reduce Your Risks, confirmed my suspicion: First-trimester losses are incredibly common—so common, in fact, that most women who have had two or three children will have had a miscarriage along the way. “Four out of five times, the pairing of chromosomes in early pregnancy happens normally; one out of five times, there's a chromosomal miscombination,” Dr. Lerner tells me. In other words, a whopping 20 percent of all pregnancies fail, more than 80 percent of them in the first trimester. So if it happens to you, know that you're not alone. And know that both your body and your heart will recover, however long it takes.
The Physical Difference
Treatment after a miscarriage depends on when and how it occurred. If the loss happened very early in the pregnancy—before seven or eight weeks—your doctor will likely recommend letting your body expel any fetal or placental tissue on its own, if it hasn't already, in the form of a very heavy period, accompanied by strong cramping. But if the miscarriage happened a bit later or you never experienced any signs that your pregnancy was in danger (bleeding, cramping) until an ultrasound failed to detect a heartbeat, you may need intervention. One option is that medication may be given to cause your body to release the pregnancy tissue, which usually occurs 24 hours to several days later. Or your doctor may suggest a dilation and evacuation procedure, a suctioning of the uterus to remove fetal or placental tissue. It sounds worse than it is; a D&E, as it's known, is done as an outpatient procedure, and you can opt either for local or general anesthesia. Afterward, you'll experience mild cramping for a day or two and light bleeding for about a week.
After a miscarriage, the body heals very quickly. “A woman will generally ovulate two to four weeks after a miscarriage, with a normal menstrual period occurring two weeks after ovulation,” says Dr. Lerner. “She can then start trying to get pregnant right away, if she wants to, with no increased risk of miscarriage.”
Having two miscarriages in a row is really not that uncommon—and doesn't necessarily indicate any sort of fertility problem, says Dr. Lerner. “One out of every five women who become pregnant will have a miscarriage, and one out of every twenty-five women will have two in a row.” It's usually not until a woman has had three consecutive miscarriages that her doctor will begin tests to see if there's an underlying problem, such as abnormal hormone levels, certain infections, blood disorders, uterine abnormalities, fibroids or an incompetent cervix (when the cervix begins to open before term). If you have a family history of diabetes or thyroid or blood disorders, however, your doctor may want to run tests before you even begin trying after the first time.
Even if your physical recovery is a snap, you may feel very raw and sad for quite some time. I ran up huge phone bills calling two college friends, both of whom had miscarried. One of them assured me that, yes, it was normal to be upset, but also that the intense sadness would pass (she was right). The other reminded me to cut myself a lot of slack, made me laugh and prescribed trashy magazines and pints of ice cream. More suggestions from moms who've been there:
Let yourself grieve
Many of the women I talked to were surprised by—and unprepared for—the intensity of their grief. “I'm a nurse, so I know how common miscarriage is, and I even knew intellectually that it was probably hormones making me feel sad,” remembers Beth Resweber of Swarthmore, PA, a mom of four who miscarried after having her second child. “But I won't lie to you: I was pretty upset.” A sympathetic ear can make all the difference. If you don't have friends who know what you're going through, find a support group locally or online.
But don't be surprised if you don't feel much emotion at all
“Does it make me sound terribly cold to say that I wasn't that upset?” wonders Georgia Hallinan of Richmond, CA, who miscarried when her son Emmet was 4. “I mean, I cried when I started bleeding, and I felt sad for a few days, but I always knew I'd get pregnant again.” (She went on to have two more kids.) “A few days after the miscarriage, I thought, well, at least I can drink again. So I called a friend with a son Emmet's age and said I wanted to spend the afternoon sitting on her deck with a beer while our kids played in the yard.” The visit was low-key: They didn't even discuss the miscarriage, Hallinan remembers. “But it cheered me up to be back out in the world.”
Expect misguided comments, even from good friends
Angela Ferguson of Fairdale, KY, who miscarried several times between her daughters Savannah, 9, and Raina, 20 months, was astounded by the insensitive comments she received. “People would tell me ‘Oh well, at least you have Savannah' and ‘Maybe it was for the best' or—my personal favorite—‘At least you weren't very far along.'”
Try to remind yourself that people don't mean to be hurtful. They probably feel helpless, and awkward, so they blurt out the first thing they think of. Unfortunately, that first thing is seldom “I'm so sorry. Is there anything I can do for you or your family?”
If you're feeling brave, you can meet insensitivity head-on. Tonia Nester of Redford, MI, mom of Owen, 3 1/2, and Avery, 14 months, was devastated when she miscarried her second pregnancy. When hurtful comments added insult to injury, “I'd look people right in the eye, and say, ‘This baby was real to us, not something I can replace like a lightbulb in a lamp. My family and I are devastated by this loss.’ I wasn't confronting them to be unkind, but to make it clear that I wasn't willing to brush my grief aside with clichés.”
You'll want a spokesperson
To avoid repeating your sad news over and over again (and sitting through botched attempts at sympathy), enlist the help of a sensitive friend or family member. Susan Kulasekara of Edwardsville, IL, who miscarried between her children Michaela, then 9, and Ryan, 4, asked her parents, her in-laws, and her “most motherly coworker” to tell others she had lost the baby.
Your kids may help…
Simply having a child (or several children) often seems to make pregnancy loss easier to take. And your kids might actually comfort you—or, at least, keep you from having time to feel sorry for yourself. Beth Resweber, whose sons Drew and Clay were 2 1/2 and 1 when her third pregnancy failed, coped by staying “so busy I didn't have time to think—which wasn't hard with two little ones!”
…But they might also make it more difficult
Other women find that being around their kids adds to their pain. “Because I had Sam, who was two at the time, I couldn't just remove myself from the world of children,” says Margaret Moxley of Nashville. “And then he kept asking me when he was going to have a baby brother or sister! It felt like salt in my wounds.”
Susan Kulasekara recalls that her daughter picked up on her distress and invented her own to match: “So there I was, sitting in one room, crying, and she was sitting in another, whining and carrying on that her stomach hurt, too. I remember thinking, This is awful—she won't even let me cry!”
Memorialize your loss
At the suggestion of a friend who'd miscarried, Kulasekara and her husband planted a maple tree in their yard. “Picking out the tree, planting it and watching it grow made me feel so much better. It gave me a way to remember what had happened without just feeling sad.”
No one ever forgets a miscarriage: “I figured out when she—a girl, in my mind—would have been born, and still mourn every year when May arrives,” says Susie Doelger of Chappaqua, NY. But the pain and sadness do abate with time. If a miscarriage happens to you, remember that one-in-five statistic: It may not take away the pain of your loss, but it guarantees there are many, many other women who know exactly what you're going through.
Fernanda Moore is a mom of two and frequent contributor to Parenting.