When all the excitement of a positive pregnancy test and imagination of being a mother end with a miscarriage, it is one of the toughest situations in life. It is similar to losing a dear one, rather more than that. You may feel like crying, sad , depressed, angry, sleepless , not wanting to eat, etc. These are normal reactions to a loss. You may pass through all the stages of an unwanted mishap: Shock and denial to start with followed by guilt and anger, depression and despair and finally acceptance.

Miscarriage is defined as the expulsion of a foetus before its viability i.e. capacity to survive on its own in the outer world. It is generally taken as 20 weeks of pregnancy or less than 500 gms weight of the foetus (24 weeks in some countries). Patient generally comes to the clinic with vaginal bleeding with or without pain. At times, it is painless expulsion of foetus. And sometimes, just a loss of heart beat on ultrasonography.

Miscarriage can be due to various causes like abnormal chromosomal pairing, abnormal hormone levels, certain infections, blood disorders, uterine abnormalities, fibroids or an incompetent cervix (when the cervix begins to open before term), medical disorders like diabetes or thyroid or blood disorders. Parents should not blame self for miscarriage because it is difficult to determine the exact cause of miscarriage.

The frequency of miscarriage ranges from 15% to 20 %. More than 80 % of them are in the first 3 months. Though common, it is a highly traumatic event. It is heart breaking. It’s a major loss to the patient and the family. It causes depression in the patient partner and family. It may lead to post traumatic stress disorder. What the surrounding people talk and behave has a lasting impact on the women. It can make or break a woman. In our society, it is generally dealt with silence. But is there a better way to deal with it?

DO’S

Acknowledge their loss. While you may worry you will say the wrong thing and upset them further, saying nothing at all is worse. It can make women feel you don’t care or think their loss was insignificant.

Listen and let them grieve. Many women need to talk about their experience. Ask them how they are. Some women find it really helpful to talk about how they are feeling, others may not be ready, but will appreciate you asking. Give the person the opportunity to grieve, because they have lost a child.

Encourage them to talk to other women who’ve had a miscarriage. Knowing they’re not alone and that others understand how they’re feeling can be really helpful. Try not to utter insensitive comments that come immediately to your mind. Think and then talk.

Offer practical support. Being with her , helping with house hold activities , caring for the children , groceries etc. can be of great help. Gifts and flowers show you care.

End the silence around miscarriage. Women want miscarriage talked about more openly so they don’t feel so alone. Even when you are physically not around them, talk to them telephonically. Crack jokes. Provide them with good reading material. Send them morally uplifting pictures. Try making them happy and engage in some hobbies.

Be with your partner when she is having a miscarriage, even if it is uncomfortable or inconvenient for you. Cancel all your meetings, and make it a priority to do whatever you need to do to be with her. If your brain goes into a fight or flight response, resist it and stay put. Focus on building deeper intimacy as a couple as a result of this shared loss. Let it build character in each of you and strength for other challenges that are sure to come in life. Talk about how you’re handling this together and ask for what you need. 

Feed them well. Losing a pregnancy can leave the body fragile. That is why it is important to know what foods to eat after miscarriage. Consider iron rich foods to compensate the blood loss of miscarriage. Pregnancy consumes your body iron so also consider replenishing the calcium from dairy and milk products. Consider giving them multivitamin supplements. Feed them with the food they like. Magnesium helps combat depression. Avoid junk food.

DONT’ S

Avoid hurtful comments like “it’s so common”. They can be hurtful and dismissive of their loss. People saying, ‘you’ll get pregnant again’ or ‘oh it wasn’t meant to be’ can be the worst thing to say. As it only makes them feel their loss was not precious.

Avoid blaming Don’t offer advice that could make a woman feel she is to blame. Be sensitive to their loss.

Don’t expect them to overcome in a limited time frame. Recognise the fact that grief doesn’t have a time limit. Give the female her own time to overcome her grief. Some take a few days while some may take a few months.

WHAT CAN BE DONE AFTER A MISCARRIAGE?

• Consult your gynaecologist if not yet done to rule out incomplete abortions, infection , bleeding etc. Your doctor may let you bleed in early pregnancy if the miscarriage is already progressed, might give you medication to facilitate the process or may advice you a dilatation and evacuation procedure to remove the incompletely expelled pregnancy. Even during recovery, keep your doctor in the loop in whatever happens.
• Consult your practitioner after a few weeks to check for complications, if bleeding for more than 7 days, foul-smelling discharge, fevers, chills and abdominal pain.
• You can cry! You can mourn! Let your emotions flow and stabilise yourself. Try to take it easy, though difficult, as a miscarriage is not the end of your fertility.
• Turn to your partner for support — remember that he or she is mourning the loss of a baby too but may show that grief in a different way. Sharing your feelings openly with each other, rather than trying to protect each other, can help you both heal.
• Try not to get affected by some insensitive comments made by people as these are not to hurt you. These comments rather follow the awkwardness they feel during the situation and they speak anything that comes to their mind first .
• Try not getting misguided by the stories of multiple abortions from friends. You are you and your body is not someone else’s. So be confident in yourself about your next pregnancy.
• Try to be with your kids, if you already have, as they keep you busy and do not give time to think about your loss. Kids help you combat your loss faster.
• Try not to be alone.
• Attend counselling sessions and seek professional help if necessary.
• Do not blame self for the same.
• Give yourself time for physical and emotional healing.pain and sadness do abate with time.
• Adopt a healthy lifestyle. Avoid smoking and drinking.
• Eat well to nourish your body.
• Consider multivitamins. Consider taking medicines for your medical disorders regularly. Take folic acid.
• Avoid sex till your doctor’s advice (generally 15 days)
• Consider pads instead of tampons for the next 2 weeks to avoid infection. Don’t douche, don’t go swimming, take showers instead during the immediate period.
• Consult your gynaecologist while planning next pregnancy.
• Try reducing your stress with activities like yoga, exercise, meditation, and counseling while trying to conceive.
• Let your emotions out than silence. Talk…It is when you talk that often, others open up to you that they has similar mishap and you realize, miscarriage is much more common than you actually think.
• It is for you to realize that a miscarriage is not the end and you can get pregnant again. Depending on your menstrual cycle, normal periods should resume in 3-6 weeks. You can try for the next pregnancy once your normal cycles are established.
• Resume your normal activities and work schedule as soon as you feel you will be able to cope up with them.
• Surround yourself with people you love and pamper your soul. Try and hold strong. This too shall pass, we promise.

When you get pregnant again, enjoy it with heart and soul.