Miscarriage feels devastating. When all you want is a baby of your own, it seems like your own body is not cooperating. What’s more, you have to deal with the hormonal disruption that miscarriage brings, which further affects mood and energy levels. 

To top it off, miscarriage is still surprisingly taboo. You may feel isolated even when surrounded by others. You may feel like your partner doesn’t fully understand. You may even dread going on social media when all you see is a shower of friends’ baby photos.

Miscarriage is all too often shrouded in silence. Yet despite this silence, miscarriage is very common – with around 1 in 5 pregnancies ending this way. Crucially though, the majority of these women go on to have successful pregnancies. So if you have experienced miscarriage, hope is not lost. Read on for information on miscarriage causes, when to try again, and when to seek screening and miscarriage treatment. 

What happens to your body after a miscarriage?

Cramping

You will experience cramping as the pregnancy passes, because your uterus is contracting to help get the pregnancy and related tissue out. Some women liken this feeling to bad period pain, others who have previously gone through labour liken it to labour contractions. After you have passed the pregnancy, you might experience less severe pains for around a day or so, and ibuprofen and paracetamol should be helpful. If the pain feels unmanageable, contact your GP, gynaecologist or early pregnancy unit, or call 111. 

Bleeding

The level of bleeding you experience during and after a miscarriage normally depends on how far along you were in the pregnancy. During the miscarriage you may bleed heavily and pass large clots and pregnancy tissue. After you have passed the pregnancy, bleeding will usually continue for between 1 and 4 weeks. As time passes, the bleeding should become lighter and the blood may turn brownish. Use sanitary towels as opposed to tampons or menstrual cups, because putting anything inside your vagina following a miscarriage can heighten your infection risk. 

If you experience bleeding that makes you lightheaded, ill, or faint, or if you are soaking a heavy sanitary towel more than once an hour for over a few hours, seek medical care immediately. 

Other potential after-effects

You might experience other after-effects and this can vary depending on the management of your miscarriage. For example, if you were given medicine to help complete a miscarriage, you may temporarily experience symptoms like:

• Nausea and/or vomiting
• Diarrhoea 
• Rash 
• Shivers 

If your miscarriage was managed surgically you will be given a local or general anaesthetic and you may experience short-term symptoms like:

• Shivering
• Nausea and vomiting 
• Short-term memory loss and disorientation 
• Soreness 
• Dizziness 
• Headaches 
• Blurry vision
• Weakness, numbness and muscle twitches 

Side effects of anaesthetic shouldn’t go on longer than a day or so. If you are concerned, contact the hospital where you were given treatment or call 111. 

Your hormones 

Following a miscarriage, your pregnancy hormones will start to drop. The speed at which this occurs will vary from woman to woman. Once the bleeding ceases, your hormones should go back to normal little by little. Other symptoms of pregnancy like tender breasts and nausea will gradually dwindle and then stop completely.

In addition to the grief of losing a pregnancy that many women feel, these hormonal changes can also affect your energy levels and mood. You may feel fatigued, experience sudden shifts in mood, and cry or get upset more quickly. 

Some women also suffer sleeplessness, oversleeping, anxiety or breathlessness after a miscarriage.

About 3 weeks after your miscarriage, your doctor may ask you to complete a pregnancy test to ensure the miscarriage is not incomplete (if it is, you may need medicine or a procedure to complete the process). 

When can I try for a baby again after a miscarriage?

Dr Amin Gorgy, Fertility Consultant at The Fertility and Gynaecology Academy says: “If you usually have a regular menstrual cycle, you can normally expect your next period about 4-8 weeks following a miscarriage, and it may take a few months to return to a regular cycle.

‘However, you will ovulate before this, and you may actually be fertile in the month following a miscarriage. So if your miscarriage symptoms have cleared up, you may want to start trying again. Sometimes doctors advise waiting for your first period before you start trying again because it can make early scanning and dating of a new pregnancy more straightforward. But really it is your choice. 

“However, you must not have sexual intercourse until all your miscarriage symptoms (e.g. bleeding) have cleared up, because you are at greater risk of infection otherwise.”

I’ve had a miscarriage. Will I have a successful pregnancy?

If you have had a miscarriage, there is every chance you will go on to have a successful pregnancy – and most women who suffer a miscarriage indeed do. However, three things are important to note:

1. The more miscarriages you have had, the more likely you are to suffer another.
2. Two or more miscarriages can be defined as ‘recurrent miscarriage’ and you should seek testing and possible miscarriage treatment. 
3. The most common miscarriage risk factors are advanced age of the mother, advanced age of the father, and a history of pregnancy loss. 

As we always say here at The Fertility and Gynaecology Academy, time is fertility. If there is a problem, it is better to get to grips with it sooner rather than later, in the form of testing and miscarriage treatment.

Why have I miscarried? Miscarriage causes and miscarriage treatment

• Chromosomal abnormality: By far the most common miscarriage cause is chromosomal abnormality in the embryo/foetus. Chromosomes are threadlike structures composed of protein and DNA, that carry genetic information to govern the baby’s development. If an embryo is home to too many or too few chromosomes, it won’t develop properly. Chromosomal abnormality is out of the mother and father’s control, and most of the time when it happens, the couple will go on to have a successful pregnancy in future. However, some couples suffer recurrent miscarriage (two or more miscarriages in a row). The Fertility and Gynaecology Academy is one of a few UK clinics that can actually offer in-house Pre-implantation Genetic Screening to test for chromosome abnormalities in a couple’s embryos during IVF/ICSI, to avoid the transfer of abnormal embryos into the uterus. 
• A health condition in the mother such as a thyroid disorder, unmanaged diabetes, or a kidney disease can lead to miscarriage. If you are experiencing miscarriage, it is important to have a thorough health consultation, to make sure any underlying conditions that could make carrying a baby to term difficult, are both diagnosed and properly managed. 
• Undiagnosed infections like gonorrhoea or chlamydia can cause miscarriage.
• Weakened cervix: Also known as ‘cervical incompetence’, this is when the cervical muscles cannot support the pregnancy, leading to miscarriage or preterm labour. This problem can sometimes be treated with progesterone supplementation and/or monitoring. Other women may need to have a ‘cervical stitch’ whereby a stitch is placed around the cervix to try to keep it shut until your final month of pregnancy. 
• Abnormalities in the womb can make it difficult to carry a baby to term. These include polyps (benign growths), scar tissue, adhesions, or even a septum you’ve had since birth (an extra piece of tissue in the womb creating two cavities instead of the usual one). In many cases where there are uterine abnormalities, miscarriage treatment involves surgery to correct them. 
• Immune system problems: In some women who suffer recurrent miscarriage (two or more miscarriages), the issue may be with the immune system. For instance, if the natural killer cells which work to defend a woman from disease are too numerous, they may set upon the embryo or tamper with the endocrine system that governs her vital pregnancy hormones. At The Fertility and Gynaecology Academy, we specialise in recurrent miscarriage treatment and are experts in an area of fertility medicine known as reproductive immunology. In a specific subset of miscarriage sufferers, reproductive immunology may work to diagnose and treat problems in the immune system that could be compromising a woman’s ability to carry a baby to term.