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Whatever the reasons, people can find miscarriage quite a shock as well as very upsetting, whether it happens after a few weeks or later in pregnancy. An early miscarriage can be just as distressing as a later one.
Miscarriage can take many forms. It can happen spontaneously. In many cases medical assistance is needed to clear the womb completely. This can be in the form of medicines or it is often necessary for her to have an operation under general anaesthetic to ensure that the uterus (womb) is completely cleared What to expect after a miscarriage?
Following a miscarriage (whether it was natural or assisted with medication or surgery ) It is usual to have pain and bleeding similar to a period, which will usually stop within two weeks. You can take ordinary painkillers for the pain. Your next period will usually come in around four to six weeks after a miscarriage. See a doctor or attend a hospital emergency department if you have strong pain and bleeding (stronger than period pain), abnormal discharge, (especially if it is smelly), or fever. These symptoms may mean that you have an infection or that tissue has been left behind. Try and avoid sex until the bleeding stops and you feel comfortable. You can use sanitary pads until the bleeding stops (do not use tampons). You may bath or shower as normal but it is advisable not to go swimming until the bleeding has stopped Wait for at least one normal period before trying to get pregnant as some research suggests a higher chance of miscarriage if you get pregnant straight away. Use some type of contraception if you don’t want to get pregnant again (please discuss with your doctor)
Checking your blood group It is important to have your blood group checked as soon as a miscarriage is diagnosed. Women with a negative blood type usually need an Anti D injection after the miscarriage. When can I return to my normal activities? Take some rest however you may resume normal activities as soon as you feel able. However, it is wise to ask your doctor for more specific instructions regarding any vigorous or strenuous exercise
Feelings and reactions There is no ‘right’ way to feel following a miscarriage. You may experience a range of physical or emotional reactions, or you may feel very little at all. Some degree of grief is very common, even if the pregnancy wasn’t planned. Try to take it a day at a time and to acknowledge your feelings and reactions as they arise. Most people find it helpful to talk about their feelings. Sometimes it’s difficult to talk to family and friends, especially if you have chosen not to share the news of the pregnancy. You may prefer to talk with a doctor or counsellor if you are having:
Difficulty coming to terms with the loss of your pregnancy Little or no support from your partner, family or friends Continuing feelings of confusion, lack of concentration, recurring thoughts, loss of appetite, not sleeping well Difficulty coping with how your spouse is reacting to the miscarriage Worries about how to deal with feelings of family (including other young children) and friends A sense of pressure to make a quick recovery, and a need for a place where you can adjust at your own pace Difficulty coping with your feelings about other pregnant women, especially relatives and friends Worries about stress on your relationship with your spouse Worries about future pregnancies Worries about going back to work and telling a colleague When is the best time for pregnancy after miscarriage? Give yourself time to heal before attempting to get pregnant again. Physical recovery from miscarriage in most cases will take only a few hours to a couple of days. Your periods will likely return within four to six weeks. Wait for at least one normal period after miscarriage Keep in mind, however, that miscarriage can cause intense feelings of loss. Once you feel ready for pregnancy after miscarriage, consult your doctor for guidance
. One miscarriage. Research has found no evidence to support delaying conception. In fact, some research has shown that women who conceived within six months of having a miscarriage in their first pregnancy had fewer complications than did those who waited longer to conceive. If you're healthy and feel ready, there might be no need to wait to conceive after miscarriage. Two or more miscarriages. If you've had two or more miscarriages, consult your doctor. He or she might recommend testing to determine any underlying issues, as well as possible treatments, before attempting another pregnancy. A molar pregnancy. A molar pregnancy — a noncancerous (benign) tumor that develops in the uterus — occurs when the placenta develops into an abnormal mass of cysts rather than becoming a viable pregnancy. If you've had a molar pregnancy, your doctor might recommend waiting six months to one year before trying to become pregnant. What are the odds of another miscarriage? Miscarriage is usually a one-time occurrence. Most women who miscarry go on to have a healthy pregnancy after miscarriage. Less than 5 percent of women have two consecutive miscarriages, and only 1 percent have three or more consecutive miscarriages. Is there anything that can be done to improve the chances of a healthy pregnancy after a miscarriage? Making healthy lifestyle choices before conception and during pregnancy can help keep you and your baby healthy. Start by taking a daily prenatal vitamin or folic acid supplement, ideally beginning a few months before conception. It's also important to maintain a healthy weight, include physical activity in your daily routine, eat a healthy diet and limit caffeine. Be sure to manage stress and avoid alcohol, smoking and illegal drugs. If you've had multiple miscarriages, future pregnancies need to be carefully planned and monitored. Consult your doctor before conceiving again and see him or her as soon as you think you might be pregnant. What are the special tests recommended before attempting pregnancy after two or more miscarriages? If you experience more than two miscarriages, consider testing to identify any underlying causes before attempting to get pregnant again. For example:
Blood tests. A sample of your blood is evaluated to help detect problems with hormones or your immune system. Chromosomal tests. You and your partner might both have your blood tested to determine if your chromosomes are a factor. Tissue from the miscarriage — if it's available — also might be tested. Procedures can also be done to detect uterine problems. For example: Ultrasound. This imaging method uses high-frequency sound waves to produce precise images of structures within the body. Hysteroscopy. Your doctor inserts a small, lighted telescope called a hysteroscope through your cervix into your uterus. He or she then expands the uterine cavity by injecting it with saline and examines the walls of your uterus and the openings of your fallopian tubes. Sonohysterogram. This ultrasound scan is done after fluid is injected into your uterus though your vagina and cervix. This allows your doctor to look for problems in the lining of your uterus. If the cause of your miscarriages can't be identified, don't lose hope. About 60 to 70 percent of women with unexplained repeated miscarriages go on to have healthy pregnancies.
Consultant Obstetrics & Gynecology MBBS, MD
Rainbow Children’s Hospital & BirthRigh, Banjara Hills.