mental health, Miscarriage

The aftermath of loss: what comes after the miscarriage?

After four pregnancy losses, you’d think I’d know what to expect in the days and weeks after miscarriage. But I don’t, because each time I’ve found myself in this unenviable position, the aftermath has been different. 

Miscarriage One

After miscarriage #1 came devastation. Not only in an emotional sense, but also the physical changes as my body returned to normal and I was forced to acknowledge the pregnancy was over.

Physically, after the shock of how raw and violent the natural miscarriage was, the days immediately afterwards felt calmer and filled with smaller changes. However, I was unprepared for how long it would take for my body to feel itself again. My breasts took weeks to return to their usual size, energy levels were slow to increase, bleeding tapered off slowly, cramping lingered before eventually settling down. It was a slow, incremental return to normality. A few weeks after my miscarriage, I was feeling – physically at least – back to my usual self.

But the emotional shock was hard to cope with. We were so invested in this pregnancy, we had planned so much for our baby’s arrival. To go from the certainty of an extra person to this most profound loss takes time to process. And I’m not sure I ever really did, in my haste to get pregnant again. 

Miscarriage Two

Miscarriage #2 was different altogether and had a longer recuperation period. Unlike my first miscarriage, which required only one hospital visit to confirm a ‘missed miscarriage’, my second loss was treated as a suspected ectopic pregnancy. As this meant it could be located anywhere outside my womb, it had a higher risk associated with it. I had a hospital visit every other day for blood tests, anxious waits to find out hcg levels, multiple scans to check my fallopian tubes and regular meetings to discuss how to proceed. All the while struggling with pain and constant bleeding. The miscarriage process lasted around 6 weeks, but it felt like 6 months, the days crawled by so slowly. 

And after this miscarriage came a level of fear I’d not had before. I didn’t trust my body. What had gone wrong? How could I know the same thing wouldn’t happen next time? A period of uncertainty followed, not knowing what our future held and unconvinced whether I wanted to try again at all.

Miscarriage Three

The next miscarriage, like miscarriage #1, was confirmed at an ultrasound scan  – this time at 9 weeks gestation, when I was 10 weeks pregnant. This time, my body had shown no signs that the pregnancy had failed and the now-familiar sense of failure was like hitting a wall emotionally. I felt paralysed, stunted, unable to see a way forward. 

Physically, this loss was managed with surgery, something that was supposed to minimise the physical trauma. However, I continued to bleed for many weeks after surgery, it was 11 weeks before I had a period and longer than that before my hcg levels reached zero. Despite asking for a scan to make sure all the ‘products’ had been removed, I was told it wasn’t necessary, as this situation that seemed so unusual to me was actually quite normal. 

It took me three months to reach a stable place emotionally after this miscarriage and I am sure this was, in part, due to how long it took me to normalise physically. 

Miscarriage Four

My most recent loss was another missed miscarriage, confirmed at a scan when I should have been 9 weeks pregnant. Due to this loss happening during the Coronavirus pandemic, I was initially told that there was no management – medical or surgical – available, and that conservative management, or waiting it out, was my only option. By now, I’ve had a naturally-managed miscarriage and a surgically-managed loss, so I know that surgery is my preferred option. And so, a week later, with no sign of the miscarriage starting, finding a hospital that agreed to surgery was a huge relief. And although the procedure is unpleasant, it is so much easier than facing weeks of waiting, stuck in that hellish limbo where your body is still officially pregnant but there is no living baby. 

I’m still in the early stages of this miscarriage’s aftermath, but I’ve been particularly surprised by the physical sensations this time around. My breasts have been agonising, my abdomen sore and swollen, and I’m having debilitating headaches. But I’m also seeing my hcg levels drop more rapidly and the bleeding has almost stopped.

Emotionally, I am mainly numb. There are periods where intense grief will take over and I sob. But that is generally followed by hours, maybe days, when I feel little at all, other than a sense of lack – lack of motivation, of hope, of that spark of joy that’s so necessary in life.

With every miscarriage impacting on me so differently, and when I’ve had little idea of how I’ll feel one day to the next, I understand it must have been difficult to be a friend to me, at times. Conscious of shutting people out during previous losses, I’ve tried to stay more connected this time. And where I’ve felt forgotten in the past, like people had stopped caring after the physical miscarriage has completed, I now understand better why this happened.

To show love, people need to feel their love will be welcomed. And I think I’ve struggled with welcoming love in the past. I’ve felt little reason to love myself and so have doubted that anyone else could genuinely care for me, or what I’ve been through. Challenging this belief has been something important for me during this fourth loss. And I’ve noticed it has allowed certain friends to be much more present in the process, which has been unbelievably valuable. 

Immediately after all my losses, I’ve felt disconnected from my normal life routines. Work has been particularly difficult. It all seems so futile and unimportant in the face of losing a baby. I have needed significant time off work after each miscarriage before I could return to that part of my life in a meaningful way. And although I’ve dealt with feelings of guilt about this, I know it has been really important for me and my recovery.

Generally, I’ve found that straight after a loss I flounder, struggling to find meaning, purpose and interest in the things that provided it before. And I’m finding this aspect particularly difficult after miscarriage #4. With the multiple limitations placed on life during the pandemic, I feel like a caged animal, wanting to return to normal life, except normal life doesn’t exist anymore. It’s difficult to let off steam when you’re stuck in the same house you’ve been in for the last four months. And so the numbness sits, with nowhere to go.

I am trying to return to exercise as a way to improve my mood and feel stronger and more positive about my body. Motivation is difficult, but I know the effort will pay dividends in the long run. 

Having our most recent loss genetically tested is also a positive step forward for me. Our third miscarriage was the first to be genetically tested, as is standard practice in the UK. That baby had a chromosomal abnormality, which helped to divert the auto-blame away from me and towards acceptance that there was nothing that could have changed the outcome. I hope I will find the same relief from genetically testing this pregnancy. 

I am also lucky, given current circumstances, to have been placed on a priority list for NHS counselling after this miscarriage. I have a lot to work through, in terms of processing my losses to date, as well as figuring out my thoughts on what might and might not work for my husband and I going forward. Should we try again at this point? Can I actually face trying again? If so, should we continue to try naturally, or is IVF with genetic testing our best route? Or, is this the point at which we call quits on having children and move forward with different plans?

Whatever comes next for us, it’s clear that the period immediately after a miscarriage is both physically and emotionally painful. Grieving is hard. Processing what has gone and what is to come – simultaneously – is draining. And I suppose that’s the only way it can be.  

There’s a quote by Jamie Anderson that really resonates with me at the moment: 

“Grief, I’ve learned, is really just love. It’s all the love you want to give, but cannot…Grief is just love with nowhere to go.”

3 thoughts on “The aftermath of loss: what comes after the miscarriage?”

  1. Hi Carly, Firstly, I am so sorry for your losses and I am sending love to you at what I know is a very difficult time (that word is not enough to cover it I know). Secondly, I just want to thank you for this blog I need it so much right now as I work my way through my fourth loss which seems never ending as the hcg levels refuse to go down this time, so I have had scan after scan and blood test after blood test whilst they try to work out what is going on. Anyway all this to say thank you. This blog is helping me more than you know.

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    1. I’m so sorry for what you’re going through, Jenny. It’s just the most awful thing, isn’t it? I really hope they find out why your hcg levels are taking so long to hit zero, you don’t need that added stress during what’s already an incredibly difficult experience. Sending you so much love 💕

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      1. Hi Carly, it really is isn’t it, we finally got an answer yesterday after we saw the consultant at the EPU and she said it is because the pregnancy sac is still there, not sure how everyone else missed it but at least we know now and I can start to make my way through this. Thank you so much for you love and kindness, I am thinking of you and sending you love in return.

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