Any miscarriage is difficult. But a late miscarriage after week 13 of pregnancy can be even more devastating, both emotionally and physically.
Here’s a look at the causes, symptoms, and how to care for yourself or a loved one who experiences a late miscarriage.
Miscarriage is the term used for losing a baby, usually prior to week 20 of your pregnancy. Many early miscarriages are caused by the fetus not developing properly. But there can be other causes, too.
Miscarriages in the first trimester, or before week 13 of your pregnancy, are fairly common. At this stage of pregnancy, many women do not feel symptoms of miscarriage. Also, if it’s very early in the pregnancy, women may not realize that they were pregnant.
A late miscarriage is when you lose a baby after week 13, but before week 20, or during the second trimester.
There are a number of factors that can cause a late miscarriage. Most are related to some abnormality of the fetus’s development. They are usually genetic or structural issues, such as a chromosomal abnormality or heart defect. Trauma can also cause a miscarriage.
The cause can be physical as well. One example is a weak cervix that can’t hold the baby inside when it gets bigger. Some medical conditions of the mother can also be a cause for miscarriages, including chronic conditions that aren’t being managed well.
Some of the physical causes of miscarriage include:
- thyroid conditions
- lupus or other immune disorders
- other genetic conditions
- some infections
While some women may not feel any symptoms of miscarriage, there are some common ones to watch for.
- not feeling movement of the fetus
- vaginal bleeding or spotting
- cramping or pain in your back and/or abdomen
- unexplained fluid or tissue that passes through the vagina
Keep in mind, not all vaginal spotting is a symptom of a miscarriage. Sometimes you’ll experience some spotting in the first trimester of a healthy pregnancy. See your doctor if you’re concerned.
Some miscarriages don’t have a specific cause, or one that can be anticipated. But some women are at a higher risk of miscarriage than others.
The following are risk factors for a miscarriage:
- experiencing two prior miscarriages in a row
- chronic medical conditions
- pregnancy over 35 years old
- being overweight or underweight
- having an abnormally shaped uterus
- a weak cervix
- having invasive prenatal tests (amniocentesis and chorionic villus sampling are examples)
- exposures to substances like alcohol, tobacco, cocaine, NSAIDs, and high levels of caffeine
- low folate level
- untreated celiac disease
While these conditions suggest a higher risk of miscarriage, it doesn’t mean that you can’t have a healthy pregnancy. Cutting out harmful substances like alcohol and drugs and properly managing other conditions can give you a good chance at a healthy pregnancy.
Physical needs and care after a late miscarriage
Physically, your body may recover fairly quickly after a miscarriage. But it depends on how far along you were in your pregnancy and what type of miscarriage you experienced. For those who go through labor and delivery of the miscarriage, it can take several weeks to recover.
You’ll experience some bleeding and cramps similar to getting your period. Most of all, you’ll feel very tired as your body recovers.
Contact your doctor if your pain, bleeding, or exhaustion becomes worse or continues longer than several weeks. Another potentially upsetting part of your recovery may be that your body begins producing milk. If this causes pain or discomfort, be sure to talk to your doctor about taking some type of pain reliever or other ways to help.
You should also talk to your doctor about when you’ll physically be ready to return to work. Every situation is different, and your doctor can help determine when it’s safe and reasonable for you to return.
Emotional needs and care after a late miscarriage
The emotional needs after a late miscarriage shouldn’t be ignored. Losing a baby at any stage of pregnancy is difficult, but even more so in the second trimester.
Every woman will react differently and have different emotions. For some, talking about it helps. For others, moving on and not talking about it may help. It’s important to find what feels right for you and get the support you need. Your doctor can usually direct you to support groups or counselors that specialize in helping you work through all of your emotions after your miscarriage.
You’ll likely feel a wide range of emotions after your miscarriage.
These might include:
- jealousy of others who or pregnant or have babies
It is also important to remember that people will not always know what to say. This can sometimes mean they say the wrong things. Being prepared for these times might help soften the emotional impact.
Consider seeking out others who have experienced miscarriages, particularly late miscarriages, who you can talk to or cry with. Knowing that someone else understands can help you tremendously as you recover.
Getting pregnant again after a late miscarriage
Thinking about getting pregnant again can be scary or stressful. You may also not know how long you should wait before trying again. The first step is to be sure that you’re emotionally ready for another pregnancy and that your partner is, too. Be sure that you’ve completed the grieving process for your miscarriage.
Physically, you’re usually able to have sex two to six weeks following a miscarriage. But it’s important to talk to your doctor about when your body may be physically ready to become pregnant again.
It should be noted that the majority of women will only have one miscarriage. It’s less common to have two or more. So your chances are very good of your next pregnancy being normal, healthy, and full-term. But that depends on any physical issues or medical conditions you have.
If you’ve had more than one miscarriage, your doctor may want to complete some tests prior to approving you to start trying to get pregnant again. Even if you do have a medical or physical condition that makes pregnancy riskier, there are usually steps that the doctor can advise you to take to increase your chances of a healthy pregnancy.
If you experience a late miscarriage, it’s important that you seek out support to help you through both the physical and emotional healing processes. Your doctor can be a great resource for helping you find the support you need and helping you prepare for your next pregnancy.
What can a woman who had a late miscarriage do in subsequent pregnancies to stay healthy?
Stay healthy by meeting with and discussing your pregnancy desires with all of your healthcare providers. If you have a chronic medical problem, like diabetes or thyroid disease, follow directions to manage the condition carefully for optimal health before and during pregnancy. Extremes of weight are other aspects of health that can be modified. Obese and underweight women have an increased risk of spontaneous abortion or miscarriage. Sometimes, a physical problem with the maternal body may need to be corrected, like a septum, or wall, in the uterus. Also, be aware of the damage that can happen to a pregnancy by viruses, medications, and other environmental exposures. Talk to your doctor about how to have a safe pregnancy.Kimberly Dishman, MSN, WHNP-BC, RNC-OBAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.