What happens after miscarriage

It can be very distressing to have a miscarriage. But aside from the emotional sides of things, there are practical things to decide on and your health to consider.

What should I do if I’ve miscarried at home?

If you wish to, you may decide to collect your baby in a container to show your doctor. Depending on your circumstances, your doctor may send the baby to a laboratory for testing to try to find out why it happened.

What will happen if I miscarry in hospital?

If you miscarry in hospital, you may decide that you wish to see your baby. Whether or not this is possible depends on:

• the stage of your pregnancy
• when the baby died
• whether you had a dilatation and curettage (also called a D&C or curette)

Sometimes your baby may no longer be recognisable, and the staff may advise you not to view the remains.

If you think you would like to see your baby, discuss your wishes with the hospital staff.

Are there any legal obligations?

Legal obligations following your miscarriage may vary according to your state or territory. Your hospital should inform you of any requirements.

Generally, if you lose your baby in the first 20 weeks of pregnancy (defined as a miscarriage), the birth and death of your baby cannot be formally registered. This means that you will not receive a birth or a death certificate.

Some state governments, such as NSW and Queensland, offer optional certificates recognising early pregnancy loss to support parents grieving a miscarriage. If this interests you, please contact the Births, Deaths and Marriage Registry in your state or territory to find out if similar certificates are available.

You are not legally required to have a funeral, burial or cremation, although you may choose to do so.

What services will the hospital offer?

The services offered for miscarriage vary between different hospitals.

Some hospitals offer services such as:

• saving the pregnancy tissue from a D&C where possible (provided you have explicitly requested this)
• arranging to have pregnancy tissue cremated at your request
• giving you back the pregnancy tissue for your own private burial or cremation

If you do not make any specific requests, the pregnancy tissue is commonly examined in a laboratory and then cremated according to the hospital protocol.

Some hospitals raise these issues with you. If they do not, it is important to raise these issues yourself.

Can I have a memorial service?

Some hospitals offer shared memorial services to commemorate the loss of all babies.

Your hospital may also offer bereavement support.

Can I have a funeral?

While there is no legal obligation to have a funeral, burial or cremation after a miscarriage, you may choose to make your own arrangements to mark the loss of your baby.

You may choose to engage a private funeral director or approach your religious leader for advice about having a funeral, burial or cremation. Alternatively, you may decide to bury your baby at home.

How long will it take to physically recover from a miscarriage?

How long recovery takes depends on how far along you were in your pregnancy, the treatment you needed and whether or not you had any complications.

Bleeding and discomfort

You may have discomfort and bleeding for up to 2 weeks.

Things to consider:

• use pads for the bleeding, not tampons
• use medication such as paracetamol for the discomfort
• avoid sex and swimming until the bleeding stops

See your doctor or go to your nearest emergency department if:

• the bleeding becomes heavy (soaking 1 to 2 pads in an hour) or goes on for longer than 2 weeks
• you pass large blood clots
• you have severe pain
• you have a temperature
• you have signs of infection, such as a temperature or a smelly vaginal discharge

Other changes

You may find the nausea gets better, and your breasts decrease in size and become less tender.

If you have had a miscarriage near 20 weeks, your breasts may produce milk. Please talk to your doctor or midwife if you have any questions or concerns.

When should I follow up with my doctor or midwife?

You should have a check-up with your doctor or midwife as soon as practical. Your doctor or midwife can provide support, answer questions and advise about contraception.

Your doctor may want to order further tests, including:

• your blood group — if you have a negative blood group, your doctor may recommend an anti-D injection. If this is required, it is best given within 72 hours
• your haemoglobin level — if you have anaemia (low blood haemoglobin), your doctor may recommend a diet to follow and iron tablets

What does this mean for future pregnancies?

If you have had a miscarriage, the next pregnancy will usually be normal. After a miscarriage, the chance of you miscarrying again is low (1 in 5 women). If you have had 3 or more miscarriages, your doctor may recommend you that you see a fertility specialist.

How soon can I fall pregnant again?

Fertility can return immediately after a miscarriage, so consider using contraception until you are ready to start trying again.

If you fall pregnant straight after having a miscarriage, the risk that you will miscarry again is slightly higher. For this reason, doctors recommend that you wait until you have had at least one period before trying to get pregnant again.

How do I plan for another pregnancy?

Planning for pregnancy after a miscarriage can be confronting. It is important that both you and your partner are physically and emotionally ready for another pregnancy. Your doctor or midwife can provide advice about emotional support, falling pregnant again and lifestyle changes that may help you have a successful pregnancy.

Who can I talk to for advice and support?

Talk to your doctor or midwife for information and advice on what do and how to look after yourself if you experience a miscarriage.

Your hospital should be able to provide details of available support services, such as bereavement support.

Red Nose Grief and Loss provides support for miscarriage, stillbirth and newborn death. Call their support line on 1300 308 307, available 24 hours a day.