What Will Happen After a Miscarriage or Stillbirth?

If you have miscarried, your doctor will do a pelvic exam and an ultrasound test to confirm the miscarriage. If the uterus is clear of any fetal tissue, then there won't be any more treatment. But if the uterus still contains the fetus or portions of the fetus, the doctor will dilate the cervix to perform a dilation and curettage (D&C) - a scraping of the uterine lining - or a dilation and extraction (D&E) - a suction of the uterus to remove fetal or placental tissue. You may have spotting or mild cramping after these procedures, which are done under local or general anesthesia so there is no immediate pain.

If it is determined that your baby has died in utero after the 20th week, the doctor might decide to induce labor and delivery. After the delivery, the doctor will examine the baby and the placenta to help determine the cause of death if it's still unknown.

If you've had several miscarriages, you may want to be evaluated to see if any anatomic, genetic, or hormonal abnormalities are contributing to the miscarriages.

Can Miscarriages or Stillbirths Be Prevented?

Although miscarriage and stillbirths usually can't be prevented, there are precautions you can take to increase your chances of having a healthy pregnancy:

• Maintain a proper diet loaded with folic acid and calcium.
• Exercise after you've gotten your doctor's OK.
• Avoid drugs and alcohol.
• Avoid deli meats and soft cheeses such as feta and other foods that could carry listeriosis.
• Limit caffeine drinks to no more than 1 to 2 cups a day.
• Stop smoking.
• Talk to your doctor about all medications you're currently taking. Unless your doctor indicates otherwise, many prescription and over-the-counter medicines should be avoided during pregnancy.
• Avoid abdominal trauma.
• Get immunized against communicable disease and know your family medical and genetic history.

Trying Again

If you've had a miscarriage or stillbirth, it's important to take time to grieve. The loss of a baby during or shortly after pregnancy is like the loss of any loved one. Give yourself time to heal emotionally and physically. Some health care providers recommend that women wait 3 months (three menstrual cycles) or more before trying to get pregnant again to give their bodies and psyches time to heal.

Here are some other things that you can do to help get through this difficult time.

• Attend a support group. Ask your doctor about local support groups for women who are expecting again after a loss.
• Find success stories. Other women who have made it through a subsequent pregnancy after having a miscarriage can be a great source of encouragement to you. Your doctor may be able to give you the name of someone to talk with.
• Request frequent prenatal visits. Even if you aren't medically high-risk, ask your doctor if you could schedule prenatal appointments more often for your own peace of mind.
• Be proactive. The more you know about the medical aspects of your pregnancy, the better you'll be able to discuss treatment options and outcomes with your doctor.
• Monitor the baby's movements. If you're far enough along - usually between 18 and 22 weeks, but sometimes not until 28 weeks - to feel kicks and jabs, keep a log of the baby's activities each morning and night and report any abnormalities or lack of movement to your doctor. If your baby isn't moving, eat or drink something sugary and lie down on your side. If you don't feel kicks about 45 minutes after you've consumed the sugary substance, call your doctor immediately.
• Try not to compare. No two pregnancies are exactly alike, so try not to dwell on any similarities between this pregnancy and the one that ended in a loss.
• Stay focused on your goal. You may feel like you've been pregnant forever, but it helps to remember that before long, the pregnancy will be a distant memory. If you didn't believe a good outcome was possible, you wouldn't have made the decision to try again.