Things I wish I knew about miscarriage as a midwife before having my own

Please do not read this content if you find it personally triggering.

October is Pregnancy and Infant Loss Awareness Month. So, I would like to talk a little about the things I learned by going through several miscarriages myself, that I wish were taught to care providers and discussed more with those experiencing a loss. Providers are taught about the different types of loss, the risks associated, signs and symptoms, as well as options available for the loss itself (such as passing the miscarriage at home or going for a D&C. Midwives and doctors don’t often know more of the nitty gritty, unless they have personal experience.

I have personally been through early miscarriage and late first trimester miscarriage. These losses have made me a better midwife for those going through loss or those pregnant with their rainbow baby (one name for a baby born after a loss). There are things you can’t learn in books and it is taboo to talk about this topic in many circles. If you are reading this and know me, then you know I don’t often share about this from my own experiences. I decided to open up in order to shine a light on some symptoms that may be surprising.

First, I didn’t know that a miscarriage could feel like labor with real contractions that come and go, that peaks with passing fetal tissue and even a placenta - or it could feel just like a particularly crampy menstrual period.

Second, I didn’t know that my water would break similar to any labor. For me this happened with a loss that occurred at the end of the first trimester. This may not happen in most cases but it could depending on how far along the loss has occurred.

(There may be a period of time with light brown, pink or red spotting that leads to heavier bleeding with clots and tissue. After passing most of the pregnancy tissue and clots, the bleeding should become lighter. If you are having a miscarriage and ever have heavy bleeding that leads to feeling faint, dizzy or unwell you should go to the nearest hospital immediately. If you develop a fever you should go to the hospital because you may have an infection.)

Third, I didn’t know that for losses occurring several weeks into a pregnancy or beyond that there is a very real postpartum period. It is not unusual to bleed for a few weeks after a loss or if it is an early miscarriage to only bleed a week or a little longer. Our bodies need time to recover and even joints may be looser - meaning getting back to exercise may take a few weeks.

Fourth, there may be hormonal changes and emotional ups/downs. This might not be too surprising but it is normal to need some time to grieve the loss. Some people going through a loss may seek privacy, while others may seek comfort from close friends or family.

Fifth, I believe this is fairly rare but I experienced intense headaches for a few weeks after one of my losses. Postpartum headaches are associate with preeclampsia but can also be a benign, yet unpleasant symptom in the postpartum (including after a loss). Any persistent postpartum headaches indicate a need to get your blood pressure checked asap and seek care with your doctor or midwife.

Sixth, if you have experienced a loss you may always remember and feel some sense of grief. It does take time but it gets better.

Lastly, in subsequent pregnancies, it is normal to need lots of extra reassurance. It’s perfectly normal to want additional ultrasounds, heartbeat checks and labs work. Getting to the point of feeling baby move is often very reassuring.