What to Expect: Natural Miscarriage

***Trigger Warning: This blog post discusses miscarriage and pregnancy loss.***

During my third pregnancy, I had an appointment for an ultrasound at eight weeks to check on my baby. I was anxious that something might be wrong, but I was mostly hopeful. My doctor had used a handheld ultrasound the week before and could only see a small and blurry image. She thought she saw a heartbeat but wanted me to have a follow-up ultrasound on a better machine a week later.

At the eight-week ultrasound, I had a strong feeling that something was wrong. As soon as the technician turned on the ultrasound machine, it became apparent that there was no fetal heartbeat. The ultrasound image was eerily quiet, and the technician refused to answer my questions. Instead, she told me that the doctor would discuss everything with me.

Finally, after what felt like an eternity of waiting alone, I was taken back to my room to meet with the doctor. As soon as she opened her mouth, words came out like a flood, and I felt overwhelmed, struggling to stay afloat. Amidst my emotional overwhelm and tears, I tried my hardest to understand her words as she mentioned that I was likely having a miscarriage and presented some options.

I dragged my heavy feet out the door and spent an exhaustingly long car ride home with my mom and sister. After we finally made it home, I rushed to my room to cry. While my ears heard the words that were just said to me, my brain and heart were struggling to process what “I’m having a miscarriage” actually meant. All I could think was, what was about to happen to me?

Let’s Talk About It

While there are so many books on pregnancy, including the popular What to Expect When You’re Expecting, there’s definitely no What to Expect When You’re Miscarrying. Although it is a situation that I would not wish upon my worst enemy, unfortunately, miscarriages do occur. In fact, they happen in one in four pregnancies. Dealing with a miscarriage can be a very isolating and confusing experience. Women are often sent home with a paper explaining their options and are expected to return to work a day or two later. The cultural stigma and lack of discussion in daily life often leave moms feeling alone and in the dark in an already difficult time.

During my own miscarriage, I was fortunate enough to have many people checking on me and supporting me. Still, no one extremely close to me had gone through the same thing. If you are experiencing or have experienced a miscarriage, please know you are not alone. You also don’t have to be left in the dark. I am writing this blog post today as the big sister that I wish I had when I walked this tough road. As someone who has been in your shoes, let me hold your hand and share my experiences with you – the good, the bad, and the ugly – so you know what to expect.

DISCLAIMER

Please hear my heart, Mama. I can’t speak to other ways to deal with miscarriage because I chose to pass my baby naturally. However, you must know there is absolutely no right or wrong, no best or worst way, to miscarry. Every woman’s decision-making process is complex and personal, taking into account medical, work, family, and mental health factors. Once she has made her decision, she doesn’t owe anyone an explanation. There are many types of miscarriages (blighted ovum, ectopic pregnancy, molar pregnancy, and more) and several options for how to respond as well. I am simply writing about natural miscarriage because that is the type I experienced and, therefore, the only type I can fully prepare other women for.

Options for Miscarriage

If you have received the news that you are experiencing a miscarriage, you will need to decide how you want to proceed. If an embryo or an empty sac has been found, it will need to be passed. Even if no embryo has been detected, the uterine lining will usually have thickened and will need to shed. Once you are aware that you are miscarrying, you have a few options for how to handle it:

Expectant Management (Natural Miscarriage)

Usually, if a miscarriage occurs in the early stages and/or there are no complications, you may be given the option to wait and see if your body will naturally expel the baby or the uterine lining. However, if this doesn’t happen within about two weeks, your doctor will likely want to intervene with the next course of action to avoid any risk of infection.

Medicine

There is another option available for miscarriage which involves taking a medicine called misoprostol, which is sold under the brand name Cytotec. This medicine helps to stimulate the uterus and open the cervix, which in turn helps to expel the contents of the uterus. It usually starts working within a few hours. Your doctor may prescribe either oral or vaginal pills.

This choice is preferred by mothers who wish to complete the process as soon as possible and begin to move on quickly. It is also chosen by some mothers who want to have a better idea of when their miscarriage will occur so that it doesn’t happen unexpectedly while they are at work or engaged in other activities.

D&C

Dilation and curettage is a medical procedure in which the doctor opens the cervix and removes the tissue from the uterus. Sedation and general anesthesia are often used during the procedure. Many women also opt for this option to have more control over the timing of their miscarriage. Additionally, it may be necessary if the mother has any retained tissue that won’t come out on its own, as it can cause serious infection if left untreated.

My Personal Reasons for Choosing to Miscarry Naturally

As stated above, there is no right or wrong choice for how all women should miscarry. How a woman miscarries is a deeply personal decision. I’ll explain the reasons that I chose to miscarry naturally to help you understand what was going on in my mind and to help you think through what you want to do in your own situation. If you choose to miscarry naturally, you may have similar or different reasons for choosing to go that route. Again, how you choose to miscarry is deeply personal, and no one else needs to know why or judge the way you choose.

Protection

I didn’t want to deal with any more medical procedures or feel like my miscarriage was just another medical issue that needed treatment. The doctor who diagnosed my miscarriage was impersonal and harsh. I didn’t like how she made me feel. I wanted to protect the rest of my experience by honoring my baby’s life in my own home and in my own way.

Flexible Schedule

I didn’t work outside the home and had family to help with my toddler, so I didn’t have to rush back to work for a deadline or have any other time constraints. I was already mourning and wanted to experience the miscarriage at the pace my body needed so that my mind could process everything as well.

Physical Connection

I had guilt from my first birth, which was an elective induction. My baby reacted poorly to the medicines, and I felt it could have been avoided if I had not been induced. I had hoped to deliver my next baby naturally to redeem the situation and choose a better way. However, I knew a future birth was not guaranteed. Also, after being numbed for my only daughter’s birth, I wanted to physically feel as much as I could of this experience so I could feel some bonding and connection with this baby.

Honor Life

I believe every baby, no matter gestational age, is a human with value. I wanted to find my baby intact in the sac if at all possible so I could bury whatever I found. I thought that it would be healing and bonding for me to lay eyes on my baby and then honor him or her with a burial.

What to Expect Before

So you’ve received the news and you have decided to have your miscarriage happen naturally. Here’s what you can expect to happen beforehand.

Waiting Period

You may already have bleeding and have discovered something was wrong by getting that checked. Or, you may be like me and find out in an ultrasound that the baby has no heartbeat. Either way, until you have heavy bleeding and entirely empty your uterus, there is a waiting period. You may have hours or days that you wait. I waited about one week from my doctor’s visit until my body fully miscarried.

The most significant difference about choosing to miscarry naturally is that your body may lose the baby at any time, and it is out of your control when that will be. Plan to take off work or arrange childcare if you stay home with older kids. You want to be in the privacy of your home and have your children taken care of so you can focus on you and your body when it happens.

Ultrasounds and Doctor’s Visits

You will have at least one more doctor’s visit to check how things are going. You will most likely have an ultrasound to make sure your uterus fully empties and does not have any remnants, which may end up causing you to need to take medicine or have a D&C. In my case, nothing else was needed after I had my final ultrasound and doctor’s visit. You never know what may be happening in your body, so it is essential to get checked, even though you may find it exhausting or emotionally painful to keep seeing your doctor for this issue.

Physical Symptoms to Expect

Once your body is ready to pass the baby, you will experience any combination of the following symptoms. I experienced all of these personally.

Bleeding

Your body will bleed, which is its way of emptying the contents of the uterus. It may start lightly as a period does. Light bleeding could last for days before the heavy bleeding begins. Once your body is fully ready, expect bleeding to be very heavy and to come in waves for a few hours. I had light bleeding start the night that I found out I was miscarrying. It lasted about one week before I had heavy bleeding and passed my baby.

Clotting

Once the heavy bleeding begins, clots are soon to follow. Clots can be pretty large, and there is usually a surprising amount of blood and clots that come together quickly. Even in early pregnancy, we do not realize how much blood our uterus holds. For me, the heavy clots came in waves for a couple of hours. I cannot stress enough how unprepared I was for the amount of heavy bleeding and clots that came.

Cramps

Your uterus will cramp to expel its contents. Some women even experience contractions that feel like labor. I had very mild cramps. I was more shocked by the blood and the emotional pain to notice the cramps.

Pain

You may experience pain ranging from mild to severe. Every woman’s pain tolerance is different. You are welcome to use pain medication if desired. Again, I didn’t notice much physical pain in the moment because I was so shocked by everything else that was going on. That may not be the case for every woman.

Possibility of Seeing Baby in the Sac

You will likely find the baby in the sac if your baby developed enough. Laying eyes on your baby is something you may or may not want to do. I hoped to find my baby in the sac so that I could have closure and honor the little life in the way I wanted to, which was to bury the baby.

I chose to pass the baby in a plugged shower so the sac wouldn’t drain away or get lost in the toilet. I did see my baby in the sac, who had stopped living at six weeks and two days. It looked just like the pictures you can find online of a baby at that gestational age. It was indescribable and will be ingrained in my memory forever. While this was healing for me, I fully understand that not every mom may feel the same way about experiencing something similar.

What to Expect Physically After

After your body has finished mostly emptying the uterus, most of your heavy bleeding will start to subside. You may still experience period-like bleeding for a few days. Here are the other things you should expect to experience physically after you miscarry:

Mess

After so much heavy bleeding, there is likely to be a mess. I had moved from the toilet to the shower, so there was blood all over the bathtub, shower curtain, and floor. Even though I stood still once I got in the shower, there was so much blood to clean up afterward. I was grateful to have family that helped me clean as I was in a state of shock directly afterward and needed to rest.

Soreness

I was not prepared for the amount of soreness I felt afterward. I was in shock and stood frozen and hunched over for a few hours, which caused me to have tight and sore hips and glutes for several days. Additionally, I had intense soreness that wrapped around my lower abs and lower back for a few days, which was excruciatingly painful and different from the feeling I get after a tough ab workout. It is a pain I will never forget and have never experienced since.

Additional Pregnancy Tests

After experiencing a miscarriage, you may be advised by your doctor to take a pregnancy test a few weeks later to check if your hormone levels have returned to normal. Personally, this was a difficult experience for me as I had taken a pregnancy test with excitement and anticipation only weeks before. Taking a pregnancy test knowing I would not be pregnant triggered several emotions and made the situation even harder to process.

What to Expect Mentally After

Every woman experiences her own timeline of emotions during a miscarriage. However, there are some common emotions that you can expect to feel even though you may feel them in a different order than someone else:

Mental Fog or Numbness

When you receive the news of your miscarriage, you may feel like you’re in a daze or fog. It can be hard to process what is happening, and you may find it difficult to focus on anything else, such as work or taking care of other children. I am grateful that I had my family to help me watch my toddler during this time because I also felt mentally out of it and like I was in my own world.

Betrayed by Your Body

You may feel that your body has let you down by being unable to support the life that was growing inside you. The news of having a baby in your body that is no longer living can evoke an incredibly strange feeling. I know from personal experience that it can be difficult and overwhelming to process.

Sadness and Depression

During this time, it’s normal to experience extreme sadness and depression, which may make it difficult for you to get out of bed. You may also have trouble sleeping or feel the need to sleep more than usual. Personally, I found that taking naps and sleeping more helped me manage my pain and cope with these feelings. It is important to note that if you feel like harming yourself or your other children, you need to call the National Suicide and Crisis Hotline at 988 immediately.

Hopelessness

After experiencing a miscarriage or stillbirth, it is common to feel that you have lost your sense of purpose and hope. You may have already set a due date, bought baby items, and imagined what life would look like with your child. These hopes and dreams can suddenly be taken away from you in just a few minutes, leaving you feeling lost and directionless. Personally, I also experienced a sense of purposelessness after my loss and had to redirect my focus towards new goals and aspirations.

Feeling Like You Must Carry On

It’s understandable to feel like you need to keep going when you have other children to care for or a deadline at work. While it’s important to maintain routines and cope with these challenges, it’s also important to give yourself time to rest and grieve. Don’t feel pressured to rush the healing process. Instead, seek help and support, and remind yourself that work or other responsibilities can wait. Your children will be okay if you need to take a break from being their primary caregiver for a while. It’s okay to ask for help, especially when recovering physically. In hindsight, I wish I had asked for more help with my toddler so I could have had a little bit more time to physically heal and mentally grieve.

Fear of the Future

it is completely normal to have fears and worries over your fertility and future family planning. It is also completely normal to worry if something is wrong with your body and to seek further testing. You may save the baby’s remains and get them tested to see if the baby had chromosomal abnormalities or not. I personally got some testing done for myself after my miscarriage. I experienced a whirlwind of emotions as they thought they had found a cause, only to be told during further testing that no known cause existed. To this day, my best guess is that my baby had chromosomal abnormalities. However, that was never confirmed with testing.

Jealousy

It is completely normal to feel feelings of jealousy, fear, anger, or any of the above feelings when you see a pregnancy announcement or when you go to the doctor for your follow-up visits and see pregnant women. I found it incredibly hard to hear friends announcing pregnancies so soon after my loss. I found it even harder to go to the doctor’s office myself for my miscarriage follow-up care while being surrounded by pregnant women.

Guilt

It is common for women to experience guilt if they did not plan to become pregnant or if they feel relieved upon discovering a miscarriage. They may believe that these thoughts are too terrible to express, which causes them to feel even more guilty. However, these feelings are normal and should not be a source of shame.

Women mahy also feel guilty because they think something they did caused the miscarriage. Miscarriage is most often caused by chromosomal abnormalities or health problems with the mother. Mayo Clinic says “Most miscarriages happen because the unborn baby doesn’t develop properly. About half to two-thirds of miscarriages in the first trimester are linked with extra or missing chromosomes.” I encourage you to experience your natural feelings without being burdened by guilt for something that happened beyond your control and that you did not cause.

Grief

It is common to experience all of the stages of grief. However, these stages are not usually felt in a predictable linear order but rather in a repeating cycle. It is important to allow yourself to feel all of the emotions associated with grief. It is necessary to understand that although you may never get over your loss, you will eventually get through the hardest parts and find peace once again. As Emily Nagoski said, “Emotions are like tunnels. You have to go all the way through the darkness to get to the light at the end.”

How to Prepare

It can be overwhelming to know all the information about miscarriage. In a future blog post, I will discuss my tips for coping in more detail, as well as what to say and what not to say to someone you know who is going through a miscarriage. If you have recently received the news that you are miscarrying, here are some tips to prepare for what is to come:

Buy Disposable Underwear

I recommend stocking up on disposable underwear and pads. Using disposable underwear can be particularly helpful as they are larger and can absorb more leaks than pads. I wore disposable underwear from the time I had light bleeding until I fully miscarried, and I’m so thankful I did. The day that I passed my baby, I woke up from a nap, sat up, and instantly felt clots in my underwear.

Ask for Help

It’s important to remember that you don’t have to go through miscarriage alone. Consider reaching out to someone you trust beyond your spouse, such as a close friend or your mom. It’s important to have a support system in place, as this will give you more people to rely on emotionally and help you with any physical needs you may have. Remember that reaching out for help is a sign of strength, not weakness.

Arrange Childcare

It is important to plan ahead and speak with someone in your support circle about who will care for any older children you have when the time comes. Consider having someone on speed dial or stay with you so that as soon as your body is ready, you can focus on healing instead of taking care of your other children.

Ask for Time Off Work

Many women suffer through miscarriage without sharing their experience with anyone and without taking any time to heal. They may take a sick day or two or not take any time off at all. However, if possible, it is recommended to take at least three days or even a week off from work to allow yourself time to heal physically and grieve mentally.

Call a Counselor

Many people finally realize they need to see a counselor but are often surprised to find that it can take weeks to get an appointment. It’s best to call a counselor as soon as possible to start the process of scheduling and getting insurance approval. If, by the time the appointment comes around, you no longer need it, you can always cancel. Speaking with a neutral third party during my miscarriage was very beneficial for me, especially since my husband was away with the military.

Conclusion

I miscarried my baby in the bathroom of my parent’s house while my husband was away at Army Basic Training. As soon as I knew what was happening, I called my dad, who was working a few minutes away, to come to take care of my toddler. I then called my mom, and she stood on the other side of the shower curtain while I passed clots and looked for the sac amidst a pool of blood.

We found the baby in the sac, took a picture and video for my husband’s and my memories, and prayed and worshipped God for the life He allowed me to carry for such a short time. We placed my baby in a jar in a shoebox, and my family helped me bury the baby in their backyard. We picked out a blue agapanthus because I felt it could have been my first son, and we planted it on top.

While it pains me to relive these deeply personal memories, I share them with you so you can know you’re not alone and so you can think through how you want to experience this devastating trial in any way that you can control. Friend, I wish I could take this deep pain from your heart and keep you from having to walk through this. But know, if you’re reading this, I know you will come out on the other side a different woman, as I have. You will be able to help the next mama go through this as well. You are beautiful. You are strong. You are Mama.