Module 16 · Family

Miscarriage & loss

What happens, what helps, and where to find support after losing a baby. 10 min · 6 lessons

Lesson 1

You are not alone, and it is not your fault

Losing a baby during pregnancy is a real loss, at any week. If it has happened to you, we are so sorry. Two things are true for almost everyone who goes through it: you are not alone, and it was not your fault.

It is common. About 10 in 100 known pregnancies end in a loss in the first 13 weeks, according to the American College of Obstetricians and Gynecologists, and some sources put all miscarriage before 20 weeks at up to 20 in 100.
It is almost never caused by something the mother did. About half of early miscarriages happen because the baby was not developing as expected, often because of an abnormal number of chromosomes, which happens by chance.
These do not cause miscarriage: working, exercising, stress, an argument, sex, or morning sickness. A fall or a fright shortly before is usually a coincidence.
It usually could not have been prevented. Nothing, including bed rest, has been shown to prevent an early loss.

A miscarriage is a loss before the 20th week of pregnancy. A stillbirth is a loss at or after 20 weeks, and the CDC says it affects about 1 in 175 births, about 21,000 babies in the United States every year.

Lesson 2

Signs, and when to get care

Signs of a miscarriage can include spotting or bleeding, with or without pain; a gush of fluid or tissue; and cramping or pain in your belly or lower back. The National Institutes of Health says to contact your provider right away about any bleeding in pregnancy.

Get medical care right away for any of these. The CDC lists them as urgent warning signs in pregnancy:

Bleeding that is more than spotting
Severe belly pain that doesn’t go away
A fever of 100.4°F or higher
Dizziness or fainting

There is no hospital on Orcas. If you can’t reach your clinician at once, call 911. Sudden, severe pain in your belly or pelvis, pain in your shoulder, weakness or fainting can be signs of an ectopic pregnancy, a pregnancy growing outside the uterus, which is a medical emergency. Don’t wait to see if it passes.

Lesson 3

Care and recovery

Once a clinician has confirmed the loss, there are usually three ways forward: waiting for your body to complete the miscarriage on its own, which usually takes up to two weeks; medicine; or a short procedure. None of the three has been shown to lead to better long-term results than the others, so your own wishes can guide the choice.

If your blood type is Rh-negative, ask about an Rh immune globulin shot. It is recommended after a loss at 12 weeks or later, and it’s worth discussing before that.
Your body: most women are back to their usual activities within a day or two. Spotting can last 4 to 6 weeks, and your period usually returns within 4 to 6 weeks, sometimes longer. Put nothing in the vagina for 1 to 2 weeks, and go to the follow-up visit.
While you recover, call right away for heavy bleeding (soaking more than two maxi pads an hour for more than 2 hours in a row), a fever, chills or severe pain.
Trying again: once your body has healed, most healthy women don’t need to wait before trying to conceive again, according to the federal Office on Women’s Health. Talk with your clinician about timing, and give your heart the time it needs too.
The next pregnancy: most women who have an early loss go on to have successful pregnancies.
After two or more losses, an exam and testing are recommended. Even when no cause is found, about 65 in 100 women have a successful next pregnancy.

Lesson 4

Grief

Shock, guilt, anger and deep sadness: the federal Office on Women’s Health calls all of these normal reactions to loss. Emotional healing often takes longer than physical healing, and grief can last weeks, months or years.

Fathers grieve too. Men and women often cope with loss in different ways, and partners can feel left out of the support. Check on each other, and let other people check on both of you.
Remember your baby. Many parents find it helps to give their baby a name, keep an ultrasound picture, plant something, light a candle on the due date, or ask their pastor for a blessing or a prayer.
Tell people what you need. Friends often don’t know what to say. “Please just listen” and “please say our baby’s name” are fair things to ask.
Get help if grief doesn’t ease. Tell a clinician about intense sadness that lasts more than two weeks and gets in the way of daily life. If you have thoughts of harming yourself, call or text 988 now.

If someone you love has lost a baby

Say “I’m so sorry” and mean it. Skip any sentence that starts with “at least.”
Bring a meal, take the other children for an afternoon, and remember the due date.
Ask about the father too.

Lesson 5

Where to find support

Perinatal Support Washington. A free warm line with peer specialists who have lived through loss, a virtual loss group, and a specialist for dads. Call or text 1-888-404-7763. It’s answered live on weekdays from 9 to 4:30, in English and Spanish.
Share Pregnancy & Infant Loss Support. Free, confidential support by phone and email, and peer companions: 1-800-821-6819.
Star Legacy Foundation. Free online groups in English and Spanish for early loss, late loss, dads and grandparents, after a miscarriage, an ectopic pregnancy, a stillbirth or the death of an infant. Call 952-715-7731, extension 1, or text that number.
First Candle. A grief line with one-on-one support: 1-800-221-7437.
The National Maternal Mental Health Hotline. Call or text 1-833-852-6262, free and confidential, 24/7, in English and Spanish.
On Orcas. Your pastor or faith community, your clinician, and the Orcas Community Resource Center, which arranges low-cost counseling for uninsured residents who qualify: 360-376-3184.

Lesson 6

Certificates and leave in Washington

After a stillbirth, at 20 weeks or later, the mother can ask the state Department of Health for a Certificate of Birth Resulting in Stillbirth. Fees start at $25. See stillbirth records.
After an earlier loss, the state doesn’t issue a certificate. Many families make their own keepsake or hold their own memorial.
Paid leave. Washington’s Paid Family and Medical Leave includes up to seven days of leave after the loss of a child, for a parent who would have qualified for leave for the birth or for bonding, and it isn’t limited to the mother. Medical leave for physical recovery is possible when a clinician certifies it. The program doesn’t spell out how early losses are handled, so call and ask: 833-717-2273.

Check yourself

Myth or fact?

Exercise, stress or an argument can cause a miscarriage.

Myth. They don’t. About half of early miscarriages happen because the baby was not developing as expected, often because of an abnormal number of chromosomes, which happens by chance.

Most women who have a miscarriage go on to have a successful pregnancy.

Fact. Most do. Even after repeated losses with no known cause, about 65 in 100 women have a successful next pregnancy.

Fathers don’t grieve a miscarriage.

Myth. Fathers grieve too, often in a different way, and they can feel left out of the support. Ask about dad.

Sudden, severe belly pain with shoulder pain or fainting in early pregnancy is an emergency.

Fact. These can be signs of an ectopic pregnancy. Call 911.

After a miscarriage, you have to wait several months before trying again.

Myth. Once your body has healed, most healthy women don’t need to wait, according to the federal Office on Women’s Health. Talk with your clinician, and give yourself time to grieve.

Questions people ask

Asked and answered.

Did I do something to cause this?

Almost certainly not. Working, exercise, stress, sex and morning sickness don’t cause miscarriage, and nothing has been shown to prevent an early loss. If guilt keeps coming back, say it out loud to your clinician or to someone on a support line. You deserve to hear it from a person.

How long will I feel this way?

There’s no schedule. Grief can last weeks, months or years, and it can come back around the due date and anniversaries. If intense sadness lasts more than two weeks and gets in the way of daily life, tell a clinician.

Can we name our baby or hold a memorial after an early loss?

Yes. Your baby mattered at every week. The state doesn’t issue a certificate before 20 weeks, but many families choose a name, keep a small box of keepsakes, plant a tree, or ask their pastor to pray with them.

I’m pregnant again and scared. Is that normal?

Yes. Fear and hope often arrive together after a loss. Tell your clinician about your history, and lean on support: the Perinatal Support Washington warm line is 1-888-404-7763. You can follow your baby’s growth in Pregnancy week by week.

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