Miscarriage & Stillbirth: What Does Physical Recovery Look Like?

The intensity and duration of bleeding and cramping varies based on a variety of factors — including how many weeks of gestation the pregnancy was at — but expect to experience bleeding and cramping for at least one to two weeks and symptoms that resemble what you’d experience on the heaviest day of your normal period. Pregnancy losses that occur in the second trimester may be followed by a longer time of bleeding. It’s standard protocol to recommend maxi pads instead of tampons while recovering from a pregnancy loss. This is for two reasons: first, and most importantly, to avoid introducing bacteria into the cervix and uterus; second, it’s much easier to keep track of the amount of bleeding on a pad than a tampon.

After a pregnancy loss, your body will experience a rollercoaster of hormones that greatly influence your emotional state. Your hormone levels after a pregnancy loss will depend on how far along you were, but in general, pregnancy hormones like human chorionic gonadotropin (hCG) will immediately start to fall. A 2013 study that tested 443 people who experienced pregnancy loss found that hCG levels decline very rapidly — the researchers reported there was a 35 to 50% reduction in hCG levels two days after and a 66% to 87% reduction seven days after the pregnancy ended. If you’re feeling a lot of ups and downs, know that the steep drop in pregnancy hormones is likely contributing to your emotional state.

Pregnancy can start to change your body as early as the fourth week, which means you may potentially be faced with looking pregnant long after your pregnancy loss, — and that can be difficult. Your uterus may have become more prominent, you may have begun to gain weight, your breasts may have become enlarged — and these changes will take some time to return to their pre-pregnancy state. It’s also important to know that hCG can remain in the bloodstream for several weeks, so you may not get your period immediately, you may still get a positive pregnancy test, and you may even produce small amounts of breast milk after a pregnancy loss. These realities can be challenging to face, and they are some of the traumatic elements of the pregnancy loss experience that we often don't acknowledge as a society. Give yourself some space and seek support that will help you to navigate this difficult time.

You may ovulate as soon as two weeks after a pregnancy loss, and you can expect your period to return within four to six weeks. In the past, it was common to tell people to wait “about three cycles” before trying to get pregnant again, based on the belief that the uterine lining needed to thicken and shed a few times to become healthy before a new pregnancy would implant. But this was never an evidence-based recommendation, and a study from 2017 that looked at a large prospective trial from 2000 to 2012 actually found the opposite to be true — that the best “interpregnancy interval” after a pregnancy loss was, in fact, less than three months. This is a very personal decision, and if you feel like you need more time to recover emotionally, it’s important to do this on your timeline.

You can expect heavy bleeding and cramps. The intensity and duration of these varies based on a variety of factors such as how far along you were, but typically, second or third trimester pregnancy loss is followed by a longer bleeding period. This bleeding and cramping resembles what you’d experience on the heaviest day of your normal period and will change as the uterus continues to empty and recover. It’s standard protocol to recommend maxi pads instead of tampons while recovering from a pregnancy loss in order to prevent infection and better keep track of blood loss.

Constipation — or difficulty having a bowel movement — is common after delivery and can be painful. It’s most common the first few days after delivery, but studies suggest that many people experience constipation for three to six months. This can be due to a variety of factors, including hormonal changes and damage to the anal sphincter and pelvic floor muscles. In some cases, it may even persist for up to 12 months following delivery. You can help prevent constipation by staying well-hydrated, increasing your fiber intake, or taking over-the-counter stool softeners.

After labor, the uterus, which grows up to 25 times its usual size during pregnancy, must shrink back down to size, and this can cause contractions. They feel like short, sharp cramps in the abdomen — sort of like menstrual cramps or labor contractions — and they should decrease in intensity each day after labor and last about seven to 10 days. You can take over-the-counter pain relievers or try a heating pad to manage the pain of postpartum contractions.

If you experience milk coming in after a stillbirth, you may want milk production to stop as quickly as possible. Studies have shown that many medical providers encourage people to avoid medication because of potential side effects, so if you want milk production to stop immediately, you may have to explicitly ask for one of these medications. If you do want to use medication, you have some options:

If you’d rather allow milk production to stop on its own without medication, you can use the following tips to cope while lactation stops naturally:

This decision is completely up to you, but you may find it cathartic to donate your breast milk. According to a paper published in the peer-reviewed journal Neonatal Network, donating milk can promote healing and closure for some people. You can ask your healthcare provider for resources or look up the non-profit Milk Banking Association of North America if this option feels right to you.