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Miscarriage & Stillbirth: What Does Physical Recovery Look Like?

FACTS TO KNOW
  • 3 months

    Physiologically speaking, you do not need to wait to try to get pregnant again despite the commonly-held belief to wait 3 months to try again. Studies show the best “interpregnancy interval” after a loss is less than 3 months but you should decide when feels best for you and your partner.

  • Emotional Tsunami?

    It is very normal to feel a lot of ups and downs. This is likely due to the steep drop in pregnancy hormones that contributes to your emotional state on top of dealing with the loss.

  • Tips For You

    • Maxi pads are recommended instead of tampons while recovering from a pregnancy loss.
    • Your body can start to change as early as the 4th week of pregnancy. Give yourself time and space to navigate this recovery.
    • If you experience milk coming in, there are ways to stop lactation with or without medication. Do whatever feels right for you during this time.
  • Share your experience on pregnancy loss to be a part of making change

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Pregnancy loss requires physical recovery that can take some time. The most important thing to know about recovery is that there is a physical recovery that lasts beyond the actual loss or procedure (if you had one), which isn’t something that’s often talked about. You may see information online that says recovery is a few hours, but that is misleading because it does not address the recovery from the pregnancy, including uterine healing, bleeding and cramping, and hormonal shifts.


Miscarriage: Loss of a pregnancy before 20 weeks.

How long will physical recovery take?

How long it takes you to recover from pregnancy loss depends on how far along you were and the type of treatment you receive. The timeline for recovering from pregnancy loss can range from a couple of days if you have a D&C to around eight weeks if you choose expectant management. You can read more about this in our article Pregnancy Loss: Treatment Options and What to Expect.

What is the physical recovery like?

There’s a cultural misconception that a miscarriage is akin to what a menstrual period is like. This is not what pregnancy loss is really like. If you feel like the experience you’re having is much bigger than what you expected, that’s normal and completely valid. Pregnancy can begin to change your body as early as the fourth week, so no matter how far along you were, your body will need recovery time as it returns to its pre-pregnancy state. It’s important to give yourself space to focus on nurturing your body through this period.

Bleeding and cramping

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.

Overwhelming emotions

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.

Still looking pregnant

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.

Myth: You should wait three months to try again

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.


Stillbirth: Loss of a pregnancy after 20 weeks.

What is the physical recovery like?

The physical recovery after a stillbirth is similar to birth recovery, with the added layers of grief and intense emotions that come from losing a baby. If you experience the loss of a pregnancy after 20 weeks, you may need to be induced into labor in order to deliver the baby vaginally; alternatively, you may opt for a c-section. Other procedures are more limited during the second and third trimesters. Here’s what you can expect to experience:

Postpartum bleeding (lochia)

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.

Postpartum constipation

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.

Postpartum contractions

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.

Milk coming in

If you’ve had a stillbirth, the drop in hormones after the loss of your baby can still cue your body to start producing breast milk. In fact, most parents who give birth to a stillborn infant or experience infant loss soon after birth will begin to lactate. This can be an extremely painful experience and feel very unfair. Your breasts may become engorged (feel full, tender, and hard) between two to five days following the delivery, and they may feel uncomfortable and leak milk for up to seven to 14 days if no medication is taken to stop milk production. This physical experience can be very difficult to manage while you are dealing with the grief of loss.

Medications to stop milk production

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:

  • Cabergoline: This medication has been approved for reducing prolactin levels and stopping milk production. A recent systematic review showed that taking 1 mg of cabergoline zero to 50 hours after delivery can lead to milk cessation within a day.
  • Sudafed: Small research studies have shown that taking over-the-counter medicine pseudoephedrine (which is found in Sudafed) can interfere with the production of prolactin, the hormone responsible for breastmilk production, and reduce breast milk volume.
  • Herbs and foods: There is very little research on foods and herbs that may reduce breast milk production, but it’s believed that parsley, sage, and mint may help reduce milk production.
  • Higher-dose combined birth control pills: Low dose birth control does not suppress lactation but higher doses may, so starting the birth control pill is an option.
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    Supporting lactation cessation without medication

    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:

  • Take over-the-counter pain relievers.
  • Wear a support bra at all times to avoid constriction and prevent clogged ducts and mastitis.
  • Use breast pads to absorb leaking milk.
  • Use cold compresses on the breast.
  • Take a warm shower, but ensure water jets are not directly on the breasts.
  • Sleep in a semi-upright position (to reduce pressure from heavy breasts).
  • Avoid all breast stimulation.
  •  

    Donating breast milk

    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.

    Explore our hub on pregnancy loss here.

    Bodily does not provide medical advice, diagnosis, or treatment. The resources on our website are provided for informational purposes only. You should always consult with a healthcare professional regarding any medical diagnoses or treatment options.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3752097/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709156/https://www.dovepress.com/is-cabergoline-safe-and-effective-for-postpartum-lactation-inhibition--peer-reviewed-fulltext-article-IJWH
    https://pubmed.ncbi.nlm.nih.gov/12848771/ https://pubmed.ncbi.nlm.nih.gov/31470391/
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