It's Time to Normalize What Happens to the Body After a Miscarriage
It was about two days after I lost my baby at 22 weeks pregnant that my breast milk came in. I vividly remember standing in the shower as the liquid dripped down my foreign-looking body—deflated and empty.
Maybe my doctor had mentioned this could happen, but in my haze of grief, I must not have heard him, and now all I felt was numbness and shock. I hadn't expected to lose my pregnancy, so I'd put no thought into what I'd look and feel like in that moment. And the truth is, not too many people talk about what happens to your body after a miscarriage.
But as Chrissy Teigen bravely shared on Instagram after suffering a pregnancy loss around 20 weeks, the body post-miscarriage is painful proof of what you've lost. "Even though I'm no longer pregnant, every glance in the mirror reminds me of what could have been," the famous mom wrote in her honest post that included a photo of her slow-to-diminish bump.
Physical Changes After Miscarriage
When you are grieving a pregnancy loss, the uncomfortable postpartum phase can feel downright impossible to bear—especially since these body changes aren't often discussed. As Megan Gray, M.D., OB-GYN with Orlando Health Physician Associates, says, "The farther along in pregnancy the miscarriage occurs, the more significant the symptoms may be."
In addition to breast changes and weight gain, Kecia Gaither, M.D., M.P.H., F.A.C.O.G., double board-certified in OB-GYN and maternal fetal medicine and director of perinatal services at NYC Health Hospitals/Lincoln, notes, "One can expect stretch marks, abdominal distension, vaginal pain—if delivery entailed an episiotomy—as well as hair loss."
Dr. Gray adds, "Some of the typical body changes that occur after a pregnancy loss include uterine contractions, vaginal bleeding that can be like a light to a heavy period, and passing small dime- or quarter-sized clots."
It can take days to weeks for these changes to resolve, typically depending on how far along one was in their pregnancy. "A woman who experienced a loss at six weeks pregnant usually experiences shorter and lighter bleeding than a woman who experiences a loss at 16 weeks," explains Dr. Gray.
The Emotional Toll of Miscarriage
For those who have experienced a miscarriage, the physical changes can be overshadowed by the emotional toll. "Patients often are less prepared for the emotional journey than the physical one," says Danielle Jones, M.D., a board-certified OB-GYN known on social media as Mama Doctor Jones. "Some people have a very emotional journey that is full of grief and sadness, others can feel relieved or confused."
Dr. Gray acknowledges a loss is an emotional experience no matter when in the pregnancy it happens and points out the shift in hormones may exaggerate symptoms. "With a pregnancy loss, the estrogen and progesterone levels drop quickly. The hCG (human chorionic gonadotropin) level will slowly drop to zero over a few weeks—depending on how far along the pregnancy was at the time of loss," says Dr. Gray.
And all feelings are justified. "The most important part of the emotional journey after pregnancy loss is to normalize that any range of feelings can be normal and that there is no guilt in pregnancy loss—there's nothing you could have done better or worse," says Dr. Jones.
How to Find Comfort
Getting support is highly recommended no matter what. Your doctor can refer you to a local pregnancy loss support group, and if you experience depression and/or anxiety, a perinatal psychologist, psychiatrist, or licensed mental health therapist can help. It may also be beneficial to open up to friends—since up to 20 percent of known pregnancies end in miscarriage, there is a good chance someone you know has been through one. But, as Dr. Gray explains, "Shame, guilt, disappointment, and failure are all negative emotions that can lead to self-isolating behavior and withdrawal from social connections." So, you may not know about someone else's experience until you share your own.
It will also take time. My body didn't go back to "normal" for a while. "Surprisingly the physical impact can linger for weeks to months after the loss," confirms Laxmi Kondapalli, M.D., MSCE, an award-wining, board-certified reproductive endocrinologist at CCRM Fertility in Colorado, adding, "Many patients have told me that they 'still feel pregnant' after a loss." This was definitely true in my case, with my mind not catching up to my new reality as quickly as I might have hoped.
Still today, years later, in many ways, I am forever changed by what I went through. Most of all, I'm left wishing that as a society we would be more open to discuss loss and the painful aftermath. As Dr. Jones acknowledges, "Miscarriage remains taboo, because it is hard to talk about. The best thing we can do is continue the conversation and give space to validate feelings and experiences, no matter what they are."