Physical Recovery

Early miscarriage/medical or surgical terminations

Physical Recovery

Whether you’ve experienced a miscarriage, termination for medical reasons or termination for other reasons (medical or surgical termination), it’s important to understand what to expect in the coming days and weeks, both physically and emotionally. 

It is important to please access clear guidance and support from the service who supported you, whether this be MSI, BPAS, Early Pregnancy, A&E or maternity. 

If you have been given antibiotics, please make sure you take all the tablets you are given as directed.

Here is an overview to guide you through:

  1. Bleeding and Discharge: You can expect bleeding similar to a heavy period for a few days, tapering off over 1-2 weeks. It’s normal to have some spotting for up to four weeks. It will be quite heavy at first, and you’ll need super-absorbent sanitary towels. Change them regularly, washing your hands before and afterwards. It isn’t a good idea to use tampons until you feel you have healed because they could increase your chance of getting an infection. You could see your GP or practice nurse for advice if helpful. It is not advised to go swimming whilst you are still bleeding. 
  2. Cramping: Cramps are common as the uterus contracts back to its normal size. These can be mild to severe and might last several days.
  3. Pain Relief: Over-the-counter pain relief, such as ibuprofen or paracetamol, can help manage discomfort. Always follow the recommended dosage and consult your healthcare provider if the pain is severe or persistent.
  4. Breast Changes: Your breasts might feel swollen and tender. Wearing a supportive bra and using cold compresses can alleviate discomfort.
  5. Follow-Up Care: No follow-up care is the same with early pregnancy loss and it is important to speak to the team who supported you throughout your loss to see what support may be needed. Usually after a pregnancy loss, spontaneous, surgically or medically managed, women and birthing people are asked to do a pregnancy test in 3 weeks, we understand this may be difficult to do with a much wanted pregnancy. If you continue to experience bleeding from the vagina that gets heavier, pass clots or have concerns, then an ultrasound may be booked. Please speak to your GP or early pregnancy clinic for advice. Each unit will have different access routes to the clinic.

Emotional Recovery

  1. Grief and Sadness: It’s natural to experience a range of emotions, including sadness, anger, and confusion. Allow yourself to grieve and seek support from loved ones or a counsellor.
  2. Hormonal Changes: Hormonal fluctuations can intensify emotional responses. Be patient with yourself as your body adjusts.
  3. Counselling and Support Groups: Consider joining a support group or seeking individual counselling. Connecting with others who have experienced similar losses can provide comfort and understanding.
  4. Partner and Family Support: Open communication with your partner and family is crucial. They are also affected by the loss and can offer mutual support. 

Practical Considerations

  1. Rest and Nutrition: Prioritise rest and maintain a balanced diet to support physical healing and emotional well-being.
  2. Work and Activity: Take the time you need before resuming work or strenuous activities. Follow your healthcare provider’s advice on when to gradually return to normal activities.
  3. Future Pregnancies: Discuss with your healthcare provider about when it’s safe to try for another pregnancy, if and when you feel ready.

Signs to Seek Medical Help Urgently

Attend A&E or call 999 if your symptoms prevent you from making your own way.

  1. Excessive Bleeding: Soaking through more than one pad an hour for several hours or passing large clots.
  2. Severe Pain: Intense pain that isn’t relieved by pain medication.
  3. Fever: A fever over 100.4°F (38°C) could indicate an infection.
  4. Foul-Smelling Discharge: This may also indicate an infection.
  5. Severe Depression: Persistent feelings of hopelessness, thoughts of self-harm, or inability to care for yourself or your baby.
  6. Difficulty Breathing: Any difficulty breathing or chest pain

Signs to seek help with GP or 111

  1. Loss of appetite and vomiting: Do call 111 or speak to your GP 
  2. Difficulty passing urine (peeing): Burning or stinging when passing urine, passing urine frequently or being unable to pass urine could be a sign of a urine infection. Do call your GP or healthcare provider to screen for this with a urine sample. 
  3. Leg pain: Painful, red, swollen, hot leg or difficulty bearing weight on your legs (this may be caused by a deep vein thrombosis (DVT). Contact 111 or go to A&E for review if unable to reach someone this way.
  4. You feel something is wrong: If you think there is something wrong and you are concerned, no question is a stupid one, do speak to your GP or call 111 out of hours.

Helpful Resources

Miscarriage Association: Care after miscarriage

NHS: Recovery after miscarriage

ROCG: Care after surgical miscarriage

MSI: Abortion Side Effects & Aftercare

Please note MSI uses the term abortion, which we know may be upsetting to read. We know this decision would not have been an easy one for you. 

Final Thoughts

Remember, recovery is a personal journey, and it’s okay to take the time you need to heal both physically and emotionally. Don’t hesitate to reach out to your healthcare provider with any concerns or questions. Support from family, friends, and professionals can be invaluable during this time.

Later loss/stillbirth/neonatal death

Physical Recovery

Whether you had a vaginal or caesarean birth, it’s important to understand what to expect in the coming days and weeks, both physically and emotionally.

It is important to please access clear guidance and support from the service who supported you within maternity services.

If you have been given antibiotics, please make sure you take all the tablets you are given as directed.

Here is an overview to guide you through:

After Birth

  1. Bleeding (Lochia): Postpartum bleeding will occur for up to 6 weeks as your body expels the remaining blood and tissue from the uterus. It will gradually change from bright red to pink, then to yellow or white. It will be quite heavy at first, and you’ll need super-absorbent sanitary towels. Change them regularly, washing your hands before and afterwards.It isn’t a good idea to use tampons until after your 6-week postnatal check because they could increase your chance of getting an infection. It is not advised to go swimming whilst you are still bleeding. 
  2. Uterine Contractions: These help shrink the uterus back to its pre-pregnancy size. These may feel more intense if you have given birth before. 
  3. Pain Relief: Pain medication may be prescribed, especially if you had a caesarean section. Over-the-counter pain relievers can also be effective for managing discomfort. Do take this regularly and as prescribed. 
  4. Breast/chest Engorgement: We know this can be very difficult to experience post birth. Wearing a supportive bra and using cold compresses can alleviate discomfort. Another option is to take medication to help suppress milk production, please do speak to your healthcare professional. Some women and birthing people have donated their breast milk. This is a very personal decision, but if you would like to find out more, please do access this link Memory Milk Gift – Lactation and Milk Donation After Loss – Our Sam
  5. Mastitis: Sometimes, engorgement can lead to mastitis which is inflammation of the breast. If left untreated, this can develop into a serious infection.Signs and symptom include those already listed as above as well as: 
  • White or blood stained nipple discharge 
  • Flu like symptoms including chills, fever and fatigue

If you are worried you may have mastitis please speak to your midwife, GP or health visitor as you may require antibiotics to treat the infection. 

  1. Perineal Care

If you needed to have perineal (your labia or vagina) suturing: 

If you’ve had stitches after tearing or an episiotomy (cut), bathe them every day to help prevent infection. Have a bath or shower with plain warm water then carefully pat yourself dry.If your stitches are sore or uncomfortable, tell your midwife or GP.

Painkillers can help. Do check with a pharmacist, midwife or GP before you buy over-the-counter painkillers.

Stitches usually dissolve by the time the cut or tear has healed, but sometimes they have to be taken out.

Going to the toilet

At first, the thought of peeing or opening your bowels can be a bit frightening – because of the soreness. Drinking water dilutes your urine, which may make it sting less. Drink water to thirst.

Tell your midwife or GP if:

  • you’re finding it really difficult to pee
  • you feel very sore
  • you notice an unpleasant smell

You probably won’t have a poo for a few days after the birth, but it’s important not to let yourself get constipated. Eat plenty of fresh fruit, vegetables, salad, wholegrain cereals and wholemeal bread, and drink plenty of water.

If you’ve had stitches, it’s very unlikely you’ll break them, or open up the cut or tear again. It might feel better if you hold a pad of clean tissue over the stitches when pooing. Try not to strain.

Talk to your midwife or GP if you have constipation that won’t go away. A gentle laxative may help. Always tell your midwife or GP if poo is leaking or you’re pooing when you don’t mean to.

  1. Caesarean section: It usually takes about 6 weeks to recover from your c-section but this will depend on your individual situation. Your wound will feel sore and bruised for a few weeks. You will need to take pain relief for at least 7–10 days after your c-section. 

Tell your midwife or GP without delay if you have any signs of infection, such as:

  • you have a high temperature
  • you feel generally unwell – for example, an upset stomach
  • your wound becomes red, swollen, painful or has a discharge.

You may also like to read:

NHS: Recovery from caesarean section

  1. Exercise and Pelvic Floor: At this time, your own physical recovery may be the last thing on your mind. Your physical recovery after the loss of your baby will take time, but there is a lot you can do to help get yourself back into shape. Regaining your fitness may help you have more energy and possibly avoid physical problems later on.

Pelvic health is an important part of your recovery. Some areas in the UK now also have a dedicated pelvic health team who can support you. This is an exercise you can start soon after birth and should be carried on throughout our lifetime. Your pelvic floor muscles are the group of muscles spanning the base of your boney pelvis, held in place by ligaments which support the pelvic organs. 

Research shows that up to one in three women experience urinary incontinence in the first year after giving birth, and up to three quarters of these women continue to experience this in the following 12 years after giving birth. Additionally, one in 10 women experience faecal (poo) incontinence and one in 12 women will have a pelvic organ prolapse. Although urinary incontinence is common, it is not normal and it is important to get support. Pelvic floor muscle exercises, sometimes known as “Kegels” will help keep these muscles strong. 

Please find attached a helpful workbook on how to do these and return to other exercises following a pregnancy loss/death of a baby.

Emotional Recovery

  1. Grief and Sadness: It’s natural to experience a range of emotions, including sadness, anger, and confusion. Allow yourself to grieve and seek support from loved ones or a counsellor.
  2. Hormonal Changes: Hormonal fluctuations can intensify emotional responses. Be patient with yourself as your body adjusts.
  3. Counselling and Support Groups: Consider joining a support group or seeking individual counselling. Connecting with others who have experienced similar losses can provide comfort and understanding.
  4. Partner and Family Support: Open communication with your partner and family is crucial. They are also affected by the loss and can offer mutual support.

Practical Considerations

  1. Rest and Nutrition: Prioritise rest and maintain a balanced diet to support physical healing and emotional well-being.
  2. Work and Activity: Take the time you need before resuming work or strenuous activities. Follow your healthcare provider’s advice on when to gradually return to normal activities.
  3. Future Pregnancies: Discuss with your healthcare provider about when it’s safe to try for another pregnancy, if and when you feel ready.

Signs to Seek Medical Help Urgently

Attend A&E or call 999 if your symptoms prevent you from making your own way:

  1. Excessive Bleeding: Soaking through more than one pad an hour for several hours or passing large clots.
  2. Severe Pain: Intense pain that isn’t relieved by pain medication.
  3. Fever: A fever over 100.4°F (38°C) could indicate an infection.
  4. Foul-Smelling Discharge: This may also indicate an infection.
  5. Severe Depression: Persistent feelings of hopelessness, thoughts of self-harm, or inability to care for yourself or your baby.
  6. Difficulty Breathing: Any difficulty breathing or chest pain

Signs to seek help with GP or 111

  1. Loss of appetite and vomiting: Do call 111 or speak to your GP 
  2. Difficulty passing urine (peeing): Burning or stinging when passing urine, passing urine frequently or being unable to pass urine could be a sign of a urine infection. Do call your GP or healthcare provider to screen for this with a urine sample. 
  3. Leg pain: Painful, red, swollen, hot leg or difficulty bearing weight on your legs (this may be caused by a deep vein thrombosis (DVT). Contact 111 or go to A&E for review if unable to reach someone this way. 
  4. You feel something is wrong: If you think there is something wrong and you are concerned, no question is a stupid one, do speak to your GP or call 111 out of hours.

Final Thoughts

Remember, recovery is a personal journey, and it’s okay to take the time you need to heal both physically and emotionally. Don’t hesitate to reach out to your healthcare provider with any concerns or questions. Support from family, friends, and professionals can be invaluable during this time.

Contraception After Pregnancy Loss/birth

Importance of Contraception

Following a pregnancy loss it is important to consider your future contraceptive needs. Your body can become pregnant again very quickly, sometimes as soon as two weeks after a loss/birth. Here are key points to keep in mind:

Physical and Emotional Readiness: It’s important to listen to your body and mind when considering contraception. Pregnancy, birth, and loss are significant events that require time for recovery.

Professional Guidance: Speak with your sexual health nurse or healthcare provider to discuss the best contraception method for you based on your health, lifestyle, and plans for future pregnancies. We have added a table below to consider your options:

 Contraception When to use or fit after childbirth Additional notes
Condoms As soon as required  
Progesterone Only Pill 3 Weeks Extra precautions if a pill is taken late – more than 3 hours.
Combined Pill 3 Weeks  
Diaphragm or Cap 6 Weeks Can only be fitted 6 weeks after childbirth due to changing shape of the cervix.
Implant 6 Weeks Effective for 3 years. Causes irregular bleeding in most women during the first year of use.
Contraceptive

Injection

6 Weeks Effective for 8 to 12 weeks. May cause heavy or irregular bleeding.
Intrauterine contraceptive device (IUCD) 8 weeks Also known as the copper coil.
Intrauterine system (IUS) 8 weeks Hormone releasing coil. May cause irregular bleeding in the first 6 months.

More about the above can be found at the Family Planning Association.