Pregnancy loss is never an easy experience, but sometimes there are individual circumstances or particular kinds of loss which can make it harder to cope with.

Recurrent pregnancy loss

If you have experienced repeated pregnancy loss, you may have found it much harder to bear than your first or even second loss. It can be devastating to lose one baby after another and this can be made worse by feelings of guilt (It must be something I did) or sheer hopelessness (I’m never going to be able to have a baby). It can be hard to cope with family, friends or colleagues who are pregnant or have new babies. What’s more, you may find that just as you need increased support from those around you, people find it harder to know what to say or how to comfort you.

Women and their partners are often desperate to know the cause of their miscarriages. You may have been referred to a specialist quite quickly, or you may have been frustrated by the length of time you had to wait, or the number of miscarriages (or ectopic or molar pregnancies) you had to experience, before being referred for specialist investigation. You might have had investigations, only to be told that doctors cannot identify a specific cause for your losses.

It is important for you to know that most couples with a history of three or more miscarriages do go on to have a healthy pregnancy, often without medical treatment. You may find that you need additional support during this time.

Read our leaflet "Investigations following recurrent miscarriage"

Ectopic pregnancy

An ectopic pregnancy is one where the fertilised egg starts to grow in the wrong place, most often in one of the Fallopian tubes rather than inside the womb. Most ectopic pregnancies can grow to around 8 weeks, but beyond this the tube is likely to burst. This causes internal bleeding and is life-threatening.

Ectopic pregnancy can be a very frightening and distressing experience for you and for your partner. Not only is it sometimes extremely painful, but you may have been completely shocked by the diagnosis – in fact, some women are not even aware that they were pregnant. Once diagnosed, it is likely that you will have been rushed to the operating theatre, with little time to think about what was happening.

Your feelings may vary a great deal in the weeks and months after an ectopic pregnancy. You may be very relieved to be free of pain and grateful to be alive, but at the same time be very upset by the loss of your baby – something that others don’t always understand. You may also be very worried about future pregnancies.

Read our leaflet on ectopic pregnancy

Hydatidiform mole or molar pregnancy

A molar pregnancy is one where an abnormal fertilised egg implants in the womb but the cells of the placenta grow very quickly and prevent it developing further. The placenta keeps growing, however and pregnancy hormone levels continue to rise, so you will still have a positive pregnancy test result.

A molar pregnancy is sometimes only diagnosed after the miscarriage has happened and during routine examination of the pregnancy tissue. There is a very small chance that the molar cells can spread rapidly and become cancerous and so all women with molar pregnancy are referred for specialist follow-up. If a cancer (called choriocarcinoma) does develop, the treatment is extremely effective.

The diagnosis of molar pregnancy can be very confusing, upsetting and frightening. It can be difficult to understand what has happened and very upsetting to realise that the beginnings of your pregnancy never developed properly into the baby you thought you were carrying many weeks later. Many women and their partners are very frightened by the risk of cancer and you are likely to need lots of care and reassurance during your follow-up.

Read our leaflet on hydatidiform mole

Late miscarriage

Most miscarriages happen in the first 12 or 13 weeks of pregnancy. It is less usual to miscarry between 14 and 24 weeks and so late miscarriage can be even more of a shock, especially when many women feel that they are safely past any ‘danger period’.

The physical experience of late miscarriage can also be particularly distressing as most women will go through the process of labour and delivery. You may have to make difficult decisions about whether or not to see your baby or to agree to a post-mortem. And in the days after the birth, you may find that your breasts produce milk, which can add to your distress. You may feel physically and emotionally exhausted.

Sadly, miscarriages before 24 weeks are not officially recorded by the Registrar, but it may be possible to have a certificate from the hospital. This would note your baby’s name, if you have given one, the date of the miscarriage and maybe some other details.

Read our leaflet on late miscarriage

 

Fertility problems

Whether you have lost a baby after fertility problems, or are having difficulty getting pregnant again after a miscarriage or ectopic pregnancy, the pain of living with the double blow of pregnancy loss and infertility can seem almost impossible to bear.

If you conceived after many years of trying and/or fertility treatment but then miscarried, you may feel that this was even worse than not conceiving – although you may be comforted to know that you can become pregnant. Or you might have finally gained the courage to try again after miscarriage or ectopic pregnancy, only to find that you are not falling pregnant. Either way, the future may seem bleak and it will be important to find support and care from people who understand the impact of this double burden.

Read our leaflet "Pregnancy loss and infertility"

Partners

Your partner is likely to feel upset because of the distress you have gone through, as well as for the loss of your baby. Both of you may be grieving over the loss of the future and of the happiness your baby was going to bring. Some couples are able to support each other very well and may not even want support from others. However, grief can put a strain on even the closest relationships, especially over time. Just when you need each other most, it may be difficult to offer each other support. Sadly, some relationships may end at this time. And some women may not have a partner with whom they are sharing the pregnancy.

Men sometimes say that their feelings, as the bereaved father, can be forgotten. In the weeks that follow miscarriage, attention is usually focused on the mother, ignoring the fact that her partner too has suffered a loss. This can be just as true if you are in a same-sex relationship. Men in particular, however, sometimes find that they are expected to be strong and supportive and our culture doesn’t make it easy for them to acknowledge their own needs and feelings.

Read our leaflet "Men and miscarriage"

Talking to children

If you already have children when you miscarry, it can be very hard knowing what, if anything, to tell them. Often parents realise children have picked up on their grief but are at a loss as to how to handle the situation. Should you be honest? What if they're upset? How do you find the right words? Will they understand? Trying to answer a child's questions about why you are crying, or why the new baby won't be coming after all can feel like an impossible task.

If you don’t have children, you may still have a similar dilemma with the children of close family and friends, or if you work with children.

There are no rules about whether or not to talk to children about miscarriage or what to say if you do, but we have two resources that you might find helpful.  The leaflet Talking to children about pregnancy loss aims to help you decide the best way to handle pregnancy loss with children. Goodbye Baby is an e-book for reading with children.