Most parents feel that the most challenging aspect of second and third-trimester babyloss is the very painful decision to end a wanted pregnancy. Often, anomalies or complications are diagnosed later in the pregnancy, which means that information must be gathered expeditiously and a decision must be made as quickly as possible. Though both an L&D and D&E are medical procedures, it is common for parents not to think about the physical symptoms they might experience in the aftermath, even though these should be discussed during the informed consent process by your provider. However, there’s so much to take in during the decision-making stage, that it’s understandable for a parent to feel blindsided. This entry is designed to help you understand what to expect after terminating a pregnancy for medical reasons.
For biologically-female-identified parents who go through a loss or termination, many are surprised to find that their breasts become engorged with milk a few days after the experience. This can be a very painful and unanticipated experience, as the breasts should be filling for a baby who can nurse or benefit and grow from a parent’s milk. Unfortunately, your body does not know that you have experienced a loss, but is responding to the fetus or baby no longer being housed within your uterus, and is responding as though a healthy birth has happened. Engorgement can feel quite physically painful, as the breasts enlarge or swell. Psychologically, it feels especially hurtful too, as it is a physical reminder of all you have lost. To prepare for the physical discomfort of engorgement, you may want to have some tight-fitting bras or sports bras on hand to help support uncomfortable breasts. If you have decided not to express or donate your milk, have some cabbage on hand and keep it in the freezer or fridge to put inside your bra against your breasts. The cabbage will help dry your milk up, and will feel physically comforting against your breasts. Take a pain reliever to help with the pain, and talk to your obstetrician about other supplements that can help dry up your milk faster. Do not pump or express your milk, as this will encourage more milk production. If you have decided to pump or donate your milk, get in touch with your local children’s hospital department of social work to see what the requirements are for donation. Often, there are blood tests and other public health requirements that must be fulfilled before your milk can be officially designated as donor-safe. If you prefer to donate in your community, organizations like Eats on Feets can help connect you with parents in need of breastmilk. You may decide just to pump a few times, or to provide milk long-term to a recipient. Know that what you do with your milk is your choice and there is no wrong choice. The right choice is what’s best for you.
Bleeding is another common symptom that follows loss or termination, and it can be another uncomfortable reminder of what you have lost. If you have had a healthy pregnancy before, this can be especially triggering, as bleeding, like engorgement, usually comes after a “successful” birth. In this situation, however, bleeding is another reminder of what you have lost. Prepare for it ahead of time with mesh underwear, “pad-sicles” (these are overnight pads you can spray with witch hazel and pop into the freezer”, and a peri-bottle that you can find cheaply online or order through FridaMom. Your bleeding should taper off over the next few weeks, though it can also become heavier if you engage in vigorous exercise or even become overly-stressed out. It is important to contact your obstetrician or care team if your bleeding doesn’t lighten up, or is accompanied by foul-smelling discharge or discharge that is a different color than bloody, clear, or mildly yellow. Though it is unlikely, sometimes infections can develop and changes in your bleeding or discharge are a sign that you need to be assessed.
Cramping and Physical Aching
You shouldn’t experience overwhelming physical pain after your loss, but cramping and body aches can also be common. Depending on how far along you were in pregnancy, your uterus needs to shrink back to its original size, and if you’ve had prior pregnancies, it may be a little more elastic than before. D&E or L&D procedures are still physical in orientation, and it is reasonable to expect physical pain after them, including body aches that can be compounded by psychological symptoms of grief. It may take some time for you to feel “normal” in your body after a loss, as you are also transitioning back into a body that is no longer pregnant. While, again, parents expect these symptoms after delivering a healthy baby, they don’t always anticipate that post-partum physical changes can happen after a loss. Remember, healing takes time. If you are experiencing unbearable physical pain that stops you from engaging in daily activities or keeps you immobile after your initial recovery, contact your obstetrician. There is no reason you need to endure excessive physical pain, and there are ways of managing it, as well as checking to see if you are healing without complication.
By far and wide, most loss parents experience a range of psychological symptoms after the end of a pregnancy. Though there are many self-help tips available on this site that speaks to the more long-term psychological challenges, it is also helpful to prepare for the immediate aftermath. Some babyloss parents can experience intrusive and distressing reminders of the loss experience, whether it is a termination surgery or delivery, spontaneous miscarriage, or stillbirth. These are understandably upsetting, and it can be helpful to interpret them as your mind’s attempt to make sense and meaning from your loss, going over the events repeatedly to try to create a memory that belongs to your life narrative. You may have trouble sleeping, or, especially in the case of a termination for medical reasons (TFMR/TOPFA/EWP), obsess over the decision to end the pregnancy, wondering if it was the “right” one. Remind yourself that you made the best decision you could with the information you were given. It can be helpful to listen to soothing music or guided meditation from apps or streaming services. One of my favorites is Yoga Nidra, a guided rotation of consciousness that helps you get out of your head and focusing on calming your entire body. You are likely to experience crying, but it’s also quite common to feel numb or without emotion after the immediate loss. Remember that no two people grieve the same way, and if you feel overwhelming emotion or nothing at all, that is what is right for you. It’s rare for parents to experience problematic or “pathological” grief, even though you may feel your grief is “abnormal”. That’s a myth perpetuated by a society that feels uncomfortable talking about loss. Remember that time doesn’t heal, but it helps. As time passes, the intrusive thoughts and overwhelming emotions will start to have smoother edges, but you will never forget the baby that you lost. It can be helpful to keep a grief journal in which you can document your physical and psychological symptoms. A journal can be a safe and non-judgmental space to chronicle your life after loss, and to put your thoughts when it feels hard to talk about them with others. You do not need to force yourself to talk during this painful time, but writing can feel safer and can also help to calm intrusive or self-blaming thoughts. You can also distract yourself with binging on TV series or reading books that have nothing to do with loss at all. Give yourself permission to focus on other simple distractions, especially as your body heals. Doing this does not mean you aren’t grieving or upset.
You’ve just gone through a major life event that might even be considered traumatic. It is common to have physical and psychological symptoms in the aftermath. Being gentle to yourself means taking the time you need in these early days as you cope with short-term symptoms. Having a therapist standing by to help can be extremely valuable, but this article also includes several other ways to cope that can help you feel empowered to take care of yourself. As the days turn into weeks, know that you will be keeping track of how long it has been since the loss, how many weeks pregnant you might have been and when your due date was supposed to fall. This is normal, even if it is upsetting. As time goes on, you may lose track of these important landmarks, which is also normal. Go easy on yourself as you transition from pregnant to grieving, because your life has truly transformed in a short time. Handle yourself with care, and healing will slowly follow.