“A second trimester loss can be devastating,” states Margaret Howard, PhD, professor of psychiatry and human behavior and medicine, and clinician educator at Warren Alpert Medical School of Brown University. “What we mostly see is bereavement, which is a normal response to such a loss, and [is] characterized by intense longing, sadness, waves of sorrow, and feelings of emptiness." It’s important to allow yourself time to grieve after a second trimester miscarriage, and to find ways to process your emotional pain. Although you may not completely heal from the hurt of the loss, you can find ways to live with—and work through—the experience.
What Is a Second Trimester Miscarriage?
Approximately one in four pregnancies ends in miscarriage. A second trimester miscarriage is one that occurs between 13 and 27 weeks, though experts say most second trimester losses happen between 14 and 19 weeks. While the time frame is easily pinpointed, the cause isn’t always as concrete. That uncertainty can be a source of incredible angst and frustration for parents. “Second trimester loss can occur for a number of reasons," explains Katherine Apostolakis-Kyrus, MD, who works within maternal-fetal medicine at Johns Hopkins All Children’s Hospital. “Sometimes the reason is unknown. Other times, there may be a genetic abnormality, a congenital abnormality, a placental abnormality, a traumatic event, a maternal health condition…[or] cervical insufficiency.” Symptoms of a second trimester miscarriage can range from vaginal bleeding or a person’s water breaking, to having no symptoms at all. Once the baby’s heart is no longer beating, an expecting parent might have a spontaneous delivery. If it doesn’t happen naturally, a patient can still choose to deliver vaginally or have a surgical procedure called a dilation and evacuation (D&E). The choice a person makes impacts the amount of time the body needs to heal. “The physical healing usually takes a few weeks,” says Scott Sullivan MD, director of maternal-fetal medicine at INOVA Health. “Good nutrition, rest, and emotional support are all important aspects of healing. An individual’s menstrual cycle may resume as early as three to four weeks following the pregnancy loss, though experts say six to eight weeks is more likely. As for trying to conceive again, experts say medical advice varies widely, with recommendations between three to six months of waiting.
How to Cope With the Physical Changes
Once the fetus is delivered or removed, the patient’s stomach and uterus are often still enlarged from housing the fetus. As a result, they may still look pregnant. “For a patient who was closer to the end of the second trimester, for example, 27 weeks, it will take longer for her body to go back to normal," Dr. Apostolakis-Kyrus notes. “For women who are less far along, such as 14 weeks, her body will go back to not looking pregnant more quickly. We usually say as much time as it took to get to that point is at least the amount of time it takes to get back to something close to the pre-pregnancy body.” People may see a person’s belly and ask when the baby is due. This can compound the pain of the loss, and knowing how to respond can be challenging. “You might just be honest about it,” suggests states Rachael Benjamin, LCSW, director of Tribeca Maternity. “If you’re left taking care of their reaction, that makes it complicated.” To avoid the feeling of being responsible for someone else’s reaction, a person can change the subject. Simply saying you don’t want to talk about it right now is a sufficient explanation. You may also decide to not even address the comment. Avoiding certain people who aren’t sensitive to what you are going through, especially when you are still coping with a recent loss, is also an option. A person who just miscarried a baby does not have control over when their body chooses to return to the pre-pregnancy state. It’s important to acknowledge the difficulty associated with these changes, and not let someone else’s reaction add to the pain.
Coping With the Emotional Impact
Talia Hollis, in Atlanta, Georgia, went to work like any normal day. After work, she enjoyed a sporting event. She experienced stomach pain throughout the day but thought it was just the baby moving around. That night, she learned that she lost her baby at 16 weeks. “To be honest, I felt like a failure. I felt guilty, like I had failed my baby,” Hollis shares. “I went through that for a long time before I had to convince myself that it was not my fault.” Moving forward didn’t happen overnight. Hollis surrounded herself with supportive family and friends, which made a big difference in her healing process. Being wracked with feelings of guilt and grief can characterize an individual’s emotional state following a second-trimester miscarriage. “Some women experience normal bereavement coupled with postpartum depression or anxiety,” Dr. Howard notes. “Some women experience post-traumatic stress disorder, depending on the circumstances surrounding the pregnancy loss. The bottom line is that while there are common threads, there is no ‘one size fits all.’" Another mom, who prefers to remain anonymous, was busily preparing for a family Thanksgiving celebration when her water broke at 16 weeks. She raced to the doctor’s office and learned her baby had no heartbeat and had to be removed via surgery at the hospital. “I…became extremely depressed and couldn’t sleep, requiring medication,” she notes. “I was traumatized. [It] seemed especially horrible to happen on a day where we were supposed to give thanks. I didn’t participate in Thanksgiving [events] for about five years…until the trauma faded just enough.” She notes that the pain is still present, just different. “I have never gotten over it, but the memory has faded over time. It took years, almost a decade, for me not to think about it every November,” she adds. Dealing with that pain should be done on the terms of the parent who experienced the loss, as there’s no definitive time frame. There are, however, actions that can guide a parent on their journey to healing.
Mindfulness and Internal Connection
Meditation and mindfulness exercises can help with the healing process. Talking about your feelings with a psychologist, counselor, or healthcare provider is also beneficial. Journaling can also be very therapeutic. Through the Heart, an organization that offers support for pregnancy loss, provides comfort kits that include a journal and other items to help on your healing journey.
Memorials and Tributes
Some families choose to commemorate the life of their baby. Planting a tree in the backyard that is dedicated to the baby can bring comfort. You can also plant a tree, or even a grove of trees, in honor of your baby in certain national forests, through A Living Tribute. Having a photographer take pictures of the baby, or items that may have been purchased for the baby, can also provide a measure of closure, and further the healing process. Now I Lay Me Down to Sleep focuses on capturing photos that serve as a gift of remembrance. You can also learn more about organizing or participating in a remembrance walk on their website. For some parents, having something to hold is meaningful. Molly Bears creates a custom teddy bear to serve as a comfort and reminder of your little one. Parents may choose to hold a service to say goodbye to the baby. These services can be organized by a loved one to hold at home, or in a church. Tommy’s provides more information on organizing memorial or goodbye services. Mommies Enduring Neonatal Death (M.E.N.D.) also holds commemorative ceremonies.
Validating Your Emotions
No matter what methods you use to move through this difficult time, know that your feelings matter. They are valid and deserve the time and space to be heard, felt, and processed. “There is no right or wrong way to mourn," Dr. Howard concludes. “Begin by acknowledging that losing a baby is a devastating loss and it takes time to heal and incorporate the loss. The goal isn’t to forget and move on. Rather, it’s a matter of ‘moving through.’ It takes time.”
A Word from Verywell
A miscarriage at any time during a pregnancy is a loss that impacts a person physically, mentally, and emotionally. While it’s not something you can necessarily prepare for, having information on what to expect, and knowing how to handle it, can help. Ultimately, giving yourself the time to grieve and heal is the most important part of the process.
