Miscarriage

A miscarriage can leave you shocked, empty and sometimes very alone, especially if you had not yet told anyone. People may say "at least it was early" or "you can try again", and that can hurt. Grieving a pregnancy is normal, whatever the number of weeks.

What is happening

Miscarriage is the loss of a pregnancy before the baby could survive outside the womb. It is common, and in most cases it is caused by things no one could control, such as the way the pregnancy developed from the very start. It is very rarely caused by work, stress, lifting, sex or a small fall. Many women still blame themselves. Please hear this: it was not your fault.

Physically, you may need care at a clinic or hospital, medicine to help the body complete the process, or a small procedure. Bleeding and cramping can continue for some days. Go to a clinic or emergency unit if you have very heavy bleeding, fever, strong pain or a bad-smelling discharge.

Emotionally, grief after miscarriage can be strong and can return at the due date, when friends announce pregnancies, or in a next pregnancy. Partners grieve too, though often quietly. Some families have rituals for pregnancy loss and some do not; you may create your own, such as naming the baby, planting something, or saying a prayer.

At work, sick leave usually covers an early loss. If a miscarriage happens in the third trimester, the Basic Conditions of Employment Act gives six weeks' maternity leave after the loss. You do not have to share every detail with your employer, only what is needed for leave.

Signs to notice

• Waves of sadness, emptiness or anger, sometimes mixed with relief
• Blaming yourself or your body
• Finding it hard to be around pregnant women or babies
• Worry about whether you can have a baby in future
• Feeling distant from your partner, or that they do not understand
• Physical tiredness and poor sleep for weeks

30-second self-check

Answer yes or no. Go with your first honest answer.

• Are you still bleeding heavily, in strong pain or feverish?
• Do you blame yourself for the loss most of the time?
• Has low mood lasted more than two weeks and is getting worse?
• Are you avoiding people or places because of the loss?
• Are you and your partner struggling to talk about it?
• Are you worried about a future pregnancy to the point that it keeps you awake?

0-1 yes: You are grieving in a way many people will recognise. Be gentle with yourself and let people help.
2-3 yes: The loss is weighing on you. A counsellor who understands pregnancy loss can help you and your partner.
4 or more yes: Please get support soon. If you answered yes to the first question, go to a clinic or hospital today.

What you can do next

• Today: Rest, eat something and let one person know what happened, if you feel ready.
• This week: Attend your follow-up check at the clinic or with your doctor, and ask any questions you have about why it happened and future pregnancies.
• This month: Consider a small ritual to mark the loss, and speak to a counsellor if sadness is not easing.
• Partners: ask how she is, share your own feelings, and help with practical things.

Your tool

Memory and Ritual Journal - gentle prompts to help you name what you lost, mark the due date or other dates, and choose a ritual that feels right for you.

When to get professional help

Get medical help straight away for heavy bleeding, fever or severe pain. Get emotional support if low mood lasts more than two weeks, if you cannot stop blaming yourself, or if anxiety about another pregnancy is taking over. Some women have repeated losses; a doctor can look into possible causes.
Who can help: doctor, nurse, counsellor, psychologist

Getting help in South Africa

Public clinics and hospitals provide follow-up care after miscarriage. The Cleared Mind 24-hour Careline on 0800 212 146 can connect you or your partner to a counsellor. SADAG (011 234 4837, 08:00-20:00) can refer you to support groups. For leave questions, see our Work hub or check the Basic Conditions of Employment Act guidance on labour.gov.za.