Losing a baby terminated for medical reasons is incredibly heart-wrenching in a different way from other kinds of pregnancy losses. While physical recovery can depend on factors related to your pregnancy and the type of procedure you had, coming to terms with your emotions after this type of loss isn't always easy.
What happens after a medical termination of pregnancy?
Medical terminations of pregnancy involve undergoing an abortion, where pregnancy tissue and the fetus and placenta, called the products of conception, are removed from the uterus. This can be done with medications or in an outpatient surgical procedure, based on the woman's health and how far her pregnancy has progressed.
In June 2022, the U.S. Supreme Court ruled there is no Constitutional right to an abortion, which means it is now up to individual states to decide whether abortion is legal in that state. Depending on where you live, you may not have the option to medically terminate a pregnancy.
Some factors of recovery depend on which type of termination was performed. But in both cases, it's normal to experience pain and bleeding and to be given antibiotics to reduce the risk of infection. Your emotions can run the gamut too, and it may take time to sort through your feelings and come to terms with your loss.
Your physical recovery after a medical termination of pregnancy
Medical terminations of pregnancy can be performed with medications or as minor surgical procedures (as long as abortion is legal in your state), and your physical recovery will depend on which method you and your provider choose.
- For medical abortions: Medical abortions, also known as medication abortions, involve taking the drug mifepristone in your doctor's office, followed by taking the drug misoprostol at home 24 to 48 hours afterwards. These medications can cause moderate to heavy bleeding and cramping for several hours. (Most experts recommend using pads, but if you'd rather use a tampon or menstrual cup, check with your provider.) It's also normal to have symptoms like nausea, vomiting, diarrhea, fever, chills or a headache. Lighter bleeding and spotting can continue for up to two weeks. You should take it easy for the first few days and avoid vigorous activity. After completing the medication, you'll likely go back to the doctor for a follow-up visit to confirm that uterus has fully cleared the products of conception. (If it hasn't, the tissue may need to be removed surgically.) Your period should return within four to six weeks.
- For surgical abortions: Surgical abortion procedures are similar to a dilation and curettage (D&C); the cervix is dilated and the products of conception are removed with a suction-like device. It's normal to feel drowsy and crampy for several hours afterwards, and bleeding or spotting can linger for up to two weeks. In the hours and days following the procedure, you might also have nausea or vomiting, diarrhea or headaches. You'll be given antibiotics to reduce the risk of infection and will need to rest and avoid strenuous activity for a few days while your body recovers. Your period should return within four to six weeks.
Cramping from medical or surgical abortions can usually be managed with over-the-counter pain relievers like acetaminophen or ibuprofen, though you should confirm with your practitioner that the meds are okay first. Your doctor may also recommend prescription options if the pain is severe. Your practitioner may advise against resuming sex for at least a week, or until after any bleeding has stopped, to reduce the risk of infection.
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Both procedures come with the potential risk of infection, so you should take your antibiotics as prescribed and notify your doctor right away if you experience possible signs or symptoms including:
- Abdominal or back pain that's severe or gets worse instead of better
- Heavy vaginal bleeding, defined as soaking more than two pads in an hour for two hours in a row
- Foul-smelling vaginal discharge
- A fever of 100.4 Fahrenheit or greater
Your emotional recovery after terminating a pregnancy for medical reasons
The loss can hit especially hard if you're struggling with the guilt of choosing to terminate your pregnancy, even if you know that you've made the right choice. Even if your termination happened very early in your pregnancy, you may be hit with a range of emotions. Know that however you are feeling is okay.
If you're mourning the end of your pregnancy, you may also be feeling guilty over making the decision to end it. Remember, though, that you made the best choice for yourself, your partner or family, and your baby. And regardless of how or when your pregnancy ended, you have the right to grieve in whatever way feels best for you.
It's normal to need some time to rest and make sense of your thoughts. There's no right or wrong way to recover from a medical termination of a pregnancy — whatever you need to do to heal and move on is okay. Talking with your partner if you have one can make a big difference. Remember that they, too, may be mourning, and sharing your feelings (instead of trying to protect each other) can help you both feel better.
You may also choose to connect with others who've had similar experiences. That may be a family member or friend who has experienced a termination of pregnancy or a pregnancy loss, or it could take the form of a support group. Grief counselors and spiritual advisors can also be good resources, if you'd rather talk with someone else one-on-one.
Honoring your baby
Planning a reflective activity by which to remember your baby can also encourage healing. You could plant flowers or a tree, have a quiet picnic in the park or a commemorative meal with your partner or other loved ones, observe a few quiet moments with a candle, or even write a letter to the baby to let out your thoughts and feelings.
There are no right or wrong ways to say goodbye. Ultimately, it's about doing something in your baby's honor that serves to provide a sense of closure for you too.
What to do if you're dealing with depression
It's normal to grieve over the end of your pregnancy, no matter how that end came about. While abortions themselves don't increase a woman's risk of depression, according to the American College of Obstetricians and Gynecologists (ACOG), research shows that some women may be more prone to becoming depressed after a pregnancy termination if the pregnancy was wanted, if they felt pressure or stigma around their decision or if they have a history of mental health problems.
There's no way to say for sure when exactly you'll have healed. But in general, you should move towards feeling more like yourself over time.
Contact a mental health professional if you notice that you're having trouble getting through regular everyday life, aren't eating or sleeping well, have lost interest in the things that you typically enjoy, or are feeling anxious, isolated or hopeless. Talking with a therapist can help you cope with your feelings and come to accept your loss.
Getting pregnant again after terminating a pregnancy
It may be hard to think about trying to conceive again right away. You may struggle with the fear of a future pregnancy being affected by similar problems and being forced to make the same heartbreaking decision all over again. Or you might worry that having a medical termination could affect your ability to get pregnant in the future.
It's normal to need some time before you're ready to try to get pregnant again after a loss. You can take comfort in knowing, though, that abortions don't affect a woman's future fertility or increase the likelihood for future pregnancy complications, according to ACOG.
In fact, it's possible to try getting pregnant again after you've had a normal period, which typically happens four to six weeks after your procedure (though keep it mind that it's also technically possible to get pregnant before your period returns). Before you get started, though, check with your practitioner. Together, you can discuss steps to have a healthy pregnancy such as having a complete preconception checkup and addressing any underlying health problems like diabetes, high blood pressure, STDs or thyroid problems.
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