Complications After a Miscarriage

If you've recently had a miscarriage, you're likely aware of the unique physical and emotional challenges that come with the experience. Yet sometimes women have complications after a miscarriage as well. For example, conditions such as excessive bleeding, infection, or depression may occur following a miscarriage.

Although most first-trimester miscarriages are relatively uncomplicated—at least from a health perspective—you may want to know what to look out for.

Incomplete Miscarriage

An incomplete miscarriage is relatively common and means that you still have some tissue retained in your uterus from the pregnancy. The most common sign of an incomplete miscarriage is bleeding or cramping longer than would be expected after a complete miscarriage.

If you've had a miscarriage, ​your doctor will tell when to expect the bleeding should stop. If, however, you're still experiencing symptoms roughly 2 weeks after the miscarriage, it could be an incomplete miscarriage and you should talk to your doctor.

Sometimes an incomplete miscarriage will resolve on its own, but other times you might need a D&C or medical treatment with Cytotec (misoprostol) to clear all of the products of conception from your womb.

Excessive Bleeding

Your doctor will advise you if the bleeding you're experiencing is normal as a miscarriage progresses. Too much bleeding, however, could be dangerous for you.

If you have symptoms of excessive blood loss such as pale, clammy skin, lightheadedness, or an increased heart rate, it's likely that you've already lost a significant amount of blood. Don't wait. Call 911.

Infection After Miscarriage

About 3% of women will acquire an infection related to a miscarriage. This infection may be caused by retained products of conception in the uterus. Be sure to contact your doctor if you think you have symptoms of an infection such as:

• Bleeding and cramping lasting longer than 2 weeks
• Chills
• Fever (temperature over 100.4 F)
• Foul-smelling vaginal discharge

A post-miscarriage infection can be dangerous but is generally easily treated with antibiotics.

Asherman Syndrome

Asherman syndrome is a rare complication of a dilation and curettage (D&C) procedure. This syndrome can develop for other reasons as well, such as infection.

With this condition, scar tissue called adhesions form in the uterus. These adhesions can cause fertility problems and further miscarriages. The most common symptom is absent, light, or infrequent periods.

A test called a hysteroscopy is usually used to either make a diagnosis of or rule out Asherman syndrome. Surgery can be used to remove the adhesions so you can try to get pregnant again.

Recurrent Miscarriages

According to the American College of Obstetricians and Gynecologists, 1% of women will have more than one miscarriage. This experience is known as recurrent miscarriage or repeated miscarriage.

Unfortunately, at least 50% of the time, no cause can be found for recurrent miscarriage. 

Depression

According to the March of Dimes, if you experience the following symptoms for a long time after your miscarriage, or if you feel them very strongly and they're interfering with your life, you could be depressed. These symptoms include:

• Difficulty sleeping or sleeping too much
• Feeling tired all the time
• Gaining or losing weight
• Little interest in your usual activities or hobbies
• Thinking about suicide or death
• Trouble concentrating or making decisions

Grief is a normal reaction to miscarriage and pregnancy loss and there is not a magic amount of time it lasts. But if you start to show signs of clinical depression after a miscarriage, talk to your doctor.

There is some controversy over whether depression after a miscarriage is the same thing as postpartum depression, but whatever the diagnosis, depression is as serious as any of the other complications discussed here.

Mental health counseling and/or medications may help you more quickly return to your normal, healthy self. If you're not sure whether you are experiencing grief versus depression, don't wait. Talk to your doctor.

Anxiety Disorders

Some research suggests that anxiety and stress disorders after a miscarriage are even more common than clinical depression, and they can become your new normal if you don't deal with them. It may even be possible to develop symptoms of post-traumatic stress disorder (PTSD) after a pregnancy loss.

In fact, according to the Women's Preventative Services Initiative (WPSI), which is a national coalition of women's health organizations, anxiety disorders are the most prevalent and consequential health disorders in the U.S. What's more, they are more prevalent among women with approximately 40% of women experiencing them throughout their lifetime.

Anxiety is a common experience among women, especially among those with underlying conditions including PTSD. Talk to your doctor about any symptoms of anxiety that you may be experiencing. Most doctors are able to do administer a quick questionnaire to gauge your anxiety level and refer you to a mental health professional for additional assistance.