It’s one of the most common questions after a miscarriage—and one of the hardest to sit with.

Late miscarriage often leaves families searching for answers, especially when things seemed to be progressing normally. The truth is: most second-trimester losses happen because of factors entirely outside your control—not because of anything you did or didn’t do.

There are many myths and outdated beliefs that can lead to misplaced guilt or self-blame. To be clear, none of the following cause miscarriage:

• Emotional stress or anxiety

• Traveling, lifting, or light exercise

• Sex during pregnancy

• Working or continuing with your regular routine

• Not bonding immediately with the baby

• Forgetting a prenatal vitamin

• Having a prior miscarriage

• Feeling uncertain or emotionally overwhelmed

In many cases, even medical professionals cannot pinpoint a single cause for a late miscarriage. That uncertainty is difficult—but it does not mean you are to blame.

Labor & Delivery

If your pregnancy has progressed beyond a certain point, your doctor may recommend induction to deliver the baby. This can be a physically and emotionally intense process, and you’ll be supported medically throughout.

What to expect:

• You’ll be admitted to the hospital for monitored care

• Labor is typically induced with medication (often misoprostol or Pitocin)

• Delivery may take several hours to over a day, depending on your body’s response

• Pain management options, including epidurals or IV medication, are available

• You may have the option to hold, name, or spend time with your baby afterward

Monitoring & recovery:

• You’ll likely remain in the hospital for monitoring after delivery

• Bleeding may continue for up to 2 weeks

• Uterine cramping and hormonal shifts are expected

• Physical recovery may take 1–2 weeks, longer for some

D&E 

D&E (Dilation & Evacuation) is a surgical procedure used to remove pregnancy tissue in the second trimester. It may be recommended depending on gestational age, medical complications, or your personal preference.

What to expect:

• Typically performed under general anesthesia or sedation

• Requires cervical preparation (medication or dilators) 1–2 days beforehand

• The procedure itself lasts about 30 minutes

• Usually done in a hospital or specialized surgical setting

Monitoring & recovery:

• You may go home the same day after brief monitoring

• Cramping and light to moderate bleeding are common afterward

• Physical recovery takes about 1 week

• Avoid heavy lifting or strenuous activity for a few days

• Watch for signs of infection: fever, heavy bleeding, or foul-smelling discharge

Suggestions for Recovery (After Labor & Delivery or D&E)

Whether you’ve delivered in a hospital or undergone a surgical procedure, your body needs care and time to heal. You may receive some of these items from your care team, but it’s helpful to have them accessible at home.

These supplies can support your physical recovery:

• Perineal ice packs – to reduce swelling and discomfort after vaginal delivery

• Witch hazel pads or liners – soothing relief for vaginal soreness

• Peri bottle – for gentle cleansing when wiping is uncomfortable

• Numbing spray (like Dermoplast) – often provided by the hospital for pain relief

• Thick sanitary pads – bleeding may continue for several days to weeks

• Disposable underwear or comfortable, loose cotton options

• Pain medication – follow what your doctor recommends (ibuprofen, acetaminophen)

• Stool softeners – to prevent straining and ease bowel movements

• Rest, hydration and bland foods – nourish your body gently

• Soft clothing and rest items – think stretchy pants, robes, and warm blankets

• Emotional comfort – whether it’s music, tea, a journal, or a trusted support person

It’s not fair—and it’s one of the many things no one prepares you for. After perinatal loss, your body may still begin producing breast milk. It’s a natural response to birth, even when the outcome is heartbreaking.

This can be both physically painful and emotionally overwhelming, especially when there is no baby to feed. Some find meaning in donating their milk as a way to honor their baby. Others feel that any reminder is too painful and just want it to stop. There’s no right or wrong decision—only what’s right for you.

Managing Milk Suppression

If you choose not to express milk, your body will gradually stop producing it. However, this process can take several days or longer and will be uncomfortable. Here are some ways to reduce pain and help your body suppress lactation:

• Hand express small amounts – enough to relieve pressure but not stimulate milk production

• Avoid nipple stimulation or frequent pumping – this signals the body to make more milk

• Cold packs or frozen cabbage leaves – placed in your bra for comfort and swelling relief

• Wear a supportive, snug bra – but avoid overly tight compression

• Drink sage or peppermint tea – both may help reduce supply naturally

• Take ibuprofen or acetaminophen – to manage discomfort and inflammation

Important: If you have allergies or medical concerns, speak with your doctor before trying any of these methods.

Watch for Signs of Mastitis

Sometimes milk ducts become blocked or infected—a condition called mastitis. Contact your provider if you notice:

• Fever or chills

• Body aches or fatigue

• Redness or swelling in one breast

• A hard or painful lump

• Yellow or pus-like discharge

Early treatment can prevent complications and reduce discomfort.

Donating Milk as a Way to Honor Your Baby

If donating breast milk feels right to you, it can be a meaningful way to honor your baby’s life. Donation requires certain screening steps, but many loss families have found healing through this path.

Here are three nationally recognized organizations that coordinate breast milk donation:

• Mothers’ Milk Bank – www.milkbank.org

• Mothers’ Milk Bank Northeast – www.milkbankne.org

• Human Milk Banking Association of North America (HMBANA) – www.hmbana.org (offers a list of accredited nonprofit milk banks across the U.S. and Canada)

You can reach out to these groups directly or ask your care team for guidance on local donation options.

Milk coming in can feel like one more heartbreak in a series of many. Talking to someone you trust—a partner, friend, support group, or counselor—can help you process the complex emotions tied to this experience. Whatever you choose to do, know that your decision is valid.