Hesperian Health Guides

Hesperian Health Guides

Women with Extra Needs

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HealthWiki > Where Women Have No Doctor > Chapter 6: Pregnancy and Childbirth > Women with Extra Needs


Loss of a Pregnancy (Miscarriage)

a woman looking sadly at heavy bleeding from her vagina

A miscarriage is a pregnancy that ends by itself before the baby is fully developed. It is often the body's way of ending a pregnancy when the unformed baby has a serious problem that would have kept it from developing well. Most miscarriages happen in the first 3 months of pregnancy. After a miscarriage, a woman can still become pregnant again and have a normal pregnancy and a healthy baby.

The signs of miscarriage are pain and bleeding. (See more information on other possible causes.) The bleeding and pain usually begin like normal monthly bleeding and then get heavier and stronger. There may also be some tissue or clots with the blood.

If the bleeding and pain continue for more than a few days, if the bleeding is much heavier than normal monthly bleeding, or if a woman gets a fever or has a bad-smelling fluid from her vagina, part of the pregnancy may still be inside the womb. This is called an incomplete miscarriage. It can lead to heavy blood loss, a dangerous infection, or even death. The woman should go to a health center or hospital where a trained health worker can empty the womb.

a woman sitting apart from two women with chldren
A woman who wants children may feel very sad if she loses a pregnancy.

If a woman has strong, constant pain in her lower abdomen, she may have a pregnancy in the tube. This is very dangerous.

After a miscarriage a woman should rest and avoid heavy work or lifting for 2 weeks. She should not douche or wash inside her vagina. Also she should avoid sex until all bleeding stops because her womb is still open and could get infected.

Many women feel very sad after a miscarriage. Some do not. This is all normal. Some women may find it helpful to talk with other women who have lost a pregnancy.

Helping Women Who Have Trouble Caring for Themselves and Their Babies

a sad-looking pregnant woman sitting alone
Do not wait for those in need to come to you. Go to them.

Some women are more likely to have difficult births and problems following birth, and their babies are more likely to be unhealthy. Mothers who are alone, very poor, very young, mentally slow, or who already have poorly nourished or sick children may have a harder time caring for themselves and their babies.

If someone takes special interest in these mothers, and helps them get the food, care, and companionship they need, it can often make a great difference in the well-being of both the mothers and their babies.

If the Baby Dies

A woman needs extra care and support when her baby dies.

Most women have healthy pregnancies and give birth to healthy babies. But sometimes, no matter what anyone does, the baby dies.

This is always a hard time for a mother. She feels great sadness and loss. At the same time, she has been through a pregnancy and birth and she needs to rest and get her strength back, just like a mother with a new baby.

The following advice may also help:

  • her breasts will probably be sore, especially around the 3rd day after the birth when her milk comes in. Cloths soaked in cool, clean water may reduce the soreness.


a woman comforting another woman as they sit together

She should:

  • not squeeze out either the first yellow milk (colostrum) or the regular breast milk. Removing milk will cause the body to make more.
  • watch for signs of breast infection and treat if necessary.
  • wait for at least 3 months before trying to get pregnant again. A woman's body needs time to heal.
  • start using a family planning method as soon as possible. She can become pregnant again too soon.

For many women, this is a death like any death of someone she is close to, and she will need to mourn her loss. She needs special care, kindness, and support.


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