Hesperian Health Guides

People Who Need More Support

In this chapter:

Loss of a pregnancy (miscarriage)

a woman looking sadly at heavy bleeding from her vagina

A miscarriage is a pregnancy that ends by itself during the first half of pregnancy, before the baby is fully developed. Most miscarriages happen in the first 3 months of pregnancy. A person can become pregnant again after a miscarriage and have a healthy pregnancy and healthy baby.

The most common signs of miscarriage are pain and bleeding from the vagina. This may be like a menstrual period or may be heavier and stronger. Some tissue or clots may come out with the blood.

If bleeding and pain continue for more than a few days, if bleeding is much heavier than a menstrual period, or if there is fever or a bad-smelling fluid coming from the vagina, part of the pregnancy may still be inside the womb. This is an incomplete miscarriage and can lead to heavy blood loss, a dangerous infection, or even death. Go to a health center or hospital where a trained health worker can empty the womb. Someone with strong, constant pain in the lower abdomen may have a pregnancy in the tube. This is very dangerous.

After a miscarriage, rest and avoid heavy work or lifting for 2 weeks. Do not douche or wash inside your vagina. Do not put anything in your vagina and avoid sex until all bleeding stops because your womb is still open and could get infected.

People have many different feelings after a miscarriage, including sadness, anger, and misplaced feelings of guilt. You may find it helpful to talk with others who have lost a pregnancy

Helping those who have more needs

People who are very poor or very young, who have cognitive delay, who already have sick or malnourished children, or who are raising children without any support are more likely to have difficult births and problems following birth.

Helping struggling parents get food, care, and companionship can make a great difference in the lives of these families.

Pregnancy for someone who does not live as a woman

Pregnant people who do not live as women need informed and thoughtful support. Their healthy pregnancies depend on health workers using respectful language to talk with them about their bodies, helping them with difficult feelings about gender that pregnancy can cause, and preparing them for birth and feeding. Health workers who can provide this care are greatly needed.

Depression after giving birth

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

Feeling anxious, sad, or numb after giving birth is not unusual, and those feelings usually go away. If not or if they return and continue, the person may have postpartum depression, which is very common and can be treated. People who feel this way need support to talk about their feelings regarding the baby and all the changes that are happening. They often need help to care for their health, home, and family. And they need to know that they are not alone. While medicines for depression might help, the support of a trusted friend or friends is most important.

Postpartum depression is more likely if someone has been depressed before, if they had a difficult birth, if they or the baby are sick or have physical problems, or if they are away from or have difficult relations with their family

When the baby dies

Give someone extra care and support when their baby dies.

Most pregnancies are healthy and produce healthy babies. But sometimes, no matter what anyone does, the baby dies.

Great sadness and loss make this a hard time for parents. The person who has been through a pregnancy and birth needs to rest and get their strength back, just like someone with a new baby. Let the person know:

  • The breasts will probably be sore, especially around the 3rd day after the birth when the milk comes in. Cloths soaked in cool, clean water may reduce the soreness.
  • Do not squeeze out the first yellow milk (colostrum) or the regular breast milk. This only causes the body to make more.
  • Treat breast infection if necessary.
  • Consider waiting at least 6 months before getting pregnant again. Start using a family planning method as soon as possible to postpone pregnancy.

Families will have different ways of mourning the loss of their baby. Help with this if you can.

This page was updated:13 Nov 2023