Hesperian Health Guides

Women who need more support

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.

Mothers who are alone, very poor, very young, mentally slow, or who already have poorly nourished or sick children are more likely to have difficult births and problems following birth.

Helping these mothers get the food, care, and companionship they need, can make a great difference in the well-being of them and their babies.

Depression after giving birth

It is normal to feel anxious or sad right after giving birth or afterwards, but those feelings usually go away. If these feelings last longer or if they come back over the course of a year, the mother needs help. Called postpartum depression, it is very common and can be treated. The new mom needs support to talk about her feelings regarding the baby and all the changes she is experiencing. She needs help to care for her health, home, and family. And she needs to know that she is not alone. While anti-depression medicines might help, the support of a trusted friend or friends is most important.

A woman is more likely to suffer from postpartum depression if she has been depressed before, if she had a difficult birth, if she or the baby is sick or has physical problems, or if she is away from or has difficult relations with her family.

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 the first yellow milk (colostrum) or the regular breast milk. This only causes the body to make more.
  • treat breast infection if necessary.
  • for 3 months before trying to get pregnant again, take time to heal.
  • start using a family planning method as soon as possible to postpone pregnancy.


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



This page was updated:23 Oct 2019