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AFTER MISCARRIAGE: Postpartum Care for Mothers Experiencing Loss

Tuesday, 11 December 2012 10:38
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People in the US are rediscovering the mind/body benefits of a 30-40 day postpartum recovery period for new moms during which they rest, are cared for, eat special foods for rejuvenation, and are supported by family and postpartum care providers. This, of course, leaves mom better able to care for and bond with her new baby, and to return to her old strength, if not even an increased vitality—quickly!

In China the term for this time is called “sitting moon” (zuo yuezi in Mandarin—one month being “one moon”), but cultures throughout Central Asia, Southeast Asia, and the Far East have similar practices, each with their own special techniques and care providers. This postpartum care is not considered something only for the wealthy or indulgent.  It is considered vital to the mother’s recovery, her long-term health, and her ability to care well for her baby and easily produce abundant milk.

The affects of the neglect that postpartum mothers and new babies experience in the US are obvious.  Just a glance at the statistics for postpartum depression and mothers failing to nurse (when they wanted to) tells of the need for a new look at this ancient practice of a “sitting moon.” 

It was long ago, but this need was recognized at one time in the US, and postpartum recovery practices were followed.  In Marriage & LOVE, published in New York in 1894, Ruth Smythers writes:

            “After the birth of the baby, the mother…should not get out of bed for ten days or two weeks. The more care taken of her at this time, the more rapid will be her recovery.”[1]

But today, the majority of women in the US do not receive the postpartum care and nutrition that is considered a fundamental part of a family’s experience around the world.

Worse, the most neglected and forgotten mothers in our culture are those who lose their baby preterm.

Statistics vary, but Western and Traditional Chinese Medicine (TCM) doctors will tell you that up to 40-50% of all conceptions end in miscarriage—many of them before a woman realizes she is pregnant, and she simply has a “period” that is a few days late. However, the number of women who miscarry further into their pregnancy—after the body is in full swing of its myriad, major changes—is still enormous.  In the US the estimate for annual miscarriages is 900,000-1,000,0000.[2]

How are these women treated? How are they cared for?

Being immersed in the “birthing world”, I hear tales often of the cold nonchalance with which these women are handled, and I’ll offer two examples from personal experience.

When I had a miscarriage, not knowing what was happening other than pain that left me unable to walk, I went to the hospital.  Very quickly, with profuse bleeding, what was happening became apparent, yet the staff still wanted to “check” me.  After extensive probing with an internal sonogram device, I asked the tech what she had to report to me.  She said, “I’m not allowed to say anything.”

About an hour later as I sat shivering and bleeding in the ER, the doctor came in and said, “You’ve had a miscarriage.” (As I’d told them earlier, I knew that.) Then he said, “On the way out, the girl at the front desk will give you a paper you need to read.”  And he left.  Apparently recognizing the void of feeling in the exchange, the tech then approached me, patted my arm and said, “Hopefully we’ll see you in the L&D next time.”

The paper they provided contained the headline, “YOU HAVE EXPERIENCED A PRETERM LOSS OF YOUR PREGNANCY” and had a list of side-effects I should watch for, and return to the hospital if I believed I was experiencing, as they could be fatal.  And that was it.

A friend experienced her loss at approximately five months.  Because of her baby’s size at that time, she actually had a full L&D experience. They allowed her to see her baby (she had to fight for this) and because he was just a few weeks below the cutoff age to be given to the parents for burial, he was taken away from her and the body was disposed of according to hospital procedures.  She’d known she was losing him, and had planned in her mind a funeral on the beach and a proper burial, but she was denied that, and sent home, again with a list of “things to watch for.”  And that was it.

Though miscarriage is extremely common—a woman holding in her hands the body of what she thought would be her lifelong love and devotion, and saying goodbye—it is trauma.

Our treatment of mothers experiencing this loss is unconscionable, but I believe it is—for the most part—simply a lack of knowledge that there are intricate and loving traditions practiced around the world to help speed postpartum moms of miscarriage to a healthy and happy recovery (that also, according to TCM, increase the likelihood of her having a successful pregnancy the next time she conceives).

While our “system” provides no guideline for postpartum care for mother’s who miscarry, at least, sometimes, family and/or friends come to care for the mother—for a day or two.  Sometimes, women don’t even receive this emotional or physical assistance.

But according to the precepts of TCM, a postpartum mother who’s miscarried requires more attention and care than a mother who delivered her full-term baby.  Amy Wong, an internationally acclaimed expert in this field, writes that, “Natural delivery requires at least 30 days of rest, while Cesarean delivery, miscarriage, and abortion require at least 40 days.”[3]

Why would a woman who’s had a miscarriage require more support and recovery time?

She’s experiencing an enormous spiritual loss—few things are harder for a mother than losing the child who has entered her life, even if briefly.


Her body has made the enormous, taxing hormonal and other physical shifts of pregnancy.

To experience strong shifts of mind, body, and spirit simultaneously, and then to be left alone and expected to return to life as usual in the next few days…many moms do “bounce back.”  However, it is a formula for depression, anxiety, and panic attacks—which, in fact, afflict many mothers who even have the joy of holding their new baby in their arms postpartum.

I see—frequently—mothers who have miscarried and are asking for help and guidance on social websites.

Of course the Internet and people we meet online can be wonderful resources, but…

we can do better for these women.

For those interested in learning more about the traditional practices used for postpartum mothers who delivered full-term or miscarried—doulas and midwives can offer great support, and there are several books I’d recommend as a start:

  • Sitting Moon, by Dr. Daoshing Ni and Dr. Jessica Chen
  • The Mommy Plan, by Valerie Lynn
  • Madam Wong’s Confinement Dishes, by Amy Wong
  • and my book, New Mother

A final thought for postpartum mothers who’ve experienced loss:

Gratitude is powerful medicine. It is helpful if we can focus (with enormous effort) on feeling gratitude for having been pregnant even briefly, since so many of our dear sisters who want to be mothers may never experience that profound blessing. 

May we all grow in love and compassion through our challenges, and experience health and joy on our journey! 

Read the second part of this article CONCEIVING AFTER MISCARRIAGE: When to Try Again & Increasing Ability to Carry Full Term to learn more.

[1] Real Advice from 1894 Marriage & Love, Ruth Smythers, Spiritual Guidance Press, New York City, 1894; republished by Lyons Press, Guildford, CT, 2011, p. 92

[3] Madam Wong’s Confinement Dishes, Seashore Publishing, Kuala Lumpur, Malaysia, 2012, p. 11

Read 16528 times Last modified on Monday, 11 February 2013 10:00

ALLIE CHEE has studied Asian martial and healing arts since 1989, earning a 2nd degree black belt and certification in TCM nutrition; she is a 42-year-old home birth mom; and author of NEW MOTHER: Using a Doula, Midwife, Postpartum Doula, Maid, Cook, or Nanny to Support Healing, Bonding and Growth; and FREE LOVE: Everyday Ideas for Joyful Living.

Her articles have appeared in: 

  • Midwifery Today
  • The Well Being Journal
  • The Birthing Site
  • The Holistic Networker
  • Kindred Community
  • Natural Mother Magazine

With 85% of US births considered traumatic for mother and child, how can we plan the gentle birth & loving postpartum we all want? View: The New Mother video...

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