How to Navigate Body Changes After Miscarriage and During Infertility

When I think about body changes after miscarriage, my mind always goes back to approximately 1:30 PM on July 10, 2023—the worst moment of my life, when I realized my baby was dead. I was lying in the ultrasound room, holding my husband’s hand. We were staring at the large projector screen, showing the inside of my uterus, which looked drastically different compared to only a couple of weeks before when all was well, and we got to joyfully glimpse our first little one (named Forrest) moving around. But that day, at 14 weeks pregnant and starting the second trimester, there was no motion and no miraculous sound of her heartbeat (Although my miscarriage occurred just into the second trimester, most pregnancy loss occurs during the first trimester). Instead, there was silence. It was a type of silence that I had never experienced before—a type that made me feel like I was dead while alive and more alone than I’d ever felt in my 35 years of living.

My silent miscarriage

After what felt like eons, I had to break it—I said, “Is everything okay?” which feels ridiculous now but there was a part of me that was not going to accept reality, at least not then. My midwife responded with the worst words ever spoken to me: “No. I’m sorry, but your baby doesn’t seem to be alive anymore.” Like many miscarriages, ours was unexplained and we were told it was simply bad luck.

Since I had a silent miscarriage, my body had no typical symptoms of miscarrying (like cramps and bleeding). Even after the loss, my hormones and body continued behaving as though I was still pregnant, making the experience even more confusing. (Those early body changes after miscarriage were especially confusing because physically, I still felt pregnant while emotionally I was grieving the loss of my baby.) My husband and I spent the rest of the week deciding and figuring out how the pregnancy would end and how Forrest’s body would leave my body. By the end of the week, it was over. It’s impossible to express exactly how I felt in the following moments, days, and month, but it was something like being stuck in a nightmare with absolutely no sign of waking up from it. I went from being shocked to infuriated to scared, and then headfirst into grief, which I am still processing now.

Reproductive issues can impact body image

One of the most unexpected body changes after miscarriage wasn't just physical—it was how dramatically my relationship with my body changed. I had spent years as a young woman making peace with it and learning how to befriend it after years of overexercising and under eating. Plus, a large part of my life’s work as a registered dietitian has also been devoted to helping others to heal from their own eating disorders and re-establish trust and acceptance with their bodies (visit our eating disorder counseling page for more information). But my miscarriage was foreign territory, and I found myself having consistent difficult thoughts and feelings toward my body for the first time in a while.

Throughout my life, I’ve heard about women struggling with their changing bodies in pregnancy, but never about how miscarriage or infertility impact body image. I can’t help but wonder if this is because the topics of miscarriage and infertility still have a taboo surrounding them, they’re discussed way less than pregnancy in general. It’s also interesting that there’s significantly less research surrounding the topics, compared to body image in healthy, full-term pregnancies. The reality is that about 10 to 20 out of 100 known pregnancies, or 10 to 20 percent, end in miscarriage and about one in five women in the U.S. experience infertility. I know several women who’ve experienced both. And it’s all happening within our bodies, so of course it’s going to impact our relationships to them.

Miscarriage and body Image

Here are some ways that miscarriage can affect body relationships:

Disassocation and hard feelings

One study shows women who went through pregnancy loss experienced disassociation, feeling a loss of control over the body, and emotions like betrayal, distrust, and anger towards the body— “both women and fetuses were described as hostages of the body.” “In my personal experience, I struggled to trust my body after my first of two miscarriages because I felt broken and angry that my body couldn't work ‘correctly,’” says Arden Cartrette, founder of The Miscarriage Doula + Co.

Mental health struggles

Straight after my loss, I felt like a stranger in my own body and scared of being alone with it, even on my yoga mat, which had been my safe place for over 15 years. Although I have been recovered from my eating disorder for a decade, I started to notice eating disorder thoughts popping up. Thankfully, I knew they were there because I was in serious emotional pain and my old go-to was controlling my food and exercise, and I was able to let the thoughts pass.

A scientific review also shows mental health issues are higher in women who have miscarried than those who haven’t. In my work as a dietitian, I see a clear connection between mental health struggles like anxiety, depression, and emotional distress and worsened body image—it often feels easier to take out hard feelings and circumstances on the body than to deal with reality and all that come with it, especially during traumatic experiences. Retrospectively, I believe part of my negative body image following miscarriage was certainly functioning in such a way.

Body distrust

I also felt like a fraud and failure because I’d spent years healing my relationships to food, body, and exercise, and getting my health to a place where I could reproduce, and it felt like all that was a waste. I felt like my body failed me and no longer viewed it as strong and powerful but instead disappointing and deeply flawed. It made me feel like all the embodiment work I’d done to be in sync with my body was pointless, since it hadn’t communicated a thing to me about my baby dying. It felt like my body had taken life from me, along with hopes, dreams, excitement, and innocence. I saw it as the former, empty home of my daughter and wasn’t sure I could ever trust it again. It was like I was in a relationship with a human who had so deeply betrayed me that I wasn’t sure we could ever be the same again.

Physical changes

The physical body changes after miscarriage were also incredibly difficult to process. There were the changes I'd already experienced, like bigger boobs and a bit of a growing belly, which was disorienting and a constant reminder my baby was gone. “In my own personal experience of a missed miscarriage, having experienced the initial symptoms of pregnancy nausea and fatigue, along with some weight gain,” shares women’s health dietitian Jamie Adams, MS, RDN, RPYT, “I struggled with my own body image as people continued to ask if I was pregnant while I held onto the ‘pregnancy weight.”

Infertility and Body Image

Here are some ways that infertility can affect body relationships:

Resentment

Like miscarriage, infertility can significantly impact a woman’s relationship to her body. Cartrette says she struggles with resentment towards her body, and sees it in some of her clients, too. “I don't ovulate on my own, which has always impacted my relationship with my body because I can't have a spontaneous pregnancy, there are no surprises for my husband or myself, and we must spend a lot of money to get pregnant in the first place.”

Stress and comparison

There’s also research showing high levels of infertility-related stress is linked to poorer body image. “There are so many things that have to ‘right’ for a pregnancy to occur and for that pregnancy to equal a healthy, living child, and when it's not happening but a woman sees friends, family, and coworkers growing their family seemingly without a problem, it can make her feel like something is wrong with her,” explains Cartrette. “The more we feel disconnected with our bodies, the more blame we might place on them, but this can also lead to a disconnect in future cycles and pregnancies.”

Treatment-induced body changes

Adams points out that some fertility treatments and hormonal medications can cause appearance and body changes and weight fluctuations, which she says is a struggle for many of her clients. Plus, research shows infertility can negatively impact women’s self-esteem, sexuality, and psychological function. “My female clients facing infertility describe to me feeling at war with their bodies,” says intuitive eating counselor Katie Schimmelpfenning, RD.

Harm caused by medical providers

Sadly, some medical providers can make everything harder. “[My clients] often unfortunately deal with weight-biased providers and harmful media messaging. These women describe to me being told to ‘eat cleaner,’ ‘lose more weight,’ and ‘be healthier.’ At every turn, these women are blamed for not being or doing enough to be worthy of pregnancy,” Schimmelpfenning adds. And obsessing over and restricting food or punitively exercising to gain control and manipulate the body can lead to issues like disordered eating and more body disconnection. “I find that there is also a lot of diet ‘advice’ out there that fuels this fire,” says fertility and prenatal dietitian McKenzie Caldwell, MPH, RDN, “and makes folks feel as if dieting is the answer to their fertility issues.”

 

Triggering old wounds

Cartrette explains that, for many people, infertility or pregnancy loss can trigger a time in life when they weren’t at peace with their bodies, which, as I mentioned, is something I noticed post loss. “If you're someone who has a history of OCD, disordered eating, or weight concerns, fertility issues can really trigger the trauma that already exists in your mind.”

 

How to heal your relationship to your body

Whether you're coping with body changes after miscarriage or navigating infertility, you can develop healthy coping tools and arm yourself with resources when dealing with negative body image. There was no way I could’ve learned how to re-establish body trust and respect post-miscarriage without such a toolkit and the help of others. Here are several resources to help in your body relationship—I encourage you to take what you need and leave the rest.

Give your body time to heal.

Your doctor will give you specific guidance on when to return to your normal activities, depending on your body’s responses and side effects, but recovery from pregnancy takes time, regardless of the outcome. For me, giving my body space to heal after my miscarriage meant sleeping and resting in abundance first, and then slowly getting back to regular physical activity, but only gentle practices like restorative yoga and walking first. Although you may recover sooner physically, the emotional toll may require more physical rest, because our emotions are felt and stored in our bodies. Remember you’re in relationship to your body and giving it time to heal is one way to show it respect and love, even if you feel at odds with it. 

Offer your body stability.

Whether you’re struggling with pregnancy loss or infertility, everything can feel incredibly unstable and insecure, and without of your control. It doesn’t help that much of the nutrition and health messaging about reproductive health is often a source of body shame. “The fertility world is a wild place, and there is so much fatphobic nonsense out there when it comes to food,” Caldwell says. “So, in my work as a weight-inclusive dietitian, I help my clients tune out the noise, and we focus on listening to body cues and adding in nutrient dense foods, instead of cutting things out with a restrictive diet.” By focusing on factors you can control in healthy ways, like nourishing your body with balanced meals and snacks every few hours, hydrating it sufficiently, moving it in ways that feel good, and resting it adequately, you’re providing it with stability and creating a safer environment within. If you're unable to connect with your body's cues of hunger and fullness (which is common during highly emotional times), you can lean on mechanical eating for as long as you need.

Write down how you feel.

In my practice as a dietitian, I often notice clients will take out hard feelings on their bodies—a feeling like sadness may get funneled into negative body thoughts because it feels easier to bash your body instead of feeling and processing the sadness. Writing in a journal can help you process your emotions related to miscarriage or infertility in a healthy way and help you to release any difficult feelings you have towards your body. I used a miscarriage grief journal with specific prompts to answer and found it to be a helpful tool in my healing process. Adams encourages validation of hard feelings when going through infertility issues, like frustration, disappointment, and grief. With loss, she says it’s only human to “feel a range of emotions after experiencing a miscarriage and normalize any feelings of grief, guilt, anger, or sadness.”

Try body-based trauma therapy. 

One of the most effective tools in my healing process was a somatic (body-based) trauma therapy technique called Eye Movement Desensitization and Reprocessing (EMDR). It’s a process prompting you to focus on your traumatic memory while simultaneously experiencing bilateral stimulation (visual, auditory, or tactile stimuli which occur in a rhythmic left-right pattern), which is linked to reduced vividness and emotions associated with the memory. By the end of one EMDR session, I no longer felt like I was re-experiencing the events of July 10, 2023, every time I thought about my miscarriage. Instead, it simply felt like a sad memory from my past.

Seek other forms of professional help.

Without starting back weekly sessions with my psychotherapist and finding specialized support through the Miscarriage Doula (an organization of bereavement doulas who offer groups and individual sessions for women struggling with miscarriage and infertility), I’m not sure how I would have made it through the months after loss. “Mental health therapy is what I recommend for my clients first and foremost - miscarriage is a trauma and working through that with a qualified professional will get to the root of what's behind the food and body image difficulties,” Caldwell adds. “Many of my clients have found therapies like mindfulness and EMDR to be helpful to pair alongside the work we do in nutrition sessions.” Working with a non-diet and weight-inclusive dietitian can also help significantly with healing your body relationship—check out our body image counseling page if you need support.

Practice self-compassion towards yourself and your body. 

Cartrette suggests women dealing with infertility or loss spend “at least five minutes in the morning or evening—specifically right when you get out of bed or right before you get in bed for the night—looking at yourself in a mirror and practicing self-compassion. Be kind to yourself, look at yourself like you're a friend going through a difficult time, and don't be afraid to openly feel any emotions that come forward.” Also, try recognizing your big, hard emotions are not you but something you’re experiencing, and you’re not alone in feeling this way. 

Integrate mindfulness practices.

Like I said, it took me a while to get back to my yoga mat post-miscarriage (honestly, I hated the thought of any type of practice for a period). However, once I was ready to step back on mat, gentle and restorative yoga combined with breathing and meditation practices helped me start turning back towards my body in a patient and kind way. Plus, experiencing both miscarriage and infertility can be dysregulating for your nervous system—I vacillated between a fight or flight state (sped up) and a freeze state (checked out)­­—and mindfulness practices were one tool to help me find a more constant state of nervous system regulation. If you’re interested in being guided, I offer mindfulness classes online.

Moving into body acceptance

Following last year's loss, I gave myself time to repair the ruptured relationship with my body and used my toolkit of resources every day (and still do). Healing from the body changes after miscarriage didn't happen overnight, but little by little I learned to trust my body again. Eventually, I realized it wasn’t my body’s fault or my body that caused the loss of my first child. Once I was able to accept it, I understood that staying mad at or ashamed of it would only keep me stuck. As I often tell my clients, hating or resenting your body only makes it harder to take care of it (you can read about body acceptance here). My body needed me to show up for it and help it to heal, because it was literally the site of significant trauma. We needed each other to get back to living again, and eventually to prepare for a new pregnancy. 

Body Image and Reproductive Issues: FAQs Section

Now, I'm sharing answers to some of the most common questions we get from clients, friends, and family members when it comes to body image and miscarriage:

How long does body take to heal after miscarriage?

The length of time it takes to physically heal after miscarriage varies and depends on how far along the pregnancy was and the mother's physical health status. It's often stated that it takes 1 to 2 weeks for bleeding and cramping to subside, then 4 to 6 weeks for hormones to stabilize.

What is something I should know after my miscarriage?

After a miscarriage, it's important to get as much support as you need from family, friends, support groups, and healthcare providers. Know that it takes time for healing to occur—mentally, physically, and emotionally. It's a time when self-compassion and taking time for lots of self-care is critical for recovery.

I had a miscarriage and now I'm pregnant again. Will my baby be healthy?

Unfortunately, it's common for women to experience miscarriages before they give birth to a healthy baby. While it's impossible to guarantee a healthy, full-term pregnancy, it's certainly true that many woman go on to have health babies after experiencing loss. It can be incredibly difficult to be pregnant after loss, so it's important to reach out for help and support throughout the process.

What happens to your body after a miscarriage?

After a miscarriage, the body still acts like it's pregnant for some time, until all bleeding and cramping has stopped and hormones begin to stabilize. It can take at least four weeks and often more for the body to return to its baseline, pre-pregnancy state.

How does the body feel after miscarriage?

After miscarriage, the body can still feel pregnant and have signs like swollen boobs and bloating. Bleeding and cramping is very common following a miscarriage, as well as other side effects like nausea, fatigue, and dizziness.

If you need support.

It can feel so hard to navigate a pregnancy loss or infertility and we'd be honored to support you in your process. Feel free to explore our nutrition counseling, body image counseling, and eating disorder counseling services. If it feels right, get in touch with us via our contact page—we'd love to help you.

In true health, 

Caroline