A miscarriage can often be a deeply traumatic and emotional experience, regardless of when in the pregnancy it is suffered, especially if you have been trying to conceive for a long time, or have suffered a miscarriage previously. From the first moment they find out they are pregnant, many women are deeply pre-occupied with impending motherhood and all the changes it involves, and even if your response to the pregnancy is more reserved or ambiguous, the sense of loss following a miscarriage can still be tremendous. Common reactions to the loss of a pregnancy are really no different to other forms of grief, you may feel deep shock, numbness, guilt, a sense of helplessness, you may find it difficult to concentrate on anything else and be unable to sleep.

Acknowledging the loss
With a miscarriage at the end of the first trimester of pregnancy it may help you to see the fetus, although this is a very personal decision. Later in pregnancy when your baby is bigger you might want to see and even hold your baby, and find that giving him or her a name helps you say goodbye. You may also feel it is appropriate to hold a funeral or farewell ceremony of some kind, which may be offered by your hospital. You can also organise a funeral yourself for your baby through your church, or alone. Do what you feel is right for you and whatever you think will help you acknowledge and start to cope with the loss.

Getting support
The amount of medical support you receive may depend on what stage of pregnancy the miscarriage took place, as well as whether it's your first miscarriage. Earlier in pregnancy, particularly before your first scan at around twelve weeks, while being sympathetic, health professionals may seem to treat the miscarriage as a matter of routine which can be both surprising and upsetting. If you needed to have labour induced or miscarried in your fourth month of pregnancy then medical staff are likely to offer more sympathy and support direct you towards help to cope with your grief. Some hospitals offer a cremation or funeral service for all miscarriages, others may only offer this for miscarriages after week fourteen or sixteen.

While it's unfortunate, a matter-of-fact approach to miscarriage among health professionals is common because miscarriage itself is so common, particularly in the first eight weeks of pregnancy. It's also the case that the vast majority of those women who do experience a miscarriage will go on to have a subsequent healthy pregnancy.

If you haven't yet told family and friends about the pregnancy then you may prefer not to look to them for support, and you may feel very isolated. Even if you have told friends and family then they may not find it easy to be supportive as miscarriage is seldom talked about, and it can be difficult for people who haven't experienced pregnancy to appreciate how you feel. If you know friends have been through a miscarriage then it might help to talk to them, but even those who have experienced miscarriage themselves may be reluctant to talk about it. You might also find it easier to talk to people you don't know, whether a grievance counsellor or a support group. The Miscarriage Association offers support for pregnancy loss from people who have experienced the grief themselves, and online forums, such as the one on ThinkBaby, can offer a wide base of sympathetic ears, experiences and advice to help you get through.

Supporting each other
As a couple, a miscarriage may be the first traumatic experience you go through together. You may both be deeply affected but may deal with your emotions in different ways: If your partner is withdrawn and reluctant to talk about it, it doesn't necessarily follow that he or she doesn't care. Fathers' feelings about miscarriage can often be overlooked, particularly if they are busy trying to 'stay strong' for their partner. That said, with early miscarriage, before the first scans, heartbeats and kicks, the pregnancy itself may well be more real to a pregnant woman than her partner. As with most difficulties, keeping up communication is the key to supporting each other and getting through it together.

When can we try again?
When you can try again for a baby after a miscarriage depends on both your emotional and physical health. From a purely physical point of view it's a good idea to wait for at least one period, and some doctors recommend waiting for two or three cycles to make sure that your body is back to normal. Emotionally you may feel that you need several months before you can contemplate the thought of being pregnant again, but equally you may be keen to try again as soon as possible. How you feel about trying again might be affected by how far along with the pregnancy you were when you had the miscarriage.

If your doctor has diagnosed a structural or anatomical cause for the miscarriage that requires treatment then discuss this with him or her before trying again: In some cases, such as incompetent cervix, you may be able to try again straight away but will require treatment once pregnant. In other cases you may need treatment before trying. If you have had two or more miscarriages your doctor will probably want to start investigations into a possible structural cause for miscarriage, but may not refer you for specialist treatment unless you have had at least three miscarriages.

The next pregnancy
When you do fall pregnant again after a miscarriage, then it's natural to be more nervous and emotional about the pregnancy than usual, and it's common to see getting past the point of the pregnancy where you suffered a previous miscarriage as an enormous hurdle. While it's unrealistic to expect you to see this as a critical date to get past, do try to shift your focus to the more positive aspects of your current pregnancy, such as ensuring that you have a suitably healthy diet and are getting enough exercise, and remember that the chances are that this time everything will be fine. The less stress and emotional tension you experience in this pregnancy, the better it will be for this baby's development.