Deciding to conceive again following a miscarriage can be a confusing, stressful and painful decision to make. It is normal to have many new questions and concerns while in the decision process. It can be an emotional rollercoaster, but knowing what to expect can help to alleviate some of the stresses that arise.
Here is some practical information to help you understand pregnancy after miscarriage.
[SEE: What to Pack in Your Hospital Bag When You’re Expecting.]
What Is a Miscarriage?
A miscarriage is the spontaneous loss of a pregnancy that occurs within the first 20 weeks, while the loss of a pregnancy after 20 weeks is classified as a stillbirth. Miscarriages can happen for various reasons, such as problems with reproductive organs or chromosomal abnormalities. But oftentimes, the cause is simply unknown.
In the first trimester, the most common cause of miscarriage is due to chromosomal imbalances, or change in the fetus’s genetic material, says Dr. Lora Shahine, a reproductive endocrinologist at Pacific NW Fertility in Seattle.
Shahine says that while some causes of pregnancy loss, like infection, could occur at any time during the pregnancy, “pregnancy loss due to cervical incompetence, preterm labor or premature rupture of membranes will only occur in the second or third trimester.”
Some factors that increase the risk of miscarriage may include the following:
— Cervical incompetence. Also known as cervical insufficiency, this condition leads the cervix of a pregnant woman to open prematurely, typically in the second trimester, says Shahine. This can lead to premature labor and delivery and occurs because the cervix cannot support the fetus’s weight. It may be possible to still carry a baby to term if cervical incompetence is detected early.
— Lifestyle factors. Habits such as smoking, alcohol and illicit drug use can increase your risk.
— Maternal age. Women over the age of 40 are at a higher risk of pregnancy loss during the first trimester due to an increased chance of chromosomal changes in their eggs.
— Maternal health conditions. Uncontrolled diabetes, blood clotting disorders, malnutrition, extremely high or low maternal weight, infections, food poisoning and severely high blood pressure are all examples of dangerous health conditions.
— Physical trauma. While some people will suffer a pregnancy loss after experiencing physical trauma, others will not, making it difficult to know what type of risk falling, a car accident or another traumatic incident will have. Shahine notes that while a pregnancy loss “can logically be thought to be due to the (traumatic) incident, other people can have a similar experience and not have an impact on the pregnancy.”
— Uterine anormalities. There are several types of possible abnormalities of the uterus that can cause recurrent miscarriage in the first or second trimester. These abnormalities can usually be diagnosed with a pelvic ultrasound, hysteroscopy or pelvic MRI.
How Long After a Miscarriage Can You Get Pregnant?
“Preparing to try to conceive after miscarriage is both an emotional and physical process,” says Shahine. She recommends that anyone who has experienced a miscarriage should seek out support and wellness resources and take time to grieve and heal before trying again. She also says that the recovery process will depend on timing and the cause of the loss.
Ovulation is the process of an egg leaving the ovary, and this generally occurs again as little as two weeks following pregnancy loss. It is possible to have a successful pregnancy immediately after a miscarriage.
More specifically, Dr. Amy Roskin, a board-certified OB-GYN in Florida and chief medical officer of Seven Starling, a women’s perinatal mental health digital platform, says that “there is no one rule or schedule for when someone might be ready to try again. There may be health issues or circumstances around the miscarriage (like excessive and prolonged bleeding) that require more time to heal or additional medical evaluation or testing. Common recommendations are to wait one to three months before trying to conceive again,” Roskin says.
If a woman is not yet ready to attempt to get pregnant again, it is a good idea to use contraceptive methods if you are sexually active after a miscarriage.
[READ: 7 Things to Know About Home Pregnancy Testing.]
What Are the Chances of Having Another Miscarriage?
It is natural for couples to worry about losing another pregnancy. Around 1% of women will experience recurrent miscarriages, which means there are numerous miscarriages in a row.
“Plenty of women who experience miscarriages go on to have perfectly healthy babies after,” says Dr. Jessica Shepherd, OB-GYN and chief medical officer of Verywell Health. She is also the founder and CEO of Sanctum Med + Wellness, a wellness concierge practice, and is affiliated with Baylor University Medical Center in Dallas.
In more than half of women who experience recurrent miscarriages, no cause can be determined. “If you have more than one miscarriage, you should talk to your doctor about next steps. Sometimes additional medical tests are necessary to find and treat the cause,” Roskin says.
[SEE: 13 Tips for a Mammogram.]
How to Prepare for Pregnancy Following a Miscarriage
Preparing to get pregnant after a miscarriage includes not only physical factors but also emotional factors.
“While it may be hard, a miscarriage shouldn’t discourage you from trying again, as they’re more common than most people think and don’t always mean you’ll have issues with following pregnancies,” Shepherd says.
The majority of women will be able to get pregnant and carry their baby to term. Still, a percentage of women have difficulty becoming pregnant or will miscarry again.
“If you have difficulty conceiving or are experiencing symptoms like irregular bleeding, pain, fever or discharge, be sure to contact your doctor to get checked,” adds Roskin.
For women who experience recurrent miscarriages or have difficulty getting pregnant again, certain tests can be performed to help determine any potential underlying causes. Some of the tests include the following:
— Genetic testing: Checking for genetic or chromosomal abnormalities of each partner can help determine miscarriages caused by chromosome abnormalities.
— Bloodwork: Blood tests can be done to check for autoimmune disorders (such as lupus), pregnancy hormone levels that are too high or too low (such as estrogen or progesterone levels) and blood-clotting factors (thrombophilia, for instance, which increases blood clots in the body).
— Uterine ultrasound: An ultrasound of the uterus will allow for visualization of the reproductive organs and can help identify structural reasons for miscarriage.
— Hysterogram: Also known as a hysterosalpingogram, this test uses a contrast dye that is injected into the uterus through a small catheter. X-ray images are taken to visualize the uterus and fallopian tubes to look for any structural problems, such as blockages or tumors.
— Hysteroscopy: A thin tube with a light and camera at the end is inserted in the vagina and will help your doctor visualize the cervix and the inside uterus to check for any abnormalities of the organs or tissues.
— Sonohysterography: A catheter is inserted through the cervix, and saline is injected into the uterus. Ultrasound images are taken to visualize the uterus and fallopian tubes to check for any structural issues.
— Magnetic resonance imaging (MRI): This non-invasive imaging tool uses radio waves and magnetic fields to clearly visualize internal body structures for any apparent problems of the organs or tissues.
Can Miscarriages Be Prevented?
Usually, there is nothing that can be done to prevent a miscarriage. A woman can, however, live a healthy lifestyle to lower her risk of losing a pregnancy. Getting adequate prenatal care, eating a well-balanced, nutrient-rich diet and taking prenatal multivitamins are vital to a healthy pregnancy. So is avoiding smoking and alcohol consumption during pregnancy.
A 2022 study in the journal Epidemiology suggested that women had a higher risk of early miscarriage during the summer months compared to the rest of the year. Researchers also pointed to environmental factors, such as heat exposure, as potentially affecting pregnancy outcomes. To prevent dehydration and heat exhaustion, pregnant women should drink plenty of water and avoid long periods of heat exposure.
The Emotions and Stress Following a Miscarriage
Experiencing a pregnancy loss can cause a rollercoaster of emotions for a woman and her support system.
“A miscarriage can often bring up feelings like grief, sadness, depression and anxiety. It’s so important to prioritize your emotional well-being and support as well as your physical health. Be sure to pay attention to these feelings and talk to your doctor about them,” Roskin says.
Before choosing to tell friends, family and coworkers about the miscarriage, it may be helpful to talk with a therapist, counselor or doctor about continuing to prioritize your health through this emotional process.
Shahine says that “it is very common to feel guilt and shame after miscarriage in large part due to lack of understanding and assumptions about pregnancy and miscarriage. Pregnancy loss is common, occurring in 1 in 4 clinically recognized pregnancies.” One of the important things to remember, Shahine says, is that miscarriages caused by chromosomal abnormalities, the most common type, are due to “an issue unique to that embryo – not the people that are conceiving together.”
One of the first things she tells people when she diagnoses a miscarriage is “This is not your fault.” Then, she recommends finding as much support as possible.
The stress of pregnancy loss can cause tension between couples and create physical symptoms as well, such as fatigue, sleeplessness, loss of appetite and problems with concentration. Seeking counseling following a miscarriage by a therapist who specializes in pregnancy loss can help with the grieving process.
Allowing time to grieve is an essential part of the healing process and will ultimately help you prepare for another pregnancy if or when you choose to do so.
More from U.S. News
Health Screenings You Need Now
How to Describe Medical Symptoms to Your Doctor
How Long After a Miscarriage Can You Get Pregnant? originally appeared on usnews.com
Update 06/02/23: This piece was previously published at an earlier date and has been updated with new information.
