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, but knowing what to expect can help to alleviate some of the stresses that arise.
Here’s what to know about navigating pregnancy after miscarriage.
[Read: How to Cope After Miscarriage]
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.
In the first trimester, the most common cause of miscarriage is due to chromosomal imbalances, or changes in the fetus’s genetic material, says Dr. Lora Shahine, a reproductive endocrinologist at Pacific NW Fertility and clinical associate professor at the University of Washington in Seattle. She’s also the host of the Baby or Bust Fertility podcast.
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.”
And oftentimes, the cause of a miscarriage is simply unknown.
[Read: Early Signs of Miscarriage: Symptoms to Watch For]
How to Prepare for Pregnancy Following a Miscarriage
Preparing to get pregnant after a miscarriage includes not only physical factors but also emotional factors.
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,” Roskin adds.
You can also check with your doctor about seeing a specialist, such as a reproductive endocrinologist, if you’ve had multiple miscarriages.
What is a rainbow baby?
For those who have experienced loss, a “rainbow baby” refers to a healthy baby born after miscarriage, stillbirth, infant loss or neonatal death.
How Long After a Miscarriage Can You Get Pregnant?
Ovulation is the process of an egg leaving the ovary, and this generally can occur again as little as two weeks following pregnancy loss. It is possible to have a successful pregnancy immediately after a miscarriage.
However, common recommendations are to wait one to three months before trying to conceive again.
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.”
Shahine adds that the recovery process will depend on timing and the cause of the loss.
“Preparing to try to conceive after miscarriage is both an emotional and physical process,” she points out.
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.
If you are not yet ready to attempt getting pregnant again, it is a good idea to use contraceptive methods if you are sexually active after a miscarriage.
[READ: Exercising During Pregnancy]
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, according to the American College of Obstetricians and Gynecologists.
What are the risk factors of a miscarriage?
In general, some factors that increase the risk of miscarriage may include:
— Cervical incompetence, which leads the cervix of a pregnant woman to open prematurely and can lead to premature labor and delivery
— Lifestyle factors, such as smoking, alcohol and illicit drug use
— Increased maternal age due to an increased chance over age 40 of chromosomal changes in eggs
— Maternal health conditions, such as uncontrolled diabetes, blood clotting disorders, malnutrition, extremely high or low maternal weight, infections, food poisoning and severely high blood pressure, or preeclampsia.
— Physical trauma occurring during pregnancy, such as falling or a car accident
— Uterine abnormalities, which can usually be diagnosed with a pelvic ultrasound, hysteroscopy or pelvic MRI
[READ: Foods to Avoid During Pregnancy: What You Cannot Eat]
Testing After More Than One Miscarriage
In more than half of women who experience recurrent miscarriages, no cause can be determined.
“Sometimes additional medical tests are necessary to find and treat the cause,” Roskin says.
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:
— 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.
— 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.
Positive lifestyle changes that are vital for a healthy pregnancy include:
— Getting adequate prenatal care
— Eating a well-balanced, nutrient-rich diet
— Taking prenatal multivitamins
— Avoiding smoking and alcohol consumption
A 2022 study in the journal Epidemiology suggests that women have a higher risk of early miscarriage during the summer months compared with the rest of the year, pointing 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.
Tips for Managing Emotions After a Miscarriage
Going through a pregnancy loss can cause a rollercoaster of emotions for a woman and her support system. Taking steps to acknowledge and process your experience are key for moving toward healing.
1. Acknowledge the emotions
Expect to experience a wide range of emotions — this is normal.
“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.
2. Seek professional support
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.”
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,” she adds.
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.
Pregnancy loss can cause tension between couples too. Seeking counseling from a therapist who specializes in pregnancy loss can help with the grieving process.
3. Recognize physical symptoms
The stress of pregnancy loss can also lead to physical symptoms, such as:
— Fatigue
— Loss of appetite
— Trouble concentrating
Recognize that these symptoms can be a response to grief, as well as your body healing, and see your doctor if symptoms become overwhelming.
4. Give yourself time to process your emotions
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.
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How Long After a Miscarriage Can You Get Pregnant? originally appeared on usnews.com
Update 11/11/24: This piece was previously published at an earlier date and has been updated with new information.
