Thinking about pregnancy after miscarriage? You might be feeling anxious or confused about what caused your miscarriage and when to conceive again. Here's help understanding pregnancy after miscarriage, and the steps you can take to promote a healthy pregnancy.
What causes miscarriage?
Miscarriage is the spontaneous loss of a pregnancy before the 20th week. Many miscarriages occur because the fetus isn't developing normally. Problems with the baby's chromosomes are responsible for about 50 percent of early pregnancy loss. Most of these chromosome problems occur by chance as the embryo divides and grows—not because of problems inherited from the parents. Sometimes a health condition, such as poorly controlled diabetes or a uterine problem, might lead to miscarriage. Often, however, the cause of miscarriage isn't known.
About 10 to 20 percent of known pregnancies end in miscarriage. The total number of actual miscarriages is probably higher because many women miscarry before they even know that they're pregnant.
What are the odds of another miscarriage?
Miscarriage is usually a one-time occurrence. Most women who miscarry go on to have healthy pregnancies after miscarriage. A small number of women—1 percent—will have two or more miscarriages.
The predicted risk of miscarriage in a future pregnancy remains about 14 percent after one miscarriage. After two miscarriages the risk of another miscarriage increases to about 26 percent, and after three miscarriages the risk of another miscarriage is about 28 percent.
Are special tests recommended before attempting pregnancy after miscarriage?
If you experience two or more consecutive miscarriages, talk with your health care provider about whether further testing is needed to identify any underlying causes before attempting to get pregnant again. For example:
- Blood tests. A sample of your blood is evaluated to help detect problems with hormones or your immune system.
- Chromosomal tests. You and your partner might both have your blood tested to determine if your chromosomes are a factor. Tissue from the miscarriage—if it's available—also might be tested.
Procedures can be done to detect uterine problems. For example:
- Ultrasound. This imaging method uses high-frequency sound waves to produce precise images of structures within the body. Your health care provider places the ultrasound device (transducer) over your abdomen or places it inside your vagina to obtain images of your uterus. An ultrasound might identify uterine problems such as fibroids within the uterine cavity.
- Hysteroscopy. Your health care provider inserts a thin, lighted instrument called a hysteroscope through your cervix into your uterus to diagnose and treat identified intrauterine problems.
- Hysterosalpingography. Your health care provider inserts a catheter inside your cervix, which releases a liquid contrast material into your uterus. The dye traces the shape of your uterine cavity and fallopian tubes and makes them visible on X-ray images. This procedure provides information about the internal contours of the uterus and any obstructions in the fallopian tubes.
- Sonohysterogram. This ultrasound scan is done after fluid is injected into your uterus though your vagina and cervix. This procedure provides information about the internal contours of the uterus, the outer surface of the uterus and any obstructions in the fallopian tubes.
If the cause of your miscarriages can't be identified, don't lose hope. Most women who experience repeated miscarriages are likely to eventually have healthy pregnancies.
When is the best time for pregnancy after miscarriage?
Miscarriage can cause intense feelings of loss. You and your partner might also experience anger, sadness, or guilt. Don't rush the grieving process.
Typically, sex is not recommended for two weeks after a miscarriage to prevent an infection. Talk to your health care provider about any recommendations or restrictions. Your period will likely return within six weeks; however, it's possible to become pregnant if you have sex before your period returns.
Once you feel ready for pregnancy after miscarriage, ask your health care provider for guidance. Also, consider these guidelines if you've had:
- 1 miscarriage. Some research has shown that women who conceived within six months of having a miscarriage in their first pregnancy had fewer complications than did those who waited longer to conceive. If you're healthy and feel ready, there might be no need to wait to conceive after miscarriage.
- 2 or more miscarriages. If you've had two or more miscarriages, talk to your health care provider. He or she might recommend testing to determine any underlying issues, as well as possible treatments, before attempting another pregnancy.
Is there anything that can be done to improve the chances of a healthy pregnancy?
Often, there's nothing you can do to prevent a miscarriage. However, making healthy lifestyle choices before conception and during pregnancy is important for you and your baby. Take a daily prenatal vitamin or folic acid supplement, ideally beginning a few months before conception. Maintain a healthy weight and limit caffeine. Avoid alcohol, smoking, and illegal drugs.
If you've had multiple miscarriages, future pregnancies need to be carefully planned and monitored. Consult your health care provider before conceiving again and see him or her as soon as you think you might be pregnant.
What emotions are likely during subsequent pregnancies?
Once you become pregnant again after miscarriage, you'll likely feel joyful—as well as anxious and scared. You might be hesitant to share your good news until later in your pregnancy. Feelings of grief over your loss also might return after you give birth. This is normal.
Talk about your feelings and allow yourself to experience them fully. Turn to your partner, family, and friends for comfort. If you're having trouble coping, consult your health care provider or a counselor for extra support.
Publication Date: 2010-12-21