Miscarriage is hard. Worrying about conceiving again after miscarriage is hard too.
Miscarriage can be heartbreaking and devastating, especially if you experience more than one. After a miscarriage, it may be hard for you emotionally to make the decision to try for another baby. We understand the feelings that come with pregnancy loss and your hesitation to possibly go through it again. While everyone processes a miscarriage differently, at some point you will begin to think, and probably worry, about conceiving again after miscarriage.
A first trimester miscarriage is usually nothing to worry about
Most early miscarriages, those that happen in the first trimester, or first 12 weeks of pregnancy, are due to chromosomal abnormalities in the embryo that likely happened at fertilization. When the egg and sperm meet at fertilization, oftentimes genetic mistakes happen. These occur mostly by chance and are really not related to anything other than bad luck. It’s important for you to know that about half of fertilized eggs stop developing before they have a chance to implant in the uterine lining. If they do implant and pregnancy is confirmed early with sensitive hormone tests, as many as 60% of cases end in miscarriage. The risk of miscarriage decreases dramatically after the eighth week of pregnancy.
All in all, one or two first trimester miscarriages are usually nothing to worry about and you have a good chance of carrying your next pregnancy to term. It’s worth remembering that most people will have a successful pregnancy, even after two or three early miscarriages in a row. While you shouldn’t completely brush off a first trimester miscarriage, if you do feel overly worried don’t hesitate to talk to your obstetrician. Getting more information from a trusted healthcare professional about miscarriages in general, as well as when to be concerned about future pregnancies, is always a better option than relying on online sources.
About 2-3% of pregnancies will be lost in the second trimester (happening between weeks 13 and 24 of pregnancy), a rate that is much lower than in the first trimester. A loss at this time in pregnancy is most often a hard and sad experience for everyone involved. Deciding when – or even whether – to try to conceive again after your second trimester loss can be difficult and you may have very mixed feelings about another pregnancy.
When should you start trying again?
So when should you think about conceiving again after miscarriage? There is no physiological evidence to support waiting after an early pregnancy loss which, when passed naturally, feels like a very heavy menstrual period. However, if you have undergone a D&C (dilation and curettage) to evacuate the lost pregnancy from the uterus, it is often recommended that you wait a few months to give your uterine lining time to recover and heal. Medically, it is safe to conceive after two or three normal menstrual periods if tests or treatments for the cause of the miscarriage are not being done.
After a second trimester loss, you should consult with a reproductive health professional about your chances of having a successful pregnancy and what tests you may need. We usually recommend waiting at least three months after a second trimester loss before trying again to get pregnant. While you may need time to physically and mentally heal from this loss, the additional waiting can also provide time to uncover the reason for your loss. This may include a review of your medical history, family history, and medication use. You may also need to undergo tests, such as an ultrasonography, laboratory tests, and a physical exam to rule out genetic, hormonal or uterine structural issues. It is also important to consider pathologic testing of the fetus and placenta to give further clues to the reason for your loss.
What you can do while you are waiting
Lifestyle is just as important before conceiving as it is during pregnancy. Eliminating unhealthy habits can help increase your chances of conceiving again after miscarriage. It’s a good idea to work towards eliminating alcohol or drug use and quitting smoking before you start trying for pregnancy. Cutting down or eliminating caffeine can also help you conceive a healthy pregnancy. Additionally, taking folic acid before pregnancy is always beneficial as are prenatal vitamins.
Your mental well-being during this time is also paramount. Miscarriage at any time during pregnancy can be hard and you should seek out support to help you in your grieving process. You can talk to your doctor, a community support group, or a counselor for information and assistance. And take heart: Most women who have recurrent miscarriage will go on to have a successful pregnancy the next time, even without any testing or treatment.
