Pregnancy after miscarriage: What you need to know

By Mayo Clinic staff

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Pregnancy after miscarriage: What you need to know

Pregnancy after miscarriage can be stressful and confusing. When is the best time to get pregnant? What are the odds of miscarrying again? Get the facts about pregnancy after miscarriage.

By Mayo Clinic staff

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. Most miscarriages occur because the fetus isn't developing normally. Problems with the baby's chromosomes or genes are typically the result of errors that occur by chance as the embryo divides and grows — not problems inherited from the parents. Sometimes a woman's health condition, such as uncontrolled diabetes or problems with the uterus or cervix, also might lead to miscarriage. Often, however, the cause of miscarriage isn't known.

About 10 to 20 percent of pregnancies end in miscarriage. The actual number is probably higher because many miscarriages occur so early in pregnancy that a woman doesn't even know yet that she's pregnant.

What are the odds of another miscarriage?

Miscarriage is usually a one-time occurrence. Most women who miscarry go on to have a healthy pregnancy after miscarriage. Less than 5 percent of women have two consecutive miscarriages, and only 1 percent have three or more consecutive miscarriages.

Are special tests recommended before attempting pregnancy after miscarriage?

If you experience more than two miscarriages, consider testing 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 also 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.
• Hysteroscopy. Your health care provider inserts a small, lighted telescope called a hysteroscope through your cervix into your uterus. He or she then expands the uterine cavity by injecting it with saline and examines the walls of your uterus and the openings of your fallopian tubes.
• Hysterosalpingography. This technique uses a dye to highlight the uterine cavity and fallopian tubes on X-ray images.
• Sonohysterogram. This ultrasound scan is done after fluid is injected into your uterus though your vagina and cervix. This allows your health care provider to look for problems in the lining of your uterus.

If the cause of your miscarriages can't be identified, don't lose hope. About 60 to 70 percent of women with unexplained repeated miscarriages go on to have healthy pregnancies.

When is the best time for pregnancy after miscarriage?

Give yourself time to heal before attempting to get pregnant again.

Physical recovery from miscarriage in most cases will take only a few hours to a couple of days. Your periods will likely return within four to six weeks, and it's possible to become pregnant during the menstrual cycle immediately after a miscarriage.

Keep in mind, however, that miscarriage can cause intense feelings of loss. You and your partner might also experience a wide range of emotions, such as anger, sadness or guilt. Don't rush the grieving process.

Once you feel ready for pregnancy after miscarriage, ask your health care provider for guidance. Also, consider these guidelines if you've had:

• One miscarriage. The World Health Organization recommends waiting at least six months before trying to conceive, but other research has found no evidence to support delaying conception. In fact, 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.
• Two or more miscarriages. If you've had two or more miscarriages, consult your health care provider. He or she might recommend testing to determine any underlying issues, as well as possible treatments, before attempting another pregnancy.
• A molar pregnancy. A molar pregnancy — a noncancerous (benign) tumor that develops in the uterus — occurs when the placenta develops into an abnormal mass of cysts rather than becoming a viable pregnancy. If you've had a molar pregnancy, your health care provider might recommend waiting six months to one year before trying to become pregnant.

Is there anything that can be done to improve the chances of a healthy pregnancy?

Making healthy lifestyle choices before conception and during pregnancy can help keep you and your baby healthy.

Start by taking a daily prenatal vitamin or folic acid supplement, ideally beginning a few months before conception. It's also important to maintain a healthy weight, include physical activity in your daily routine, eat a healthy diet and limit caffeine. Be sure to manage stress and 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.

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