Pregnancy After Miscarriage: 3 Months Wait or More?

Pregnancy after miscarriage may be more likely to survive. The chances of healthy pregnancies within 3 months of trying (after a pregnancy loss of around 20 weeks or less) are more or less the same as that of trying after 3 months, a study informed.

This may be good news for those who wish to try for another pregnancy after a miscarriage. After all, you may feel excited about the thought of having your future baby. However, a miscarriage due to any complication in pregnancy can evoke intense feelings of fear and other insecurities for another attempt besides being a depressive event in itself.

This can be one reason why waiting longer should be considered before getting pregnant after a miscarriage, because the trauma caused by the miscarriage may need time to heal, the foregoing study stated.

Pregnancy After Miscarriage – A Study on When Should You Try Again?

The study involved 1,083 women (18–40 years old) with 1-2 earlier losses (the last pregnancy complication mostly being the miscarriage without complication occurring before week 20). The researchers monitored them from their conception to the delivery to assess the results of trying again at different intervals.

The researchers noted that not only the women (around 76%) who tried within 3 months after a miscarriage were more likely to get pregnant (68.6%) than those who tried after 3 months (51.1%) but were more likely to deliver healthy babies as well (53.2% vs 36.1%) with no physiological difficulties.

Also, the ability to get pregnant was higher within 6 months of trying than 12 months after a miscarriage.

Miscarriage

Miscarriage occurs when there’s a loss of an embryo or fetus (an embryo develops into a fetus) during the first trimester (before 12 weeks) or the second trimester (after 12 but before 20 weeks). A pregnancy loss after the 20th week is called a stillbirth.

As per the American College of Obstetricians ¹and Gynecologists, 10 out of 100 reported pregnancies end before week 13 in a miscarriage which is the most common early pregnancy failure. It’s also termed spontaneous abortion probably because it just ends up abruptly before it’s noticed. The occurrence of unreported spontaneous abortion can be as high as nearly 30%.

Symptoms of a Miscarriage

Symptoms of a miscarriage can differ as per its type. Missed miscarriage may not show any symptoms and might be confused with periods because it happens at an early stage of pregnancy. However, some of the common symptoms that most women have are as follows –

• Light or heavy vaginal bleeding with clotting
• Pain in the lower back
• Cramps and abdominal pain
• Vaginal discharge
• No pregnancy signs like morning sickness and aching breasts.

Causes of a Miscarriage/ Risk Factors

The causes of miscarriages can be different and often become harder to detect in the first trimester miscarriages. They just happen and can be understood as a hit-and-miss affair.

1. Chromosomal Issues

However, the major factor resulting in 50 per cent of the miscarriages can be chromosome ²irregularities. Chromosomes are the substance of proteins responsible for passing genes to the next generation. Each parent has 23 sets of chromosomes which are passed to the baby through fertilization in which the fertilized egg must carry 23 sets of chromosomes. If it gets imbalanced, the risk of miscarriage increases.

Miscarriages can follow in the following circumstances –

2. Age

One-third of pregnancies end due to the age factor but mostly due to abnormalities in the baby’s chromosomes where men’s age can also play a role. About 74.7% of cases of women above 40 can turn into miscarriages whereas this risk is limited to only 8.9% for women up to 30 years.

3. Earlier Miscarriages

History of miscarriages can be a risk factor too with a 20% chance of loss following one miscarriage which increases to 43% with 3 successive miscarriages.

3. Other Risk Factors

• Chemical Pregnancy

Chemical pregnancy (a type of miscarriage) can be a cause of early loss where the embryo (known as blastocyst at this stage) doesn’t get fixed to the uterus lining due to thinning of the lining or any other reason. But pregnancy tests detect HCG hormone³ (pregnancy hormone) to make it look like an actual pregnancy. Sometimes, it doesn’t even get noticed because it ends too early and can be misunderstood with the menstrual cycle.

• Issues With Placenta

The placenta is an especially formed organ during pregnancy to provide the fetus with oxygen, nutrients, and hormones. It even helps remove waste and works through the attached umbilical cord. Placental problems can cause hindrance in the growth of an embryo.

• Medications

Certain medications such as ibuprofen (for pain and fever), natalizumab (for multiple sclerosis), antithyroid medications, and ergotamine and methysergide (for migraines) may result in miscarriages.

• Chronic Conditions

Women’s health conditions in which autoimmune disorders like systemic lupus erythematosus and multiple sclerosis come can be one of the underlying causes of repeat miscarriage. These diseases lead the body’s immune system to harm itself.

3 Difficulties in Early Pregnancy

Besides miscarriages, other pregnancy issues may involve –

1. Ectopic Pregnancy

It’s a rare case of pregnancy loss in which the embryo grows somewhere else than in the womb of a woman’s body. It mostly can be inside the fallopian tubes ⁴( a tube joining ovaries to the uterus where the egg is fertilized) – in which case it’s called a tubal pregnancy or rarely in the cesarean section injury (a surgical cut made through the abdomen and uterus) or cervix (a link between the uterus and vagina).

Tubal ectopic pregnancies can’t last and non-tubal can rarely last that too with a potential risk.

2. Molar Pregnancy

It’s the rarest form of a pregnancy complication where the fetus doesn’t develop or develop partly. But the noncancerous tumor-like placenta produces the pregnancy hormones in excess. The pregnancy ends because the unhealthy placenta can’t support the healthy baby (embryo).

3. Stillbirth

If a baby is born dead or dies before birth after the 28th week of pregnancy, the loss is called a stillbirth. According to WHO, around 2 million babies are stillborn and around 84% happen in lower-middle-income countries. More than 40% of stillbirths take place during delivery.

Emotions After a Miscarriage

Emotions can be hard to deal with whether it’s about one miscarriage or two or more miscarriages. You may find yourself guilty of whether it was your fault but the reality is different. Most miscarriages occur of an unknown cause and a healthy pregnancy is possible for most women.

Before planning another baby, you may want to manage your difficult emotions thoroughly by grieving and accepting the loss and changes that occur afterwards. You may feel physically weak and have hormonal adjustments. Validate every reaction and wait for your health conditions to return to normal.

Bond with friends and family for emotional support or seek medical help if things take an extreme turn.

Postponing Pregnancy after Miscarriage?

Trying again for pregnancy after a miscarriage can be different for different couples as there are multiple factors involved such as mental health or waiting for the symptoms of miscarriage to go away to be in a reproductive shape again, Dr. Kirtly Jones, an expert in this field shared in a podcast, The Scope.

A peer-reviewed study concluded that it’s no longer necessary to wait longer unless you choose it for yourself for personal reasons. You can get pregnant to likely reduce the risk of another miscarriage if the previous miscarriage was without problems. You may try again past your first menstrual period after miscarriage.

In case of stillbirth or recurrent pregnancy loss, you may need to consult your healthcare provider before trying to get pregnant again. And of course, planning and recovery from a disease, in case you’re dealing with one, should be deciding factors to get past further chances of miscarriages.

Suggested Reading: Top 8 Tips For Preparing For Pregnancy

How to Get Pregnant After a Miscarriage?

You may need time at first to be emotionally ready. It can be from a few days to weeks for your physical health which may again depend on your symptoms and the duration after which the miscarriage happened.

Your periods may start again a few weeks after the miscarriage with irregularities which will resolve subsequently. You would be facing hormonal changes past your miscarriage. It’s the time your body takes to deal with the remains of miscarriage.

You can try again when your ovulation starts after 4-6 weeks. Ovulation usually occurs around 14 days before your period in a 28-day cycle (it can be less or more than that), it’s when the chances of getting pregnant are higher. An egg is released from the ovaries in this process and is likely to meet with sperm if you’ve had intercourse before the ovulation. In extreme cases, you should wait more or act on your doctor’s advice.

Taking care of essentials like intake of folic acid for surviving a normal gestation period, stress, and other medical conditions, i.e., blood pressure (if you’re dealing with any) eliminates the possibility of future pregnancy loss to a great extent.

Frequent Conditions During Pregnancy

Handling pregnancy or pregnancy after miscarriage requires vigilance, but there are a few issues that may be relatively common or harmless and can be handled at home through consultation. They are –

Morning sickness – It can also be termed as all-day sickness as its signs, namely vomiting and nausea can last throughout the day mainly through the second trimester.

The majority of pregnant women face it and it’s even linked to improved pregnancy outcomes by reducing the risk of early pregnancy loss by up to 75%, a study claimed. Sometimes, it can turn extreme in that case it’s called hyperemesis gravidarum which requires consultation and treatment.

Other changes in your body are as follows:

• Headaches and pain in any other parts of the body
• Bodily changes such as stretch marks
• Constipation
• Swelling
• Clear vaginal discharge

Prevention of Miscarriage

1. Treatment With Progesterone

The National Institute for Health and Care Excellence (NICE⁵) issued new guidelines on treating miscarriages with the progesterone drug for women who experience repeated miscarriages and face bleeding through the initial stage. However, the option isn’t beneficial for many women who don’t bleed or haven’t had a previous pregnancy loss.

400mg of micronized progesterone is recommended twice a day until week 16 in case of a viable pregnancy for possible treatment of early pregnancy loss.

2. Men’s Role

Sperm health can also be an underlying cause of miscarriage ⁶as most miscarriages involve chromosome abnormalities that include both sets of chromosomes. This means men should also be tested when looking for a possible cause of a miscarriage.

Other factors to take into consideration for miscarriage prevention –

• Adjusting habits such as managing diet and weight and giving up on alcohol and smoking would ensure a healthy pregnancy.
• Maintaining prenatal care ensures the health and growth of your baby through blood tests, hormone tests, chromosomal tests, and ultrasounds.
• Going through all the tests, especially after a miscarriage to rule out the possibility of next pregnancy loss.

Clearing Myths About Miscarriage

Myth 1. Stress can cause you to miscarry.

Truth: Research suggests that the main cause of miscarriage is improper development of the child in the uterus due to chromosome problems. Other reasons may be uterine lining thinning or chronic medical conditions. Often the cause remains undetected, especially in an early loss.

Myth 2. The mother is at fault.

Truth: Although healthy habits support the pregnancy blaming the mother isn’t reasonable as the habits of both the parents affect the baby (if that’s the case), other factors are usually responsible.

Myth 3. Abortion increases the risk of miscarriage.

Truth: It’s unlikely to affect your chances of a healthy pregnancy.

Key Takeaways

Thus, in this article, we have learned about miscarriages. How to deal with it, myths and other such important facets related to the topic.

FAQs

1. When do the majority of miscarriages happen?

Out of around 26% of miscarriages (of which about 10% are reported), 80% of them end in the first trimester.

2. Do miscarriages need treatment?

With the help of your healthcare providers, you may either decide to let the process of clearing pregnancy tissue occur normally or opt for medicines or surgery if the bleeding gets heavier or doesn’t start.

3. How to lead a normal pregnancy after a miscarriage?

Both parents need to watch their habits, especially mothers after conception to ensure that the baby gets all the nutrition through the womb. Taking essential vitamins and 400 micrograms of folic acid each day, eating nutrient-rich foods, avoiding alcohol, smoking, and certain foods, and staying active are the steps that lead to a successful pregnancy.

1. Khalil, A., et al. “Monkeypox and pregnancy: what do obstetricians need to know?.” Ultrasound Obstet Gynecol 60.1 (2022): 22-27. ↩︎
2. Furman, Benjamin LS, et al. “Sex chromosome evolution: so many exceptions to the rules.” Genome biology and evolution 12.6 (2020): 750-763. ↩︎
3. Lucas-Herald, Angela K., et al. “Serum anti-Müllerian hormone in the prediction of response to hCG stimulation in children with DSD.” The Journal of Clinical Endocrinology & Metabolism 105.5 (2020): 1608-1616. ↩︎
4. Berek, Jonathan S., et al. “Cancer of the ovary, fallopian tube, and peritoneum: 2021 update.” International Journal of Gynecology & Obstetrics 155 (2021): 61-85. ↩︎
5. Zhang, Zhe, et al. “Overcoming cancer therapeutic bottleneck by drug repurposing.” Signal transduction and targeted therapy 5.1 (2020): 113. ↩︎
6. Quenby, Siobhan, et al. “Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss.” The Lancet 397.10285 (2021): 1658-1667. ↩︎

Last Updated on February 14, 2024 by Suchi