A miscarriage can feel profoundly isolating. You spent days, weeks, or even months getting excited to tell everyone about your pregnancy. Instead, all you’re dealing with is dashed hopes. And if you’re like many people who experience a miscarriage, you might opt to keep it private. That means you’ll have little support, and may even have to continue dealing with intrusive questions about when you intend to have a baby.
You’re not alone. 10-25% of pregnancies end in miscarriage. Most women go on to have healthy pregnancies following a miscarriage, so don’t allow a miscarriage, or even multiple miscarriages, to dash your hopes.
Here in Houston, TX, at the Center of Reproductive Medicine, we understand how painful a miscarriage can be. We work with our patients to ensure healthy pregnancies, and to understand their miscarriages. Here’s what we want you to know about pregnancy after miscarriage.
Why Did I Have a Miscarriage?
The most common reasons women have miscarriages is that the embryo had a catastrophic genetic defect that made it not viable. These genetic defects aren’t preventable once a pregnancy begins. There’s nothing you could have done to stop it. In most cases, the genetic defect won’t happen again. In some cases, however, other factors -- such as an underlying disease, smoking, drug use, or exposure to carcinogens in the environment -- caused the genetic defect that led to the miscarriage.
A reproductive endocrinologist can help you identify whether the genetic defect was merely bad luck, or was caused by something else. In most cases, it’s possible to test a fetus for genetic defects to determine the cause of the miscarriage. However, some very early miscarriages can’t be tested for genetic defects.
Other common causes of miscarriage include:
- Thyroid disorders
- Hormonal imbalances
- Blood clotting disorders
- Physical health issues such as autoimmune disorders or cancer
- Lifestyle issues such as smoking or drug use
Even if you have an underlying condition that caused the miscarriage or an unhealthy lifestyle, please know that miscarriage is never your fault. Many people have successful pregnancies even while making unhealthy choices. There’s no way to predict who will have a miscarriage and who will not. A miscarriage is not a moral judgment. It’s not a reason to feel bad or guilty. You have suffered a loss. You don’t need to feel like a bad person on top of it.
In almost all cases, a miscarriage is only a one-time occurrence. Most people who have miscarriages go on to have healthy pregnancies, even without treatment. A small fraction of women, about 1%, will have a second miscarriage. Though a second miscarriage slightly decreases the chance of a successful pregnancy, doctors really only begin to get worried after three miscarriages.
This means that, while painful, a miscarriage is usually just unlucky -- not something that means you can’t get pregnant.
Is a Chemical Pregnancy a Miscarriage?
Some women have heard of a chemical pregnancy. A chemical pregnancy is just a term for a pregnancy that ends before it is medically recognized. A woman who has a positive pregnancy test might later begin bleeding and get a negative test. This is often due to a very early miscarriage -- not due to a false positive. These early miscarriages are the most common type of miscarriage, and are called chemical pregnancies.
Chemical pregnancies don’t usually mean something is wrong. In fact, a chemical pregnancy is the most common form of miscarriage. Many women have chemical pregnancies and never even know it because they don’t take a pregnancy test until several days after a missed period.
Is a Failed Implantation a Miscarriage?
For a pregnancy test to detect a pregnancy, the embryo must implant in the uterus. After it does this, the body begins producing pregnancy hormones that can be detected on a pregnancy test. So implantation is the moment at which a woman technically becomes pregnant.
Sometimes, a fertilized egg -- or an embryo implanted via IV -- fails to implant in the uterine wall. This isn’t technically a miscarriage, but a woman who has undergone IVF that fails may still experience many emotions similar to a miscarriage. Implantation failure is a relatively common cause of fertility issues. A number of tests can determine whether fertilized eggs are failing to implant in the uterus. So while implantation failures are not miscarriages, they are treatable.
Does a Miscarriage Mean I Can’t Have a Healthy Pregnancy?
A miscarriage only tells you that something went wrong with the pregnancy that miscarried. It might be an isolated incident, or it might indicate a serious underlying problem. Most women who have miscarriages go on to have successful pregnancies, even without treatment. Some don’t. The only way to know for sure is to know what caused the miscarriage.
To know what caused it, you’ll need a number of tests. In many cases, the cause might not be immediately apparent. That’s why it’s so important to work with a skilled infertility doctor.
Some miscarriages have multiple causes, and it’s important to assess every potential factor. For example, a genetic test of a miscarried embryo might reveal a genetic anomaly called a trisomy. An infertility specialist can dig deeper, to assess potential causes -- such as an autoimmune disorder or diabetes -- that led to this trisomy.
Is There Anything I Can Do to Prevent Miscarriage?
The specific health and embryo factors that cause miscarriages usually come into play well before a woman knows she is pregnant. That’s always the cause for genetic defects. Even when the cause is something preventable, like smoking, by the time a woman is pregnant, the damage may already be done.
Nevertheless, a woman may be able to reduce the chances of having a miscarriage by practicing good self-care before and during pregnancy. Remember that you will have a fertilized egg in your body for about two weeks before you get a positive pregnancy test.
So it’s helpful to take steps to ensure that your body is always a healthy place to grow a pregnancy.
Those steps include:
- Not smoking, using drugs, or drinking when trying to conceive.
- Taking a prenatal vitamin containing folic acid.
- Managing any chronic conditions you have.
- Avoiding dangerous chemicals such as pesticides.
- Regularly seeing your doctor.
- Maintaining good oral health.
- Maintaining a healthy body weight that is neither too low nor too high.
- Eating a balanced, nutrient-dense diet.
- Keeping your stress under control.
- Getting plenty of exercise according to the schedule recommended by your doctor,
When you are pregnant, a number of additional strategies may reduce the risk of miscarriage.
- Avoiding chemicals that can be harmful to the developing baby, such as alcohol.
- Continuing to take a prenatal vitamin.
- Eating plenty of healthy, protein-rich food.
- Avoiding smoking.
- Getting plenty of sleep.
- Promptly telling your doctor about any unusual symptoms you experience, such as bleeding or abdominal pain.
Many women have miscarriages in spite of these choices. Almost all go on to have healthy pregnancies. So if you have a miscarriage in spite of your best efforts, we urge you not to beat yourself up. You can still have a healthy baby.
How Soon After a Miscarriage Should I Try for a Pregnancy?
Every woman feels different after a miscarriage. Some women feel the need to grieve for the baby they lost. Others find that the best way to grieve is to throw their efforts behind getting pregnant again. There’s no right or wrong way to do things.
When deciding when to try again to conceive, you should look at two factors:
It’s common to experience depression and anxiety during pregnancy. Having a child is a major life transition, and people have many reactions. Yet emotional turmoil during pregnancy can be bad for both the baby and mother. If you’ve recently had a miscarriage, you might feel like you need time to heal. If that’s the case, consider waiting a cycle or two so that you don’t struggle with depression, grief, or anxiety during pregnancy. If, however, you feel eager to try or think trying might help heal your emotional wounds, it’s fine to immediately try again as long as you are in good health.
A miscarriage can be hard on your body, particularly if it takes place during the second trimester. In most cases, it is physically safe to try again in the first cycle following a miscarriage. However, if you have had complications, your doctor might recommend waiting.
If your miscarriage is due to a physical health issue, such as diabetes or a thyroid disorder, you might have another miscarriage if you don’t get that condition under control. Your doctor may recommend treating your condition first, particularly if treatment might harm a developing baby.
Getting pregnant again after a miscarriage, even immediately following a miscarriage, does not increase the risk of miscarriage. The only women who are more likely to have a miscarriage are those who have had two miscarriages in a row, or who have an underlying medical condition. You won’t know if you fall into the latter category until you seek a fertility specialist.
Recurrent miscarriage is two or more consecutive miscarriages. A woman who has a miscarriage, then gives birth, then who has another miscarriage does not have recurrent miscarriage. Miscarriage is only recurrent if it happens in two or more pregnancies in a row.
Even a recurrent miscarriage can simply be bad luck. So doctors typically don’t worry about recurrent miscarriage until a woman has had three or more miscarriages. Nevertheless, multiple miscarriages in a row suggest that there may be an underlying problem. So many fertility specialists treat a woman for recurrent miscarriage after two or more miscarriages.
When Should I See a Fertility Specialist for Miscarriage?
A single miscarriage does not mean you need to see a fertility specialist unless you have other risk factors, such as trying a year or longer to get pregnant. So when should you see a specialist? We recommend seeking help if:
- You have had two or more miscarriages in a row.
- You have had a second trimester miscarriage.
- You have had a miscarriage due to an underlying health condition.
- You are over the age of 35 and have a miscarriage with your first pregnancy.
- You have a miscarriage after trying 12 months or longer to get pregnant.
- You have a miscarriage accompanied by other symptoms that you may have fertility issues, such as irregular menstrual cycles or abnormal bleeding between periods.
What Can a Fertility Specialist Do to Treat Miscarriages?
Many people worry that seeking help from a fertility specialist is a costly endeavor that will only produce frustration. That’s why so many couples avoid seeking help. Yet fertility is time limited. Each year that passes reduces a couple’s chances of having a baby. So the best strategy is always to seek help now.
Don’t be discouraged. Even if you have had many miscarriages, treatment is possible. It all begins with comprehensive testing. That’s what makes infertility specialists different. They test for conditions that other doctors might not even consider. They ask about your lifestyle, your health, your family history. They’re like detectives, digging deeply to understand why you’re struggling and what might fix it. Once they know what the problem is, they can begin treating it. In most cases, we are able to either cure the underlying problem or find a way to work around it.
For instance, in women who continue to have pregnancies with fetuses who have genetic anomalies, we often try IVF. This allows us to select the healthiest embryos, and to implant them directly into the uterus. This greatly increases the chances of pregnancy. In other cases, such as when a woman has a serious medical condition, we might treat the condition while offering strategies for increasing fertility. In many cases, the woman is eventually able to successfully carry a pregnancy without IVF or other interventions. It all depends on what’s wrong -- and you won't know what’s wrong until you seek expert help and insight.
Pregnancy After Miscarriage
Almost all women who have a miscarriage go on to have a healthy pregnancy. However, many find themselves struggling with anxiety or guilt. They may worry about childbirth, about the health of the baby, or about having another miscarriage. Getting pregnant again will not necessarily make the pain of a miscarriage go away. So it’s important to seek help from people you trust -- a partner, friends, a support group, or perhaps a therapist.
If you’re struggling after having a miscarriage, we can help. We’ll help you understand why you had a miscarriage, ease your mind when you get pregnant again, and offer you resources that help you grieve. You didn’t cause this. You don’t deserve it. And you can overcome it. Let us show you how. Contact the Center of Reproductive Medicine today!