Content warning: Miscarriage, pregnancy loss
When it comes to miscarriage, the common — and well-known — statistic is that 15-20% of all pregnancies end in miscarriage [1]. The lesser-known figure that you may not hear much (if at all) is that with a pregnancy after miscarriage, there's an 80% chance of a healthy pregnancy [2].
Of course, none of this changes the lived experience that you, or someone in your life, may have gone through — whether one or multiple miscarriages. The reality in Australia — and research backs this up — is that social and medical support after a miscarriage is poor; as one woman described, "The silence is deafening" [3].
We're here, not only to normalise conversations around miscarriage but also with our #WeNeedMoreLeave movement, which encourages businesses to support at least 10 days of paid miscarriage leave. As evidence has found, significant professional support is needed for some [3].
And as miscarrying women often find that there's "inadequate" medical information regarding miscarriage and its implications for a potential future pregnancy, we're here to guide you through the wealth of information, studies, and research (you name it) out there [3].
Understanding a miscarriage
Miscarriage is defined as a "spontaneous loss of pregnancy", that occurs before 24 completed weeks of gestation [1][4]. Most, between 75-80%, happen in the first trimester [5].
It occurs, approximately, in ⅓ of all women [1]. Furthermore, 6% of women have 2 or more miscarriages, consecutively [6].
The instance is often described as "tumultuous", where many complex emotions arise; some women experience negative emotions, and others feel more positive ones, like relief. You may find your emotions bounce back quicker, while other people's stories may involve a prolonged period of time.
There's no right or wrong way to feel.
The fact is that a miscarriage can impact your physical and emotional health in many ways — higher levels of pregnancy-specific anxiety, and even a fear of delivery in those who have experienced a previous pregnancy loss [7]. There is pain, blood loss, potential further treatments — and fluctuating hormone levels, after the fact [6][5].
Although there is no universal response to experiencing a miscarriage, there is one universal fact we want you to know — a miscarriage is not, in any way, shape or form, your fault. It is most often without an identifiable cause, and it is always without blame.
Is it possible to get pregnant immediately after a miscarriage?
Yes, it is possible to immediately experience another pregnancy after a miscarriage. This is because you can ovulate any time after you miscarry — so pregnancy could predate your period [8].
However, it's not recommended to have sex — unprotected or otherwise — for at least 2 weeks afterwards, to give your womb time to settle and to prevent infection [8][9]. It's also important to wait until any bleeding related to your miscarriage has stopped.
Many organisations suggest waiting until you've had at least 1 menstrual period. Not only because the first one after the fact is often much longer or shorter than your usual menstrual cycle, but also because it's easier to calculate dates for your next pregnancy [10][11].
And don't forget to take the mental health, and physical health, of you and your partner into account — are you both ready for pregnancy after miscarriage?
How soon after a miscarriage can you safely get pregnant?
So we know it's recommended to wait until you've had a period before trying to get pregnant — but beyond that, you may be a bit confused.
Since 2007, the World Health Organisation has recommended waiting 6 months before trying again, however, more recent studies have disputed this [12].
One study from 2010, that looked at over 30,000 women in Scotland, found that for pregnancy after miscarriage, live birth rates were highest in those with an interpregnancy interval of fewer than 6 months.
They were less likely to experience a miscarriage, termination or ectopic pregnancy. In addition to this, they were less likely to have a caesarean, deliver preterm, or have an infant of low birth weight [13].
In 2017, other research found that an interpregnancy interval of 3 months or less, after pregnancy loss, resulted in a significantly reduced risk of subsequent miscarriage, in comparison with those who wait longer — between 6 and 18 months. [14]
For women over 35 — particularly first-time mothers — it is more likely to experience difficulties conceiving; delaying conception could decrease the chances of healthy pregnancies, and a healthy baby [13].
Trying to conceive can be a stressful time, especially if you have been on the journey for a while.
Is it easier to get pregnant after a miscarriage?
Potentially, yes.
When you're pregnant, particularly within the first trimester, your body undergoes many physiological changes. So, after a miscarriage, there may be a time when the body is "primed" for pregnancy — before it returns to its pre-pregnancy state. Some researchers believe that conceiving before that baseline may promote successful pregnancy [14].
Our very own Department of Health even writes that if you've had a miscarriage, the next pregnancy will usually be normal — the chance of recurrent miscarriage is 1 in 5 [15].
What can I do to prevent a miscarriage?
Unfortunately, there's often nothing that can be done to prevent another miscarriage — but as you now know, the odds are on your side this time for a healthy pregnancy.
Counselling from your medical practitioner on how to optimise your health for subsequent conception is recommended; adapting your lifestyle and timing intercourse around ovulation is also (and with the latter, obviously) helpful [13][6].
You can also consider getting a fertility test which looks at relevant hormone levels, helping you understand egg count in addition to your ovulation cycle — and whether anything is impacting it. Undergoing fertility testing can help you make an informed decision about your reproductive health.
Prior to conceiving — ideally a few months in advance — it's important to take a daily prenatal vitamin, something that's important for you and your baby [9].
In addition to this, the old well-balanced diet and moderate exercise are always a winner. Miscarriage Association recommends:
- 5 portions of fruit and vegetables a day, fresh or frozen, and thoroughly washed
- Meat, fish, eggs, lentils, soya and tofu; make sure eggs and meat are cooked thoroughly
- Pasteurised milk and cheeses, or vegan alternatives
- Cereal, breads and grains.
In terms of cutting down, or cutting out completely — it's alcohol, smoking and caffeine (sorry for that last one) [10].
Does pregnancy after miscarriage feel different?
In terms of your body, not necessarily. In terms of your emotions, yes — pregnancy after a miscarriage can feel very different to previous pregnancies. Particularly, pregnancy after a previous pregnancy loss can be "emotionally and psychologically distressing" [1].
Don't be surprised if you feel such intense feelings, or find that although it's not possible to prevent a miscarriage, you still search for strategies to increase the feeling of being in control.
Studies have found this a common phenomenon, an overarching theme of “balancing between loss of control and searching for control” [6].
If you do become pregnant after a miscarriage, it may be that you find yourself dealing with 3 different waiting periods:
- Miscarriage period: The period between pregnancy loss until trying to conceive;
- Conception period: The period between renewing the attempt to conceive, and falling pregnant;
- Pregnancy period: The period between conception, and confirmation of a viable pregnancy.
Each of these periods can be stressful, as each is unpredictable and difficult to manage. And when you have a previous miscarriage or repeated miscarriages, you may feel uncertain about a new pregnancy occurring, or consecutive miscarriages occurring — which in turn, can result in anticipatory anxiety [6].
I'm pregnant again but I'm not excited. Is this normal?
When you get pregnant after experiencing a pregnancy loss, it's not uncommon that you won't feel excited.
In fact, statistics show that 45% of women experience "clinically relevant anxiety symptoms" for 3 months after miscarriages, and the prevalence of "clinically depressive symptoms" is between 10-30% [16][3].
From this, pregnant women who have experienced a previous miscarriage have higher anxiety than women who haven't [16]. This is justified anxiety, as it's based on a real threat, and lived experience.
Not only is there the response to the loss of the previous pregnancy but there is the challenge of responding to the "uncertainties" of early pregnancy as well [6].
So, if you find yourself using more "problem-focused" coping strategies, rather than emotion-focused ones, know that you're not alone — women interviewed for studies have described it as "distancing" themselves from the new pregnancy [6].
In addition, they focus on symptoms, search for confirming information and ask for their social circles, as well as professionals, to provide support — which we're here to give to you [6].
What happens if I miscarry again?
If you're someone who has experienced 2 or more miscarriages, talk to your GP, OBGYN or other healthcare professionals before trying to get pregnant, as testing may be required to identify any underlying causes:
- Blood tests, to identify potential problems with hormones or the immune system
- Chromosomal tests, to identify issues with chromosomes — yours or your partner's
- Procedures such as an ultrasound or MRI, to examine potential uterine problems
Know, however, that even after 2 miscarriages, there’s a 65% chance of a healthy pregnancy [17].
Most of all, it’s important to talk about your feelings and find healthy ways to cope with your emotions. If you’re having trouble doing so, talk to your doctor or seek help from a mental health specialist. It’s okay and normal to feel stressed, sad and even angry, but you are never alone.
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