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Pregnancy after miscarriage

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.
Thinking about pregnancy after miscarriage? You might be 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. Many miscarriages occur because the fetus isn't developing normally. Problems with the baby's chromosomes are responsible for about 50 percent of early pregnancy loss. Most of these chromosome problems occur by chance as the embryo divides and grows, although it becomes more common as women age. Sometimes a health condition, such as poorly controlled diabetes or a uterine problem, might lead to miscarriage. Often, however, the cause of miscarriage isn't known.
About 8 to 20 percent of known pregnancies end in miscarriage. The total number of actual miscarriages is probably higher because many women miscarry before they even know that they're pregnant.

What are the odds of another miscarriage?

Miscarriage is usually a one-time occurrence. Most women who miscarry go on to have healthy pregnancies after miscarriage. A small number of women — 1 percent — will have repeated miscarriages.
The predicted risk of miscarriage in a future pregnancy remains about 20 percent after one miscarriage. After two consecutive miscarriages the risk of another miscarriage increases to about 28 percent, and after three or more consecutive miscarriages the risk of another miscarriage is about 43 percent.

When is the best time for pregnancy after miscarriage?

Miscarriage can cause intense feelings of loss. You and your partner might also experience sadness, anxiety or guilt. Don't rush the grieving process.
Typically, sex isn't recommended for two weeks after a miscarriage to prevent an infection. You can ovulate and become pregnant as soon as two weeks after a miscarriage.
Once you feel emotionally and physically ready for pregnancy after miscarriage, ask your health care provider for guidance. After one miscarriage, there might be no need to wait to conceive. After two or more miscarriages, your health care provider might recommend testing.

Are special tests recommended before attempting pregnancy after miscarriage?

If you experience two or more consecutive miscarriages, your health care provider might recommend testing to identify any underlying causes before you attempt 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 your body. Your health care provider places the ultrasound device over your abdomen or places it inside your vagina to obtain images of your uterus. An ultrasound might identify uterine problems, such as fibroids within the uterine cavity.
  • Hysteroscopy. Your health care provider inserts a thin, lighted instrument called a hysteroscope through your cervix into your uterus to diagnose and treat identified intrauterine problems.
  • Hysterosalpingography. Your health care provider threads a thin tube through your vagina and cervix to release a liquid contrast dye into your uterus and fallopian tubes. The dye traces the shape of your uterine cavity and fallopian tubes and makes them visible on X-ray images. This procedure provides information about the internal contours of your uterus and any obstructions in the fallopian tubes.
  • Sonohysterography. This ultrasound scan is done after saline is injected into the hollow part of your uterus though your vagina and cervix. This procedure provides information about the inside of your uterus, the outer surface of the uterus and any obstructions in the fallopian tubes.
  • Magnetic resonance imaging (MRI). This imaging test uses a magnetic field and radio waves to create detailed images of your uterus.
If the cause of your miscarriages can't be identified, don't lose hope. Most women who experience repeated miscarriages are likely to eventually have healthy pregnancies.

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

Often, there's nothing you can do to prevent a miscarriage. However, making healthy lifestyle choices is important for you and your baby. Take a daily prenatal vitamin or folic acid supplement, ideally beginning a few months before conception. During pregnancy, limit caffeine and avoid drinking alcohol, smoking and using illicit drugs.

What emotions are likely during subsequent pregnancies?

Once you become pregnant again after miscarriage, you'll likely feel joyful — as well as anxious. While becoming pregnant again can be a healing experience, anxiety and depression could continue even after the birth of a healthy child.
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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