Pregnancy After Miscarriage: What You Need to Know When Trying to Conceive by Dr. Alan Lindemann

The most important thing you need to know after miscarriage is that it is not your fault. Allow yourself to grieve. Here are some commonly asked questions about pregnancy after miscarriage:

Q. Who is likely to miscarry?

Anyone can miscarry. It’s often estimated that 10 to 20 percent of all pregnancies end in miscarriage. With today’s newer testing options for pregnancy, miscarriages can be detected before a period is missed. When the miscarriage rate includes those fetuses lost before missing a period, the miscarriage rate increases to up to 40 percent of all pregnancies.

Q. How long do you have to wait to get pregnant after miscarriage?

One precaution: always remember that after miscarriage, getting pregnant again is often very easy. Some providers say wait for three months before getting pregnant again. I always suggest waiting for one regular period before getting pregnant again. It can then be determined with more accuracy when you are due. In addition, having a normal period signals that you are done with the miscarriage.

Q. What is the probability that miscarriage will occur again?

A beating heart is the line in the sand. Miscarriage before there is a beating heart is common and usually from a chromosomal mutation. These miscarriages are not preventable. Whatever the mutation is, the resulting egg cannot develop into a viable fetus. The miscarriage before the detection of a beating heart has a low risk of recurring.

Once there is a discernable beating heart, there are a number of possible causes of miscarriage, and these causes can mean repeatable miscarriages in some women. Bacterial infections. Clotting disorders. If you have had a second miscarriage, it’s time to ask your obstetrician to look for possible causes. After one miscarriage, I recommend checking for sexually transmitted diseases (STDs).

Q. Does additional testing help or hurt?

In my experience, common bacterial infections can cause some women problems in pregnancy. We do not know why these organisms cause some women problems in pregnancy but not others.

• Bacterial Infections: There are many bacterial infections that can cause miscarriage, including Strep B. Many of these organisms are so common that they are considered normal and left untreated in pregnancy. The current fashion is to leave Strep B untreated until delivery because one course of antibiotics may not successfully eradicate the organisms. However, if the recurring infection is not treated until delivery, in some women the organism can cause miscarriage before you reach full term.

• Clotting Disorders: Another possible problem for some women are clotting disorders such as methylenetetrahydrofolate reductase (MTFHR), Factor 5 Leiden, and antiphospholipid antibodies.

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