Pregnancy after Miscarriage

Experiencing a miscarriage is an emotionally challenging, often devastating experience for women and their partners. A miscarriage, also called early pregnancy loss, is the loss of a pregnancy within the first 12 weeks. Everyone reacts differently after an early pregnancy loss. It’s important to give yourself time to grieve and to recognize that the loss was not your fault.

When you feel ready to start trying to conceive again, you may have many questions like  —  Why did I have a miscarriage this time? How soon can I get pregnant after a miscarriage?  Can I prevent another miscarriage from happening?

Let’s start with one of the most common questions our providers are asked:

Why did the miscarriage happen?

As advanced as modern medicine is, we still don’t know the exact cause of most miscarriages. About half the time, the miscarriage happened because the embryo didn’t form correctly. This is called a chromosomal abnormality. It can mean that the embryo had either too many or too few chromosomes or even though there is the correct number of chromosomes, something about one or more of them is not normal.

Other times, we simply do not have an answer.

What we do know, however, is the following activities do NOT cause miscarriage:

• working
• exercising
• falling
• feeling upset
• or having sex.

Will I have a successful pregnancy after a miscarriage?

After an early pregnancy loss, it’s common to worry if it will happen again. Getting your hopes up again after a loss feels risky. But we have some good news for you — most women (about 85%) go on to have a successful pregnancy after a miscarriage.

Recurrent miscarriage, which means two miscarriages in a row, happens to less than 5% of women. Three miscarriages in a row are even more rare, occurring less than 1% of the time.

Are special tests recommended before trying to conceive after a miscarriage?

If you have had two miscarriages in a row, then we recommend evaluation which will include genetic testing for you and your partner. Tests can help us discover the reason for recurrent miscarriages about 50% of the time.

How long do pregnancy symptoms last after miscarriage?

After a miscarriage, you may still have some pregnancy symptoms, like nausea and vomiting, breast tenderness, and fatigue. These symptoms are related to the amount of beta HCG (pregnancy hormone) that is still in your bloodstream, and they usually go away after about two weeks. If you’re still experiencing pregnancy symptoms after two weeks, it is important to contact your doctor.

Pregnancy symptoms typically stop sooner for women who have a DNC (dilation and curettage), which often causes beta HCG levels to drop more quickly.

Bleeding and cramping can also vary greatly from woman to woman. It could feel like a heavy period at first. But heavier bleeding should only last a few days at most. Although Some women may experience lighter bleeding for up to a month. As long as the bleeding appears to be decreasing, this is normal. If bleeding or cramping increases instead, call your doctor.

About 90% of the time, a woman’s body will resume its typical cycle within 8 weeks.

How soon after a miscarriage can I start trying to get pregnant?

You may have been told that you should wait a certain number of months or menstrual cycles before trying to conceive. However, there aren’t any large, quality studies that suggest it’s beneficial to wait after a first-trimester miscarriage. (Second- and third-trimester losses require a more personalized plan.)

Instead of recommending patients wait a specific number of months or cycles, we track beta HCG levels after any kind of pregnancy loss. When these levels return to pre-pregnancy levels, your body is ready to try to conceive again.

If you experience a first-trimester loss, talk to your OBGYN about whether you want to track labs early in the next pregnancy. For example, your doctor might track your beta HCG levels to indicate whether the pregnancy is likely to be viable. If the beta HCG level doubles every 48 hours, then there is a good chance that the pregnancy is on the right track.

When will you begin ovulating or menstruating after a miscarriage?

The body usually reacts to a miscarriage as if it’s a “period.” Some women’s bodies will resume ovulation right away, meaning they do not miss an ovulatory cycle after having a miscarriage. Others may miss one ovulation cycle. Sometimes the stress of miscarriage or surgery might affect ovulation and push it out a week or so.

Can you test false-positive for pregnancy after a miscarriage?

Pregnancy tests measure the amount of HCG in a woman’s blood or urine. Once beta HCG numbers are normal (close to zero), you would not get a positive pregnancy test. However, it could take about 2-4 weeks for those numbers to return to pre-pregnancy levels. While waiting for the beta HCG level to return to normal, you might get a positive pregnancy test. For that reason, we don’t recommend testing at home.

If you get a positive pregnancy test after a confirmed miscarriage, it may be due to testing too early. If beta HCG levels stay the same and do not decrease, your OBGYN may check to see if tissue is still present in your uterus. Sometimes, a prescription can help the tissue pass, but other times it may need to be removed with surgery (D&C).

What can I do to improve the chances of a healthy pregnancy after a miscarriage?

Remember, a miscarriage is not your fault. There’s nothing you can do to prevent a first-trimester loss.

While you can’t prevent a miscarriage, you can prepare your body for a healthy pregnancy. Be physically active. Nourish your body with whole foods and a balanced diet of carbohydrates, fats and protein. Read more about preparing for pregnancy.

We’re here for you

We’ve talked a lot about how to know if your body is physically ready for pregnancy after miscarriage. But it’s just as important to consider your mental health. Give yourself time to grieve after a miscarriage and seek therapy to help you process your loss. And when the time is right, we’ll be here for you to try getting pregnant again.

Dr. Beth Wiedel has been providing healthcare to women in Madison since 2002 and is a founding partner of Madison Women’s Health.  She shares the vision of all the partners of being a strong healthcare advocate for her patients, emphasizing compassion and communication throughout her practice.