All About Pregnancy After Miscarriage
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For women who have experienced a miscarriage, there's no "one size fits all" solution to managing grief. While some start trying to conceive again right away, others take months or years to overcome their emotional burden.
But take heart—it's very likely you will come out on the other side with the baby you've dreamed about. "If you've had one miscarriage, your chance of having a successful pregnancy isn't any different from anybody else's," says Jani Jensen, M.D., a reproductive endocrinologist and assistant professor at the Mayo Clinic in Rochester, Minnesota. "That should be hopeful news for couples." Once you're able to create an embryo, odds are that you'll carry another one to term in the future.
RELATED: What Causes Miscarriage to Happen?
So how soon after a miscarriage can you get pregnant, and is there an ideal time to begin having baby-making sex? We spoke with experts to find out.
Having Sex After Miscarriage
After a miscarriage, your body will likely complete the process on its own; otherwise, you'll need a dilation and curettage (D&C) to surgically remove the contents of the uterus. So how long after a miscarriage can you have sex?
Angela Chaudhari, M.D., a gynecologic surgeon and assistant professor in the Department of Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine in Chicago, recommends visiting your OB-GYN for a follow-up appointment about two weeks after the miscarriage. If everything looks fine, "I tell my patients to go ahead and have intercourse," says Dr. Chaudhari. She notes, however, that women who had a D&C might need to wait a few weeks to control the bleeding.
How Soon After a Miscarriage Can You Get Pregnant?
While it's safe to have sex soon after miscarriage, women should consider waiting two months to conceive again, explains Dr. Zev Williams, M.D., Ph.D., director of the Program for Early and Recurrent Pregnancy Loss (PEARL) at Montefiore Medical Center and Albert Einstein College of Medicine in New York. However, Dr. Williams goes on to say, "it is most likely safe to try to conceive following one full menstrual cycle after the miscarriage."
Women may ovulate as soon as two weeks after a miscarriage, assuming the baby was lost before 13 weeks, but it generally takes two months for her cycle to return. Waiting for a full two months—or for a complete and normal menstrual cycle, which generally takes about two months—ensures that the pregnancy hormone hCG has dipped to levels so low that it's undetectable. The uterine lining will also return to normal, making it receptive to receive a future fertilized embryo.
When trying for a successful pregnancy after miscarriage, the goal, explains Dr. Williams, is to "reset" the body by allowing a full menstrual cycle to occur. If a woman attempts pregnancy right away, before the pregnancy hormones from the miscarriage have cleared from her body, she may receive a false positive on a pregnancy test. Conversely, her doctor may mistakenly pick up falling pregnancy hormone levels from the miscarriage and deduce that she is miscarrying the second pregnancy.
Unfortunately, the only way to know for sure if the pregnancy hormones have completely decreased down to "zero" is to receive a blood test. Although Dr. Williams admits that it may not be the standard of care in all offices, he encourages women to ask their doctors for the blood test after miscarriage, especially if they're hoping to try for another pregnancy as soon as possible. In general, he recommends waiting about six weeks in the case of a first trimester miscarriage for the test.
Note that the further along in the pregnancy a woman is, the higher her pregnancy hormones will be, so you might need to wait longer for second trimester miscarriages. "It's important to make sure that your hormone levels and the uterine lining have returned to normal," explains Dr. Williams. "And that can take longer when a pregnancy has been farther along."
How to Conceive After Miscarriage
Conceiving after miscarriage is no different than it was initially. "You need to try to time intercourse as close to ovulation as possible and have sex every other day in the days leading up to it as well," says Dr. Chaudhari.
In addition to general recommendations for pregnancy planning—such as maintaining a nutritious diet and starting on prenatal vitamins—mothers-to-be should "check in" on their emotional well-being. "You don't want to get pregnant simply to replace that pregnancy," explains Alice Domar, PhD, executive director of the Domar Center for Mind/Body Health at Boston IVF, assistant professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School, and author of Conquering Infertility. "Start trying when you feel truly ready for the outcome, whether it's not getting pregnant, getting pregnant and having another loss, or getting pregnant and having a baby."
The most important thing: always ask your doctor when you should try to conceive again. Every miscarriage is different, and your doctor can advise you on personal health.
Is It Easier to Get Pregnant After a Miscarriage?
It's unclear whether fertility increases after a miscarriage. However, a 2016 study from the National Institute of Health, published in the journal Obstetrics & Gynecology, studied more than 1,000 women, and it found that 70 percent conceived within three months of miscarriage. Compare this with the 51 percent of women who conceived after waiting longer. More information is needed, but the study may show that there's no need to wait for conception after miscarriage.
Will I Miscarry Again?
According to Dr. Chaudhari, some old data said that perhaps people were more likely to suffer pregnancy loss again if they try to get pregnant immediately after miscarriage, but that's all been debunked. In reality, the odds of a successful, healthy pregnancy after miscarriage are definitely in your favor. According to the American Pregnancy Association (APA), at least 85 percent of women who have suffered a miscarriage will go on to have a healthy, full-term pregnancy afterward.
The Emotional Impact of Pregnancy After Miscarriage
Of course, getting the green light for sex after miscarriage physically doesn't mean you're actually up for it mentally. Many doctors feel that a woman's emotional and mental health is as vitally important her physical health.
"Attitude, positive thinking, receiving the correct information about her previous miscarriage, knowing her possibilities, considering that more than 85 percent of women get pregnant after a miscarriage, but at the same time, knowing her risks," are all part of the package, explains Dr. Ricardo Huete, Chief of OB-GYN at Torrance Memorial Medical Center in California.
What's more, this whirlwind of emotions won't disappear when you successfully get pregnant after a miscarriage. Indeed, if your last pregnancy ended in a loss, you may find yourself feeling overwhelmed with anxiety at every milestone you reach during your new pregnancy. It's also natural to rein in your excitement about having another baby after you've suffered a loss. You might do this in order to protect yourself, hoping to lessen your grief if you miscarry again.
Try leaning on family, friends, and health care providers for extra support—and realize that your partner might need additional attention too. And remember: the odds are in your favor that your next pregnancy will go smoothly!
