Pregnancy after miscarriage: What you need to know

Thinking about getting pregnant again after a miscarriage? You might worry about why you lost the pregnancy. You might wonder when to try again. Here are answers to some common questions about pregnancy after miscarriage.

What causes miscarriage?

Miscarriage is an unplanned loss of a pregnancy before the 20th week. Many miscarriages happen because the fetus isn't growing as expected.

Chromosomes are responsible for more than 50% of early pregnancy loss. Chromosomes are in every cell of the body. They give directions to the body's genes on how to grow and develop. If there is an unusual number of chromosomes as the embryo divides and grows, it can lead to miscarriage. Problems with chromosomes become more common as a pregnant person gets older.

Sometimes a health condition might lead to a miscarriage. Examples include poorly controlled diabetes and conditions that affects the uterus. But often, the cause of miscarriage isn't known.

About 10% to 15% of known pregnancies end in miscarriage. But the number of miscarriages is likely higher. Many miscarriages happen before a pregnant person even knows about the pregnancy.

What are the odds of another miscarriage?

Most pregnant people who miscarry do so only once. Many go on to have healthy pregnancies.

The risk of miscarriage in a future pregnancy is about 20% after one miscarriage. After two miscarriages in a row, the risk of another miscarriage goes up to about 25%. After three or more miscarriages in a row, the risk of another miscarriage is about 30% to 40%.

When is the best time for pregnancy after miscarriage?

Miscarriage can cause strong feelings of loss. You and your partner also might feel sad, anxious or guilty. Give yourselves time to grieve. If you're depressed, talk to a healthcare professional about treatment.

Most couples are told not to have sex for two weeks after a miscarriage. This is to prevent an infection. But you can become pregnant as soon as two weeks after a miscarriage.

Once you feel ready for another pregnancy, ask your healthcare professional to guide you. After one miscarriage, you might not need to wait to try again. After two or more miscarriages, your healthcare professional might suggest testing before you try to conceive.

Are special tests recommended before attempting pregnancy after miscarriage?

If you have two or more miscarriages in a row, your healthcare professional might suggest testing to try to find the cause before you try to get pregnant again. Tests might include:

• Blood tests. Testing a sample of your blood can help find out if your hormones or your immune system aren't working as they should.
• Chromosomal tests. You and your partner might both have your blood tested to see if your chromosomes are a factor. If there's tissue from the miscarriage, it also may be tested.

Other tests may be suggested, too, such as an ultrasound or an MRI, to help find conditions that effect the uterus.

If the cause of your miscarriages can't be found, don't give up. Most people who have more than one miscarriage go on to have healthy pregnancies.

What can be done to improve the chances of a healthy pregnancy?

Most often, there's nothing you can do to prevent a miscarriage. But making healthy lifestyle choices is good for you and your baby. Take a daily prenatal vitamin or folic acid supplement. This should begin a few months before you conceive.

Reach a healthy weight before you get pregnant again. During pregnancy, exercise and eat a healthy diet. Limit caffeine to 200 mg daily, which is about 1 to 2 cups of regular coffee. Don't drink alcohol, smoke or use illegal drugs.

What emotions are likely during later pregnancies?

Once you become pregnant again after a miscarriage, you'll likely feel joyful and worried. Becoming pregnant again can help you heal. But you may still be worried and depressed even after the birth of a healthy child.

Talk about your feelings. Let yourself feel them fully. Turn to your partner, family and friends for comfort. If you're having trouble coping, talk to your healthcare professional or a counselor for support and guidance.