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It's less time than you might expect.
By Fatherly — Written on Oct 03, 2020
Getting pregnant can be difficult.
The same goes for staying pregnant, considering the fact that approximately 25 percent of pregnancies end in miscarriage.
While pregnancy after miscarriage can be a scary thing to imagine, many hopeful parents want to know when, exactly, is the best time to try to get pregnant again, and they dream of someday having a "rainbow baby" to hold.
Enduring pregnancy loss is often painful, but as much as healing takes time, evidence suggests that patients may not want to wait too long before they try again.
Here's what we know about the best time to try to get pregnant after a miscarriage.
Pregnancy after miscarriage: When should you try again?
Learning the risk factors and causes of miscarriage, the risk of having a second miscarriage, and what one can do before trying to get pregnant again after pregnancy loss can be helpful in deciding when to get pregnant again.
While there are suggestions from scientific and medical institutions around the world, each patient and family should be able to decide what's best for them based upon advice from their doctor and by respecting their own unique grieving and healing processes.
Common causes of miscarriage, explained.
According to Cleveland Clinic, approximately 1/3 to 1/2 of miscarriages happen in the very early days of a pregnancy, before the patient realizes they've missed a period. Among women who know they are pregnant, around 10% to 20% will miscarry.
The Mayo Clinic explains that among first trimester miscarriages, "about half of all miscarriages that occur in the first trimester are caused by chromosomal abnormalities — which might be hereditary or spontaneous — in the father's sperm or the mother's egg."
In other words, there was simply nothing anyone could have done to prevent the pregnancy from being lost.
Cleveland Clinic shares a more comprehensive list of common causes of miscarriage:
Infection
Exposure to environmental and workplace hazards such as high levels of radiation or toxic agents
Hormonal irregularities
Improper implantation of fertilized egg in the uterine lining
Maternal age
Uterine abnormalities
Incompetent cervix
Lifestyle factors such as smoking, drinking alcohol, or using illegal drugs
Disorders of the immune system including lupus, an autoimmune disease
Severe kidney disease
Congenital heart disease
Diabetes that is not controlled
Thyroid disease
Radiation
Certain medicines, such as the acne drug isotretinoin (Accutane®)
Severe malnutrition
Group B beta strep
It's important to note that stress does not cause miscarriage in a healthy pregnancy, and neither does exercise, sexual intercourse or working in a reasonably safe environment.
People have many different reactions after a miscarriage, and often feel conflicted about trying to get pregnant again. Some people blame themselves, even when the miscarriage was totally out of their control. They may need time to work through that, perhaps even with a therapist or counselor.
For many people, the hope of having another child, often called a rainbow baby, helps them get through the pain and grief of pregnancy loss.
Parents magazine explains that a rainbow baby "'is a baby born after a miscarriage, stillborn, or neonatal death," Jennifer Kulp-Makarov, M.D., FACOG. 'It is called a rainbow baby because it is like a rainbow after a storm: something beautiful after something scary and dark.'"
What are the odds of having another miscarriage?
The good news is, most people who have had a miscarriage go on to carry a pregnancy to term.
According to USC fertility, the chance of another miscarriage following a first pregnancy loss is around 14 to 21%. While that sounds terrifyingly high, it's still considered rare to have more than one loss in a row.
"About 15 percent of pregnant women experience sporadic loss of a recognized pregnancy. Just 2 percent of pregnant women experience two pregnancy losses in a row, and only about 1 percent have three consecutive pregnancy losses."
So, while it does happen, it's significantly less likely than you might expect.
What to do before trying to get pregnant again.
Before trying to conceive again after a miscarriage, it's important to try to eliminate any risk factors such as drinking alcohol, smoking and using drugs or exposure to substances or situations that are potentially dangerous to a pregnancy.
What To Expect, a pregnancy support website, suggests first scheduling an appointment with your doctor to address risk factors or health issues that may raise your chances of another pregnancy loss.
They also suggest limiting stress, maintaining a healthy weight, and limiting your caffeine intake to 200mg per day.
While you should always consult your doctor for specific advice, The Mayo Clinic advises that your body may ovulate as soon as two weeks after a miscarriage. Once cleared by your doctor, if you feel emotionally ready to try again, it's possible to start trying to conceive again as soon as the next ovulation cycle.
Contrary to commonly-held beliefs and even many official recommendations, research shows that patients who try to conceive within three months of a miscarriage may be more likely to become pregnant and have a healthy pregnancy than those who wait longer.
The National Institute of Health has found that patients who conceived within three months following a miscarriage had a higher live birth rate than those who waited longer — 53 percent compared to 36 percent.
Additional research from the NIH found that women who got pregnant again within three months of a miscarriage reduced their risk of another pregnancy loss compared to women who conceived after three months.
“If a woman decides to wait to attempt conception, the miscarriage risk is slightly higher,” says Dr. Mark Trolice, an OB/GYN and reproductive endocrinologist.
This thinking goes against recommendations from very big organizations.
The World Health Organization, for one, recommends couples wait up to six months before trying again, citing that "six months is ideal "in order to reduce risks of adverse maternal and perinatal outcomes."
The reasoning here is partly psychological. It is fair to say that extreme emotional distress is not healthy for pregnant women or their developing babies.
Bereavement during pregnancy has been linked with an increased risk of stillbirth and depression during pregnancy is associated with a greater risk of sleep and mental health problems for their children later in life.
But, it is also fair to say that extreme emotional distress does not accurately characterize every person’s experience with miscarriage.
In addition, it's also key to bear in mind that WHO is responsible for giving advice to patients across the globe, in varying living situations, and with a wide range of differences in access to medical care.
Trolice puts it more bluntly: “This recommendation was not based on solid medical evidence.”
Exactly why trying to get pregnant again within a three-month window is advantageous is not settled science.
Trolice suspects that couples who conceive right away might be more likely to make the health and lifestyle adjustments needed for a healthy pregnancy.
For instance, women who waited longer to conceive had higher rates of obesity compared to women who tried to get pregnant right away.
Another possibility — women who tried to get pregnant within three months may have had more luck, for the simple and unflattering fact that prospective parents are not getting any younger.
As more and more couples opt to have children later in life, advancing maternal age has put many women at an increased risk of miscarriage and advancing paternal age comes with risks for the fetus as well.
Given the tendency for some people to feel a "ticking clock" as we age, it makes sense that waiting to try after a miscarriage may not be feasible. This may also be the case for folks who have spent significant time dealing with infertility.
“A woman’s peak fertility is actually in her mid-to-late twenties and begins to decline more rapidly after the age of 35,” Dr. Tom Molinaro, a reproductive endocrinologist at the Reproductive Medicine Associates of New Jersey, says. “Because of this, a couple should begin trying to conceive as soon as they are ready.”
Every pregnancy is different and so is every miscarriage, so there are many limitations to consider with this data.
If the miscarriage involved any medical procedure, it is crucial to take advice from a doctor about when to hold off in order to avoid complications and infections.
Couples who have had recurrent miscarriages or experienced a miscarriage after 13 weeks (most miscarriages occur before), there are caveats about trying sooner than later that could pose a health threat to women and their babies and it is important to discuss these with medical professionals.
Both Molinaro and Trolice agree that there is no one-size-fits-all prescription for men and women trying to conceive after a miscarriage.
However, if patients are physically and psychologically ready to get back on the baby-making horse, there is no need to wait six months to start trying.
On the other hand, there is no need to minimize the loss or rush the grief process either. Pregnancy after miscarriage can be emotional even just to consider.
“The impact of miscarriage on the couple is often akin to a death in the family. A grieving process is important to ensure full emotional recovery,” Trolice says. “If the couple feels they have healed emotionally and the woman has recovered physically, then they can attempt conception within three months following a pregnancy loss — with reassuring evidence of no increase in miscarriage and probably a higher live birth rate.”
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Lauren Vinopal is a writer who focuses on family, marriage, and relationships. For more of her family content, visit her author profile on Fatherly.
This article was originally published at Fatherly. Reprinted with permission from the author.