Losing a pregnancy is a common experience, albeit a distressing and often isolating one. More than one in five pregnancies end in miscarriage, typically taking place within the first three months of pregnancy. "Now that we can detect pregnancy earlier, it's likely that more women may know about having had one than their mothers or grandmothers might have in the past," says 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.
For women under 35, the chance of having a miscarriage in any given pregnancy is about 15 percent. Rates rise as you age, up to 20-35 percent between ages 35 and 45 and as high as 50 percent for women over 45.
But take heart—it's very likely you will come out the other side with the baby you've dreamed of. "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.
Kim Malburg found herself fearful when she and her husband decided to try to conceive after experiencing two back-to-back miscarriages. "It is an emotional roller coaster," said Kim. "I just try not to think too much about it and treat each pregnancy differently."
Fortunately, there's no danger in trying to get pregnant after a miscarriage has fully completed. Still, many women are under the impression it's not safe to conceive right away. "There's some old wives' tale about waiting three cycles after a miscarriage to get pregnant again," says Angela Chaudhari, MD, a gynecologic surgeon and assistant professor in the Department of Obstetrics and Gynecology at Northwestern University Feinberg School of Medicine in Chicago, Illinois. "There was also some old data that perhaps people are more likely to miscarry again if they try immediately after, but that's all been debunked."
So how soon after a miscarriage can you get pregnant? Whether you've had a miscarriage or a procedure such as dilation and curettage (D&C), you should see your OB/Gyn for a follow-up appointment about two weeks afterward to make sure everything looks fine physically. "If that's the case, I tell my patients to go ahead and have intercourse," says Chaudhari. "The only thing that would prevent that is a traumatic procedure which might require longer healing." For instance, with a D&C, you may need a course of drugs to help control bleeding.
The trick to 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 Chaudhari. Of course, getting the green light physically doesn't mean you're actually up for it mentally. "You don't want to get pregnant simply to replace that pregnancy," explains Domar. "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."
Moving forward may take more—or less—time than you think. "After a miscarriage, women experience a range of emotions," says Andrea Braverman, Ph.D., a clinical psychologist in the Department of OB/Gyn at Jefferson Medical College in Philadelphia, Pennsylvania. "What's right for one person is not for another, so don't force yourself to feel a certain way if you want to move on earlier or grieve longer than you perceive you should." For some women, a public recognition of the lost pregnancy, such as having a burial, planting a tree, or setting up an altar in the home, is healing. "Other women find it therapeutic to journal or write letters to the wished-for baby so they can privately honor the soul," says Beth Jaeger-Skigen, LCSW, a psychotherapist in private practice in San Francisco, California specializing in infertility.
You might be tempted to ruminate on how aspects of your lifestyle in the past, like those crazy party days of college, might be connected to the miscarriage. Experts say that's counterproductive, as the cause of most pregnancies losses is unknown. "Instead, focus on what you can do now and address all known risk factors for miscarriage," says Jaeger-Skigen.
Stopping smoking and all drug use is critical; giving up alcohol is probably a good idea as well. It's wise to cut caffeine intake to less than 20 milligrams a day (roughly 2 cups of coffee), though eliminating it completely is best. Eating a balanced diet rich in fruits and veggies is important, as is staying within a healthy body weight—your physician can help you figure out your target range. You should also review environmental factors that could be problematic, such as excessive exposure to toxins, radiation, and X-rays.
It seems obvious, but you'll also want to limit contact sports and any activities that might risk injury, particularly to your abdomen and back. Once it's safe to start exercising again, you may find that yoga is a gentle option for easing back into physical activity. Also, consider acupuncture as a form of stress relief. "Overall the data on acupuncture is that there may be some benefit and very little downside in doing it," says Jensen. "As long as it's not cost prohibitive, there may be some benefit particular in stress reduction."
If you've had two or more miscarriages in a row, see your doctor for a more extensive evaluation to look for potential causes, such as an untreated infection, hormonal issue, or a reproductive abnormality. There could be an underlying genetic or even a structural issue, like a septum wall in your uterus, causing problems. Many women swear by the benefits of progesterone therapy to ward off repeat miscarriages. "It's not routine for first-time pregnancies," explains Dr. Elizabeth Nowacki, an OB/GYN at St. Vincent Fishers Hospital in Indiana. "But for someone with a previous loss or someone who has had trouble getting pregnant...absolutely start that progesterone conversation." Be prepared, though, if no clear answers come to light from tests and your doctor.
And stay optimistic: According to the American Society for Reproductive Medicine, less than 5 percent of women experience two consecutive miscarriages and an even lower percentage—just 1 percent—experience more than two recurrent losses.
"It's frustrating, but it's no reason to stop trying to get pregnant, as plenty of women who had unexplained miscarriages have delivered healthy babies," says Dr. Jensen.