10 Ways to Lower Your Miscarriage Risk

About 10 to 15% of known pregnancies end in miscarriage, according to March of Dimes. Some people who have experienced a pregnancy loss may wonder if there is anything they did that could have caused the miscarriage, or any way they could have prevented it.

The truth is, most early miscarriages are caused by genetic abnormalities that are far beyond the control of any parent-to-be. "When the chromosomes of the egg and those of the sperm fuse to form an embryo, they usually pair up correctly," says Henry Lerner, M.D., an OB-GYN at Newton-Wellesley Hospital in Newton, Massachusetts. "But sometimes they get scrambled. If they're paired incorrectly, the embryo stops developing." It doesn't mean that anything's wrong with the biological parents; the pregnancy simply ends because it's not viable.

In most cases, there's nothing you can do to cause a miscarriage, and nothing you can do to prevent it, says Siobhan Dolan, M.D., a medical advisor to the March of Dimes and an attending physician in the Division of Reproductive Genetics at Montefiore Medical Center, the University Hospital for Einstein, in New York City. "It's a very challenging condition. We'd love to have a treatment we can offer, but there are very few effective interventions."

That said, a healthy lifestyle before and during pregnancy may help pave the way for a healtheir pregnancy, says Erika Nichelson, D.O., a board-certified OB-GYN at the Family Childbirth and Children's Center at Mercy Medical Center in Baltimore. Here are some recommendations for how to potentially lower your risk of a miscarriage.

1. Be Prepared

"Up to half of pregnancies are unplanned, which means that some parents are not best prepared for pregnancy when it occurs," says Stephanie Zobel, M.D., an OB-GYN with Winnie Palmer Hospital. Zobel adds that while many people do not realize that they are pregnant until a couple weeks after their missed period, by that time, the fetal spinal cord has already been formed and the heart is beating.

Thus, whenever possible, it's best to take steps before conception to pave the way for a healthier pregnancy. "Preparing for pregnancy by modifying diet and exercise, limiting stress, optimizing chronic medical disorders, and beginning prenatal vitamins is ideal for all pregnancies," Zobel notes. When choosing a prenatal vitamin aim for one that has 400 mcg of folic acid because it might prevent major birth defects that could cause miscarriage, according to the Centers for Disease Control and Prevention (CDC).

2. Schedule a Preconception Visit

If you're not already pregnant, schedule a preconception visit with your gynecologist. They'll review your medical history, ask about your lifestyle, and perform an annual exam (if you're due for one). They'll also take blood samples to check for blood type, Rh factor, and varicella (chicken pox) and rubella immunity. If you haven't been vaccinated against these infectious diseases, now's the time to get your shots. Though skipping them won't increase your odds of a miscarriage, the vaccines are live viruses that can't be given once you're pregnant.

3. Eat a Well-Balanced Diet

You may already be taking a prenatal vitamin, but don't think of it as a magic bullet. A well-balanced, healthy diet is the best way to get the vitamins and nutrients your body needs to nourish your baby, says Dr. Nichelson. While studies aren't conclusive about the exact link between nutrition and miscarriage, there is some evidence that there may be a connection between certain nutritional deficiencies and pregnancy loss.

4. Exercise in Moderation

You should continue your usual exercise routine once you're pregnant, though now's not the time to start training for your first marathon. The key is moderation: Some research suggests that a very high, vigorous level of physical activity may be linked to early pregnancy loss, although the exact link is not 100% clear. Contact sports are also off the table for now, as they could lead to an injury or fall, which could harm the pregnancy.

5. Limit Caffeine

Some doctors suggest pregnant parents-to-be restrict their caffeine intake to no more than 200 milligrams a day, or roughly two 6-ounce cups of coffee, tea, or other caffeinated beverages as there is some evidence that suggests caffeine may be linked to miscarriage. There isn't a clear link between caffeine and miscarriage, tut to be on the safe side, ask your pregnancy care provider what they recommend.

6. Avoid Drugs, Smoking, and Alcohol

Dr. Zobel suggests that people who might become pregnant limit or eliminate alcohol from their diets. She says those who smoke or use recreational drugs are also advised to quit. These substances might be linked to an increased risk of miscarriage. Currently, there are no conclusive studies in humans proving that marijuana use during pregnancy can cause miscarriage, but animals studies suggest a link, especially in the first trimester.

7. Get Help for Stress Management

Besides improving your overall mood, staying relaxed may also help the health of your pregnancy. A 2017 review of available studies in Scientific Reports found that stress might increase the risk of miscarriage by as much as 42%. Keep in mind, though, that everyday tension or anxiety isn't linked to pregnancy loss, says Jonathan Schaffir, M.D., an assistant professor of obstetrics and gynecology at Ohio State University College of Medicine. The problem occurs with major stresses, like divorce, abuse, or another type of loss. If you are experiencing significant stress in your life, talk to your doctor about some resources that can help, such as therapy or medication.

8. Manage Diabetes and Other Chronic Conditions

According to Dr. Nichelson, elevated blood sugar can lead to fetal malformation and a subsequent loss, so pregnant people with diabetes should control their condition. The best plan of action is seeing your doctor before becoming pregnant to optimize your health. "Chronic medical disorders including diabetes, hypothyroidism, hypertension, and autoimmune illnesses need to be addressed and well-controlled prior to pregnancy," says Dr. Zobel. "Establishing care with a physician early in the pregnancy is key to a successful pregnancy in women with chronic medical conditions."

9. Ask About Low-Dose Aspirin

Are you trying to conceive after one or two pregnancy losses? A study published January 2021 in Annals of Internal Medicine found that low-dose "baby" aspirin might help prevent another miscarriage. Specifically, taking one 81-milligram tablet each day while trying to conceive and throughout pregnancy was associated with more pregnancies, more live births, and fewer pregnancy losses in the trial participants—as long as they strictly adhered to the aspirin regimen. Of course, taking a blood thinning medication will not be best for everyone trying to conceive, so be sure to talk to your doctor before adding this to your daily routine.

10. Evaluate Your Medications

If you're taking medication (even an over-the-counter remedy), always run it past your OB-GYN first to make sure it's safe for pregnancy. ACE inhibitors (heart medications), for example, can cause fetal malformations and increase your odds of a miscarriage. While avoiding some medications will be safest during pregnancy and while trying to conceive, others should be evaluated carefully with their risks vs. benefits. For instance, for some people, continuing on mental health medication may be the best route for a healthy pregnancy, so have that discussion with your doctor before making any chances to your medications.

Preventing Miscarriage: The Bottom Line

While these strategies might help potentially lower your risk of a miscarriage, they can't minimize the risk due to chromosomal abnormalities. Sometimes a pregnancy simply isn't viable, and there's nothing the parents-to-be can do to prevent miscarriage. If you're trying to conceive, talk to your doctor about some steps you can take and if you're struggling after a loss, know that help and resources are available to you as well.