Pregnancy After Miscarriage

After a miscarriage, some couples do not want to think about babies for a while, but many want to try to conceive again right away. Here are a few thoughts based on my own experiences, and on things that friends have shared with me.

1--Be honest about why you do (or do not) want to get pregnant again right away. It may be a manifestation of denial--wanting to hurry up and be pregnant again so that you can pretend that you were never 'unpregnant.' You may carry the hope that conceiving again will help heal the loss. I can say from experience that a new pregnancy may help distract you from the loss, but unless you are well on the way to healing already it will not magically fix anything.
If you do not want to get pregnant, is it a product of fear, or simply a desire to wait? It's important to be sensitive to your spouse's feelings and desires too. I don't think there is any one right answer, and certainly not a simple one, but realize that both perspectives are valid.

2--Realize that being pregnant after having miscarried is a scary thing for most of us. There is an ever present fear of miscarrying again. Women who have never lost a baby may have some concerns about miscarriage, but they do not compare to when you have actually been there before. We tend to fixate on every little thing as either a sign that all is well, or a sign that we're about to miscarry again. For example, vaginal moisture is common in pregnancy, but after having lost babies I found myself running to the bathroom six times a day to check and make sure that what I was feeling wasn't blood. When I began to feel better from my morning sickness, I was terrified that it might mean that I was about to lose the baby.

3--Consider your timing. Different providers give different advice. My first OB told me that we should abstain from procreative activities for so long as I was bleeding, and then use preventative measures until after I had had at least one normal period. Essentially his advice was to let my body figure out that it is not pregnant before trying to get it pregnant again.
I have also heard the recommendation that after a baby you should wait for a time equal to (or longer than) the length of the pregnancy. So after a full-term baby you should wait 9 months, after a 13wk miscarriage you should wait 3 months, after a 5wk miscarriage you should wait at least a month, and so on.
On the other hand, I have heard many midwives and mothers say that that first ovulation after miscarriage (in other words, before that 'one normal period') is particularly fertile, and that if you really want to get pregnant again then you should try right away. I believe the theory is that the body doesn't figure out that it's not pregnant, and is therefore more welcoming of a new embryo. I don't know if there is any science to that or if it's just an old wives tale, but I do know an awful lot of women--including myself--who have conceived in the first month following a miscarriage.