I just had a miscarriage: what does this mean moving forward?

For many women, miscarriage is one of the worst events of their lives. It is painful physically, emotionally, spiritually. Pregnancy loss is a worst fear realized, and the mourning process is complicated, in part because it may be suffered in silence. 

But O For the Touch of a Vanished Hand, 1888, Walter Langley. Photo by Birmingham Museums Trust on Unsplash

Is this you? If so, I’m so sorry you are going through this. You are not alone. At least 10% of pregnancies may end in miscarriage. This can feel like a scary statistic, but an important counterpoint is the low chance of it happening again. Studies show that only 5% of women will have 2 consecutive miscarriages, and only 1% will have 3 or more. The likelihood is that your next pregnancy will be a baby. 

What does it mean to have a miscarriage?

Photo by Claire Kelly on Unsplash

Just like so much else in medicine, we have multiple names for the same entity. We use early pregnancy loss (EPL) or spontaneous abortion (Sab) as other interchangeable terms for miscarriage; they all signify a spontaneous pregnancy loss before 20 weeks. 

We further subdivide miscarriage into a chemical or clinical loss. Chemical means that it is early, found typically either with a urine or blood hCG test. Clinical is when the pregnancy is noted on ultrasound and then unfortunately passes. 

The diagnosis of pregnancy and its location is complex: we use your last menstrual period, if you know when you ovulated, hCG levels, and ultrasound to deduce the health of the pregnancy. 

Your doctor will discuss with you specifics on management of a miscarriage. Please continue the monitoring and to get immediate care if you are having any worrisome symptom. 

The question you can’t stop thinking about — why did this happen?

Photo by K. Mitch Hodge on Unsplash

Feeling guilty about doing (or not doing) almost everything you can think of is common, so it’s important to specify what isn’t the cause for miscarriage:

  • typical exercise
  • lifting objects
  • sleeping habits
  • intercourse
  • usual diets
  • stress

Though this needs to be tailored to your circumstances (which is why it’s always good to check in with your doctor!), certain conditions may contribute to pregnancy loss:

  • a random chromosomal error within the embryo. 
    • The majority of the time in the 1st trimester
    • This doesn’t increase the chance it will happen in a future pregnancy
  • a cause in the uterus
    • a change in the shape of the uterus
    • an easily removed benign tissue overgrowth, such as an endometrial polyp or uterine fibroid
    • issues with the reproductive microbiome or a subacute inflammation in the lining of the womb called chronic endometritis
  • hormonal imbalances
    • thyroid or prolactin abnormalities — these can be corrected and the risks of miscarriage will then decrease
    • PCOS (polycystic ovary syndrome) may be associated with an increased risk of miscarriage
  • certain medical conditions, such as
    • uncontrolled diabetes 
    • possible associations with autoimmune diseases
    • extremes of weight
  • maternal age
    • mainly due to age and egg quality’s intertwined impacts
  • certain medications, such as

So, when can I try again?

Photo by The Creative Exchange on Unsplash

You may begin trying to conceive. This can be as early as with the next cycle. One study showed there was no increase in risk of another miscarriage when the interval between pregnancies was even less than 3 months. 

However, the physical healing from miscarriage is but one facet. Talking with your partner to decide when you are emotionally ready helps you both move forward together. And grief is complicated; it’s okay to wait if you need more time. Please seek help if you need it.

Ways to optimize fertility naturally

Environmental factors that you can work on include:

  • quitting smoking
  • decreasing alcohol and caffeine
  • decreasing plastics, fragrances, and pesticide exposure (eating organic foods is an easy way to impact this)
  • taking a prenatal vitamin and considering other tailored supplements

Diet changes may also improve not only your cardiovascular health, but are suggested to have beneficial effects on fertility:

  • Plant based
  • Organics 
  • Decrease processed foods & sugars
  • “Good” fats
  • Decrease red meats
  • Consider decreasing gluten

There are many different emotions involved in coping with this loss, and there is no one right way. Seeking support, obtaining the knowledge to process what happened and deciding on a path that you feel peace with are all important components to healing. Know that hope exists and that you are loved. 

Photo by Mike Labrum on Unsplash


Leave a Reply