Subsequent pregnancy

It is very important to complete grieving for the baby you have just lost before conceiving again. Unresolved grief after a miscarriage can lead to postnatal depression after the birth of a baby later on. For accurate dating, it is recommended to have at least one period (four to six weeks after the miscarriage) and preferably more for physical recovery. Contrary to some doctors, we as a group believe that even though our bodies are capable of ovulation and conception within weeks of a miscarriage, it does not follow that we are capable of full term pregnancy. Our recommendation is to wait at least three to six months to give ourselves the optimum chance. Research indicates that women experiencing multiple miscarriages have a higher chance of a successful pregnancy when given lots of reassurance and emotional and psychological support. One partner may feel ready before the other and this may be a problem as it needs to be a mutual decision.

I've miscarried before - is it more than bad luck?

Many women miscarry more than once in their life. Considering the frequency of miscarriage, about 1 in 36 women will have 2 miscarriages due to nothing more than chance. Any miscarriages after that might prompt your doctors to suggest some tests to ensure that it isn't happening for some other reason. If you're worried have a chat with your GP or one of the Gynaecologists.

Miscarriage may be more common after a previous miscarriage, or less common following previously normal pregnancies. One London study from Prof. Regan's Recurrent Miscarriage clinic found that the risk of miscarriage is related to the past pregnancy history in the following way:

Statistics of success

• Couples with no history of miscarriage have an 80% - 85% chance of a successful pregnancy.
• Couples who have had one miscarriage have an 80% chance of a subsequent successful pregnancy.
• Those who have had two, three or four miscarriages still have a 68% chance of success.
• Even those who have had five or more miscarriages will usually have a baby eventually.
• Hormonal, structural and infectious causes continue till treated.
• Chance chromosomal abnormalities are unlikely to reoccur.
• Five percent of couples have chromosomal abnormalities which are passed on to their babies. These can be confirmed by blood tests.

Common fears

As a result of miscarriage the joyful innocence of pregnancy is lost. The subsequent pregnancy is often a time of fear that ends only when the child is safely born. We often have:

• Fear of finding blood in our knickers every time we go to the toilet.
• Worry about any twinge of pain in our abdomen.
• Fear that "overdoing things" will bring on a miscarriage, so we treat ourselves as if we were extremely fragile.
• Worry that our unborn child will be abnormal in some way. Almost everyone worries about this, but for people who have had a miscarriage, the fear of abnormality is often much greater.
• Worry about our emotional detachment from the growing child, e.g. refuse to think about baby names.
• Fear about buying or borrowing baby clothing and equipment.

• Use the time before you try getting pregnant again, to build yourself up physically. Really take care of yourself. You deserve it!
• Get lots of emotional support for yourself also. Consider joining a support group or finding other people who have been through similar experiences and are thinking about a subsequent pregnancy. It helps to be able to talk with others who have been there and done that. Counselling may also be helpful.
• Keep a journal writing down all your fears, tears, hopes and excitement. Share your feelings with your partner.
• Make sure you really trust your doctor. If you do not feel you are getting the care you deserve, or they won't take your fears seriously, consider changing doctors. Do not be concerned with his feelings, just your own. If you have had multiple miscarriages and live in a large city, they may have a re-current miscarriage clinic.

• Continue looking after your body. Eat well and try light exercise like walking, swimming, or pregnancy yoga.
• Take time out to relax as much as you can. Try massage, listen to relaxing tapes or soft gentle music. Go for a walk in the park or at a beach.
• Go to Websites like SPALS to help keep you positive.
• Avoid the list of things that can lead to miscarriage.
• Let the housework build up and don't go that extra mile at work, at least for the first 3 months. Do as little as you can and ask family and work mates to help out. Tell them how fearful you are feeling. If possible, give up work for that time at least if you feel too stressed, as stress is associated with miscarriage.
• Dare to be positive if you can. Try visualising yourself holding your healthy happy baby in your arms or, if it feels comfortable, buy something for your baby.
• Hang in there! Remember that the odds are firmly in your favour, even if you have experienced multiple losses. Hopefully your fears will lessen as the weeks pass.
  
  (a compilation of information, some quoted courtesy of Kate Frykberg & the Wellington Miscarriage Group).

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