How to Prepare for Pregnancy After a Miscarriage

A miscarriage is the unintended loss of pregnancy before the 20th week, and unfortunately, it is a relatively common experience for women. Around 10%-25% of pregnancies end in miscarriage, and the emotional aftermath can leave feelings of anxiety, sorrow, and uncertainty about trying to conceive again. The most frequent cause of a miscarriage is chromosomal abnormalities, and this rarely happens more than once. Most women who have experienced a miscarriage go on to have healthy pregnancies and babies, provided no serious complications arise. Less than 5% of women experience recurrent miscarriages.

It’s recommended to wait one to two months before attempting to conceive again. It can be emotionally difficult to stabilize after a miscarriage, and you may feel an urge to try to get pregnant again as soon as possible in an effort to move on. Some people experience emptiness and seek to fill that void by trying again soon after the miscarriage. However, the recommendation is to give your body time to heal and rest by waiting at least one or two months, or until you’ve had two regular menstrual cycles before trying again.

• Physically, it may take only a few hours to a few days for your body to recover from the miscarriage, and your menstrual cycle should return within four to six weeks. But it's essential not to rush, especially while you are grieving. Take the time to process the loss and heal.
• Some healthcare professionals suggest waiting six months before trying to conceive again, though there’s no scientific evidence confirming that a longer wait is necessary after a miscarriage. If you are healthy, have had at least one regular period, and are emotionally ready to try again, there’s no need to wait longer.

Identify any medical issues or complications caused by the miscarriage. Talk to your doctor about any potential risks or complications that could arise from the miscarriage.

• Some women may experience a molar pregnancy, where a non-cancerous tumor forms in the uterus. This occurs when the placenta develops into an abnormal sac that prevents pregnancy. If you have a molar pregnancy, it is recommended to wait six months to a year before trying to conceive again.
• If your miscarriage was caused by an ectopic pregnancy, or if you have had one in the past, your doctor will examine your fallopian tubes to ensure that neither one is blocked or damaged. If one of the tubes is damaged, you may be at risk for another ectopic pregnancy.

Consult your doctor about the risks if you’ve had multiple miscarriages. Women who have experienced more than one miscarriage should be evaluated to determine if there are underlying issues before attempting pregnancy again. Your doctor may perform tests such as:

• Hormone testing: Your doctor will check your thyroid levels and possibly also test your prolactin and progesterone levels. If there are abnormalities, treatment will be provided and the levels monitored at a later time.
• Hysterosalpingography (HSG): This test checks the shape and size of your uterus, looking for scars, polyps, fibroids, or septums. These abnormalities may affect implantation during IVF (in vitro fertilization), so it is essential to check the uterus for these issues. A doctor may also perform a hysteroscopy, using a small camera to examine the inside of the uterus.
• Additional tests could include blood tests or even DNA testing for both parents, or an ultrasound.

Get tested and treated for infections. To ensure a healthy pregnancy after a miscarriage, it is advisable to test for infections, including sexually transmitted diseases, and treat any infections before trying to conceive again. Certain infections can increase the risk of another miscarriage, including:

• Chlamydia: This sexually transmitted infection (STI) often shows no symptoms. If you or your partner have had an exposure, get tested and treated before attempting pregnancy.
• Infections of the uterus or vagina: Your doctor may test for infections in these areas and treat them if necessary.
• Listeria infection: This bacterial infection is typically contracted by eating unclean cheese or milk products.
• Toxoplasmosis: This infection can be contracted through contaminated fruits, vegetables, and meats. Always cook meat thoroughly and wash fruits and vegetables. Wear gloves when cleaning cat litter boxes or gardening, as cats carry the bacteria in their intestines.
• Parvovirus: Also known as “fifth disease,” this viral infection can lead to miscarriage, though most women who are infected during pregnancy have normal pregnancies.

Seek therapy or counseling if you're feeling depressed or downhearted. Your doctor may refer you to a support group or a counselor to help you and your partner cope with the grief of the miscarriage. Talking to others who have experienced similar losses can provide some comfort and understanding. Overcoming grief together can strengthen your relationship and better prepare both of you for the next pregnancy.

• You may also find support from family and friends. Sometimes, just having someone to listen to your worries and fears about trying to conceive again can be incredibly helpful.

Maintain a balanced diet and healthy weight. To reduce the risk of another miscarriage, it’s important to eat a well-rounded diet that includes all four food groups: fruits and vegetables, protein, dairy, and grains.

• Ensure your daily diet includes five servings of fresh or frozen fruits, about 170g of protein from meat, fish, eggs, soybeans, or tofu, three to four servings of fresh or frozen vegetables, six to eight servings of grains like bread, rice, pasta, or cereal, and two to three servings of dairy like yogurt and hard cheese.
• It’s also crucial to maintain a healthy weight for your age and body type. Avoid being underweight or overweight. You can calculate your Body Mass Index (BMI) using an online calculator to determine how many calories you need to consume daily to maintain a healthy weight.

Exercise daily, but avoid intense activities. While recovering from a miscarriage, it’s important to steer clear of strenuous exercise and focus on light activities such as walking, yoga, or meditation. Maintaining a regular exercise routine keeps you healthy and energized. It also ensures your body is in the best possible shape for trying to conceive again.

• Gentle exercises like yoga can help reduce stress or anxiety that may stem from the miscarriage. Managing your stress levels is essential for keeping your body healthy and ready for pregnancy.

Take prenatal vitamins, folic acid, and supplements. A balanced diet and exercise will provide essential nutrients and minerals, but prenatal vitamins and supplements like folic acid have been shown to reduce the risk of miscarriage and preterm birth, or having a baby smaller than expected for gestational age. Speak to your doctor about taking folic acid supplements to help you recover after a miscarriage.

• Folic acid supplements help reduce the risk of neural tube defects, such as spina bifida, which occurs when a baby’s spinal cord doesn’t develop properly. You will be prescribed folic acid supplements once you’re pregnant.

Limit alcohol, caffeine, and smoking. Research has shown that consuming alcohol, smoking, and caffeine can increase the risk of miscarriage.

• Limit or eliminate alcohol from your diet. Women who drink alcohol daily or consume more than 14 units a week have a higher risk of miscarriage. Stick to one to two units of alcohol per week or eliminate it completely when trying to conceive. If your partner heavily drinks, it can also affect sperm count and quality.
• Always stay safe by reducing smoking or quitting entirely when trying to conceive.
• Pregnant women are advised to limit caffeine to 200 mg a day or about two cups of coffee. Remember that caffeine is also found in green tea, energy drinks, and some sodas. Caffeine can also be present in certain cold and flu medications, as well as chocolate. Try cutting down on caffeine, especially when you’re trying to conceive.

Avoid all medications unless necessary. Unless your doctor recommends certain medications to treat infections or other medical issues, it’s best to avoid all medications while trying to conceive. Avoid over-the-counter drugs and herbal remedies. Since herbal remedies are not regulated by the FDA, always check with your doctor before using any herbal treatments or medications.

• If you are taking antibiotics for an infection, wait until you have completed the full course of antibiotics and the infection is cleared before attempting to conceive.
• If you are taking medication for an ectopic pregnancy, wait three months after treatment with methotrexate before trying to get pregnant.
• If you are being treated for illness or infection, wait until you have finished your treatment before attempting conception.