• Kim Hood, MD

Life After Miscarriage

Updated: Dec 2, 2019

I was asked recently to write about "life after miscarriage." This seems like it would be a simple topic, but it’s actually very complex. There are so many paths one could take with this topic. You see, I have taken care of ladies who have had a miscarriage followed by normal pregnancies afterwards, ladies who’ve had multiple back to back miscarriages, ladies who have had normal pregnancies and then have a miscarriage, and the list goes on. What I do know is that regardless of when you have a miscarriage or how far along you are when it occurs, it is one of the most difficult experiences for any woman, anywhere.

Miscarriage is often defined as a loss of pregnancy before 20 weeks of pregnancy. It occurs in 1 out of every 4 pregnancies. That’s 25%! Unfortunately, it is more common than I’d like to see.

The most common reason for it is a chromosome problem in the developing baby. This can be a number is genetics issues like Down syndrome. However, most commonly, it is Turner’s syndrome.

Turner’s is when the baby has XO sex chromosomes, rather than XX or XY. She is a girl. If she makes it to delivery, she is short with a webbed neck and infertile. She can be of normal intelligence, but she may have learning difficulties. I’ve taken care of a handful in my career, and most of those were on my Reproductive Endocrinology rotation as an OB resident.

There are times when women have miscarriages repeatedly, and many times, we don’t know why. There is a workup for women with 3 or more miscarriages. It looks for things like Leiden Factor V deficiency, antiphospholipid antibody syndrome, lupus anticoagulants, protein C and S deficiencies, thyroid dysfunction, diabetes, and others. These are autoimmune or blood clotting disorders, also known as thrombophilias, that can disrupt pregnancy, especially early on in the pregnancy. They can also cause issues throughout the pregnancy if present.

A bit of information that I always try to stress, is that the woman did absolutely nothing wrong to cause the miscarriage. If the pregnancy is in there, then there is nothing you can do to make it come out, apart from an abortion, and if the pregnancy is not a healthy pregnancy, there is nothing you can do to keep the pregnancy in place.

Women always want to know why this happened, which is normal. What is hard to accept and understand is that it often is “just one of those unfortunate and horrible things.” I cannot stress enough that there is nothing “wrong” with you. You are not less of a person, broken, or doomed. If it is your first miscarriage, you have a 75% chance of a normal healthy pregnancy the next go round.

For ladies who do have 2-3 back to back miscarriages, you do need further investigation. I like doing the work up after 2 miscarriages, but the recommendation is to not do the work up until the patient’s had 3 miscarriages. Sometimes, insurance won’t pay for a work up if you’ve only had 2. Just be aware of that.

Once the miscarriage is complete, what is next? You actually need time to grieve. You have lost a child. The minute the “pee stick” turned positive, you bonded with that child. That child’s DNA is in you. It’s not something most women bounce back from quickly and easily.

These are some things to be mindful of:

1. DO NOT blame yourself or others.

2. God did not cause your miscarriage. Bad things happen and God gets us through it.

3. Accept your grief. It’s ok to be sad. Give yourself time to heal. You may even get angry. That is part of grief.

4. Talk about it with others, especially your partner. Men do want to try to fix things for us, but they need to know that it’s not something that needs fixed. It just needs support and lots of love. Men grieve too but differently.

5. Consider naming and memorializing your child. It really does aid in the closure you need.

When it’s time to try again, especially if your first pregnancy was a miscarriage, you will be nervous. “What if it happens again?!?!” you may worry. I hope you don’t have to walk through it again; however, you may.

After the first miscarriage, your risk does not increase. It’s still 25%. The risk does increase after the 3rd miscarriage and for each one after that.

My patients that have been through miscarriage are often a wreck. They feel better once they see a heartbeat and especially once they enter the 2nd trimester. After seeing a heartbeat, your risk of miscarriage is less than 10%, and once you exit the 1st trimester, your risk is less than 3% chance of miscarriage.

When should you try again? Most literature says that you don’t have to wait. You can try again once your periods resume. I have asked for patients to give themselves 2-3 periods before trying again. One, just to let your body heal. Two, to let your emotions heal, and three, to get your cycles regular enough for accurate dating of the next pregnancy. It can be an unpleasant experience to go into your first OB ultrasound after a recent miscarriage, and not see a heartbeat. This could be because you’ve had another miscarriage, but it could be that you’re much earlier than you thought, and we just cannot see the heartbeat yet. Sometimes, giving your periods time to regulate, can help prevent this.

If you are a friend or family member of someone who’s had a miscarriage, please be careful what you say. Most people mean well, but some sentiments can come across mean. Here are few statements to avoid:

1. At least you weren’t further along.

2. At least you can try again.

3. It could be worse. At least it’s not cancer.

4. It just wasn’t your time.

5. It wasn’t in God’s timing.

6. God must have other plans.

7. Well, you didn’t really want a baby now, anyway.

8. Well, you didn’t really want a baby with him, anyway.

These are just a few that I’ve heard that I can remember. For those of you who know me, biting my tongue after these comments was not an easy task.

People have always asked me when they should announce their pregnancy. I will tell you my opinion, and you can disagree. I announced both of my pregnancies the minute the test was positive. If I had a miscarriage, I would want everyone to know also. I would want that support and love to get through such a hard time. I would never keep my spouse’s death a secret; likewise, I would never keep my miscarriage a secret either.

Whatever you do, don’t do it alone!!! We need each other to get through the hardships of life. Accepting help, support, love doesn’t make you weak. It makes you human, and one day, you’ll be there to support and love someone else through their hardship and stronger for it.

Disclaimer: While I am a doctor, I am not your doctor. The information in this blog post is for information and entertainment purposes only and are not intended as medical advice!

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