Having a Baby After a Miscarriage

Where in our minds do we place our past loss that is respectful of our baby, but that also leaves room for the new one? It is very important to come to terms with this thought and complete grieving before conceiving again.

Unresolved grief after a miscarriage can mean we may not invest any emotional energy to bond with this baby until we feel safe to do so. This is because of the pain from the remembered previous one and can be a conscious or unconscious decision. Among other things, unhealed grief may lead to postnatal depression after the birth of a new baby, as unlikely as it may seem.

Where’s your head at?

Our bodies are able to ovulate and conceive four to six weeks after our miscarriage. However, we believe it does not necessarily mean that we are all emotionally ready to cope with a healthy full term subsequent pregnancy. The decision is a personal one and perhaps dependent on age, too.

We recommend taking into account your state of mind over the grief of your loss before making a decision. The next baby does not replace the lost one, as is sometimes expected (see more details here) Sometimes another baby can exacerbate unresolved grief and may also cause post-natal depression.

Full support from a partner is essential

Full partner support is crucial. Research indicates that women who have experienced a miscarriage have a higher chance of a successful pregnancy when given lots of reassurance and emotional and psychological support. This is especially true after multiple miscarriages.

Success statistics

• Couples with no history of miscarriage or if their last pregnancy was a live birth, have an 80% – 85% chance of a successful pregnancy.
• This only drops by 1% if the last pregnancy was terminated
• Couples who have had one miscarriage still have an 80% chance
• Those who have had two miscarriages drop to 72%
• Three previous miscarriages drops to 43%

Even those who have more miscarriages will usually have a baby eventually, if they feel they can continue to try, although hormonal, structural and infectious causes continue until treated.

Chance chromosomal abnormalities are unlikely to reoccur. Five percent of couples have chromosomal abnormalities which are passed on.

Common fears

As a result of miscarriage, the carefree, joyful innocence of having a baby is lost. The subsequent pregnancy is often a time of scepticism and uncertainty. Women are therefore steeling themselves against stressful feelings of overwhelming fear and anxiety.

Trying to remain emotionally stable as well as being constantly aware of possible threats to the pregnancy (rather than to ‘my baby’) is paramount but often in a disengaged way. This only usually ends when a healthy child is safely born.

We can often:

• Have a fear of finding blood in our underwear 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 the outcome of the pregnancy 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.
• Fear buying or borrowing baby clothing and equipment, having a baby shower, accepting presents before the birth or preparing a nursery
• Have an expectation that having other living children will be helpful in allaying anxiety after a miscarriage
• Try to protect ourselves from another emotional blow, and may distance ourselves from the reality of having a baby, viewing our pregnancy as an ‘impersonal biological condition’, refusing to think about names etc.
• Then worry about the outcome of this emotional detachment when we recognise it.

Coping with fear

• 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. NZ Forums are often useful and counselling an alternative if you feel you have become too obsessive or depressed
• Keep a journal writing down all your fears, tears, hopes and excitement. Share your feelings with your partner.
• Substance abuse when unaware of a pregnancy until weeks or months after conception may have caused your miscarriage but it may not have been the reason either, so holding onto the guilt around this is pointless and soul destroying. Instead, learn from past experience and be aware and responsible this time.

• Make sure you really trust your medical professional. If you do not feel you are getting the care you deserve or your fears are not taken seriously, consider changing. Do not be concerned with the professional’s feelings, just your own. It is your choice and is important.
• If you have had multiple miscarriages and live in a large city, there may be a recurrent miscarriage clinic available where you can receive special help (see Auckland RPL Clinic).

Before you get pregnant

• Continue looking after your body and get your weight to a reasonable level. A diet suitable for pre-pregnancy can be critical. Try this site.
• Dr. Richard Fisher, Fertility Associates, NZ; ‘The best gift you can give your child is that they were created from healthy eggs and sperm’.
• Your partner’s contribution could be about his diet. Carrots make sperm better swimmers. See ‘Sperm‘ under ‘Things we may not know’
• B12 Insufficiency and Folate – a Crucial Factor in Pregnancy – See here
• MTHFR Support Australia run a preconception course and have a free webinar about preparing for pregnancy if you are in the half of the population that has the gene and it is expressed. They can also consult via Skype if you prefer individual support. see here
• Dr. Weston A. Price‘s list of vitamins and minerals for fetal development: Concept to birth.

While you are pregnant

Avoid alcohol, cigarettes and excess caffeine. Certain prescription and over-the-counter drugs need to be checked out by your doctor. (Harm from recreational drug use applies to both partners pre-pregnancy.)

Nutrition advice

It is recommended that you avoid the following foods:

Soft cheese like camembert, brie, feta, blue, mozzarella, ricotta

Houmus and other dips containing tahini

Raw eggs (which are also in mayonnaise, aioli, and hollandaise sauce and can show up in undercooked desserts such as mousse).

Rare meat, pate, liver

Seafood; any raw seafood, Bluff and Pacific oysters, blue fish tuna & marlin.

Smoked or pre-cooked fish including sushi, smoked salmon and marinated mussels or oysters.

Fish Options: Many kinds of fish, including snapper, may be eaten. Infact, fresh fish oil has been shown to have excellent benefits.

Advice for once you become pregnant again

• 400 micrograms Folate before pregnancy and until 12 weeks minimum gestation

• The use of Vitamin C has recently been recommended from research at the Johns Hopkins University Bloomberg School of Public Health.
• Omega 3 and pre-natal multivitamin (including B12) & mineral formula.
• A medical professional can give you the latest information and make other suggestions and if necessary have some basic testing done – we suggest this after 2 or more miscarriages.
• You may consider consulting a naturopath or an acupuncturist
• Read up on helpful information. Suggestions are listed under ‘resources’ e.g. (Miscarriage; Why it happens and how best to reduce your risks – A doctors guide to the facts. By Henry M. Lerner, M.D., OB/GYN Amazon)

• 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.
• See the list of things to avoid 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 workmatess 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.
• Helping yourself will give you more confidence to know that you have done the best you could for yourself and your baby.
• 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.

Advice for after the birth

Further support