Barb's Daily Dose

Pregnancy After Miscarriage

I was recently asked by a reader what I thought she should know now that she's pregnant again after 2 miscarriages.

Here's what I told her:

Congratulations! I’m guessing that after the 2 miscarriages that you’re probably more than a little worried. I’d recommend that you give your doctor a call right away. Sometimes a provider may want to check a mom’s progesterone level if she’s had more than 1 miscarriage. We like to see the progesterone level at about 20 to 30 ng/ml. If yours is low, then you might need more progesterone.  I recommend Endometrin, which many fertility experts also prescribe. 

Many moms have experienced the tragedy of one or more miscarriages. It’s scary to think about getting back on the emotional roller coaster again until you know that everything is ok.

Your provider may want you to have an ultrasound as early as 5 ½ to 6 weeks after the 1st day of your  last menstrual period. That’s as early as we can see a heart beat. Some may want to see you at 8 -9 weeks, that’s about the earliest that most providers can hear a heartbeat. In any case, be sure to take your prenatal vitamin each day and we’ll keep our fingers crossed for you. 

If you have an underlying health problem, such as diabetes or high blood pressure, then you'll need to be monitored more closely. Many providers will likewise order other lab tests to rule out Lupus or other auto-immune disorders.

In any case, you'll want to take your prenatal vitamins every day, get your lab tests, see your health care provider regularly and try to enjoy your pregnancy as much as possible.

Good luck.

Coping with miscarriage

Though everyone experiences pregnancy loss in their own way, for many women, this is a heart breaking experience. Many women are surprised to discover that 1 in 5 pregnancies will miscarry. Often a cause for the miscarriage can’t be determined, which can lead to more confusion and questions. The mood changes that occur from surging hormones in pregnancy are magnified when the hormone levels drop suddenly with a miscarriage. These wild swings in hormone levels can push women into despair. Couples need time to grieve before they can try again. Wanting a baby, allowing ourselves to be hopeful, and yet preparing for a possible loss is like walking an emotional tightrope over a chasm of worry.

Rates of pregnancy loss
About 1 in 5 (20%) pregnancies miscarry. Most are discovered before 12 weeks. Women over 40 have a slightly higher rate of loss, which is estimated at between 25 to 30% or higher. One miscarriage DOES NOT mean that there is a greater chance of miscarriage with the next pregnancy. The likelihood of a 2nd miscarriage is the same, about 20%; it’s not higher.

Recurrent Miscarriage
Thankfully, only about 5% of women will experience 2 or more miscarriages in a row, yet miscarriage rates are higher if a woman has experienced more than 2 miscarriages in a row. For recurrent miscarriage, testing for possible causes is recommended, though in 50 – 75% of cases a cause can’t be determined according to ASRM, the American Society of Reproductive Medicine.

Share Your Insights on Loss

Losing a child is an unspeakable tragedy. Researchers are trying to determine some of the best communication strategies for healthcare providers to use when providing bad news to parents. If you or anyone else you know has suffered this type of loss and might be willing to share some of their insights, there is a research project through Stanford University that you can participate in. Please see the link below for details.


https://www.surveymonkey.com/nld