Question: Is There Higher Risk If I Don't Wait to Conceive After Miscarriage?
I really want to try again ASAP, but my doctor said to wait three months because it would reduce the risk of having another miscarriage. But my friend says her doctor told her she could try again right away after her miscarriage and there was no increased risk. Why would our doctors tell us two different things? I don't want to wait three months to try again but I really don't want to have another miscarriage.--really confused
Answer:
You're not alone in being really confused! In my years of writing about miscarriages, I have seen many different answers to the question of when to conceive after miscarriage, with different justifications behind each. Some doctors may refer to an increased risk if couples conceive too soon, while others may believe that couples need time to grieve the previous loss, and still others may recommend waiting at least one period simply to have a normal menstrual period date to use in dating the next pregnancy.
Yet, short of individual medical circumstances, there's no convincing evidence that it's medically necessary for most women to wait any set period of time to conceive after a miscarriage. In studies that followed women who became pregnant after a previous first-trimester miscarriage, researchers have found no evidence that the time between pregnancies affects the risk of miscarrying again. Women who conceived less than three months after a miscarriage did not have a higher risk of complications compared to women who had more time between pregnancies.
It is possible that the answer is different if your loss happened in the second or third trimester. Some studies have found that women who conceived less than six months after a childbirth (meaning a preterm or full-term delivery of a baby) have faced a higher risk of complications in the subsequent pregnancy. However, it's not clear that the cause of the increased risk is directly related to the spacing between pregnancies, and the finding may be due to other factors. Thus, it's not certain that waiting is absolutely necessary after a late miscarriage or stillbirth either.
Still, there is no universal answer that applies to everyone, so it's best to discuss your concerns with your doctor if you don't want to wait three months. Explain your preferences, ask your doctor about the reasoning behind the recommendation that you should wait, and don't be afraid to ask questions.
Sources:
Goldstein RR, Croughan MS, Robertson PA. "Neonatal outcomes in immediate versus delayed conceptions after spontaneous abortion: a retrospective case series." Am J Obstet Gynecol. 2002 Jun;186(6):1230-4; discussion 1234-6.
Interpregnancy interval and pregnancy outcome. UpToDate. Accessed: Sept 22, 2009. http://www.uptodate.com/online/content/topic.do?topicKey=pregcomp/19923&selectedTitle=1~11&source=search_result.
Bjarne Rud a; Kurt Klnder. "The course of pregnancy following spontaneous abortion."Acta Obstetricia et Gynecologica Scandinavica, Volume 64, Issue 3 1985 , pages 277 - 278.
Vlaanderen W, Fabriek LM, van Tuyll van Serooskerken C. "Abortion risk and pregnancy interval." Acta Obstet Gynecol Scand. 1988;67(2):139-40.
Wyss P, Biedermann K, Huch A. "Relevance of the miscarriage-new pregnancy interval." J Perinat Med. 1994;22(3):235-41.
I really want to try again ASAP, but my doctor said to wait three months because it would reduce the risk of having another miscarriage. But my friend says her doctor told her she could try again right away after her miscarriage and there was no increased risk. Why would our doctors tell us two different things? I don't want to wait three months to try again but I really don't want to have another miscarriage.--really confused
Answer:
You're not alone in being really confused! In my years of writing about miscarriages, I have seen many different answers to the question of when to conceive after miscarriage, with different justifications behind each. Some doctors may refer to an increased risk if couples conceive too soon, while others may believe that couples need time to grieve the previous loss, and still others may recommend waiting at least one period simply to have a normal menstrual period date to use in dating the next pregnancy.
Yet, short of individual medical circumstances, there's no convincing evidence that it's medically necessary for most women to wait any set period of time to conceive after a miscarriage. In studies that followed women who became pregnant after a previous first-trimester miscarriage, researchers have found no evidence that the time between pregnancies affects the risk of miscarrying again. Women who conceived less than three months after a miscarriage did not have a higher risk of complications compared to women who had more time between pregnancies.
It is possible that the answer is different if your loss happened in the second or third trimester. Some studies have found that women who conceived less than six months after a childbirth (meaning a preterm or full-term delivery of a baby) have faced a higher risk of complications in the subsequent pregnancy. However, it's not clear that the cause of the increased risk is directly related to the spacing between pregnancies, and the finding may be due to other factors. Thus, it's not certain that waiting is absolutely necessary after a late miscarriage or stillbirth either.
Still, there is no universal answer that applies to everyone, so it's best to discuss your concerns with your doctor if you don't want to wait three months. Explain your preferences, ask your doctor about the reasoning behind the recommendation that you should wait, and don't be afraid to ask questions.
Sources:
Goldstein RR, Croughan MS, Robertson PA. "Neonatal outcomes in immediate versus delayed conceptions after spontaneous abortion: a retrospective case series." Am J Obstet Gynecol. 2002 Jun;186(6):1230-4; discussion 1234-6.
Interpregnancy interval and pregnancy outcome. UpToDate. Accessed: Sept 22, 2009. http://www.uptodate.com/online/content/topic.do?topicKey=pregcomp/19923&selectedTitle=1~11&source=search_result.
Bjarne Rud a; Kurt Klnder. "The course of pregnancy following spontaneous abortion."Acta Obstetricia et Gynecologica Scandinavica, Volume 64, Issue 3 1985 , pages 277 - 278.
Vlaanderen W, Fabriek LM, van Tuyll van Serooskerken C. "Abortion risk and pregnancy interval." Acta Obstet Gynecol Scand. 1988;67(2):139-40.
Wyss P, Biedermann K, Huch A. "Relevance of the miscarriage-new pregnancy interval." J Perinat Med. 1994;22(3):235-41.
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