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When considering pregnancy after recurrent miscarriages, it’s normal to experience a rollercoaster of emotions and worry. You probably have questions about if and when it’s safe to try again. And you’re likely still dealing with sadness, along with anxiety about being able to give birth in the future.

If you’ve experienced recurrent pregnancy loss, your health care team is a valuable resource for information, support, and care.

What Causes Recurrent Pregnancy Loss?

Recurrent pregnancy loss means you have had two or more miscarriages in a row. An estimated 10% to 20% of pregnancies end in miscarriage, and it’s often a one-time event. But about 1% of people have recurrent miscarriages.

It’s essential to see your doctor if you’ve had multiple miscarriages. They may refer you to a maternal-fetal specialist specializing in high-risk pregnancies and recurrent pregnancy loss.

Often miscarriages happen for no apparent reason, but a specialist can run advanced tests and look for clues. These tests might include bloodwork, genetic tests, or imagining tests.

Sometimes there are genetic or underlying health problems to address. Identifying these may provide answers or help prevent a future loss.

Recurrent pregnancy loss can happen for various reasons, including:

• The embryo has an abnormal number of chromosomes. This can happen by chance during fertilization. Nothing specific causes it, but the chances increase with age.

• Chromosome translocation. This is when one partner has part of a chromosome that moves to another chromosome. It results in abnormal chromosomes in some eggs or sperm and an embryo with too much or too little genetic information.

• Congenital problems with your uterus. Some women have a condition called septate uterus, which is when a band of tissue divides your uterus into two sections. Surgery to repair this before you conceive can reduce your chance of a miscarriage.

• Scar tissue in your uterus. This can happen as a side effect of surgeries on your uterus or due to previous pelvic infections. Doctors can sometimes remove the scar tissue to reduce your risk of a miscarriage.

• Uterine fibroids. These are noncancerous growths in your uterine cavity. Doctors can do a surgery called myomectomy to remove them.

• Celiac disease. Some research suggests people with undiagnosed celiac disease have a higher risk of recurrent miscarriage. Following a gluten-free diet appears to reduce the risk. Ask your doctor to check for celiac disease if you have ongoing symptoms like diarrhea, stomach pain, fatigue, anemia, or skin rashes.

• Antiphospholipid syndrome. This autoimmune disorder causes blood clotting problems, especially during pregnancy. It increases your risk of miscarriage, but medications and close monitoring can help.

• Poorly controlled diabetes. If you have a history of diabetes, it’s essential to manage your blood sugar before and during your pregnancy. High blood sugar is dangerous for you and your baby and increases your risk of miscarriage.

• PCOS (polycystic ovarian syndrome). This common condition causes an imbalance in your sex hormones. Women with PCOS are three times more likely to have an early miscarriage. Medication may help reduce the risk.

• Other health conditions. Chronic health conditions like high blood pressure, thyroid disease, or kidney disease can increase your risk of recurrent miscarriage. Work with your health care provider to manage these before getting pregnant.

Coping with Pregnancy Loss

It’s heartbreaking to have a pregnancy loss. And it’s also normal to wonder if you did something wrong to cause a miscarriage. However, pregnancy loss is almost always out of your control; you didn’t cause it and likely couldn’t prevent it.

Many people struggle with feelings of depression, anxiety, or worry about having another pregnancy loss. These can affect your health and well-being, so allow yourself time and space to grieve, process, and heal.

Your health care team can help. Ask your doctor for a referral to a behavioral health therapist or support group. They can help you process your feelings and understand you’re not alone.

Your maternal-fetal specialist can run tests to identify the root cause of your miscarriages and help you move forward. Sometimes that means trying again, but it’s also OK if you don’t want to. It’s essential to do what’s right for you.

Trying for a Future Pregnancy After Loss

It’s possible to get pregnant again in a few weeks or as soon as you ovulate. But if you’ve had several miscarriages, your doctor may recommend waiting until any testing and treatment, if necessary, are complete.

It also takes time for your body to recover and your uterine lining to prepare for another pregnancy. And it’s vital that you feel emotionally as well as physically ready.

If you and your partner are ready to try again, see your obstetrician for a prenatal checkup. They can do a complete physical exam to ensure your body is as healthy as possible before you conceive.

Then try these tips to help support a healthy pregnancy:

• Don’t drink alcohol or smoke; limit caffeine to no more than 200 mg (about one cup of coffee) per day.
• Eat a healthy diet with plenty of fruits, vegetables, and lean proteins like poultry, fish, eggs, or Greek yogurt. Limit fast foods, sweets, and highly processed packaged foods.
• Get at least 30 minutes of brisk physical activity most days to help maintain a healthy weight. Exercise is also great for your mental health.
• Manage any underlying health conditions like high blood pressure or diabetes.
• Take a prenatal vitamin with at least 400 mcg of folic acid daily.

With future pregnancies, staying in close contact with your health care providers is essential. They may recommend more frequent monitoring or ultrasounds to ensure you and your baby are healthy. And don’t ever hesitate to reach out to them if you have questions, concerns, or feel that something isn’t right.

It’s also important to acknowledge that you may have mixed feelings after you give birth. Memories may resurface about your previous loss, causing grief and joy at the same time. Many people find it helpful to continue to work with a therapist before, during, and after pregnancy.

Coping with recurrent pregnancy loss can be hard, and trying for another pregnancy brings challenges and mixed emotions. But you and your partner don’t have to go through it alone. Your health care team has experts to support you every step of the way.