The baby showers are planned, the list of potential names chosen, the nursery painted. Baby is on the way, and a family is overjoyed.
Sometimes, however, nature has other plans, and a couple is left to cope with a miscarriage.
Miscarriage, or the loss of a pregnancy before the 20th week, is the most common pregnancy complication. About 15 to 20 percent of recognized pregnancies end this way [source: WebMD].
How is a pregnancy lost? Most are caused by chromosome problems in the fetus that won't allow it to develop as it should, according to Medline Plus. Some other possible causes are hormone problems, certain diseases or disorders (such as uncontrolled diabetes, lupus and congenital heart disease), abnormalities of the uterus or cervix and infection. The age of the mother is also a factor, with older mothers facing an increased risk. In many cases, we simply don't know why the baby didn't survive.
Most miscarriages (80 percent of them) happen early in a pregnancy, sometimes before a woman even realizes she's pregnant [source: WebMD]. This is why many women wait until the first trimester is over to announce their happy news -- there's a much better chance that the baby will live.
The fact that miscarriages are common doesn't make one any easier to deal with emotionally. A well-meaning friend or family member will surely say just the wrong thing in an attempt at consolation, and a doctor who's seen many miscarriages and thinks of them as fairly routine may neglect to realize a woman needs time to grieve.
The truth is that the emotional aftermath of a miscarriage is different for each woman. If a woman felt ambivalent about the pregnancy, she may secretly be relieved. For some, it's a setback in the quest for a healthy baby, and feelings of sadness last for a short while. For others, it's devastating.
The range of emotions can include anger, fear, disbelief, guilt and feelings of emptiness and inadequacy. There is less research on a male partner's reaction, but studies have shown that a solid support system is key to a woman's emotional recovery [source: Swanson].
But what about physically? Does having one miscarriage make it harder to try again for a baby?
Planning a Pregnancy After Miscarriage
Eighty to 90 percent of women who've had one miscarriage go on to have a successful pregnancy the next time they conceive. Even after two miscarriages, the percentage is still 75 [source: Brody]. Those are some good, high numbers -- and good news for a woman hoping to conceive again.
Doctors have long advised women to "wait awhile" before trying for another baby, but a study out of Scotland has proven this conventional wisdom wrong. Researchers analyzed the records of almost 31,000 women who had a miscarriage and then went on to have a second pregnancy. Their findings showed that an interval of less than six months between the two events yielded the best outcomes -- women were less likely to miscarry or have an ectopic pregnancy. Babies were less likely to be born prematurely or require a C-section delivery and were also less likely to have a low birth weight [source: Hollander].
This doesn't mean that a woman must conceive in less than six months after a miscarriage to have a healthy baby -- the study was limited in some ways (for example, was the second pregnancy planned?) and can't be used to answer the question of when's the best time to try again.
What it does mean is that a woman doesn't need to wait to conceive if she doesn't want to, and as soon as she's decided she's emotionally ready, her health care provider should support her decision.
Of course, it's common for an expectant mother who's already miscarried to be more anxious with her second pregnancy. Some women even feel it harder to bond with the baby once he or she is born -- the fear of potential loss puts them on their guard.
Trying again after a loss is scary -- there is the risk, however small, of another loss. But if the possibility of a healthy, happy baby trumps that risk, then perhaps it's time to begin hoping again.
- Brody, Jane. "Trying Again After Recurrent Miscarriages." The New York Times. March 25, 2008. (March 21, 2011)http://www.nytimes.com/2008/03/25/health/25brod.html
- Hollander, D. "Short Interval Between Miscarriage and Conception Is Linked to Best Outcomes."Perspectives on Sexual & Reproductive Health. December 2010.
- MedlinePlus. "Miscarriage." Nov. 21, 2010. (March 21, 2011)http://www.nlm.nih.gov/medlineplus/ency/article/001488.htm
- O'Connor, Anahad. "The Claim: A Woman Is More Fertile After a Miscarriage." The New York Times. Oct. 13, 2008. (March 24, 2011)http://www.nytimes.com/2008/10/14/health/14real.html
- Rai, Raj and Lesley Regan. "Recurrent miscarriage." The Lancet. August 2006.
- Swanson, Kristen M. "Predicting Depressive Symptoms after Miscarriage: A Path Analysis Based on the Lazarus Paradigm." Journal of Women's Health and Gender-based Medicine. 2000. (March 30, 2011)http://nursing.unc.edu/about/docs/lazarus.pdf
- Utah Department of Health. "Miscarriage and Pregnancy Loss." (March 24, 2011)http://health.utah.gov/mihp/pregnancy/preged/duringpreg/Miscarriage_Loss.htm
- Washington University Infertility and Reproductive Medicine Center. "Infertility Issues: Multiple Miscarriages -- Information You Should Know." (March 21, 2011)http://sleep.wustl.edu/fpp/infertility.nsf/WV/62104EBEDBCEDE448625707E006826C9?OpenDocument
- WebMD. "Pregnancy and Miscarriage." 2009. (March 24, 2011)http://www.webmd.com/infertility-and-reproduction/guide/pregnancy-miscarriage