A new pregnancy can bring such joy, hope, anticipation . . . and anxiety - especially if you have ever experienced a miscarriage. As a board-certified Ob-Gyn, I help guide women through healthy pregnancies as well as miscarriages on a regular basis. After a miscarriage, as time passes, the body heals and resets. The body, in most circumstances, automatically prepares itself for another pregnancy. The mind, however, does not necessarily automatically reset. Pregnancy by nature is a very mysterious experience that is in many ways outside of our control.
I hope to help women who have miscarried put their minds at ease by offering coping strategies to help manage feelings of uncertainty and fear that can arise with a new pregnancy. Understanding the percentage rates and causes of miscarriage also helps provide some clarity around the eternal question: "Why did I have a miscarriage?"
What causes a miscarriage?
Understanding the causes of miscarriage can remind you that you didn't do something wrong to lead to the miscarriage. Often, the cause of a miscarriage is unknown. We suspect that most miscarriages happen because of chromosomal abnormalities. We all have 46 chromosomes in every cell of our body. Those chromosomes contain all of the genetic material that makes us who we are. We get 23 of those chromosomes from our mother and 23 from our father, the original building blocks being the egg and sperm. The issue is that all eggs and sperm are not perfect with 23 chromosomes. Some may have 22 chromosomes, while others may end up with 24. If any of those gametes (which is what we collectively call the egg and sperm) happen to be the ones that collide and result in a pregnancy, that pregnancy will grow for a few weeks and then stop, leading to a miscarriage.
That miscount of genetic material is usually completely random and not a result of you or the partner having abnormalities in your genetic makeup. Rather than a "bad apple" analogy, it's much like having one bad egg in a carton of eggs. Every so often, one is just abnormal - and it's worth noting that only 1 in 7 or so sperm are genetically and structurally complete. In some ways, a miscarriage is your body's way of helping to ensure that the fetus created will be genetically complete.
What percentage of women will miscarry?
If you have had a miscarriage, you are not alone. About 1 in 5 women who become pregnant will experience a miscarriage. The number is higher than that if you count women who become pregnant but miscarry before they know that the pregnancy ever existed. Despite those statistics, most pregnancies - especially ones that make it beyond 13 weeks - will do just fine. The miscarriage rate after a heartbeat is detected is less than 4 percent, and between weeks 13 and 20, the rate is less than 1 percent.
There is comfort in knowing that miscarriages are rare, but at the same time, common. Many people will not experience a miscarriage, and even fewer will have more than one. It is equally important to remember that if you do miscarry, you are among a multitude of women who have experienced the same thing and still have gone one to have very healthy pregnancies in the future.
How can I manage the anxiety of a previous miscarriage as I embark on a new pregnancy?
Don't underestimate the power of positive affirmations. Remind yourself that this pregnancy is not your previous pregnancy. Choose affirmations that make you feel confident about this pregnancy. Here are some examples:
- My pregnancy is healthy.
- My body is capable of carrying this baby.
- I am doing all that I can to create a healthy environment for my growing child.
- I am learning how to trust my body.
- My body has overcome many physical feats and shows its beauty.
Consider therapy. The hurt associated with losing a pregnancy won't always lessen without help. You may benefit from talking to a therapist about what you have been through. A trained professional can help you to reframe your thinking about a current early pregnancy or future pregnancy. Therapy can be additionally helpful during pregnancy and postpartum as the hormones of pregnancy - and the life changes and upheaval a new baby brings - can have a profound effect on your emotions. It is a good idea to establish care early as a just-in-case strategy.
Get regular, moderate exercise. Prioritizing workouts can also help with stress reduction. Not only does exercise boost endorphins, which give you energy and elevate your mood, but being physically fit is also important for your pregnancy. Too much exercise is not ideal. Avoid training or high intensity workouts. If you don't have a workout regimen, a general goal is 30 minutes of moderate intensity exercise five times per week. Massage can also help with stress reduction.
Schedule a preconception appointment with your doctor. Your doctor can help you to tweak anything in your day-to-day lifestyle that may reduce your risk for future miscarriage, like examining your caffeine intake or looking over your prenatal vitamins for example. They can help you to know if there are any other red flags in your medical history or family medical history that warrant further evaluation. Your doctor can also help to reassure you that you are doing everything in your power to create a welcoming environment for a new pregnancy. Then, when you get that positive test, you'll also know what early adjustments to your diet and lifestyle will continue to support your early pregnancy.
Remember that, ultimately, most pregnancies do not result in miscarriage. When you have had a miscarriage, or you have friends or family who have had a miscarriage, it can be hard to remember that fact. As an Ob-Gyn, when I was pregnant, it was easy to think about all of the things that could go wrong, so I would literally say to myself: "In my pregnancy, everything is normal until proven otherwise." The tools and methods that work for you may be different, but I hope these suggestions help you stay positive throughout your pregnancy, too.