Trying again

I found this passage very helpful in thinking about getting pregnant again after a miscarriage. I copied and lightly edited the text from a religious site that I do not otherwise recommend.

Many sites and many providers give oodles of false information. There is no evidence to support waiting three months. There are some good reasons (listed here) for waiting at least one cycle.

Accept that there are many opinions.

Doctors are trained to recognize that a woman needs emotional healing, but not really to help them or explain it to them, since it goes beyond their "bones and tissues" type of practice. Three months is considered the average amount of time a woman will grieve hard over a loss, and will have a difficult time if she gets pregnant prior to that. While there are a few doctors who believe that your uterine lining must take three cycles to get back to rebuilding itself fully each time (especially after a D&C, where it gets scraped pretty thin), most doctors know that it doesn't really matter, and getting pregnant again right away does not carry any increased physical risk or miscarriage risk.

So even among doctors, some will say the standard "wait three cycles" and might even scare you into thinking you'll have another miscarriage if you don't wait, and others will say go ahead and try again now.

As for my opinion (and have talked to thousands of women who have had miscarriages) you really should wait for one cycle to complete, because if you do not, you will experience one of two situations, both of which will cause you much unnecessary grief and pain:

1. If you do get pregnant again before having a period, you will not establish a reliable Last Menstrual Period date (your miscarriage date is of no use). You will run into problems when you go in for your first prenatal sonograms and blood tests, causing you grief (often for nothing) and can wreck your relationship with your doctor (supporting the "difficult patient" theory.)

For example, the blood test will say you are six weeks; you will insist you are eight. The sonogram will not show a fetal pole yet, but you have read that you should see a baby by now. You will think your doctor should do something, but he or she will just say your date is wrong and come back in a week. You will spend a week of torture, wondering if the baby is dead, and why do you have to wait for answers. All these things can be avoided by knowing your LMP, or preferably ovulation. Most of the time, the babies are fine, but sometimes you are having another miscarriage. Everything is murky because you don't know for sure when you got pregnant, because you didn't complete a full cycle.

2. If you have retained tissue, your period will be "late" (although all post-miscarriage periods take more than four weeks and are late) and you can even have a POSITIVE PREGNANCY TEST, but you are not pregnant. This is hCG left in your system from the miscarriage, which has not completed. You may begin bleeding and cramping and think you are having another miscarriage, but you are just still going through the first one. We have had women on the site grieving over a 2nd lost baby, naming it and everything, when it turned out she only had missed tissue from the previous loss. Having a D&C does not guarantee that all the tissue was taken. If you did not wait for a real period, you will not know if a pregnancy test really means you are pregnant again, or if your loss has become a long drawn-out ordeal.

Additionally, charting and even ovulation predictor kits are not reliable tools during that first cycle after a miscarriage, and the body will put out lots of signs of fertility or lack of it as it tries to adjust itself. Women may be absolutely sure of their pregnancy's gestational age, and still be wrong.

On the other extreme, not getting pregnant that first cycle, or for the next few, when you are fervently trying, will actually push your grief further down the line, month by month, and it can really be detrimental to healing, your life, and your relationship. Often your life will completely revolve around trying again and you will feel even more a failure, more unable to cope. This may also happen if you wait, but is more likely to pull you into a clinical depression if you are not yet dealing with your loss and are still having some hormonal upheaval.

Even if you feel like you are fine, the grief is really out there, and you need to work directly through it.

In the end, this is your life and your body, your baby, your future, and your decision.

These concerns do not dissuade me from trying again right away, as both of my pregnancies have had an unhelpful LMP, I've already had a negative pregnancy test since my miscarriage and I do not feel full of unresolved grief. However, the issues raised here are worth thinking over. They are certainly so much closer to the heart of the matter - which is that the primary healing and readying to be done before, and even after, getting pregnant again is emotional.