You've Had A Miscarriage - What Now?

The process of having a miscarriage can be frightening, painful, and tremendously disappointing.  If you had just had a miscarriage, you may be upset and confused about what you have just been through. You may feel that something you did brought on your miscarriage. You may be fearful that you will never have a baby--or another baby, if you already have children.

But while these may be natural ways to feel, by learning why miscarriages occur and what you can do to reduce your risk the next time you try to conceive, you can help relieve these feelings of confusion, fear, and guilt.

There is a beautiful poem, probably familiar to you, called the "Serenity Prayer".  It was written in 1932 by theologian Reinhold Niebuhr.  Part of it goes like this:

God, Grant me the serenity to accept the things I cannot change
Courage to change the things I can
And the wisdom to know the difference

I feel this prayer provides a very useful model for thinking about and coming to terms with having had a miscarriage.

"Accepting what I cannot change":  The first thing you need to know is that most miscarriages are spontaneous natural events that occur because of random, accidental miscombinations of the chromosomes of the egg and sperm during conception. These are spontaneous acts of nature over which you have no control.  You did not cause your miscarriage and bear no responsibility for it. This is also the reason why, at least for the present, medicine cannot prevent these sorts of sporadic miscarriages.

"The courage to change what I can":  By learning more about the causes of miscarriages, you will come to understand that some miscarriages are caused by specific, potentially correctable medical problems.  You will learn that many of these problems can be treated with excellent results.  You will be able to determine when medical testing following a miscarriage is reasonable and when it would be a waste of your time, money, and energy.

What are some of these "changes" you can make to reduce your risk of having a miscarriage the next time you conceive?

1.  Get to know more about your family medical and genetic history. Learn what conditions, if any, "run" in your family.

2.  Make sure you are immunized against communicable diseases such as German measles and chickenpox.

3.  Avoid exposures to infectious diseases such as Lyme disease, toxoplasmosis (contact with cat liter boxes, eating raw meat), and cytomegalovirus.

4.  If you have had several miscarriages, have yourself checked for the possibility that there are anatomic abnormalities in your uterus or other reproductive organs.

5.  Similarly, if you have had several miscarriages, make sure that your body is making sufficient levels of reproductive hormones to be able to sustain an early pregnancy.

6.  Make sure your environment and your workplace are safe.  Make sure the air you breathe and the materials you work with are not harmful to either you or your future fetus.

7.  Make sure any medical problems you have are under the best possible control.  If you are a diabetic, make sure your blood sugar levels are where they should be.  If you are an asthmatic make sure that your medications are properly adjusted.

8.  Of course stop smoking, stop the use of any recreational drugs, and keep alcohol consumption to a minimum.  Check with your doctor before taking any medications other than Tylenol or antacids.

Then - after making sure you are in the best possible condition to become pregnant - go ahead!  Since miscarriages occur in one in five pregnancies, you have a four out of five chance - 80 percent - of having a successful pregnancy and a healthy baby with your next conception.  Yes, you will likely have many fears during the early months of your next pregnancy.  Yes, you will have difficulty discussing your early pregnancy with relatives and friends.  But as the months of your pregnancy go by, as you first hear the fetal heart in your obstetricians office, and as you first begin to feel your baby moving around 20 weeks gestation, you will know that you have overcome the ordeal of having had a miscarriage and will soon be blessed with the healthy baby you have so long dreamed of having.

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Copyright © 2003 Henry Lerner

Henry Lerner, M.D., OB/GYN is the author of Miscarriage: Why It Happens And How Best To Reduce Your Risks. Whether it occurs in the first trimester or later in a pregnancy, a miscarriage is always an emotionally traumatic event, sometimes a physically daunting one, and all too often an isolating experience. Adding to the frustration and disappointment of the 800,000 women who miscarry every year, busy obstetricians often lack up-to-date or specific knowledge about the causes and consequences of this profound event. Into this fact-vacuum comes Miscarriage, a book that every physician will confidently recommend and that women hungry for information will seek out. From the chromosomal, illness-related, immunological, and genetic reasons for miscarriage to the diagnostic tests and surgical procedures now available, this authoritative guide reflects the latest medical information on why miscarriages do and don't happen and the best methodologies known for recovery and preparing to conceive again. Complete with stories from women who have miscarried and reassuring input from a female doctor, Miscarriage also provides substantive advice for coping with the anxiety and depression that often accompany the loss of pregnancy. Henry Lerner, M.D. is a graduate of Harvard Medical School, and has been an obstetrician/gynecologist for more than twenty years.

Please check-out A conversation with Dr. Henry Lerner, OB/GYN author of "Miscarriage: Why It Happens And How Best To Reduce Your Risks"