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Pregnancy After Miscarriage: 15 Things Not To Ignore

Miscarriage is a devastating consequence of pregnancy for around 25 percent of expecting women. That’s just how many pregnancies we know end in loss. Most of those losses occur in the first trimester. It can be difficult to bounce back from miscarriage, because the side effects are both physical and emotional.

They cause a rippling effect that extends beyond the expectant mother and onto her partner, other family members, and friends that were in the know about the little one on the way. It is a death like any other and requires a grieving period to mourn that loss.

As with most things in life, time tends to heal this wound, too, but it’s an uphill battle getting there. Still, most women go on from miscarriage to conceive again and have perfectly healthy pregnancies. Only around 1 percent of women have a repeat miscarriage. While that is comforting news to the mother who has experienced such a loss, the thought of having a baby again is still scary.

The uncertainty riddles women with anxiety. Every twinge and cramp makes the knot in their stomachs tighten. The fear that it will happen again is never out of reach. It can be difficult to enjoy the current pregnancy and revel in all that expectant motherhood brings when there is a cloud looming overhead that reminds women of the pain and heartache they suffered through prior to getting where they are now.

There is hope, though. There are telltale signs of miscarriage that women should be on the lookout for — especially when they’ve been there before. There are also behaviors they might want to abstain from in order to try and maintain optimal odds of success for a new pregnancy.

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15 Pregnancy Symptoms

Ah, the telltale pregnancy signs. You knew you were expecting before the second line even came up because you’ve been throwing up for three days, right? The miscarriage was so awful that you won’t even complain about the morning — ahem, all day long — sickness, because you’re just so grateful to be expecting and puking because of it.

So, when those symptoms suddenly stop, you freak out. You’re telling yourself it’s okay and reaching out to every pregnancy group you belong to on Facebook for reassurance that symptoms can come and go, but you can’t help but worry that the reason you suddenly don’t feel like there's a baby there anymore, is probably because you aren’t expecting anymore.

This is totally normal. It’s normal to worry about miscarriage to this extent, and it’s normal to lose pregnancy symptoms. Yesterday may have brought food aversions, nausea and sore breasts, and today you feel ready to tackle the world and have no problem getting down three square meals. Accept the day off. Tomorrow you could be back to staring at your toilet bowl.

A lack of symptoms combined with bleeding or cramping is more worrisome, but on its own is nothing to worry about.

14 Leaking Fluid

Throughout pregnancy, you not only make tons of progesterone but also loads of estrogen. Your body is at its peak hormonally, and as a result you are going to produce all kinds of bodily fluids. You will pee more than you’ve ever peed in your life. You might have frequent runny noses. You’ll even retain more fluid, and in case you didn’t know, your vagina is going to expel more fluid.

Your cervical mucus will change throughout pregnancy. Early on, it might remain the same, but soon it will thicken up. At times when there is a surge in estrogen, you may notice something you haven’t seen in a while — egg white-like cervical mucus similar to what you see around the time you ovulate.

No, you aren’t ovulating during pregnancy. All that estrogen creates that same mucus while you’re expecting. Sometimes it may get so thin that it’s downright watery. It’s normal!

What isn’t normal is if you’re leaking amniotic fluid. The problem is that many women can’t tell the difference. First, sniff it. Amniotic fluid will smell different and kind of sweet. It will also feel viscous and slippery between the fingers. If your waters are leaking, they’ll gush a tad when you stand up after lying down for a while.

If you still can’t tell, get to the doctor and they’ll test it for you. This isn’t something to write off and ignore.

13 A Negative Test

A lot of women like to try to use pregnancy tests to confirm their pregnancies again, and again, and again. These women might refer to themselves as pee-on-a-stick addicts. Having been there myself I can say this addiction is so legitimate they might as well add it to the Diagnostic and Statistical Manual of Mental Disorders.

All jokes aside, this is absolutely one of the worst ways to wager whether you’re miscarrying or not. Pregnancy tests work by testing for HCG — that hormone we talked about earlier. It’s presence over a certain threshold makes the test pop positive. For more sensitive tests, it will be a lower threshold around 8 to 25 mIU.

For less sensitive tests that don’t work until your period is late, the sensitivity may be as high as 100 mIU.

The amount of HCG in the urine is about three days behind what is actually in the bloodstream. In addition, there is no way to control for how concentrate or diluted a urine sample is compared to the one you used the last time you tested. In other words, if today’s test is more faint that last week’s, that is absolutely no indication that anything is wrong with your pregnancy.

Faint still means positive. However, if you have had positive tests and are now getting glaring negatives, it’s time to call your provider.

12 Serious Cramping

This is one of the worst things that can happen to an expecting mother. For an expectant woman who has lost a baby before, the stress and anxiety are all the more compounded. Unfortunately for these women, cramping is also a completely normal part of early pregnancy.

These cramps typically occur in the lower pelvic region in the beginning ten weeks of pregnancy when the uterus begins to stretch. They might feel similar to a twisting sensation near the ovaries, too. This can be worrisome for women who have had ovarian cysts before as they may think a cyst is amiss again. Rest assured, it’s normal in most cases.

That being said, some cramping is not normal. Sometimes, sharp or stabbing pains deep in the pelvis are related to fibroids, cysts or miscarriage. These cramps usually won’t occur on their own, though. They are most often accompanied by bleeding.

11 Spotting Or Bleeding

From spotting to a heavy flow of blood, both are worrisome to women who have miscarried before. There is nothing more unsettling to these women than taking a trip to the bathroom and finding blood in their underwear.

It’s so disturbing and life-altering when you experience a miscarriage that every future pregnancy will likely be filled with a thorough inspection of your undergarments every time you have to pee. That’s just the way it is living life as a woman who has lost a baby.

Bleeding can be completely normal during pregnancy. Sometimes, it’s leftover brown blood from last month’s period or implantation. In other instances, it’s blood draining from somewhere that cannot be explained in the uterus. It could be bleeding from a subchorionic hematoma, too.

In other instances, bleeding is indicative of more serious problems, like another miscarriage. While implantation is usually pinkish, and old blood from a period or burst capillaries is typically brown, bleeding from an impending miscarriage is normally bright red. It is new blood, and it’s often a hefty dose of it. In addition, there may be clots. These things should not be ignored.

10 Decreased HCG Levels

When a fertilized embryo implants into the uterine lining, the body starts producing a hormone known as human chorionic gonadotropin. This hormone — HCG for short — is what pregnancy tests test for. It helps to maintain the pregnancy, as do other hormones, like progesterone.

Early in a pregnancy, HCG levels will double in most women every 48 to 72 hours. The time that it takes for the levels to double increases as the pregnancy progresses. By around 10 weeks along, HCG levels reach their peak and will begin to slowly decrease. As early as 8 days after implantation, HCG can be detected in the bloodstream.

By about three days after that, it shows up in the urine. An HCG level of about 25 mIU/ml is considered a positive pregnancy test while anything under 5 mIU/ml is negative. So, what about the grey area in between?

If your quantitative HCG test comes back as between those two numbers, a repeat test will be needed. Nonetheless, most quantitative tests are done in two steps. The first test gives the doctor a baseline and the second test is performed two or three days later to make sure levels are doubling. If they aren’t, there may be reason to suspect the pregnancy won’t last.

9 Lower Progesterone Levels

When a woman becomes impregnated, her body starts to produce copious amounts of the hormone progesterone. This hormone is responsible for thickening the uterine lining in preparation for implantation. After that occurs, it helps to maintain the pregnancy. Your body makes more progesterone during one pregnancy than it will the rest of your life outside of pregnancy!

So, it is vital that those progesterone levels start to rise exponentially after conception. If they don’t, miscarriage may be more likely to occur. Low progesterone can be tested for via a simple blood test. If your levels come back below the threshold that your doctor wants to see, then they will likely recommend supplementation to keep the pregnancy going.

Supplementing means you’ll add progesterone to your body yourself. This is usually done with a progesterone cream or suppository. Bioidentical creams are more bioavailable to the body and the safest option over synthetic hormones. Fortunately, supplementation is only necessary through 10 to 14 weeks, at which point the placenta starts producing progesterone for you.

8 The Cervical Area

Your cervical area definitely deserves some attention if you have had previous losses associated with early dilation. This occurs mostly in women who have a condition known as an incompetent cervix. In other words, their cervix is too weak to support the pregnancy and stay tightly closed on its own. So, it needs a little help.

That help comes in the form of a stitch — known as a cerclage — that is sewn into the cervix to keep it closed during pregnancy. This may be necessary if a woman has had an abortion in the past that damaged her cervix, if she’s undergone a LEEP procedure or cone biopsy that left her cervix weaker, or if she has a history of miscarriage in the second trimester.

Around a quarter of all miscarriages stem from complications with an incompetent cervix. The mother-to-be is hardly to blame. Still, she may feel like it’s her fault and may worry moving forward with future pregnancies that repeated losses are due to her anatomy and thus, she may blame herself. I

It's important to discuss these concerns with your doctor in advance. Sometimes, they will place a cerclage even without any sign of problems for reassurance.

7 The MTHFR Status

When a woman suffers through a miscarriage, it’s a troubling time that is often plagued with concerns about how it happened. It is understandable that parents have a strong desire to know what went wrong. Why? Because they want to make sure it doesn’t happen again.

There is no mother on the planet who has had a miscarriage that doesn’t worry it will happen again. It’s the nature of the beast. Fertility work-ups exist for a reason and they can tell us a lot about what is making our bodies more or less likely to conceive or maintain pregnancies.

Likewise, when a woman miscarries she may also choose to send the contents of the pregnancy — whether passed naturally or via D & C — to pathology.

An analysis of the pregnancy contents can often pinpoint reasons that the loss may have occurred. This can be tremendously helpful for parents who are affected by the MTHFR SNP gene mutation; approximately 40 to 60 percent of the population is. This mutation can cause the blood to clot and attack the fetus as though it is a foreign object in the body that doesn’t belong there.

Knowing about MTHFR in advance means the appropriate supplements and medications can be employed ahead of pregnancy next time to safeguard against this kind of loss repeating itself.

6 Getting Professional Care

This often gets overlooked. While expectant moms spend a lot of time analyzing everything they do when they’re expecting in effort to make sure they don’t lose another baby, they forget all about the midwife or obstetrician that may be partially to blame.

It is totally normal for a provider not to take new pregnancy patients until they are more established into their pregnancy. If you’ve ever had to call and make that first appointment, you may have been taken aback when they told you they wouldn’t see you until 10 to 12 weeks along. Women with a history of losses should be seen sooner.

No, it’s not your provider’s fault that you miscarried, but they should be doing what they can to try to prevent that from happening again. In most cases, a miscarriage can’t be stopped. However, if the cause is something treatable like low progesterone or MTHFR, then it often can be prevented entirely. So, being seen sooner is a good idea.

5 Maintain Physical Activity And Exercise

First and foremost, getting impregnated is not typically a reason to become a couch potato, and no one is suggesting you do that now. Maintaining physical activity is important during pregnancy as long as you haven’t been restricted to bed rest or low activity levels.

Still, if you’ve had a miscarriage then you might want to take it a little easier this time around until the doctor gives the green light for increased activity. Likewise, if you were never much of a cardio enthusiast or into weight lifting, not isn’t the time to dig into reps with barbells or jump on the treadmill for a run.

In most cases, women who have a history of losses will be permitted to continue with light exercise starting in the second trimester, if not before. This is merely because the risk of miscarriage decreases significantly once a woman reaches the 14-week mark. The placenta is established at this stage. The heartbeat is ticking away. The risk of loss is as low as 5 percent.

4 Intimacy Feels Wrong

It might qualify for cardio in some bedrooms around the world, but the risk of intimacy has a lot more to do with uterine contractions and poking around at the cervix than physical activity. Women who have a history of miscarriage may worry going into the next pregnancy that messing around down there could pose a risk to the baby.

While intimacy is a healthy benefit to any expectant woman’s life, it may only add more anxiety if she is worried about miscarrying. Thus, pushing pause on it for a few weeks won’t do any harm. In all actuality, orgasms do cause contractions in the uterus, and intimacy can aggravate the cervix.

While this is unlikely to cause a healthy pregnancy to be lost, it can cause bleeding which could lead to significant stress for the expectant parents.

Furthermore, if the pregnancy were to be lost, parents often look back and wonder if it’s because of their late-night bedroom romp and have a hard time convincing themselves it had nothing to do with it. So, while intimacy isn’t likely to lead to miscarriage, it could cause a whole lot of unnecessary grief. Weigh the pros and cons before sliding between the sheets.

3 How Dad Deals With The Loss And Pregnancy

There are many things that go overlooked in early pregnancy. Sometimes, we are so excited that we are getting another chance at making a baby after a loss that we look right past one of the most important parts of this experience — the dad!

Ladies, they’ve got feelings, too! Dad went through that miscarriage, as well. He was elated to be a father and devastated when that opportunity was ripped away from him. He felt the same heartache that you did. This time around, he’s just as nervous that it could happen again.

Often, dads won’t speak up and say so because they don’t want to worry mom any more than she’s already worrying herself; they try to be strong for us, but they’re scared, too.

Communication is key! Talk to your partner about the risks of another miscarriage. Tell them your feelings and ask them about theirs (or you might never know). If he has concerns about having intimacy or that cup of coffee you’re having a hard time giving up each morning, listen to him. This is his baby, too and he is allowed to feel however he feels.

2 Back Pain

Sometimes, a miscarriage doesn’t start with telltale cramping. Instead, back pain comes on. Moms who’ve miscarried can really torment themselves when they experience back pain in a pregnancy. It’s pretty unfair, too, because nearly all pregnancies come with some degree of backache.

Women often don’t expect it early on but the stretching of the uterus and round ligaments in the pelvis leads to a dull backache for many moms-to-be in the beginning stages of a pregnancy. This achiness often seems quite similar to what women have experienced with miscarriage.

Unfortunately, there’s no way to really decipher what is causing a backache. Supporting yourself when standing and sitting, and making sure you are wearing comfortable shoes are a good start. Seeing a Webster-trained chiropractor or opting for a massage are also great ideas.

Back pain will usually subside for most women after the initial 8 to 10 weeks of pregnancy has passed. Unless it is severe or accompanied with fever or cramping, it’s not a cause for ringing the doctor.

1 All The Feelings

Aside from every single physical issue that could be plaguing your body, a new pregnancy is also a time to process what’s bothering you emotionally. It’s okay to grieve the loss of the other baby or babies. It’s normal, and even expected in some cases that a woman would feel a sense of bittersweet emotions when she becomes pregnant again.

It’s a time to set aside blame and anger. There is a new life on the horizon and it is okay to celebrate that and feel happy again. It doesn’t mean you didn’t love the other baby or want that baby every bit as much as you want this one.

Pregnancy comes with so many emotions for the average woman that adding miscarriage and the worry of another to the mix can really make the hormonal rollercoaster even more loop-dee-loop. This isn’t a time to ignore your feelings and deal with them another day. Today is that day.

A new pregnancy means it’s time to start moving on, and you won’t be able to if you haven’t dealt with the past. Healing is coming. Deep breaths. You’ve got this.

Sources: Mayo Clinic

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