Are there ways that miscarriages can be prevented?
That’s a good question. There are lots of supplements that have been shown, in the medical literature, to improve the chances of carrying a pregnancy. But most miscarriages are genetic in nature, meaning that even if you’re not over 35, which [is when] we consider you at higher risk for having a miscarriage … Even if you’re under that age, most miscarriages are genetic in nature, up to 85%.
When that happens, genetically, when the egg and sperm come together, those chromosomal divisions don’t happen properly. Either too much chromosomal material or too little is placed in those cells. In that regard, you can’t really prevent those. Even if you’re a 20-year-old, you might have a miscarriage that is likely deemed genetic. In that regard, there’s not a ton that you can do.
Some of the other causes of miscarriage, like metabolic disorders such as diabetes and other endocrine things, those miscarriages have a higher chance of being avoided if those baseline chronic conditions are under good control. If your hemoglobin A1C level is normal, then if you’re diabetic, you have a better chance of not miscarrying.
How can prospective parents take care of their mental health after a miscarriage?
I’m a huge proponent of counseling, therapy, sessions with your pastor — basically, addressing some of the unspoken hurt and grief that’s associated with a miscarriage. Although most miscarriages happen before 12 weeks, and it’s super early in the game, most women — or most people in general — when they see that positive pregnancy test, they see a baby. They don’t see a line. Now we have to jump through all these hoops and have our ultrasound and then have our genetic testing and then see if the baby progresses and grows. We expect a baby out of a positive pregnancy test.
You have to address the grief of losing someone you never met. A lot of people who have not encountered miscarriage have no idea what that means. Lots of family and friends might not know how to address a person who’s grieving that loss and don’t understand the gravity of it.
When can parents start trying again after a miscarriage?
This is one of my most favorite questions because it’s an opportunity, when I’m in the exam room, to tell patients something that is optimistic and hopeful. Traditionally, the answer was three months. You allow your body to recover and recoup mentally, physically, emotionally. But now, once you’ve had one cycle after, or at least a cycle after having had a prior miscarriage, then you are safe to try again. There are all sorts of nuances and caveats that might play into that. But in general, if you’ve had an early first-trimester loss, then you can try again after having one menstrual cycle.