Miscarriage is the spontaneous loss of a pregnancy before the 20th week. A miscarriage may occur because the fetus isn’t developing normally or if there are problems with the unborn baby’s chromosomes as the embryo divides and grows. Sometimes a health condition, such as poorly controlled diabetes or a uterine problem, might lead to miscarriage. Often, however, the cause of miscarriage isn’t known.

Experiencing a recurrent miscarriage can be difficult to talk about – or even write about – but that’s one of the few ways to address the frustrating phenomenon. Many women have a miscarriage at one time or another. From clinical records, miscarriages can happen for many reasons, but having a miscarriage doesn’t mean that you will have another miscarriage if you try to get pregnant again. 

However, it is not unusual that you can suffer more than one miscarriage – called recurrent pregnancy loss (RPL). If you worry that you did something to cause the losses, you should know that this is often a natural process. To be exact, less than half of recurrent miscarriages have an obvious or treatable cause, however, several women with recurrent pregnancy loss will eventually have a healthy pregnancy, even often without any extra treatment.  

Miscarriage can cause intense feelings of loss. You and your partner might also experience sadness, anxiety, or guilt. However, one thing that you should not do is rush the grieving process. Once you feel emotionally and physically ready for pregnancy after miscarriage, ask your health care provider for guidance. After one miscarriage, there might be no need to wait to conceive. After a series of miscarriages, your health care provider might recommend testing.

However, if you have had two or more miscarriages, commonly known as recurrent miscarriages, it may be somewhat difficult to heal quickly and move forward. The first concern is your mental health. You may have an even harder time dealing with your second loss than you did with your first one, given that you may understandably find no comfort in statistical reassurances (even though statistics remain in favor of your next pregnancy being normal).

At this stage, in addition to feeling sad, you are probably deeply frustrated. The first time you miscarried, your doctor probably told you the odds were low that it would happen again and tried to reassure you that, everything will be fine next time. You may have even reassured yourself by believing that.

Recurrent miscarriages may shake your belief. Recurrent miscarriages can also feel like a betrayal by your body—everything was supposed to be fine and then it was not. If you have more than one miscarriage, you may be discouraged.

If you have had recurrent pregnancy losses, you do have higher than average odds of developing anxiety and depression for obvious reasons. You may find yourself especially anxious about the prospect of trying to get pregnant again.

Your relationship with your partner may face additional strain after multiple miscarriages. In couples, sometimes the man may tend to feel that the woman is dwelling too much on the experience. He may not give her room to grieve the way she needs to.

If you have suffered two or more miscarriages, talk with a healthcare provider who might suggest treatments to help reduce your risk for future miscarriage. Whether you’re trying to conceive again or not, there are physical and online support groups that exist for recurrent pregnancy loss. As with any type of loss, you should not have to face your experience alone.

In some cases, surgery can fix some problems in the uterus (womb), like extra tissue that divides the uterus (septum), some fibroids (benign tumours), or scar tissue. Correcting the shape of the inside of the uterus can often lower the chance of miscarriage. 

Recurrent pregnancy loss may be related to some medical problems such as abnormal blood sugar levels, an over-or underactive thyroid gland, or high levels of the hormone prolactin. Treating medical conditions such as diabetes, thyroid dysfunction, or high prolactin levels can improve the chances of having a healthy, full-term pregnancy.

In general, whatever is healthy for you improves the chance of a healthy pregnancy. For instance, stopping cigarette smoking and stopping illicit drug use will lower the risk for miscarriage. Limiting alcohol and caffeine intake may also help. Being overweight has been linked with an increased risk of miscarriage, so healthy weight loss might also help pregnancy outcomes. There is no proof that stress, anxiety, or mild depression causes recurrent pregnancy loss. 

Psychological support and counseling can help you to cope with the emotional pain of miscarriage and create a healthy environment for a pregnancy. As mentioned, if you have had two miscarriages in a row, you should see a medical practitioner for a basic testing workup for miscarriage causes, such as uterine shape problems, blood clotting disorders, and possible hormonal imbalances. 

Once you become pregnant again after a miscarriage, you’ll likely feel joyful — as well as anxious. While becoming pregnant again can be a healing experience, anxiety and depression could continue even after the birth of a healthy child.

The bottom line is that the odds are still in your favour that you will have your own baby after a successful pregnancy and all that you are experiencing right now will be just a distant bad memory.

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