Ready to Try Again
When you’re ready to get pregnant again after a miscarriage here is what you should consider. Your miscarriage should be over once the bleeding and cramping have ceased. Any persistent bleeding can be suspicious of an unfinished miscarriage. If you experience persistent cramping, your body may still be trying to empty the uterus and is indicative of an unfinished miscarriage. What to expect and what to watch for are the same after a D&C procedure and a spontaneous miscarriage.
After the bleeding and cramping resolves your periods must restart. The period, or the resumption of ovulation, will be confirmed by crampy period bleeding which comes 5-8 weeks after the miscarriage is finished. Bleeding which comes within three or four weeks of miscarriage is not likely to be the return of a normal menses cycle. It’s Not normal for the period to take more than 8 weeks to come after a miscarriage.
Periods should be regular, monthly, and predictable with symptoms like cramps and/or breast tenderness. However, if periods were irregular before the pregnancy and miscarriage they will probably remain irregular after the miscarriage.
Women with irregular periods, and women whose periods do not return predictably within 8 weeks of a miscarriage, should be seen by their healthcare provider.
Women should wait for One Normal period after miscarriage before getting pregnant again. The normal period will clean out and reset the lining of the uterus, preparing for a healthy pregnancy. There may be a higher chance of another miscarriage if the next pregnancy follows too close to a miscarriage. Also, we use the last period to help figure out the due date. If the last period was the miscarriage, we will have to do more testing to find out the due date.
Most women/couples are more nervous in the pregnancy immediately following a miscarriage, especially in the first three months. Emotions can be on edge, especially around the same week of the previous miscarriage. There are ways to address the nerves without too many blood tests, or inconclusive ultrasound tests. Timing is everything and it starts with a positive pregnancy test.
Proving there has not been a miscarriage is achieved at 12 weeks. So, assuming the period is correct, here is what things can look like:
- Missed period is 4-5 weeks since last period, do home urine pregnancy test.
- Come in for a blood test soon after positive home urine pregnancy test.
- Often one more blood test, 2 or 4 days later, to make sure your levels are rising appropriately.
- Ultrasound at 7-8 weeks, to confirm due date, and show the heartbeat.
- Visit at 9-10 weeks which will consist of a brief office visit with an ultrasound to confirm the heartbeat.
- Visit at 12 weeks to hear heartbeat. (It is rare to hear the heartbeat with a doppler before 11 weeks.)
Patients may elect to do all, or just part of this pregnancy after miscarriage testing.
If the last period is certain, we can limit things to the home urine test and the 12 week doppler visit or we can add the 7-8 week ultrasound for an earlier confirmation of pregnancy wellbeing.
If the last period is uncertain, then at least the initial, and maybe the second blood tests will precede the 7-8 week ultrasound.
This discussion assumes you have had no bleeding and no extra pain, either of which can alter the schedule of tests.
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