Prevent Recurrent Miscarriages

Up to 20 percent of pregnancies may end in miscarriage. A number of factors impact a woman’s chance of miscarrying, from biological to lifestyle factors. While doctors suspect that some miscarriages may be avoided by a change in lifestyle, the vast majority of miscarriages are likely caused by biological factors that are beyond an expectant mother’s control. There are no scientifically proven ways to prevent recurrent miscarriages, and there are limited treatment options. Close work with a doctor, though, combined with a healthy lifestyle and informed choices may help some women while they work to conceive and carry a pregnancy to term.

Steps

Working With Your Doctor

1. Make an appointment before conception. Before you start trying to conceive, talk to your obstetrician about any trouble you may have had carrying a pregnancy to term in the past. Ask them about testing and lab work options so that they can check for things like chromosomal abnormalities, high androgen levels, or other factors that may lead to miscarriages.
   • The many variable causes of miscarriages mean that there is no set panel of tests that will be done. Speak openly and honestly about your medical history, family history, and your efforts to become a parent so that your doctor can suggest appropriate testing and potential treatment options.
   • Let your doctor know, "I have a history of certain medical conditions and I would like to discuss whether these impact my current efforts to try and have a baby."
   • If you have a history of Polycystic Ovarian Syndrome, Endometriosis, uterine fibroids, or other conditions that specifically impact your reproductive organs, let your doctor know, "I have an ongoing effort to manage a condition that impacts my reproductive health. How might this impact my ability to carry a baby?"
2. Check your blood type. If you have blood type that tests negative for the Rh-factor, you may need a low dose of RhoGAM. This may help prevent problems with future pregnancies where Rh incompatibility is a factor.
   • RhoGAM is administered b injection, and is generally only used with mothers who have Rh-negative blood types carrying a child with an Rh-positive blood type.
3. Look for imbalanced hormones. Hormone imbalance may manifest in a number of ways, including through conditions such as Polycystic Ovarian Syndrome, and Endometriosis. If you know you’ve had problems with these conditions in the past, or if you suspect you may have problems relating to your thyroid or adrenal gland, ask your doctor to check your hormone levels.
   • Some signs of hormonal imbalance may include weight gain, irritability, abnormally heavy periods, irregular periods, missed periods, headaches, back pains, and more.
   • Some hormonal imbalances may be treated with medication or with supervised therapy from your doctor.
   • Ask about hormone support. One of the factors causing early miscarriage may be a lack of progesterone. A progesterone hormone in the form of injection or tablets in the first three months of pregnancy may help. However, this technique is based on older studies. Newer research does not indicate that this treatment is effective.
4. Take a look at your chromosome. Repeated miscarriages may be due to chromosomal abnormalities. There are a number of types of chromosomal abnormalities that may impact pregnancy, some of which are easier to address than others. Ask your doctor about chromosomal analysis to help you determine if this may underpin your recurrent miscarriages. This analysis may be done on you and your partner.
   • Be aware that some forms of testing may require you save tissue from your miscarriage in order to run the analysis.
   • Know that many chromosome problems are unavoidable, and may be unpredictable and untreatable.
5. Talk about current medications. Talk with your obstetrician about any medications prescribed by your general practitioner, as well as any over-the-counter drugs you may use, including vitamins and herbal supplements. Ensure that these are safe for you to use while trying to conceive and during pregnancy.
   • Don't wait for your doctor to ask. Tell them outright, "I am on these medications by prescription of my general practitioner, and these are the over the counter drugs I use regularly. Might any of them impact my ability to successfully carry my child?"
   • Avoid nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen while trying to conceive or while pregnant. Stick to acetaminophen as a pain reliever during this time.

Changing Your Lifestyle

1. Minimize smoking and drinking. Smoking and consumption of alcohol is not only frowned upon during pregnancy. Women trying to become pregnant are advised to abstain from smoking and drinking during the conception process.
   • It is also advisable for women to stay away from any illicit drug use while trying to carry a pregnancy to term.
   • Quitting smoking is a long-term process, but many women have found a combination of nicotine reduction supplements such as the gum or the patch and community support groups either online or in person helpful tools in their struggle to quit.
2. Take supplements. Certain supplements may be beneficial for women trying to maintain a healthy pregnancy. Consult with a medical professional before beginning any course of supplements and ask your doctor for advice on dosages.
   • Supplements for women who are already pregnant include folic acid and prenatal vitamins that contain folic acid, calcium, iron, and Vitamin D.
   • Taking a multivitamin that is not formulated for the needs of pregnancy is not advised as it may provide improper nutrients for the mother and child.
3. Get enough rest. Rest is crucial. Sleep as much as your body tells you is necessary, and adhere to bed rest if it is recommended by your doctor. If you suspect any complications due to over-activity, especially where you've had recurrent miscarriages, seek medical help immediately.
   • An extra 45 minutes to an hour of sleep per night is recommended during the first trimester.
   • Getting eight restful hours of sleep during the second trimester is recommended. This may be difficult, however, as the second trimester often sees the start of nighttime indigestion and poor sleeping patterns.
   • It is advisable for women in the third trimester to rest whenever they feel fatigued, as sleep patterns may become irregular due to discomfort at this time. Naps and regular bed rest are advised.
4. Cut down on caffeine. When trying to conceive and during pregnancy, it is recommended that you keep your caffeine intake under 200 milligrams per day. This includes coffee, tea, and soda. You can try decaf versions of your favorite drink or even try "herbal coffees", which are caffeine-free tea drinks that imitate coffee flavor.
   • If you are trying to become pregnant, try gradually cutting back so that you don’t shock your system by going cold turkey after conception.
   • Remember to look for caffeine in more than just beverages. It can also be found in chocolate and even certain over-the-counter medications such as those meant for treating headaches.

Taking Care of Your Mental Well-Being

1. Avoid self-blame. Do not cause undue stress on yourself as you try for your child by blaming yourself or feeling guilty. Many of the factors that cause miscarriages are unpredictable and unavoidable. Know that these circumstances are not your fault.
   • Depending upon the criteria used, between ten and thirty percent of pregnancies are thought to end in miscarriage. Miscarrying does not automatically indicate that something is wrong biologically, or that you will never be able to carry a pregnancy to term.
2. Seek community support. Recurrent miscarriages can cause stress and heartache that may bring about some stress-management techniques and lifestyle choices that are not optimal in the long run. Look for a supportive community, instead, to help you deal with the stress and pain in a more healthful way.
   • Ask your doctor about local support groups for mothers dealing with miscarriages or struggling to conceive.
   • Look at online forums and message boards to get advice from and exchange stories with others going through similar hardships.
   • If you have the means, consider finding a therapist or a counselor that deals specifically with family planning.
3. Turn to friends and family. Some may find it difficult to talk with those closest to them about their miscarriage, but seeking support from friends and family ultimately lets you feel uplifted by those closest to you, and may even provide some information to help you down the road.
   • Let your friends know that you are going through a difficult time, and ask them to be sensitive to this matter. Try saying, "I'm dealing the emotional aftermath of a miscarriage and I really need your friendship and support right now."
   • Ask your friends if any of them have dealt with similar situations, and what, if anything, helped them overcome.
   • Let your family know, and use that as an opportunity to ask about whether any of your female relatives have a history of miscarriages, as well. This may point to something hereditary rather than an individual anomaly or a lifestyle issue.
4. Reduce your stress. There is no evidence that stress levels cause miscarriages in and of themselves, but stress does impact hormone levels, which can contribute to your baby's overall health in utero.
   • Remove stressful influences from your life. If a person tends to cause you undue stress, let them know that you cannot handle that at the moment. If your work causes you excess stress, tell your supervisor, "I fear that the stressful environment here may be impacting my health, and I would like to speak with you about creating a more stress-free environment."
   • Calm yourself during a stressful situation by taking ten minutes to deep breathe or perform a body scan. Start by relaxing the muscles in your toes, and work your way up one body part at a time until you reach the top of your head.
   • Don't be afraid to walk away. When your main focus is getting yourself ready for your future child, there is no shame in saying that you can't do or take on more in that moment. Walk away from things that seem like too much at the moment.
5. Watch for depression and anxiety. Women who experience recurrent miscarriages are at risk for depression and anxiety, two mental health issues that may impact your will to continue trying to build your family. If you notice symptoms of either, consult your doctor immediately to see if referral to a mental health professional is advisable.
   • Symptoms of depression include a feeling of sadness, feeling empty or hopeless, angry outbursts, loss of interest in daily activity, change in appetite, feelings of guilt, trouble concentrating, and more.
   • Symptoms of anxiety include feeling nervous or restless, a sense of impending doom, rapid breathing, increased heart rate, sweating, trembling, fatigue, trouble sleeping, uncontrollable worry, and more.

Tips

• Keep in mind that it is usually only possible to find a cause for repeated miscarriages about 50% of the time. But just because you don’t have answers, that does not mean that you can’t have a baby. If you have had multiple miscarriages, then there is still a 65% chance that you will have a successful pregnancy.
• Use the prone position when lying down if you have a retroverted uterus. Spend 10 to 15 minutes at a time in that position at in the morning, afternoon, and right before bed.

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Sources and Citations

See also

• Prevent a Miscarriage
• Determine If You Had a Miscarriage
• Know the Signs of Miscarriage
• Prepare Your Body for Pregnancy After Miscarriage
• Care for Yourself After a Miscarriage
• Recover from a Miscarriage
• Console Someone Who Had a Miscarriage
• Get Through a Miscarriage

What links here

• Know the Signs of Miscarriage
• Determine If You Had a Miscarriage
• Prevent a Miscarriage