Precautions for Healthy Conception After Spontaneous Abortion

Q: Hi, I am 37 years old female. Last month I suffered a missed abortion. Can you please advice precautions, so that I can deliver a healthy baby.
-By Rajni

Reply:

It is important to first investigate the cause of abortion. After that, corrective measures need to be taken before planning the next pregnancy.

Reasons of miscarriages are different in the three trimesters of pregnancy.

Causes of Abortion During the First Trimester

Fetal Causes

Fetal chromosomal abnormalities is the commonest reason of abortion during early pregnancy. There may be genetic defects in the fetus not letting it grow beyond a certain period. Not much can be done to prevent abortions in such cases.

However, such fetal abnormalities are not repetitive. They may not occur in subsequent pregnancies.

Embryonic anomalies in the fetus.

Maternal Causes

Maternal disease like, diabetes or hypertension may be a reason for miscarriages.

Infections like chronic fevers, urinary infection or infections like TORCH group are frequently found to be responsible for such events. These can be ruled out by simple blood or urine examinations. It is advisable to get them treated before conceiving again.

Blood group incompatibilities like that of Rh antigen.

After conception, the fetal tissues depend upon the placenta for its growth. A well formed placenta with adequate supply of maternal hormones is essential for the growth of the baby. Sometimes, placental abnormalities or deficiency of pregnancy hormone (progesterone ) could cause an abortion.

In such cases, subsequent pregnancy is closely monitored. A low dose supplement of progesterone levels is given as a precaution throughout the first trimester. This supplement is usually injectable HCG, every week.

Stress in itself is a big killer and can be a cause of spontaneous abortion. To combat stress, assure a warm caring environment at least during early pregnancy.

Cause in Second Trimester

In late pregnancy, cause of abortion is usually structural. Uterine abnormalities or structural problems in the cervix need to be ruled out. For this, uterosalpingography is done. This is an investigation where a dye is inserted into the reproductive tract of the woman. The tract is then directly visualized by ultrasound to see for any structural defects.

You need to get yourself examined by a doctor to evaluate the cause of your abortion. There is nothing to worry, as most of the causes are treatable, you just need to know it.

Tips for Pregnancy After Miscarriage

  • Get any underlying cause treated first, before planning the next pregnancy.
  • It is advisable to wait for 3 months before conceiving again.
  • From 3 months before you plan your next conception, start eating healthy. Take plenty of fruits and fresh vegetables to replenish your vitamin stores.
  • Take Tablet Folic acid, 5 mg ms/day from three months prior to the next pregnancy.
  • After conception, limit on your daily exercises. Take a lot of rest in initial phases.
  • Avoid taking any kind of stress. Make a habit of relaxing.
  • The next pregnancy needs close monitoring. A low dose progesterone supplement may be taken as a precautionary measure throughout first trimester.
  • Do not miss your antenatal visits to the doctor.

Many women have given birth to healthy babies after events of miscarriages. So just relax and get yourself evaluated to prepare for the next pregnancy.

Take Care,

Buddy M.D.

Medical Advice (Q&As) on “Tips for Having Normal Pregnancy After a Miscarriage

  1. Jan

    Good Day Doc!

    First, I want to reiterate my situation. I had a miscarriage last February 2013 and my period went back on March 20, 2013. My partner and I had an unprotected sex by April 1, 2013 and after a day I experienced early pregnancy symptoms like breast tenderness, back pain, cramps and feeling lightheaded.

    After 2 weeks, I underwent a pregnancy test and it revealed a negative result. Up to this date I’m experiencing on and off mild cramps and slight breast tenderness and as of today April 26, I underwent a pregnancy test for the 2nd time and it still reveals a negative result.

    What do you think the problem is? Am I pregnant again or is there any reasons behind this?

    Your response will be much appreciated. Thank you very much.

    Reply
    1. Buddy M.D. Post author

      This doesn’t sound like a pregnancy. Home pregnancy tests are quite accurate. By this time, it would have shown a positive result if you were pregnant.

      May be your hormones are taking time to stabilize after the miscarriage. It takes around three months before the normal hormonal levels are attained after such events.

      Give yourself some more time, you’ll be alright and the symptoms would go on their own.

      Reply
  2. Helena

    I had abortion two times after that I used birth control for four years. Now I tried to have a baby two years but still I can not get pregnant, what is the reason? I am so worried. I think some times I better to die to get relief from this stupid worried.

    Reply
    1. Buddy M.D. Post author

      You need a thorough gyne evaluation. It is essential to investigate the reason of your previous abortions.

      Don’t loose hope. Take an objective approach, evaluating your case.

      Reply
  3. Jaiss

    Hello Doctor,
    Recently conceived. But had two missed abortion due to baby growth stopped last year with unknown reasons (1st by Medication & 2nd by Surgery). Now, I just want to know how can I save my this pregnancy, actually I’m very worried about my pregnancy. I don’t want to lose this time. My Thyroid, Glucose and hormones tests are normal, but I have a Vitamin D Deficiency. Please help me, what should I do or what not to do.
    Thank you so much. It’s killing me. Please reply soon.

    Reply
    1. Jaiss

      Hi, One thing I forget to mention that I’m having aches in my very lower abdomen area and on my back hip (only right side). Is this serious or normal?

      Reply
  4. Anmol pari

    Hello doctr.. I want to ask that i had a misscarriage at 7 1/2 week due to weakpregnancy..In march 10_03_2017. The reason was missed heart beat nd growth stopped.. I have a bladder infection also..

    Baby’s growth nd hearbeat was showing Normal at 6 week u/s.
    But aftr one nd half week it was stopped nd baby(fetus)did not can grow aftr 6 week.. Than i had d&c by surgery..
    My periods went end aftr 20_25 days of miscarriage.
    I had not periods yet.. But aftr one mnth we left the precaution nd meet again..time to time..
    My period cycle is regular nd round about of 27, 28 days..

    Now i feel little heavy nd some pain in abdomin nd in my back nd legs.. Very much Frequent urination nd headache mostly..i want to eat some thing crispy or junk food evry time..
    Now tell me plz what is the meaning of these signs nd what shoul i do…
    Is there is pregnancy again. ???
    Your reply is most important to me..

    Reply
    1. Buddy M.D. Post author

      You may go for a home pregnancy test.

      What reason did your doctors give for your previous miscarriage.

      Reply
        1. Buddy M.D. Post author

          If you continue to have those symptoms, HPT may be repeated after a week. If it’s still negative, you need to see a gyne.

          Reply
  5. mash

    Hello Dr.
    I had a miscarriage of 6wks pregnancy. it was done by d&c surgery. first i was diagnosed with a uterine fibroid at the superior end of the uterus. it’s now 6days after the surgery and have a mild bleeding.
    what precautions should one take when trying to conceive again with such a fibroid and after how long should I try to become pregnant.

    Reply
    1. Buddy M.D. Post author

      How big is the fibroid? For a mid to large sized one, it’s suggested you go for treatment before the next conception. It’s likely to interfere with the growing fetus again.

      Reply
  6. Diana

    Hi, doc! I had a missed abortion at week 8, heartbeat stopped and 2 weeks ago we did medical abortion, I was bleeding 3-5 days, the results of last ultrasound are positive and doctor told me that uterus is ready for the next pregnancy and the only thing I should do is to take folic acid.. another doctor told me that we should wait for 3 months and use condoms, not contraceptives. I am living in Kenya now, and medicine is completely different from my native country Russia. What would you recommend to do? I feel good and would like to have a baby soon! Waiting patiently for your recommendation.

    Reply
    1. Buddy M.D. Post author

      Better to wait for three months before conceiving again. Using condoms would be better. That won’t disturb your hormones.

      Reply
  7. Siri

    Hi doc, I had a miscarriage in March, 2017. In September, 2017 I have got a positive pregnancy. My last miscarriage (no fetal heart beat) is due to some chromosomal abnormalities and the doctor gave me vaginal pill during 6th week of my pregnancy, should I worry about my next pregnancy? What care is taken?

    Reply
  8. akanksha

    hi am 29 yrs in my last LMP was 12oct 2017 i did home pregnancy test on 20 nov it was not clear but on 23nov it was clear two positive line. 7 dec dr called me for sonography there was no heartbeat dr told me no growth she have asked to wait for ek week. Before this in july2017 i had abortion reason was same no growth no hearbeat. why this is happening again what i we have to do to plan again? it will be difficult to plan again complication will increase? this is very disappointing i dnt have words to express my feeling.

    Reply
    1. Buddy M.D. Post author

      Very sorry for your situation, dear.

      Though it’s difficult to say, causes of no growth may be related either to your placenta or the fetal tissue itself. Needs to be investigated. It’s recommended that you investigate the cause of abortion, so that further pregnancies may be planned.

      Reply
  9. Delight

    Hi I had miss abortion for three times,after the second one I had an ultrasound done and it’s said I had left ovarian cysts and I was on metfomin 500mg for 7days and continued with 750mg for 3weeks after that I went for the ultrasound and it gone. Then I had my third pregnancy and its happened again,I’m so much confused, I need your help,is something wrong with my uterus or cervix?

    Reply
      1. Anonymous

        hi i had missed abortion in december 2017 by sugery. my period was on 15 January 2018..but in February i have no period . i test home pregnancy on 20 feb its negative . but on 8 march 2018 again test it its positive….it is possible

        Reply
        1. Buddy M.D. Post author

          May be the test you did in February was done at a very early stage. So, it showed negative.

          If you,re getting a positive result now, better get it confirmed by your doctor.

          Reply
  10. AMVISHIKA

    Hello doc. I am 32 yrs old and plan for the family after 10 months of trying i m unable to conceive then we consult doc and after examine me she told me that i have a cyst problem. In my treatment she gave me Dufoston and endogest tablet to reduce the cyst and after 2 mnths of treatment she said the cyst is still there and you have to operate for that. We r confused and take time to make the decision near about one month in between with the grace of god i have a positive test for the pregnancy really we r vry much happy for that. But after my 7th week of pregnancy we go for a checkup doc check me and take my blood sample to check for THYROID, HIV, BLOOD GROUP AND UIT all r well except UIT as it shows some infication. Doc gave me folic acid tablet and infiction killing tablet and ask for ultrasound after 2 weeks. All is going well but after 10 weeks i have a back pain for 2-3 days and ask my husband to go for doctor but in the evening i have seen some bleeding in me urine and got shocked we rush to doctor he ask to do ultrasound as it is night time their is on USG facilty in our town so we have to wait gor the nxt morning but that night is vry much painful for me i have received to major blood clots( of size of 2 inches) duiring urination. In the moring we rust to doctor and she checked and ask us that we have faced a missed abortion. As the baby growth is not upto her exception and suggest us foe the evacuation and with this we loose our hope to became a father and mother.
    Now you suggest me what time it should take me for the next periods and when we plan for the pregnacy again as the doctor suggest me for avoid it for three months and give me RUBIRED AND FOLBEL PLUS CAPSULES TO take for the 2 to three months.
    And will u please tell us the problem of missed abortion as my doctor didn’t tell us any reason and precaution should we take to be safe during nxt pregnancy.
    Your suggetion metter for us a lot and wait for ur precious reply

    Reply
    1. Buddy M.D. Post author

      Better wait for 3 months, as your doctor says.

      You need to be very careful after conception. Avoid infections, that’s most important.

      Reply
  11. Khan

    Heyy doc…
    I had my miscarage on 23th of oct…. nd it was 6 weeks prgncy evrythg was fine but sddn pain startd nd bleeding startd nd i had a miscarage now its been 3 months nd now i am prgnt… what are the precautions i need to take for this prgncy…. reason for my abotion was growth was nt corrct nd some precations i dint took like sitting down carryng heavy weights nd going out…. so plz tell me what all precautions i should take for this prgncy… i dont want to loose this baby….. plz suggst me the precations…

    Reply
    1. Buddy M.D. Post author

      Be restful. Avoid lifting heavy weight, prolonged standing, climbing stairs, sitting in sqauating position. Avoid very spicy, heavy or pungent meal. Take frequent, easily digestible diets.

      You need to lie down frequently during the day hours as well. Avoid traveling, especially on bumpy roads.

      Regular check up with the doctor is required. HCG levels need to be closely watched. If required, more hormone may be injected.

      Reply
  12. Aasha

    Hello doc,
    I got a mis abortion by medication in jan first week. It was a 12 week fetus. I don’t know the reason behind the misabortion. But my period was not regular after the misabortion. My period continued for a month or more. (Sometimes the blood was less or sometimes more)Then I consulted a gyne and had a medicine. So after the medication, last time I had a normal period on 24march. But now I wanted to have a baby again and is it okhy to plan a baby now? Or if it’s not, then how long I have to wait ?

    Reply
      1. Aasha

        Yes, in ultrasound the doctor said that there is no trace of any fetus. So is my body is ready to get pregnant now? And sorry my report is not with me now . I left it at my home town. After the misabortion, my first period was not regular then after that the second period I had on time and now 23-24 April I’m expect my third period now . So can i get pregnant again. And one more important thing is I’m newly married andIt’s only been 6-7 month and that was my first child which got misabort

        Reply
        1. Buddy M.D. Post author

          Safely speaking, wait for at least three cycles before conceiving again. Stay relaxed, stress free and eat healthy food stuff. Avoid too much of tea or coffee. Take more of fruits and vegetables in your diet.

          It’s very common for the first fertilized egg to get aborted. So, don’t worry. You’ll have a normal pregnancy next time!

          Reply
  13. Anonymous

    Hello Doctor!
    I am 29 years old. I have two missed abortions. in the first abortion in 8th week there is no fetal pole & no cardiac activity. my doctor give me HCG injections every week . but I have aborted in 8th week and clean my stomach. and after one year I have again conceive. in this time I have aborted. In 9th week ultra sound fetal pole seen but no cardiac activity so again I have abortion by the tablets. what is the reasons it happens. now I am waiting for pregency. Is there the male sperm is also one of the reason to missed abortion.

    Reply
  14. Jareena

    Hi,8 years later i was pregnent i consult the doctor say ihave no fetal devolupment and3rd month 18 days missing abborsion please tellme how much time take another pregnency pls tellme me sir

    Reply
  15. Megan

    Hello. I had a missed miscarriage on 26/09/17, took cytotex, expell on 29/09/17. Didn’t have a lot of bleeding or pain. Went to my doctor in October 2017, he said everything was fine and I was even ovulating. Had a normal period 28 -30 October 2017, then one on 20-24 December 2017. Then on January 2018 6-9 heavy bleed. Then another normal period January 30- February 1 2018. Then February 11-15 bleeding again. Then periods March 9-11 2018. Now after a long wait periods started on May 8. Can you maybe tell me why my period is now totally messed up? Also I’m bleeding much heavier after the miscarriage. Any advice/ info will be greatly appreciated.

    Reply
    1. Buddy M.D. Post author

      Did you go for any follow up ultrasound after abortion? If yes, can you share the report.

      Reply
      1. Megan

        Hello. Thank you for replying. On 30/11/17 I went for the follow up. Doc said everything was great, I was even ovulating at the time, the ultrasound showed everything was fine (very healthy eggs). I would like to ttc again but since my periods are so messed up I can’t tell when I’m ovulating/fertile. This last period lasted 3 days (when I go to the bathroom the blood was literally dripping out of me, very fresh it seemed)(with all my periods since the miscarriage) I have no cramps or pain. Before my miscarriage I was pretty regular, light bleeding, no pains or cramps. Also it just stopped, no tapering off. I’ve been intimate since the miscarriage and been having intercourse during my fertile times according to my app Period Diary. I’m 36 and would like to have a baby now but my body seems messed up. Again any advice/suggestions/info will be greatly appreciated.

        Reply
        1. Buddy M.D. Post author

          Since the ultrasound after abortion was good, there’s no visible cause of irregular menses. If you’re menstruating, you have all chances to conceive.

          Reply
  16. Sindhu

    Hi.I’m 25 yrs old.I had a missed abortion at 12 weeks of pregnancy due to fetal cardiac activity stopped at 11 weeks. my periods are regular.when should i start using folic acid? Can i start immediately after d&c?
    We are planning to conceive after 3 months.so should i start using folic acid now?

    Reply
  17. Anonymous

    After missed abortion is it safe to plan after 3 after or should i need to wait for 6 months.I had missed abortion at 11 months of pregnancy.now all my reports are normal

    Reply
  18. Anonymous

    In my torch panel test, rubella igg is positive 5.7 & igm is negative.does it effects my future pregnancy?can i plan to conceive after 3 months.recently i had gone through d&c due to missed abortion.

    Reply
    1. Buddy M.D. Post author

      Yes, you may plan a pregnancy ahead.

      The test is good, just indicating that you are immune to the rubella virus.

      Reply

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