Dear Dr Mitchell,
I had a miscarriage three months ago and my doctor told me to wait for three menstrual cycles before trying again. However, I haven't got back a proper period yet — just one bout of dark brown discharge about four weeks after the miscarriage. When can I start trying to get pregnant again? I am getting up in age and don't want to delay pregnancy for too long.
I am truly sorry to learn about the loss of your pregnancy. The most common cause for an early pregnancy loss is an abnormality in the make-up of the foetus. The problem could either be due to an abnormal egg or sperm. However, a woman is born with thousands of eggs and a man with millions of sperm, and the fact that a few abnormal forms may be present does not mean that you will not eventually have a normal pregnancy. It is just nature's way of aborting foetuses that are abnormal.
The older you are, the greater the risk of having an abnormal foetus and a subsequent early pregnancy loss. It is usually advised that you wait at least two weeks after a miscarriage before resuming sexual activities. In fact you should wait until the bleeding has completely stopped before resuming sexual intercourse. This allows the uterus to return to pre-pregnancy state and reduces the risk of an infection in the lining of the uterus which could compromise a subsequent pregnancy.
Ovulation usually takes at least one month to start again, and it is quite possible that if you are sexually active you could become pregnant after a miscarriage without even having a normal period.
There is no need to wait three months. You should try at the earliest opportune time once the bleeding stops. It is important to take folic acid 5mg daily in the pre-pregnancy period and continue throughout the first 14 weeks of pregnancy. This helps to reduce the risk of birth defects in the brain and spinal cord. It is also advisable to do a blood test at 16-18 weeks to screen for chromosomal abnormalities once your pregnancy is confirmed.
You should try to achieve your ideal weight in proportion to your height with regular exercise and dieting in order to reduce any risk of diabetes mellitus and hypertension during the pregnancy.
Consult your doctor as soon as the pregnancy is confirmed to ensure that everything is perfect from early in the pregnancy so as to reduce the risk of another pregnancy loss.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to firstname.lastname@example.org; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.