Pregnancy After Miscarriage: A Rainbow Baby

You get to decide when and if you want to try for another baby.

Pregnant belly - rainbow baby
Getty Images/Cathérine/Moment Open

The term "rainbow baby" is used by parents who are expecting another child after losing a baby to miscarriage, stillbirth, or neonatal death. It is used frequently on blogs and message boards by mothers who have gone through pregnancy loss.

The term refers to the fact that a rainbow appears only after the rain. In this case, the “rain” or “storm” is the grief of losing a child. Many mothers who use the term point out that the rainbow doesn’t negate the effects of the storm, but does bring light to the dark and is a symbol of hope.

Please keep in mind that after miscarriage it's very possible to become pregnant and deliver a healthy, beautiful, and full-term pregnancy.

Because your body returns to baseline fertility after miscarriage, stillbirth or neonatal death, it may be helpful to consider what this means exactly.

When Does Ovulation Resume After Miscarriage?

After a pregnancy ends, either by spontaneous or induced means, ovulation can resume in as early as 2 weeks, which means you can get pregnant. 

Research shows that there's a surge in luteinizing hormone (LH) between 16 and 22 days after miscarriage, neonatal death, stillbirth or so forth. This surge in LH is followed by a surge in progesterone levels. Furthermore, endometrial biopsy confirms that these hormone changes result in changes to the lining of the uterus conducive to pregnancy. These hormone surges mean that your body is ready to start ovulating again.

In other words, a previous pregnancy loss doesn't mean that you are any less fertile.

When Is It the Best Time to Get Pregnant After a Miscarriage?

Advice regarding how long a woman should wait to get pregnant after a miscarriage used to be confusing and controversial. For instance, you may have heard that you should wait more than 6 months to optimize your chance of having a healthy pregnancy following a miscarriage.

But this is not true, according to scientific evidence.

For example, a large review study in Human Reproduction Update found strong evidence that waiting less than 6 months to become pregnant following a miscarriage is not linked to adverse outcomes in the next pregnancy, like low birthweight, pre-eclampsia, or stillbirth.

In fact, a study in British Medical Journal, which examined 31,000 women after a miscarriage, found that those women who had pregnancies within 6 months of miscarriage had better pregnancy outcomes than those women who had pregnancies after 6 months of miscarriage.

Regardless, the big picture here is that the how long you wait to become pregnant after a miscarriage is really a personal decision, something to discuss carefully with your partner. There is no medical reason to hold off on trying to get pregnant after a miscarriage. Sometimes women like to wait after they get their next menstrual period, so it's easier to calculate a due date—again, this is a personal decision.

Contraception After Miscarriage

Some women and couples don't want to wait to get pregnant after a miscarriage. In these people, contraception should be started, as soon after miscarriage as possible.

Specifically, oral contraceptives can be immediately started after miscarriage. Furthermore, an IUD can also be immediately inserted after miscarriage. 

Sources:

American College of Obstetricians and Gynecologists. (2015). Frequently Asked Questions: Early Pregnany Loss.

Hoffman BL, Schorge JO, Schaffer JI, Halvorson LM, Bradshaw KD, Cunningham F, Calver LE. Chapter 6. First-Trimester Abortion. In: Hoffman BL, Schorge JO, Schaffer JI, Halvorson LM, Bradshaw KD, Cunningham F, Calver LE. eds.Williams Gynecology, 2e.New York, NY: McGraw-Hill; 2012.

Kangatharan C, Labram S, Bhattacharya S. Interpregnancy interval following miscarriage and adverse pregnancy outcomes: systematic review and meta-analysis. Hum Reprod Update. 2016 Nov 17.

Love ER, Bhattacharya S, Smith NC, Bhattacharya S. Effect of interpregnancy interval on outcomes of pregnancy after miscarriage: retrospective analysis of hospital episode statistics in ScotlandBMJ. 2010 Aug 5;341:c3967.

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