Waiting to try again?

Medscape reports: August 26, 2010 — Women may not need to delay pregnancy after an initial miscarriage, according to the results of a retrospective, Scottish population–based cohort study reported Online First August 5 in the BMJ.

"How long a couple should wait before trying for another pregnancy after a miscarriage is controversial," write Eleanor R. Love, from the University of Aberdeen in Aberdeen, Scotland, and colleagues. "Some clinicians believe that there is little justification for delaying the next pregnancy, as an increased interpregnancy interval is unlikely to improve perinatal outcomes, whereas a new viable pregnancy and the birth of a child could enhance the women's chances of recovery.... Current guidelines from the World Health Organization recommend that women should wait for at least six months before trying again, whereas others suggest a delay of up to 18 months, based on reports that interpregnancy intervals of 18-23 months after a live birth can enhance maternal and perinatal outcomes in the next pregnancy."

"...Compared with an interval of 6 to 12 months between the miscarriage and second conception, an interval less than 6 months was associated with lower risks for repeated miscarriage , termination, and ectopic pregnancy. The risk for an ectopic second pregnancy was greater with an interpregnancy interval exceeding 24 months, as was the risk for termination.

"Women who conceive within six months of an initial miscarriage have the best reproductive outcomes and lowest complication rates in a subsequent pregnancy," the study authors write.

Limitations of this study include potential lack of uniformity in documenting gestational age and outcomes of interest as well as possible misclassification. This study also evaluated only miscarriages that led to hospital contact, and the findings therefore cannot be generalized to all women with a miscarriage."

Reported online August 5 in the BMJ. Eleanor R. Love, from the University of Aberdeen in Aberdeen, Scotland, and colleagues. The goal of this study was to evaluate the optimal interval to subsequent pregnancy after miscarriage in a first recorded pregnancy. At Scottish hospitals between 1981 and 2000, a total of 30,937 women who had a miscarriage in their first recorded pregnancy and subsequently became pregnant were followed up during the second pregnancy. (Source: Medscape, August 26, 2010 Laurie Barclay, MD CME Author: Désirée Lie, MD, MSEd)

October is National Pregnancy Loss Awareness Month

Click the post title for About.com's article on this important subject. We also have posts on this site that deal with loss in pregnancy. It's every woman's nightmare, but miscarriage is actually quite common so learning about it and knowing you aren't alone can sometimes help. Fortunately stillbirth is less common, but still something to be aware of.

Learn to do kick counts (third trimester) and become familiar with your baby's movement patterns, attend your prenatal appointments and take care of yourself to make your pregnancy as safe as possible.

Sharing and Caring - The Unexpected Outcome

Thankfully, most pregnancies result in a positive outcome with healthy mother and newborn. In rare cases things don't go as planned and we may grieve for a lost child. Grief is an emotion we wish we never had to experience. If you are one of these mothers, please recognize that the emotional roller-coaster is normal but there are resources to help you get through it.
Parents hurt

I have recently spoken with two WeeCare moms whose babies won't live. They chose to carry their babies and appreciate the limited time they have with them. It is difficult. "A life worth remembering and celebrating...no matter how short" is the message from BabyGrief, a website devoted to prenatal loss.

Community resources for parents are usually hospital based. IHC offers a program called Angel Watch which consists of a small group of professionals who help the family plan and cope with loss either before or after pregnancy, regardless of the circumstances. The University of Utah hospital also offers grief support program and the March of Dimes provides the Parent to Parent programs for parents of fragile NICU babies. If you know someone in need of such services, contact them or your local hospital.

BabyWorld says, "A little life; not a little loss."

Children hurt too

In Salt Lake, The Sharing Place is where grieving children can get help through group participation and counseling - sharing with each other and helping each other get through the process of grief. There's a waiting list but it's worth the wait and once you're in you can stay. If you know a child who is grieving or may be soon, please contact them. The Sharing Place, 1695 E. 3300 South. Call 801-466-6730

Click the link to learn more about what they do and how they got started.

There are more grief and loss links on the right sidebar here. Scroll down to the Grief section, near the bottom. Also, please feel free to call the WeeCare nurses if you need someone to talk to or would like help in finding help. (801) 538-9943 or (800) 662-9660