Increased fertility after miscarriage – an old wives tale?

In my previous post I talked about the frustration and stress and uncertainty of trying again after a miscarriage. One of the things that makes this worse is the old wives tale that suggests that your body ‘knows how to be pregnant’ and so conception should be quicker second time round. I have heard this from a few different people, and it definitely made it worse when it didn’t magically happen for us the first month of trying again.

I thought I’d do a bit of research into the suggestion and see whether there’s any truth in it. Most of the more reliable websites seem reluctant to say more than ‘some evidence suggests’ and ‘some studies show’ that miscarriage could increase fertility – many don’t even mention the possibility at all, and I am inclined to think that Baby Centre’s conclusion is sensible (http://community.babycenter.com/post/a26307987/helpful_ttc_info):

After a miscarriage it’s difficult to determine what a ‘normal’ conception time frame is. Some women will get their period 28 days after their loss and some won’t get it back for 8 weeks[…]. Once your period returns you fall back under the standard conception time frame (in other words, already experiencing a pregnancy doesn’t give you a ‘headstart’). There is a lot of misinformation about being ‘more fertile’ after a miscarriage. There is simply no scientific evidence to back that up. In fact, after a miscarriage (especially after 8 weeks) your body will need time to recover and get back to normal. Many women do not ovulate for a few months. It’s totally normal to take 6-12 months to conceive after a miscarriage no matter how fertile you are.

OK. So I should probably expect to be in this for the long haul – no more naive expectation that we’re young and healthy and therefore should be pregnant instantly.

BabyMed has a view that supports the ‘more fertile’ idea a little more:

While doctors say there is a brief period right after a miscarriage occurs that a woman experiences increased fertility, this does not mean that her fertility will be increased for long. Experts report that a woman’s normal fertility level should return within four to six weeks after the miscarriage when ovulation starts and her cycle begins to function as normal again.

Anyone who felt very inclined to actively try again within four weeks of a miscarriage gets top marks for effort from me – I was still bleeding for most of that time let alone being an emotional wreck.

In any case, some research has shown that it’s better to wait even as long as sixth months after a miscarriage – in fact that’s still the World Health Organisation’s recommendation, even though more recent research has shown that it’s best just to go for it straight away (http://www.nhs.uk/news/2010/08August/Pages/conceiving-baby-after-miscarriage.aspx). Physical symptoms and the benefit of dating the pregnancy accurately aside, I’m not sure anyone would be ready emotionally straight away, but also six months seems like a long time in limbo.

I’m now three and a half months down the line from my miscarriage, and in my second month of trying – last month was very difficult and I found it traumatic and upsetting when I wasn’t pregnant straight away. This month I feel much better about it, and think I will cope much better with negative results this time round. Although I can’t say I won’t be upset, I think I will be more philosophical and accept that we really, truly are back to square one.

In some ways I’m glad I haven’t got pregnant again straight away. It would have been hard to separate the two pregnancies in my mind, and I want next time to be a fresh start. It will be better for our next pregnancy if I can see it with hope and optimism, and see our baby as an individual and not as a replacement for the one we lost. Plus, it will be better for our lost baby too – not just swept under the carpet by a quick ‘rerun’, but remembered and grieved for.

“Trying for a baby”: the most unhelpful term ever

My husband and I are into our second month of trying for a baby. The longer it takes us to get pregnant, the more I hate that term – to me, trying without succeeding equals failing.

The fact that you have to “try” for a baby makes it seem like like hard work, rather than something exciting with a lovely outcome to look forward to at the end of it. It puts the emphasis on the negative rather than the positive. If you’re an athlete at the start line of an Olympic race, the last thing you want is someone saying: “Right, you’ve done all this hard work and preparation, and now all you have to do is start trying.” You’ve been trying all along – trying to get your body in the best shape, trying to break bad habits, trying to keep your relationship on the strongest footing, trying to get as much from your pre-baby career and life as you can. And now the trying really starts, with the possibility you might not succeed at the end of it? How depressing. The word “trying” is a synonym for tiresome, difficult and stressful (eg “it’s been a trying time”) – and it still has that connotation even when it isn’t used as an adjective.

My Mum and Dad tell an awful story about some friends of theirs who had been trying for a baby for about a year, when they were all in their twenties. Mum and Dad asked them sympathetically how they were doing, whether they’d had any good news yet, and the man said, “No, we’re still slogging away”. Slogging away! Everyone was embarrassed and upset when he said it, but in lots of ways I understand him – I don’t see it like that myself and I’m lucky that things are so great between me and my husband, but society makes us all feel that trying for a baby is a “slog”, a protracted and difficult process. And a lot of that feeling comes from the word “trying”.

It’s not that I resent that you have to be committed to it, or the fact that “trying” for a baby might take some time. All that is part and parcel of the experience, and if it was easy and required no sacrifices or fears it wouldn’t be such an exciting and life-changing adventure.

Maybe it should be called “waiting” for a baby, or “hoping”. That’s a bit more how I want it to feel. My husband and I understand all the days when we could be most fertile, and all the reasons why we might not conceive in a given month, and so really we’re just waiting for exactly the right combination of timing and circumstance. We’re waiting for everything to be just right. And isn’t that a more positive attitude? You’ve done all the preparation and hard work, and now you’re waiting – like waiting for Christmas with an advent calendar. It’s exciting and fun and you’re filled with anticipation of good things. Not bogged down in “trying” hard work.

Anyway, back to the practicalities of the matter – my husband and I are still waiting. My cycle has never been particularly regular, so it’s hard for us to know exactly the most fertile days – maybe there’s a bit more of an element of chance for us than there is for a couple where the woman operates like 28 day clockwork. So we have a period of about a week mid-month where we’ve got even more motivation than normal to be ridiculously in love with each other. We’re in that period now (woohoo!) and I’m hyper-aware of every single thing going on in my body – is it a sign? Has it happened? Has a little egg been fertilised? I know there’s no way I’d be able to feel anything or know anything within one or two days of conception, so it’s purely in my over active imagination.

For now, then, we’ll keep on being excited, and try not let the process feel stressful and strewn with obstacles. And I’ll tell people that we are waiting and hoping for a baby.