To wait or not to wait?

You may have seen the news reported yesterday that a large, high quality study has confirmed that conceiving in the months immediately after a miscarriage does not raise the risk of complications in a subsequent pregnancy.

This subverts the current advice given by the World Health Organization that it’s best to wait six months after a loss before trying to get pregnant again.

The same conclusion was made by the researchers for pregnancies that are terminated – which is potentially useful information for anyone who has had to end a much-wanted pregnancy and is wondering when it is safe to try again.

In its report of the new study, Radio 4’s Today programme quoted miscarriage specialist Professor Siobhan Quenby (who I interviewed for my book, and who is – technical term incoming – a total legend). She said: 

‘Most people who have miscarried are actually very frightened that if they do get pregnant again the pregnancy will go wrong again. And, also, lots of doctors and midwives give them conflicting advice, so that’s also confusing. But now we’ve got this high-quality study based on a large number of babies, we can confidently advise people that it is safe to try again soon after you’ve miscarried.’

She’s right. (I mean, of course she is, she’s Professor Quenby).

I cannot stress enough how important it is to have actual evidence to work with when it comes to decisions like when to try again or whether you can ‘afford’ to take a break from what can become a soul-grinding cycle. A major strand of my book is laying bare just how much high-stakes decision-making we’re expected to do – as people going through pregnancy loss or infertility, but also as women more generally – without adequate information about the ways our bodies do and don’t work.

Without it, the fear of doing the wrong thing never really leaves you. In fact, yesterday morning, as I woke up to the news bulletin on the radio, I initially misheard the report of this new study and, brain still foggy with sleep, thought they’d said the opposite: that there is a risk if you conceive again within three months of a miscarriage. My heart hiccuped into my mouth at that – imagining I’d just been given a reason for why my subsequent pregnancies after my first miscarriage, all conceived in relatively quick succession, might have been doomed from the start. The guilt!

When there’s so little concrete information, too, it’s hard to counter things you hear from friends or from strangers on fertility forums. Such as the idea I came across – not infrequently – that you’re ‘really’ fertile after a miscarriage, or that it’s best to conceive sooner rather than later.

In fact, this new study is reassuring both ways, showing no significantly increased risk of subsequent pregnancy complications if you conceive within three months of a loss or if it takes more than 12 months.

This feels key, because, actually, in my experience, the decision towards another pregnancy (or not) is more of a bodily instinct than a rational weighing-up process. After my first miscarriage, the desire to be pregnant again was more akin to hunger. It wasn’t a thing that could be persuaded against or negotiated with. Likewise, after the fourth, the utter depletion I felt functioned the same way: attempting to get pregnant again didn’t feel like an option, whatever the evidence might have said was best.

Sometimes, the value of proper information is to affirm a decision you feel you have no choice but to make.

And, of course, that’s before you factor in that when you conceive is often far from a straightforward matter of choice. There is a huge amount of stress and angst bound up with having to wait before trying, when it already takes you a long time to get pregnant in the first place. Or that you might somehow miss the ‘ideal’ window for the best chance of a healthy pregnancy if it takes you a long time to conceive.

Essentially, whichever way you look at it, this study is good news for anyone navigating the aftermath of a miscarriage or trying to conceive again. It should quieten a lot of external noise that might otherwise prevent you from listening to what you instinctively need.

PS. This post was originally published via my newsletter, which as well as writing about pregnancy loss and fertility also offers reading recommendations, women’s health news round-ups, and other musings. I am attempting to amalgamate all of my content – social media posts, writing for this website, journalism, book stuff – into one place, partly to ease the rather clumsy mental juggling act I’ve been attempting over the last year or so. My plan is that it will all cross-pollinate, but if you want to make sure you don’t miss anything, do subscribe to my substack newsletter (you can do this here) it’s free, although there are options for extra paid-for content, including audio posts, which you can add to your podcast feed. I’ll be completely upfront and say this is all a bit of an ongoing experiment, but in essence nothing’s really changing, I’m still writing and plan to keep on doing so!