Pregnancy After Loss
Rosie Phillips • July 25, 2020 • 5 min read
In the weeks after losing Olivia the gaping emptiness left within me stayed brutally apparent. Time and time again, Jonathan would ask how I was doing, and all I had to say was “I just want my baby back.” And I did. I do, I suppose, although I’m acutely aware that having her back would mean not having this baby growing away within, and I don’t want that either. I love this baby just as much as I love Olivia, neither is comparable to one another. Every life is as precious as the next.
We had decided to try again as soon as I was physically able to do so. Following the medical management, though Olivia passed from me that same day, the miscarriage itself lasted for a little over three weeks. A week later and I got my first menstrual cycle and, annoying as it was to have had only about five days without a bleed, I was grateful to my body for beginning to return to normal so soon. I have known friends who have miscarried and still been without a regular cycle six months later, only compounding their pain, denying them the chance to try again.
Though regular in length my first cycle wasn’t entirely ‘normal’ lets say, so we held little hope for a positive test, but were at least once again grateful when twenty-eight days later the next cycle began. Three weeks later and I knew it was silly, it was too soon to know, but when I first woke up I took one of the many, many cheap tests I had stockpiled ready for my impatience then brushed my teeth, certain I’d be dropping a negative in the bin in three minutes time. I finished up and looked at the test. There they were, two lines, one significantly fainter than the other, but still visible. Still clear. Pregnant again.
This time though I am experiencing pregnancy through a different lens. I am excited, I am grateful to have fallen so quickly, I am madly in love with the life growing inside me, but this isn’t the same as Harry or Olivia’s pregnancies; this is pregnancy after a loss. I don’t for one second assume I am alone in the feelings, the fears, the anxieties I am experiencing in this third pregnancy. After all, when one in four pregnancies ends in miscarriage there are plenty of other women out there in my position, and that is exactly why I want to talk about it, to write about it, to normalise the rollercoaster of emotions that comes with being pregnant again following the loss of a baby.
Pregnancy after loss, for me at least, is scary. My anxiety rolls and crashes like waves. I can be calm and confident for days or weeks and then, as quick as the turning of the tide, it’s gone and I am terrified. For me this fear manifests in obsessive behaviours. After my early pregnancy test I continued to take tests daily until I reached the point I would have missed my period. I watched the line get darker, more solid, and with it I relaxed a little. A week or so later I took a clearblue digital just to make sure that it had gone from saying 1-2 weeks to 2-3. A week later I did the same again, making sure it had gone to 3+ weeks. I knew each week this was not ‘normal’ behaviour, but it gave me some reassurance, kept my anxiety at bay a little longer. But that’s it, beyond that point it just says 3+ weeks and there’s no way of checking your hormones are increasing. There’s no need, in reality, but that’s easier said than believed when you’ve lost your much loved baby.
I took cheap pregnancy tests too, maybe once a week, all the way through to about nine weeks. I know deep down this was a fairly pointless exercise. When I lost Olivia and then developed the infection in my womb I was told to take a pregnancy test to see if all signs of the pregnancy had gone. A week and a half after the medical management of my miscarriage – a suspected three or four weeks after she had died – and I got the strongest line on a test that I had until that point in my life ever had. So in reality my continuing to take pregnancy tests was utterly pointless, but nevertheless eased my worried mind a few days.
Pregnancy after loss in my case is not rational. We booked a scan privately so that Jonathan could come with me. The idea of lying on my own whilst being scanned gave me palpitations; last time I’d been alone for a scan I watched my baby lying still upon the screen and was told what I already knew; the baby I’d seen alive, heart beating, a few weeks earlier was now dead. I could not shake the image every time I thought of my scan; despite my sickness, my tender breasts, my rapidly growing bump, I felt so sure it would happen again, and I couldn’t bare to be on my own when it did.
The scan went well, as you all know. There it was, baby number three, heart beating away happily, bigger than we had predicted. The sonographer was happy, we were happy, I was relieved. This relief lasted a week or so, as the anxious part of my brain reminded me we’d had a scan with Olivia, she was fine too. And then she was not. Maybe the baby’s heartbeat was too slow this time and the sonographer chose not to tell me? Something I recognise as highly insulting to the professionalism of the sonographer who I am sure wouldn’t do this, but then intrusive thoughts are rarely sensitive to anyone.
I don’t believe for a second any one type of miscarriage is more painful than the next. They are devastating, cruel and I feel like unless you have had one it’s hard to comprehend the magnitude of the loss. People who haven’t had one I think often judge their severity by how far along the pregnancy was which, I think, once you get into the realms of a stillbirth I would agree is likely ‘worse’ given the necessity for a full labour and the fact your baby should live at this point, regardless of what happens; there is absolutely no expectation of death like in the early weeks and it’s a pain I only hope I never know first hand, no parent should have to. But in terms of miscarriage I don’t really see it that way; pain shouldn’t be compared. Why would someone who lost their baby at six weeks not have their pain recognised in the same way mine was? My pain is not ‘worth more’ than theirs, just because I’d had scans, just because I got to hold my baby when she came out. In fact sometimes I think I would have struggled more not being able to hold my baby. I got closure from the hour I spent with her in my palm, stroking her tiny body, telling her my thoughts. The be all and end all for every miscarriage is a mother, a father, a family, has lost a much loved child. Not a six week, or twelve week, or fifteen week old fetus; they’ve lost the lifetime they planned for their child, the future they envisioned, and that’s the same for them all.
This being said, I do wonder sometimes, had I had a ‘conventional’ miscarriage, rather than a missed or silent one, would my anxiety be more manageable this time around? If I had miscarried Olivia through spontaneous bleeding then I would no doubt be worried this pregnancy, I would be checking my tissue for blood every time I went to the toilet just like I do now, but would I get comfort from the lack of blood that eased my mind? Would I get comfort from my strong symptoms, the sickness and tender breasts? Because these do not help. The lack of blood does not tell me my baby has not died. The sickness does not tell me my baby has not died. My aching breasts do not tell me my baby has not died. Because I had all these things last time. They remained, as my baby passed and beyond, and now it seems my anxious mind is adamant I will not trust my body to complete the task at hand.
Pregnancy after loss is exciting. Pregnancy after loss is a blessing. Pregnancy after loss is terrifying. Pregnancy after loss is taking too many pregnancy tests. Pregnancy after loss is irrational thoughts. Pregnancy after loss is constant photos of my stomach to compare with previous ones, desperately trying to make sure it isn’t shrinking. Pregnancy after loss is inspecting the tissue for blood every time I wipe. Pregnancy after loss is what feels like agonisingly long waits between scans.
Pregnancy after loss is, importantly, not a replacement for the lost baby. Our new baby is loved and wanted on its own. Our new baby does not negate our grief for Olivia, nor does it replace her. A person is not replaceable. But that does not mean we are not overjoyed at the impending arrival of baby number three. It is a conflicting feeling, as I said previously, knowing without the grief for Olivia this baby would not exist. But we know she is not coming back, and so at this point I do not wish for her back anymore, but wish instead for her to always be remembered. She will always be part of our family, and a new baby does not change that fact. I can only wish, and hope, that this baby remains safe in my womb and then, when it’s fully grown, I can deliver it safely into my arms. Our third baby will always be our third baby. Not our second. Harry will always have at least two younger siblings. Olivia, and baby number three, are as real as Harry, regardless of how long they live. As the Skin Horse in the Velveteen Rabbit so aptly put it, “once you are real, you can’t become unreal again. It lasts for always.”
***
This article was originally published on Rosie’s personal blog, Words for Olivia.
About the Author
Rosie is 28 and lives in Oxford with her husband, son Harry and their dog, Nigel. She is mother to three children, Harry who is now three, Olivia who they sadly lost in March of this year and their third baby who she is busy growing. Rosie has a degree in English Literature and Creative Writing and has always enjoyed writing. Since losing Olivia, Rosie has found it incredibly therapeutic to write and talk about the reality of miscarriage in the hope of supporting other women who have experienced the same thing.
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Everything you Need to Know About Hypnobirthing
* Jasmine Collin from [Love Parenting UAE](https://www.loveparentinguae.com/), Nabta Health’s hypnotherapy partner, takes us through her guide to all things Hypnobirthing. * Learn how Hypnobirthing supports natural birth, reducing pain and creating an optimal environment during labour. * Nabta’s aim to empower women to reach their health goals as naturally as possible is very much in line with Jasmine’s approach and the benefits of hypnotherapy in labour. * Book Jasmine’s popular online Hypnobirthing course [here.](https://nabtahealth.com/product/the-love-birthing-hypnobirthing-course/) You may have heard of hypnobirthing due to its increasing popularity with expecting parents and [celebrities such as Jessica Alba and Angelina Jolie.](https://www.madeformums.com/pregnancy/celebrity-mums-who-used-hypnotherapy-in-labour/) It’s even been suggested that royal family members, Kate Middleton and Meghan Markle used it to prepare for their births – but what exactly is it and why are so many women turning to Hypnobirthing? **What is Hypnobirthing?** Hypnobirthing is a childbirth preparation method taken as a set of weekly classes either in groups or privately, any time between 20-35 weeks of pregnancy. There are lots of styles of Hypnobirthing available today but they all originate from the Mongan Method, which is over 30 years old. There are also online Hypnobirthing classes available too There are a lot of [misconceptions as to what Hypnobirthing](https://www.loveparentinguae.com/single-post/2019/10/07/why-there-is-no-such-thing-as-a-hypnobirth) is and the type of person who chooses it. Many think it’s just for hippy types wanting a home or [water birth](https://nabtahealth.com/glossary/water-birth/) or those seemingly crazy women who want to do it without pain relief, but the truth is, all women can use it to have a calmer more positive birth experience, no matter what birth they choose or what path it takes. **What is the aim of Hypnobirthing?** One of the aims of Hypnobirthing is to support and increase the likelihood of physiological birth with the least amount of chemicals and interventions wherever possible. However if drugs or medical interventions are truly needed it enables the couple to remain calm and make informed evidence based decisions for themselves and their baby. #### **What are the benefits of natural physiological birth?** Studies have shown us that women and babies who have natural physiological births benefit from better health outcomes, adjustment to life outside the womb, emotional satisfaction with the birth experience and being able to cope well with the transition to motherhood. Read more about [physiological birth](http://www.birthtools.org/What-Is-Physiologic-Birth) and its benefits for families and society as a whole. Hypnobirthing promotes births that mirror nature as closely as possible so that babies and families can get off to the best start possible. #### **What if natural birth is not possible?** Unfortunately, natural physiological birth is not always possible in our current birth culture. There are a large number of influencing factors that we can’t control and birth can be quite unpredictable. So it’s important to acknowledge the wide range of birthing styles, combinations of drugs, interventions and different experiences that can happen, so we can fully prepare couples for all eventualities. The great news is that the knowledge and techniques learnt in Hypnobirthing classes are applicable in all situations and in all types of birth. In fact the tools can be even more useful in assisted births like C- sections, epidurals and inductions etc. because they keep the mother and baby calm during potentially more stressful events. #### **Real Hypnobirthing stories** Here are a few birth stories from parents who had all types of birthing experiences and how Hypnobirthing helped them through. [The induction for](https://babyandchild.ae/uae-birth-guide/article/1523/labour-was-more-powerful-and-beautiful-than-i-could-have-imagined) [gestational diabetes](https://nabtahealth.com/glossary/gestational-diabetes/) one [The induction and low](https://www.jasminecollin.com/single-post/2019/05/06/Taylors-Birth---A-calm-positive-tale-of-thrombocytopenia-induction-low-fluid-and-more) [amniotic fluid](https://nabtahealth.com/glossary/amniotic-fluid/) one [The planned gentle C-section one](https://www.jasminecollin.com/single-post/2017/04/16/Hanis-Birth---A-Family-Centred-Cesarean) [The one with no progress](https://www.jasminecollin.com/single-post/2017/05/04/Charleys-Birth) [The big baby one](https://babyandchild.ae/uae-birth-guide/birth-stories/article/1372/how-hypnobirthing-helped-me-give-birth-to-my-5kg-baby-drug-free) [The unplanned C-section one](https://www.jasminecollin.com/single-post/2015/05/10/10-Healthy-Foods-That-Calm-DeStress) [The VBA2C (Vaginal Birth after 2 C sections) one](https://www.jasminecollin.com/single-post/2017/04/23/Marsels-Birth---A-VBA2C-Story) [The planned vaginal](https://www.jasminecollin.com/single-post/2017/08/13/Phoenix-Willows-Breech-Birth) [breech](https://nabtahealth.com/glossary/breech/) one [The unplanned vaginal](https://www.jasminecollin.com/single-post/2017/01/26/Georges-Breech-Birth) [breech](https://nabtahealth.com/glossary/breech/) one As you can read in the birth stories, Hypnobirthing can benefit mothers and babies in all situations – but it’s not just them that benefit. Let’s not forget the partners. These days’ partners are not just welcome in the delivery room; they are expected to support the mother during labour and birth. However, without adequate training this can throw them into an environment and situation that they are not adequately prepared for. In Hypnobirthing classes partners gain invaluable knowledge and skills that they can apply in the birthing room to ensure a positive birth experience for the mother, baby and themselves. And the benefits don’t just stop in the birthing room. Lots of couples continue to use the tools for relaxing the mind and body long after the birth is over. Read- [7 surprising reasons to do Hypnobirthing that have nothing to do with birth](http://www.loveparentinguae.com/single-post/2017/08/02/7-Surprising-Reasons-To-Do-Hypnobirthing-Classes-That-Have-Nothing-To-Do-With-Birth) #### **So how does Hypnobirthing work exactly?** **During pregnancy** It empowers couples with the knowledge and belief that women’s bodies are designed to grow and birth their babies and that childbirth is a natural physiological process. It promotes healthy nutrition and physical exercise in pregnancy as being key factors in having a safe and easier birth as well sharing top tips on how to get the baby into the optimal position for birthing. Like any big physical event such as running a marathon or climbing a mountain, it’s not just physical preparation that makes the difference. Yes, physical fitness plays a big part, but a positive mindset and being emotional fit is just as important, and this is where Hypnobirthing comes in. Hypnobirthing de-hypnotises couples from all the negative information and fear that they’ve been conditioned with all their lives and updates their mindset through guided visualisations, affirmations and fear release work, all while they are very deeply relaxed or ‘in hypnosis’. Being in a natural state of hypnosis, promotes deep relaxation and being open to suggestion, so during pregnancy we can give the mind set an upgrade by accessing the sub conscious mind and reprograming it with more positive beliefs, thoughts and feelings about birth. When pregnant woman are calm and feel fully supported, their babies, who are literally swimming in their emotions, also feel the benefits. During classes there is also a focus on pre birth family bonding and this helps couples to adjust to their new roles and embrace early parenthood more easily. #### **Hypnobirthing during labour & birth** When a woman goes into labour with less fear and more understanding of how her body works and what it’s doing at each stage she can accept it more easily and experience it in a more positive way. When she relaxes and welcomes the sensations, rather than fighting them, they can then become easier to manage. Practically speaking Hypnobirthing teaches couples how to maximize the normal physiological birth process by creating the optimal environment for birth. Humans are biologically programmed in the same way that all mammals are and our birth environment needs are very similar. All mammals birth more easily in safe, warm, dark, private, quiet and undisturbed settings where there is no rush and no feeling of being watched or observed. In this ideal setting the perfect and natural combination of birthing hormones can be released and labour can progress. If however there is any sense of a potential threat or disturbance, our fight or flight response can release hormones that will slow or even stop labour. Even a bright light or a cold room is enough to slow down labour. It’s not always possible to control the external environment though, for example when driving to the hospital or in a typical hospital room, where it’s normally bright, busy and rushed, with lots of observation, disturbances and possible fear triggers. Hypnobirthing skills are crucial in these less than optimal settings because they enable the mother to create a calm and resourceful internal mental state. Using her practiced breathing, visualisations, affirmations and hypnosis she can bring her body and mind into a deep state of relaxation as if she were in the ideal environment. The body cannot tell the difference between real and imagined, so she can use this mind-body hack to convince her body that it’s a safe space and a good time to be birthing her baby. The body then continues releasing the perfect cocktail of hormones for a quicker, easier and more natural birth. #### But what about the pain? A birthing mother automatically reduces pain by being calmer and less frightened of the birth, and in calm, safe settings the birthing body naturally produces [endorphins](https://nabtahealth.com/glossary/endorphins/), our own natural pain relief, to help us cope with the intense physical sensations. In addition, Hypnobirthing mums can use hypnosis to disrupt and change the way that their brain processes pain signals. They also learn mental coping strategies and physical comfort tools to deal with any discomfort that they feel. All these factors make it less likely that they will need pain relieving drugs or unnecessary interventions and they tend to have more straightforward and quicker labours. Of course if a woman is struggling then there is a selection of pain relieving drugs that the hospital can offer. The aim of Hypnobirthing however is to ensure the couple have a complete toolbox of skills and techniques that they can utilize before getting to that point, so that it can be delayed or avoided all together. But, no matter how a baby is born or whatever interventions or drugs are used, the most important elements for every birthing mother are that: * She feels calm, safe, and supported throughout. * She feels that she did her best and gave it all she had. * She feels treated with dignity and respect. * And she was able to make her own informed choices about her baby, body and birth, every step of the way. These are the key ingredients to a positive birth experience and what Hypnobirthing is all about. Surely every mother and her family deserves this birth experience…not just the hippies. \_\_\_\_\_ Jasmine Collin is a mother of two, a qualified Hypnotherapist, NLP Practitioner, Childbirth Educator and Doula who specialises in Hypnobirthing and Parenting Originally from the UK she is the longest running teacher in the UAE and has been teaching her award winning ‘Love Birthing’ classes since 2009. She is the co founder of Love Parenting UAE, winner of the 2018 Time Out Kids Award for ‘Special recognition for pre and post natal care’ and is dedicated to helping couples have calmer, more positive births so that they can ‘Love Birthing’ no matter what kind of birth they choose or what path birth takes. For more information contact: [\[email protected\]](/cdn-cgi/l/email-protection) You can book Jasmine’s popular online Hypnobirthing services on the [Nabta Women’s Health Shop.](https://nabtahealth.com/product/the-love-birthing-hypnobirthing-course/) \_\_\_ Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [](https://nabtahealth.com/glossary)[menopause](https://nabtahealth.com/glossary/menopause/). You can track your menstrual cycle and get [personalised support by using the Nabta app.](https://nabtahealth.com/our-platform/nabta-app/) Get in [touch](/cdn-cgi/l/email-protection#acd5cdc0c0cdecc2cdced8cdc4c9cdc0d8c482cfc3c1) if you have any questions about this article or any aspect of women’s health. We’re here for you.
Stillbirth – Knowing the Risks and Warning Signs
* [Stillbirth](https://nabtahealth.com/glossary/stillbirth/) is the loss of a baby in the womb after 24 weeks of pregnancy. * Every year there are an estimated 2.6 million stillbirths worldwide. * One third of stillbirths are unexplained. Around a quarter are caused by birth defects. Other risk factors include higher age, drug use and multiples. * Early warning signs of [stillbirth](https://nabtahealth.com/glossary/stillbirth/) include change the baby’s movements, bleeding, itching, fever and headaches. One [stillbirth](https://nabtahealth.com/glossary/stillbirth/) tragically occurs every 16 seconds according to the [World Health Organisation (WHO)](https://www.who.int/health-topics/stillbirth#tab=tab_3). The [National Institutes of Health (NIH)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5139804/) acknowledges that there is no universally accepted definition for when a fetal death is called a [stillbirth](https://nabtahealth.com/glossary/stillbirth/). Rather than a [miscarriage](https://nabtahealth.com/glossary/miscarriage/) and the interpretation of gestational age differs by country. What causes [stillbirth](https://nabtahealth.com/glossary/stillbirth/)? ----------------------------------------------------------------------- [Around one third of stillbirths are unexplained](https://my.clevelandclinic.org/health/diseases/9685-stillbirth). According to the Centers for Disease Control and Prevention (CDC) [](https://www.cdc.gov/ncbddd/stillbirth/facts.html)[stillbirth](https://nabtahealth.com/glossary/stillbirth/) can happen to women of any age, background or ethnicity. The CDC goes on to say that the loss of a baby due to [stillbirth](https://nabtahealth.com/glossary/stillbirth/) occurs more commonly among: * Women with a higher maternal age; * Women who smoke or use recreational drugs during pregnancy; * Black women; * Women of a low [socioeconomic](https://nabtahealth.com/glossary/socioeconomic/) status; * Women who are pregnant with multiples (twins, triplets and quadruplets); and, * Women who have had a previous pregnancy loss. Blood-clotting disorders and chronic diseases (diabetes, heart disease, [lupus](https://nabtahealth.com/glossary/lupus/), obesity and thyroid disease) are also linked with increased risk of [stillbirth](https://nabtahealth.com/glossary/stillbirth/). As are complications with the [placenta](https://nabtahealth.com/glossary/placenta/) and [umbilical cord](https://nabtahealth.com/glossary/umbilical-cord/), maternal infections (group B streptococcus, [malaria](https://nabtahealth.com/glossary/malaria/), [HIV](https://nabtahealth.com/glossary/hiv/) and some STDs) and physical trauma. ##### Research says; [The Cleveland Clinic](https://my.clevelandclinic.org/health/diseases/9685-stillbirth) says birth defects are the cause of around 25% of stillbirths. While Tommy’s says that [failure of the](https://www.tommys.org/baby-loss-support/stillbirth-information-and-support/causes-stillbirth) [placenta](https://nabtahealth.com/glossary/placenta/) is the most common known reason for a baby to be stillborn. Half of all stillbirths linked to complications with the [placenta](https://nabtahealth.com/glossary/placenta/). The risk of the [placenta](https://nabtahealth.com/glossary/placenta/) calcifying increases when the baby reaches [full term](https://nabtahealth.com/glossary/full-term/). Over half of all placentas will experience some degree of calcification at [full term](https://nabtahealth.com/glossary/full-term/). Placental calcification preterm ranges wildly – from 3.8 to 23.7 percent – based on the risk factors listed above. What are the warning signs of [stillbirth](https://nabtahealth.com/glossary/stillbirth/)? ----------------------------------------------------------------------------------------- [Stillbirth](https://nabtahealth.com/glossary/stillbirth/) can occur without any obvious indicators but there are some signs to look for. If you experience any of the below symptoms during your pregnancy you should contact your medical team immediately. * **Change in baby’s movements**: Most women will start to feel the flutterings of their baby moving anywhere from 16 weeks onwards. By around 24 weeks the baby’s movements will be becoming more regular. [UK charity Tommy’s](https://www.tommys.org/baby-loss-support/stillbirth-information-and-support/stillbirth-symptoms-and-risks) recommends that you learn to recognise your baby’s pattern of movements in the womb. Some women notice that their baby seems more active in the evenings. This is when they sit down and put their feet up or in response to the music beat during an exercise class. Others find their baby’s kicks increase when they eat spicy foods or drink a large glass of cold juice. The important point here is that if you notice any change in your baby’s movements – if the kicks suddenly seem less frequent or not as strong as usual – you should contact your doctor immediately. As this may be a sign that your baby is not getting enough oxygen or nutrients. * **Vaginal spotting or bleeding and cramping:** This could be the sign of placental abruption, [a serious condition in which the](https://www.marchofdimes.org/complications/placental-abruption.aspx) [placenta](https://nabtahealth.com/glossary/placenta/) separates from the wall of the [uterus](https://nabtahealth.com/glossary/uterus/) before birth. * **Vaginal discharge or fluid leaking from the [vagina](https://nabtahealth.com/glossary/vagina/)**: Discharge could be linked with an intrauterine infection or infection in the womb. Leaking fluid could be your waters breaking early. * **Feeling something in your [vagina](https://nabtahealth.com/glossary/vagina/) during pregnancy:** This might be the sign of an [umbilical cord](https://nabtahealth.com/glossary/umbilical-cord/) prolapse which would mean your baby isn’t getting enough oxygen. * **Itching:** Severe itching on your palms and soles of your feet may be a sign of Intrahepatic Cholestasis of Pregnancy (IHP). It is a pregnancy-related liver condition that can [lead](https://nabtahealth.com/glossary/lead/) to [stillbirth](https://nabtahealth.com/glossary/stillbirth/). Also called obstetric cholestasis you should report any itching to your physician. * **Fever:** Some infections during pregnancy can be dangerous for an unborn baby. * **Headaches, blurred vision or swelling:** These can be [symptoms of](https://nabtahealth.com/articles/what-is-preeclampsia/) [preeclampsia](https://nabtahealth.com/glossary/preeclampsia/) which can [lead](https://nabtahealth.com/glossary/lead/) to loss of pregnancy in the womb. Your medical team will monitor your symptoms including carrying out an ultrasound to check your baby and using a [doppler ultrasound](https://nabtahealth.com/glossary/doppler-ultrasound/) to measure the fetal heart rate. It is important that you attend all your routine antenatal tests and scans and report any concerns or unusual symptoms you have. However slight you feel they may be, as soon as you notice them. Getting the support you need after [stillbirth](https://nabtahealth.com/glossary/stillbirth/) --------------------------------------------------------------------------------------------- Losing a baby at any stage is devastating and it is important that you, your partner and family get the physical and emotional support you need. Your [healthcare team](https://nabtahealth.com/team/) will be able to advise on the local support networks and dedicated charities there to support you. — Nabta is reshaping [women’s healthcare](https://nabtahealth.com/). We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [](https://nabtahealth.com/glossary)[menopause](https://nabtahealth.com/glossary/menopause/). You can track your symptoms and get [personalised support by using the Nabta app.](https://nabtahealth.com/our-platform/nabta-app/) Get in [touch](/cdn-cgi/l/email-protection#740d15181815341a151600151c111518001c5a171b19) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources** “[Stillbirth](https://nabtahealth.com/glossary/stillbirth/)” The Cleveland Clinic https://my.clevelandclinic.org/health/diseases/9685-[stillbirth](https://nabtahealth.com/glossary/stillbirth/) “[Stillbirth](https://nabtahealth.com/glossary/stillbirth/)” WHO, [https://www.who.int/health-topics/](https://www.who.int/health-topics/stillbirth#tab=tab_3)[stillbirth](https://nabtahealth.com/glossary/stillbirth/)#tab=tab\_3 Tavares da Silva, F, “[Stillbirth](https://nabtahealth.com/glossary/stillbirth/): Case definition and guidelines for data collection, analysis, and presentation of maternal immunization safety data” Dec 2016, Vaccine, [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5139804/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5139804/) “What is [Stillbirth](https://nabtahealth.com/glossary/stillbirth/)” CDC https://www.cdc.gov/ncbddd/[stillbirth](https://nabtahealth.com/glossary/stillbirth/)/facts.html “Causes of [Stillbirth](https://nabtahealth.com/glossary/stillbirth/)” Tommy’s, https://www.tommys.org/baby-loss-support/[stillbirth](https://nabtahealth.com/glossary/stillbirth/)\-information-and-support/causes-[stillbirth](https://nabtahealth.com/glossary/stillbirth/)
Does Having PCOS Increase my Chance of Miscarriage?
Polycystic ovary syndrome ([PCOS](https://nabtahealth.com/glossary/pcos/)) is a common hormonal disorder that can affect a woman’s ability to get pregnant. While having [PCOS](https://nabtahealth.com/glossary/pcos/) does not necessarily increase a woman’s chance of [miscarriage](https://nabtahealth.com/glossary/miscarriage/), it can make it more difficult for her to conceive and can also increase her risk of other pregnancy complications. [PCOS](https://nabtahealth.com/glossary/pcos/) is a condition in which the [ovaries](https://nabtahealth.com/glossary/ovaries/) produce an excess of male hormones, which can interfere with the development of eggs and make it more difficult for the eggs to be released from the [ovaries](https://nabtahealth.com/glossary/ovaries/). This can make it more difficult for a woman with [PCOS](https://nabtahealth.com/glossary/pcos/) to get pregnant. * There is a known link between [PCOS](https://nabtahealth.com/glossary/pcos/) and [miscarriage](https://nabtahealth.com/glossary/miscarriage/), but there is not enough data on this topic. * There is no solid evidence that any drugs can mitigate the risk of [miscarriage](https://nabtahealth.com/glossary/miscarriage/). * Choosing a healthy lifestyle is one of the key ways you can increase your chances of staying pregnant and preventing [miscarriage](https://nabtahealth.com/glossary/miscarriage/). A link between [PCOS](https://nabtahealth.com/glossary/pcos/) and [miscarriage](https://nabtahealth.com/glossary/miscarriage/) was first described in the late 1980s and yet, despite this, in the past 30 years very little progress has been made. We are still not sure why women with [PCOS](https://nabtahealth.com/glossary/pcos/) are at greater risk of miscarrying and, perhaps more importantly for those affected, we are no closer to finding a solution. It almost goes without saying that this is an area of research that desperately needs more attention and resources. Here we explore the limited data available, discuss why the need for answers is getting greater, and suggest what you can do to maximise your chances of falling pregnant and staying pregnant. You can track your pregnancy free of charge [using the Nabta App](https://nabtahealth.com/our-platform/nabta-app/). **What does the data suggest about [PCOS](https://nabtahealth.com/glossary/pcos/) and [Miscarriage](https://nabtahealth.com/glossary/miscarriage/)?** ----------------------------------------------------------------------------------------------------------------------------------------------------- Women with [PCOS](https://nabtahealth.com/glossary/pcos/) often struggle to conceive; in fact, the condition is considered to be one of the [leading causes of](https://nabtahealth.com/causes-of-female-infertility-failure-to-ovulate/) [infertility](https://nabtahealth.com/glossary/infertility/) in females. The problem is that once pregnant, those women with [PCOS](https://nabtahealth.com/glossary/pcos/) are also at increased risk of going through the trauma of one, or even multiple, [miscarriages](https://nabtahealth.com/miscarriage-101/). Women with [PCOS](https://nabtahealth.com/glossary/pcos/) are three times more likely to miscarry than those without [PCOS](https://nabtahealth.com/glossary/pcos/). There is some evidence that women who suffer recurrent miscarriages are more likely to have [polycystic](https://nabtahealth.com/do-polycystic-ovaries-equal-pcos/) [ovaries](https://nabtahealth.com/glossary/ovaries/), but no proof that this abnormal ovarian morphology is causing pregnancy loss. There is also very little data to support the idea that increased levels of luteinising hormone or [testosterone](https://nabtahealth.com/glossary/testosterone/) are implicated in [miscarriage](https://nabtahealth.com/glossary/miscarriage/). One of the biggest issues with the work that has been completed to date is that many of the studies rely on retrospective evidence. The accuracy and reproducibility of the results is dependent on participant recollection. As a result, many of the large scale reviews have deemed the evidence that is currently available to be of low quality and inconclusive. Also, the variation in the criteria used to define [PCOS](https://nabtahealth.com/glossary/pcos/) before the Rotterdam criteria became the [gold](https://nabtahealth.com/glossary/gold/) standard in 2003, led to some inconsistencies in the association between [PCOS](https://nabtahealth.com/glossary/pcos/) and miscarriages. **Why does the association between [PCOS](https://nabtahealth.com/glossary/pcos/) and [miscarriage](https://nabtahealth.com/glossary/miscarriage/) urgently require further work?** ----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- [](https://nabtahealth.com/what-is-pcos/)[PCOS](https://nabtahealth.com/glossary/pcos/) is a medical condition that is not going to disappear any time soon. In fact, the percentage of women affected by it is likely to increase over the coming years. [PCOS](https://nabtahealth.com/glossary/pcos/) is [strongly associated with obesity and](https://nabtahealth.com/treating-the-associated-symptoms-of-pcos/) [insulin resistance](https://nabtahealth.com/glossary/insulin-resistance/); and, whilst these two conditions are increasing in prevalence across the developed world, an unfortunate consequence of this will be that more women will find themselves facing the realities of a [](https://nabtahealth.com/problems-with-traditional-diagnosis-of-pcos/)[PCOS](https://nabtahealth.com/glossary/pcos/) diagnosis. We know that women with [PCOS](https://nabtahealth.com/glossary/pcos/) who do conceive are at risk of further pregnancy complications, including [](https://nabtahealth.com/gestational-diabetes-8-things-you-should-know/)[gestational diabetes](https://nabtahealth.com/glossary/gestational-diabetes/), [](https://nabtahealth.com/what-is-preeclampsia/)[preeclampsia](https://nabtahealth.com/glossary/preeclampsia/) and premature delivery. This is financially costly, placing an increasing burden on healthcare systems across the world; but it is also emotionally draining for those couples who have to go through it. Experiencing a [miscarriage](https://nabtahealth.com/glossary/miscarriage/) can be a devastating experience. There can never be a right or wrong way of coping with and managing your loss. However, for many women, closure, or acceptance, is possible once they understand why something has happened. We need to improve our knowledge on [](https://nabtahealth.com/pcos-and-pregnancy/)[PCOS](https://nabtahealth.com/glossary/pcos/) and pregnancy; we need to better understand why [PCOS](https://nabtahealth.com/glossary/pcos/) increases the risk of [miscarriage](https://nabtahealth.com/glossary/miscarriage/); and, perhaps above all, we need to give those women who have experienced a loss, answers. **What can you do to manage your risk of miscarrying and increase your chances of a healthy pregnancy?** -------------------------------------------------------------------------------------------------------- As already discussed, there is significant work to be done to support the risk of [PCOS](https://nabtahealth.com/glossary/pcos/) and [miscarriage](https://nabtahealth.com/glossary/miscarriage/). Some reports have suggested that [ovulation](https://nabtahealth.com/glossary/ovulation/) induction agents, such as clomiphene citrate and [metformin](https://nabtahealth.com/i-have-pcos-should-i-take-metformin/), might improve live birth rates. In fact, metformin is not strictly an [ovulation](https://nabtahealth.com/glossary/ovulation/) inducer, it is used to treat [insulin resistance](https://nabtahealth.com/glossary/insulin-resistance/), and has, therefore, been used ‘off-label’ to manage some of the symptoms of [PCOS](https://nabtahealth.com/glossary/pcos/). There is limited evidence that it improves [ovulation](https://nabtahealth.com/glossary/ovulation/) rates. There is no solid evidence that either of these drugs reduce the risk of [miscarriage](https://nabtahealth.com/glossary/miscarriage/) and the data across different studies remains conflicting. Whilst this may all be sounding a little depressing, there is one key thing that should be remembered; [many of the symptoms of](https://nabtahealth.com/is-it-possible-to-reverse-pcos/) [PCOS](https://nabtahealth.com/glossary/pcos/) can be alleviated by making healthy lifestyle decisions. Losing weight, exercising more, making considered choices with regards to your [diet](https://nabtahealth.com/eating-to-conceive/), these are all things that can help to improve menstrual cycle regularity. This in turn, increases your chances of getting, and staying, pregnant. Nabta is reshaping women’s healthcare. We support women with their personal health journeys, from everyday wellbeing to the uniquely female experiences of fertility, pregnancy, and [menopause](https://nabtahealth.com/glossary/menopause/). Get in [touch](/cdn-cgi/l/email-protection#354c54595954755b545741545d505459415d1b565a58) if you have any questions about this article or any aspect of women’s health. We’re here for you. **Sources:** * Cocksedge Karen, et al., “How common is polycystic ovary syndrome in recurrent [miscarriage](https://nabtahealth.com/glossary/miscarriage/)?” _Reproductive Biomedicine Online_, 2009 Oct;19(4):572-6. doi: 10.1016/j.rbmo.2009.06.003. PMID: 19909600. * “Does [PCOS](https://nabtahealth.com/glossary/pcos/) Affect Pregnancy?” _Eunice Kennedy Shriver National Institute of Child Health and Human Development_, U.S. Department of Health and Human Services, [www.nichd.nih.gov/health/topics/](http://www.nichd.nih.gov/health/topics/pcos/more_information/FAQs/pregnancy)[pcos](https://nabtahealth.com/glossary/pcos/)/more\_information/FAQs/pregnancy. * Kaur, R and Gupta, K. “Endocrine Dysfunction and Recurrent Spontaneous Abortion: An Overview.” _International Journal of Applied and Basic Medical Research_, vol. 6, no. 2, 2016, pp. 79–83., doi:10.4103/2229-516x.179024. * Legro, Richard S., et al. “Clomiphene, Metformin, or Both for [Infertility](https://nabtahealth.com/glossary/infertility/) in the Polycystic Ovary Syndrome.” _New England Journal of Medicine_, vol. 356, no. 6, 8 Feb. 2007, pp. 551–566., doi:10.1056/nejmoa063971. * Mills, Ginevra, et al. “Associations between Polycystic Ovary Syndrome and Adverse Obstetric and [Neonatal](https://nabtahealth.com/glossary/neonatal/) Outcomes: a Population Study of 9.1 Million Births.” _Human Reproduction_, vol. 35, no. 8, 9 July 2020, pp. 1914–1921., doi:10.1093/humrep/deaa144. * Rai, Raj, et al. “Polycystic [Ovaries](https://nabtahealth.com/glossary/ovaries/) and Recurrent [Miscarriage](https://nabtahealth.com/glossary/miscarriage/)—a Reappraisal.” _Human Reproduction_, vol. 15, no. 3, 1 Mar. 2000, pp. 612–615., doi:10.1093/humrep/15.3.612. * Sagle, M., et al. “Recurrent Early [Miscarriage](https://nabtahealth.com/glossary/miscarriage/) and Polycystic [Ovaries](https://nabtahealth.com/glossary/ovaries/).” _Bmj_, vol. 297, no. 6655, 22 Oct. 1988, pp. 1027–1028., doi:10.1136/bmj.297.6655.1027. * Sharpe, Abigail, et al. “Metformin for [Ovulation](https://nabtahealth.com/glossary/ovulation/) Induction (Excluding Gonadotrophins) in Women with Polycystic Ovary Syndrome.” _Cochrane Database of Systematic Reviews_, 17 Dec. 2019, doi:10.1002/14651858.cd013505.