Q: I recently had a miscarriage, and I’d like to know how long I should wait before trying to conceive again. What do you think caused it? — Anonymous, Orlando
A: When a miscarriage happens, we are forced to bear witness to the complexity of human life and the mystery of creation. Miscarriage is often kept private, and its frequency of occurrence (15 percent to 25 percent) is in sharp contrast to the view that “pregnancy = healthy birth.”
The why may be a simple matter of the mother’s age: Over the age of 35, the risk of chromosomal defects that are incompatible with life increases significantly. About 7 percent of all miscarriages or stillborn deaths are due to a chromosomal abnormality.
There may be a disease or infection that the mother has contributing to an unfavorable environment for a developing baby to grow and develop. Examples include severe kidney disease; uncontrolled diabetes; an underactive thyroid; autoimmune disorders like rheumatoid arthritis or lupus; or uterine infection from sexually transmitted disease like chlamydia, gonorrhea or herpes simplex virus.
If it was a first pregnancy, one cause of a miscarriage could be anti-phospholipid antibody syndrome. With this disorder, a mother is at increased risk of blood clots, especially affecting the blood vessels of the placenta.
Anatomical factors may also increase the risk of miscarriage. If the uterus is abnormally shaped or the cervix is short and weak, the mother may be unable to successfully carry a baby to term.
If the pregnancy was longer than six weeks, there are developmental hormones such as progesterone that need to return to pre-pregnancy levels. I’d recommend a resting period of at least 60 to 90 days before trying to conceive again. In most women, the emotional healing time may take a lot longer than that.
Dr. Mitchell Hecht is a physician specializing in internal medicine. Send questions to him at: “Ask Dr. H,” P.O. Box 767787, Atlanta, GA 30076. Due to the large volume of mail received, personal replies are not possible.