You were elated when the pregnancy test showed two pink lines. Now, your dreams of becoming a mother are shattered, leaving nothing but grief and a sense of emptiness.
A miscarriage is the spontaneous loss of pregnancy before the 20th week. Occurring in about one in five pregnancies, the risk increases with age. In women over 40, miscarriage occurs in more than one in two pregnancies, said Dr Nur Azleen Sidek, associate consultant with the department of obstetrics and gynaecology at National University Hospital (NUH).
Beyond the physical recovery, the emotional weight of a miscarriage – the lingering sense of pain, isolation, anxiety and grief – can feel overwhelming for the woman.
Dr Sanveen Kang, clinical psychologist and founder of Psych Connect, noted that such feelings often stem from a sense of shame, loss of purpose or a belief that their bodies have somehow let them down.
“Trying again after a miscarriage can both be a hopeful and terrifying decision. For many women, the desire to grow their family co-exists with deep anxiety, grief and fear of another loss,” Dr Kang explained.
Understanding what happens after a miscarriage can help women prepare physically and mentally for the next chapter of their fertility journey.
During a miscarriage, some women may notice a drop in nausea
“Physically, there may be more cramps and vaginal bleeding, though some women may not experience any changes,” Dr Phoon said.
After the pregnancy loss, HCG levels will gradually decline. “Women should expect their menses to return by around four to six weeks later, or even slightly longer, depending on how far along the pregnancy was,” said Dr Azleen.
There is no one-size-fits-all answer to when couples can try for pregnancy after a miscarriage. Much depends on how far along the pregnancy was, and whether the woman feels physically and emotionally ready.
While there is no strong evidence showing any benefit in delaying conception after a miscarriage, experts generally advise trying after normal menstrual cycles resume.
Doctors advise waiting until normal menstrual cycles resume to start trying to get pregnant again. (Photo: iStock/PonyWang)
Dr Phoon recommended waiting for one menstrual cycle to ensure that periods have returned to normal. “Then, the woman may start trying from the second cycle, if the miscarriage happened in the first trimester,” she said.
For miscarriages in the second trimester or later, the body needs more time to recover. “In such cases, the general advice is to wait three to six months,” Dr Phoon added.
That said, timing intercourse and tracking ovulation generally do not make a difference to pregnancy outcomes after a miscarriage, said Dr Azleen.
“If a couple has managed to conceive naturally prior to the miscarriage, they can try to do so again naturally especially if they have regular cycles.
“However, if a couple tries to conceive consistently but has difficulty doing so, they can consult a fertility specialist for further evaluation and support in trying to conceive,” she advised.
Equally important is psychological readiness. “A miscarriage is not just a physical event but also an emotional loss that can affect confidence in trying again. Couples should take the time to be both physically and mentally ready before trying,” said Dr Azleen.
One of the most common concerns after a miscarriage is whether it will recur in the next pregnancy. The reassuring news, according to Dr Phoon, is that most unexplained miscarriages occur by chance and do not recur.
However, the risk does rise with repeated miscarriages. For women who have had two miscarriages, the risk in the next pregnancy increases to about 25 per cent and increases to 30 per cent or higher, for those with three or more consecutive miscarriages, said Dr Azleen.
Factors such as the mother’s age and underlying causes also play a role. For instance, if the loss was due to an unaddressed medical disorder
Managing underlying medical conditions such as diabetes or thyroid issues can significantly improve the chances of a healthy pregnancy. (Photo: iStock/dmphoto)
If you’ve experienced recurrent miscarriages, it is helpful to seek medical advice to find out if there is a treatable cause, the doctors advised. For example, conditions such as thyroid disease, uncontrolled diabetes or autoimmune issues can play a role in some cases, and managing them can improve the chances of a healthy pregnancy.
While there is no guaranteed way to prevent a miscarriage in cases without a treatable cause, taking steps to improve overall health can optimise the chances of a healthy pregnancy. This means adopting healthy lifestyle habits, a balanced diet and managing any existing medical conditions, said NUH’s Dr Azleen.
Dr Azleen advises starting supplements like folic acid before pregnancy, as well as ensuring that vitamin D levels are adequate.
Multivitamin supplements designed for women planning for pregnancy can also help plug any micronutrient gaps they may not be aware of. These typically also contain the necessary dose of folic acid for pre-pregnancy health, added Dr Azleen.
She also recommended maintaining a healthy body mass index between 18 and 25, getting regular exercise and limiting caffeine intake to less than two cups daily. Also avoid smoking, vaping and recreational drugs. Regular sleep, good oral hygiene and reducing stress can also improve pregnancy outcomes, Dr Azleen added.
For men, a healthy lifestyle and diet are also important in optimising fertility. This includes getting sufficient sleep and rest, reducing stress, eating well, exercising regularly and maintaining a healthy BMI, said IVF clinician Dr Jessie Phoon.
To support sperm health, Dr Phoon recommends incorporating antioxidant-rich foods such as berries, kiwis, nuts, as well as oysters, which are rich in zinc, into the diet.
General men’s health supplements containing zinc, selenium, L-carnitine, L-arginine, CoQ10, vitamin E may also be considered to support sperm production and quality, said Dr Phoon.
Beyond diet, lifestyle habits matter too. Quitting smoking and limiting alcohol can improve sperm quality. Dr Nur Azleen Sidek from the National University Hospital advised optimising sperm health by wearing loose-fitting underwear and avoiding excessively hot showers and baths.
Collapse Expand
The emotional impact of a miscarriage varies greatly from one individual to the next. Even after being medically cleared to try for another pregnancy, the emotional decision is rarely a simple yes or no.
Because the loss happened early in the pregnancy, people may assume that it should hurt less. But “a loss is a loss”, Dr Kang from Psych Connect pointed out. “Its impact is shaped not by the gestational age, but by the meaning, hopes and emotional investment attached to the pregnancy.
“When we minimise the early loss, we unintentionally silence grief that is very real,” the psychologist added. Healing begins when the experience is recognised as valid and worthy of compassion, regardless of how far along the pregnancy was, she said.
A loss is a loss, even if the miscarriage happened in early pregnancy, and the grief should not be minimised. (Photo: iStock/Pen Sangraksawong)
According to Dr Kang, signs suggesting a woman might benefit from professional counselling or psychological support after miscarriage include persistent sadness, heightened anxiety or fear of another pregnancy, guilt or self-blame that does not subside.
They might also notice emotional numbness, have problems functioning at home and at work or avoid reminders of the loss. Other signs include intrusive thoughts related to the loss, strained relationships or a feeling of being “stuck” in grief.
“Even beyond these symptoms, if you simply feel hurt, stuck or alone, that is reason enough (to seek help). Therapy can help you make sense of the loss, hold space for complex emotions and begin rebuilding meaning without minimising your pain,” Dr Kang said.
Healing from the grief of a pregnancy loss is not something that can be rushed. For many, the emotional pain may linger for years – and that is normal too.
Dr Kang highlighted a misconception about grief, that it goes away or lessens but that is not true. “What changes is us,” she said. “Healing happens when our life and experience expand around (the loss), not when grief disappears. We gain new experiences, perspectives and meaning that help us carry the loss with greater strength.”
“Only you can decide when or if you are ready to try again, or if you want to try at all,” said Dr Kang.
Therapy may be useful in helping a couple work through guilt, shame or self-blame after a miscarriage. (Photo: iStock/FatCamera)
She shares the following tips on how to navigate the emotional ups and downs when trying again after a pregnancy loss.
Practices such as journalling or guided reflection can help women reconnect with a sense of purpose and inner strength.
Therapy can also help the couple work through deeper emotional conflicts, such as feelings of guilt, shame or self-blame even when the woman logically knows the loss was not her fault, said Dr Kang.
The clinical psychologist also emphasised the importance of addressing thoughts and fears like “what if I lose this one too?” or “I cannot go through that pain again”.
Gently challenge and reframe these thoughts into more balanced, compassionate inner self-talk, such as “This pregnancy is a new experience”, or “I have support and tools to help me through whatever happens”.
“Most importantly, women need to know they don’t have to do this alone. Reach out to a therapist, partner, support group or friend, and naming what you need rather than carrying it in silence,” said Dr Kang.
Support groups providing space for those navigating pregnancy loss include: Fertility Support SG, Child Bereavement Support (Singapore), Grief Program Support Group by Angel Hearts and the Pregnancy and Infant Loss Support Group Singapore Facebook page.
CNA Women is a section on CNA Lifestyle that seeks to inform, empower and inspire the modern woman. If you have women-related news, issues and ideas to share with us, email CNAWomen [at] mediacorp.com.sg.
Continue reading...
A miscarriage is the spontaneous loss of pregnancy before the 20th week. Occurring in about one in five pregnancies, the risk increases with age. In women over 40, miscarriage occurs in more than one in two pregnancies, said Dr Nur Azleen Sidek, associate consultant with the department of obstetrics and gynaecology at National University Hospital (NUH).
Beyond the physical recovery, the emotional weight of a miscarriage – the lingering sense of pain, isolation, anxiety and grief – can feel overwhelming for the woman.
Dr Sanveen Kang, clinical psychologist and founder of Psych Connect, noted that such feelings often stem from a sense of shame, loss of purpose or a belief that their bodies have somehow let them down.
“Trying again after a miscarriage can both be a hopeful and terrifying decision. For many women, the desire to grow their family co-exists with deep anxiety, grief and fear of another loss,” Dr Kang explained.
Understanding what happens after a miscarriage can help women prepare physically and mentally for the next chapter of their fertility journey.
WHAT HAPPENS TO THE BODY AFTER A MISCARRIAGE?
During a miscarriage, some women may notice a drop in nausea
“Physically, there may be more cramps and vaginal bleeding, though some women may not experience any changes,” Dr Phoon said.
After the pregnancy loss, HCG levels will gradually decline. “Women should expect their menses to return by around four to six weeks later, or even slightly longer, depending on how far along the pregnancy was,” said Dr Azleen.
WHEN TO TRY TO GET PREGNANT AGAIN?
There is no one-size-fits-all answer to when couples can try for pregnancy after a miscarriage. Much depends on how far along the pregnancy was, and whether the woman feels physically and emotionally ready.
While there is no strong evidence showing any benefit in delaying conception after a miscarriage, experts generally advise trying after normal menstrual cycles resume.
Doctors advise waiting until normal menstrual cycles resume to start trying to get pregnant again. (Photo: iStock/PonyWang)
Dr Phoon recommended waiting for one menstrual cycle to ensure that periods have returned to normal. “Then, the woman may start trying from the second cycle, if the miscarriage happened in the first trimester,” she said.
For miscarriages in the second trimester or later, the body needs more time to recover. “In such cases, the general advice is to wait three to six months,” Dr Phoon added.
That said, timing intercourse and tracking ovulation generally do not make a difference to pregnancy outcomes after a miscarriage, said Dr Azleen.
“If a couple has managed to conceive naturally prior to the miscarriage, they can try to do so again naturally especially if they have regular cycles.
“However, if a couple tries to conceive consistently but has difficulty doing so, they can consult a fertility specialist for further evaluation and support in trying to conceive,” she advised.
Equally important is psychological readiness. “A miscarriage is not just a physical event but also an emotional loss that can affect confidence in trying again. Couples should take the time to be both physically and mentally ready before trying,” said Dr Azleen.
WILL A MISCARRIAGE HAPPEN AGAIN?
One of the most common concerns after a miscarriage is whether it will recur in the next pregnancy. The reassuring news, according to Dr Phoon, is that most unexplained miscarriages occur by chance and do not recur.
However, the risk does rise with repeated miscarriages. For women who have had two miscarriages, the risk in the next pregnancy increases to about 25 per cent and increases to 30 per cent or higher, for those with three or more consecutive miscarriages, said Dr Azleen.
Factors such as the mother’s age and underlying causes also play a role. For instance, if the loss was due to an unaddressed medical disorder
Managing underlying medical conditions such as diabetes or thyroid issues can significantly improve the chances of a healthy pregnancy. (Photo: iStock/dmphoto)
If you’ve experienced recurrent miscarriages, it is helpful to seek medical advice to find out if there is a treatable cause, the doctors advised. For example, conditions such as thyroid disease, uncontrolled diabetes or autoimmune issues can play a role in some cases, and managing them can improve the chances of a healthy pregnancy.
PREPARING YOUR BODY FOR THE NEXT PREGNANCY
While there is no guaranteed way to prevent a miscarriage in cases without a treatable cause, taking steps to improve overall health can optimise the chances of a healthy pregnancy. This means adopting healthy lifestyle habits, a balanced diet and managing any existing medical conditions, said NUH’s Dr Azleen.
Dr Azleen advises starting supplements like folic acid before pregnancy, as well as ensuring that vitamin D levels are adequate.
Multivitamin supplements designed for women planning for pregnancy can also help plug any micronutrient gaps they may not be aware of. These typically also contain the necessary dose of folic acid for pre-pregnancy health, added Dr Azleen.
She also recommended maintaining a healthy body mass index between 18 and 25, getting regular exercise and limiting caffeine intake to less than two cups daily. Also avoid smoking, vaping and recreational drugs. Regular sleep, good oral hygiene and reducing stress can also improve pregnancy outcomes, Dr Azleen added.
YOUR OTHER HALF: TIPS TO BOOST MALE FERTILITY
For men, a healthy lifestyle and diet are also important in optimising fertility. This includes getting sufficient sleep and rest, reducing stress, eating well, exercising regularly and maintaining a healthy BMI, said IVF clinician Dr Jessie Phoon.
To support sperm health, Dr Phoon recommends incorporating antioxidant-rich foods such as berries, kiwis, nuts, as well as oysters, which are rich in zinc, into the diet.
General men’s health supplements containing zinc, selenium, L-carnitine, L-arginine, CoQ10, vitamin E may also be considered to support sperm production and quality, said Dr Phoon.
Beyond diet, lifestyle habits matter too. Quitting smoking and limiting alcohol can improve sperm quality. Dr Nur Azleen Sidek from the National University Hospital advised optimising sperm health by wearing loose-fitting underwear and avoiding excessively hot showers and baths.
Collapse Expand
SIGNS YOU MAY NEED MORE TIME EMOTIONALLY
The emotional impact of a miscarriage varies greatly from one individual to the next. Even after being medically cleared to try for another pregnancy, the emotional decision is rarely a simple yes or no.
Because the loss happened early in the pregnancy, people may assume that it should hurt less. But “a loss is a loss”, Dr Kang from Psych Connect pointed out. “Its impact is shaped not by the gestational age, but by the meaning, hopes and emotional investment attached to the pregnancy.
“When we minimise the early loss, we unintentionally silence grief that is very real,” the psychologist added. Healing begins when the experience is recognised as valid and worthy of compassion, regardless of how far along the pregnancy was, she said.
A loss is a loss, even if the miscarriage happened in early pregnancy, and the grief should not be minimised. (Photo: iStock/Pen Sangraksawong)
According to Dr Kang, signs suggesting a woman might benefit from professional counselling or psychological support after miscarriage include persistent sadness, heightened anxiety or fear of another pregnancy, guilt or self-blame that does not subside.
They might also notice emotional numbness, have problems functioning at home and at work or avoid reminders of the loss. Other signs include intrusive thoughts related to the loss, strained relationships or a feeling of being “stuck” in grief.
“Even beyond these symptoms, if you simply feel hurt, stuck or alone, that is reason enough (to seek help). Therapy can help you make sense of the loss, hold space for complex emotions and begin rebuilding meaning without minimising your pain,” Dr Kang said.
Healing from the grief of a pregnancy loss is not something that can be rushed. For many, the emotional pain may linger for years – and that is normal too.
Dr Kang highlighted a misconception about grief, that it goes away or lessens but that is not true. “What changes is us,” she said. “Healing happens when our life and experience expand around (the loss), not when grief disappears. We gain new experiences, perspectives and meaning that help us carry the loss with greater strength.”
PREPARING YOURSELF MENTALLY FOR THE JOURNEY AHEAD
“Only you can decide when or if you are ready to try again, or if you want to try at all,” said Dr Kang.
Therapy may be useful in helping a couple work through guilt, shame or self-blame after a miscarriage. (Photo: iStock/FatCamera)
She shares the following tips on how to navigate the emotional ups and downs when trying again after a pregnancy loss.
Practices such as journalling or guided reflection can help women reconnect with a sense of purpose and inner strength.
Therapy can also help the couple work through deeper emotional conflicts, such as feelings of guilt, shame or self-blame even when the woman logically knows the loss was not her fault, said Dr Kang.
The clinical psychologist also emphasised the importance of addressing thoughts and fears like “what if I lose this one too?” or “I cannot go through that pain again”.
Gently challenge and reframe these thoughts into more balanced, compassionate inner self-talk, such as “This pregnancy is a new experience”, or “I have support and tools to help me through whatever happens”.
“Most importantly, women need to know they don’t have to do this alone. Reach out to a therapist, partner, support group or friend, and naming what you need rather than carrying it in silence,” said Dr Kang.
Support groups providing space for those navigating pregnancy loss include: Fertility Support SG, Child Bereavement Support (Singapore), Grief Program Support Group by Angel Hearts and the Pregnancy and Infant Loss Support Group Singapore Facebook page.
CNA Women is a section on CNA Lifestyle that seeks to inform, empower and inspire the modern woman. If you have women-related news, issues and ideas to share with us, email CNAWomen [at] mediacorp.com.sg.
Continue reading...