When the rug is pulled out from under you as you find out your little bean isn’t going to make it, grief sets in. You might need to feel held, you might want to treat it more matter-of-factly, but however you handle it next you grieve in your way.
Eventually, the time will come, to decide when to try again. That’s what this article is about.
This is a journey to your rainbow baby, which is a live birth after a loss or multiple losses.
To help decide when to try, you’ll want to talk to your doctor. Currently, most studies suggests that conceiving within 3 months after a miscarriage is not associated with increased risks of adverse pregnancy outcomes, but as always it comes down to your specific situation.
That means you might attempt pregnancy soon after your loss, a month later, or after many months.
The timing is impacted by many factors.
Your next steps depend in part on whether it was a chemical pregnancy (before a fetal pole/heartbeat was detected in an ultrasound), blighted ovum (also no heartbeat, empty sac), ectopic pregnancy or pregnancy of unknown location, triploidy, termination for medical reasons, missed miscarriage, or whether it’s another type of pregnancy loss. For example, with molar pregnancies the timeline depends on treatment, and for an ectopic it might mean removing a tube surgically which requires additional healing.
The ways you keep their memory and remain as their parent after this loss is another journey and is personal. It doesn’t matter how early the loss is, you get to decide.
Here are some general considerations for this delicate process toward your rainbow baby.
How you separate from your little bean affects the timeline
After you’ve confirmed this won’t end in a live birth and your little bean will separate from you, how this separation happens will affect the timeline. This is the end of your little bean’s journey inside you, and the start of the next steps.
Your options will depend on a number of factors but usually there are 4 scenarios for separation
1) It happened without doing anything, your body expelled on it’s own.
2) Wait to see if your body will expel like in #1 above eventually.
3) Take oral medications to help move your body to expel.
4) Choose the surgical option to separate through a D&C.
Ensure your hcG goes down to zero
If you’ve been doing hCG blood tests to track your pregnancy progress, then it’s a tool to help watch how things are progressing on this side of your loss. Unfortunately hCG can rise even after there’s no sign of the little bean progressing. Depending on how you managed your miscarriage in scenarios 1 to 4 above, may impact this part of the journey. For example, if you had a D&C then your hCG will more likely reduce to zero once the procedure is complete. If you wait, you’ll be waiting to get to zero.
Unfortunately this process can even take up to about 6 months in rare cases. It’s a part of the loss journey that can come as a huge, painful surprise. This doesn’t mean anything about hope for your rainbow baby, though. Each pregnancy is different. Check with your doctor.
Check on your uterus readiness
Other than checking your hcG levels, you might have a transvaginal ultrasound to check how everything looks internally. You might also have a hysteroscopy which is a camera up your vagina to take an even closer look. There could be scarring and the benefit of a hysteroscopy, if you need one, is they can also sometimes be ready for your surgeon to treat scarring or other fertility obstacles like fibroids, polyps or debris.
This is to check that you’re ready to go after your next period.
Check on your emotional & circumstantial readiness
This can sometimes be forgotten in the process. Your emotional readiness matters. You might have the all-clear from a medical standpoint to try again but how you and your partner feel about being emotionally ready is another. Trying after a loss or losses often come with fear and anxiety. Feeling as healed and ‘ready‘ as possible is personal and has different meaning for different people. Only you can define that.
Grief has no timeline.
Plus, there could be other life events that influence when you try like when you tried for the first time such a career, moving, trips, an ill family member and other life events. Although it’s also not the same because you’re trying after a loss and that’s a different journey with new emotions mixed in.
You’re not alone no matter how it goes. There are support groups and professionals if you need more.
Do (more) optional testing
Depending if this was your first time, or after multiple loss or whether it was a tested or untested embryo, or the age of your uterus or donated egg/embryo factored in, or ether you have future insurance coverage and are financially able to move forward – you have options for further testing.
Examples include: karyotyping, KIR, EMMA and ALIVE, ReceptivaDx, Fertlysis, gentic carrier screening, exploratory laparoscopic surgery, an ERA, and plans for testing your embryo(s) like PGT-A, to name a few.
With testing can come the potential financial costs, more waiting (another type of cost – ugh), and time passing and losing opportunities, to name a few.
If you need more support with your options, a sounding board to help with your decision-making and to understand your personal options, feel free to talk to your fertility coach.
Hope is here. Baby dust to you.