The Physical Difference
Treatment after a miscarriage depends on when and how it occurred. If the loss happened very early in the pregnancy—before seven or eight weeks—your doctor will likely recommend letting your body expel any fetal or placental tissue on its own, if it hasn't already, in the form of a very heavy period, accompanied by strong cramping. But if the miscarriage happened a bit later or you never experienced any signs that your pregnancy was in danger (bleeding, cramping) until an ultrasound failed to detect a heartbeat, you may need intervention. One option is that medication may be given to cause your body to release the pregnancy tissue, which usually occurs 24 hours to several days later. Or your doctor may suggest a dilation and evacuation procedure, a suctioning of the uterus to remove fetal or placental tissue. It sounds worse than it is; a D&E, as it's known, is done as an outpatient procedure, and you can opt either for local or general anesthesia. Afterward, you'll experience mild cramping for a day or two and light bleeding for about a week.
After a miscarriage, the body heals very quickly. “A woman will generally ovulate two to four weeks after a miscarriage, with a normal menstrual period occurring two weeks after ovulation,” says Dr. Lerner. “She can then start trying to get pregnant right away, if she wants to, with no increased risk of miscarriage.”
Having two miscarriages in a row is really not that uncommon—and doesn't necessarily indicate any sort of fertility problem, says Dr. Lerner. “One out of every five women who become pregnant will have a miscarriage, and one out of every twenty-five women will have two in a row.” It's usually not until a woman has had three consecutive miscarriages that her doctor will begin tests to see if there's an underlying problem, such as abnormal hormone levels, certain infections, blood disorders, uterine abnormalities, fibroids, or an incompetent cervix (when the cervix begins to open before term). If you have a family history of diabetes or thyroid or blood disorders, however, your doctor may want to run tests before you even begin trying after the first time.
