A miscarriage often has a devastating impact on couples. The loss of a newborn infant is unbearable. According to expert opinions, a healing period is necessary for things to return to normal- physically, mentally, or emotionally. Females bear the majority of the impact due to miscarriage. As a female, the act of sex might become too painful– with a lot of negative emotions lurking in the background.[1]
As per doctors- your body is physically ready for the act of lovemaking after 2 weeks. The bleeding of the inner walls due to miscarriage stops within that time. Complications, if any, can delay the waiting period further. However, just being physically fit doesn’t always mean that you are ready. It is not uncommon.
This article will shed light on issues, difficulties, and
possible questions you might have about sex after a miscarriage.[2]
Miscarriage: Why does it occur?
Scientifically, miscarriage is the death of a fetus in the womb before 20 weeks of pregnancy. Up to 15% of the miscarriages occur before the 12th week of pregnancy. The remaining 5% occur in the 2nd trimester(between weeks 13 to 19). Women may unknowingly suffer from one- without knowing about their pregnancy. About 20% of pregnancies result in a miscarriage- around one in five. But, the reasons for the miscarriage may vary individually- from person to person.[3]
Chromosomes
Around 50% of all miscarriages occur due to chromosome issues. Chromosomes are intracellular structures that consist of genes. There are 23 pairs of chromosomes within each person. Each pair consists of genetic information that makes a person unique- one from the mother and the other from the father. Miscarriage occurs when there is a wrong number of chromosomes- which occurs by chance and not by heredity.[4]
Chromosome issues that may be responsible for pregnancy miscarriage include:
- Blighted ovum: Embryo fails to grow into a baby- despite being implanted inside the uterus. Symptoms include dark-brown bleeding at the onset of pregnancy.
- Intrauterine fetal demise: The embryo stops growing and dies.
- Molar Pregnancy: The uterus tissue changes into a tumor at the onset of pregnancy.
- Translocation: Part of a chromosome transfer and attaches itself to another one. This is the primary cause of multiple miscarriages.
Issues with the Uterus or Cervix
Complications in the uterus or cervix may also result in miscarriage. Some of the noted problems are:
- Septate Uterus: A tissue(septum) divides the uterus into two segments. Doctors recommend surgery before trying to get pregnant to reduce the chances of miscarriage in this congenital uterine abnormality(meaning you are born with it).
- Asherman Syndrome: Scars tissues that damage the inner linings of the uterus(endometrium). The recommended treatment procedure usually includes hysteroscopy- used to remove the scars.[5]
- Fibroid inside the Uterus: Can limit space for the embryo to grow and also interrupt the blood supply. The surgical removal procedure is known as myomectomy.
- Incompetent Cervix: The cervix dilates much before the usual stage. The dilation often occurs without any pain or contractions- leading to miscarriage, usually in the second trimester. Doctors often recommend cerclage- a stitch to keep the cervix closed.
Issues with the Mother’s health
Underlying health conditions and illnesses often have a negative impact on the growth of the fetus. Lifestyle habits may also be responsible. Contrary to popular belief- exercise or sexual intercourse is not accountable for a miscarriage. The possible factors that may be responsible are malnutrition, usage of drugs or alcohol, obesity, maternal age, thyroid, uncontrolled diabetes, infections, injuries, and hormonal imbalance. Each of these can result in a miscarriage.[6]
Sexually Transmitted Infections and Listeriosis(Food poisoning
during pregnancy) can result in premature birth, miscarriage, or stillbirth.
Timely testing with proper medication can protect both you and your baby from
STDs like Syphilis and genital herpes. For listeriosis, the doctor will
likely prescribe antibiotic medications for both of you.[7]
Pregnancy After Miscarriage
A miscarriage drains a lot from you. You might experience severe bouts of pain and depression. Women with prior miscarriages recall how they often underwent a turbulent wave of emotions- often many at the same time. Several women reported an absolute loss of libido or sexual urges. Take your time to recover- for all hope is not lost.[8]
About 65 in 100 women enjoy a successful pregnancy after an initial miscarriage. Only 1% of women suffer a repeat miscarriage- as per reports. Depending upon the period of the pregnancy prior to miscarriage, the time period for the return of pregnancy hormones ranges from a few weeks to a month at most. The periodic cycle returns within 4 to 6 weeks in most women.[9]
The usual procedures that immediately follow a miscarriage are:
- D and C: The full name of the procedure is dilation and curettage. The process removes the remaining tissues from the uterus. The cervix is dilated(widened) and the excess tissues are then removed- either by suction or a device called the “Curette”.
- Medication: Doctors prescribe medications that facilitate the passing of tissues of the uterus.
The Mental or Emotional State
According to most women- it is actually the mental and emotional turmoil that makes sex unthinkable after a miscarriage. Rapidly changing hormone levels cause feelings of desolation and frustration to creep in at unwarranted times. The hurt amplifies when you remember tiny details like the child’s name(which you had decided). Mood swings and tears are normal during this time. The uncontrollable grief results from having never met the baby. People may argue that an unborn fetus is not really a baby. However, everyone is entitled to feel differently- including you. Take your time to recover.[10]
Restoration of the Body Clock
Ovulation resumes generally after two weeks of the miscarriage. The timing may vary slightly.
The body starts the restoration process first by repairing the reproductive routine. This means the ovulation process occurs before the upcoming menstrual period. You can thus get pregnant before your period resumes.
Multiple studies have in fact shown a positive outcome on getting pregnant within one to three months of a miscarriage. A 2017 study actually suggests that pregnancy within the first 3 months of a miscarriage has a better chance of being successful than waiting for longer periods. The theory stated- the body becomes primed for a future pregnancy. For further issues, contact a doctor or a grief counselor. Additional tests may be necessary for repeated miscarriages.[11]
Undergoing a Dilation and Curettage may delay your plans for pregnancy. Doctors suggest waiting for months to let the endometrium epithelial lining of your uterus regenerate.
Ovulation Symptoms
The ovulation symptoms after a miscarriage are similar to those before the loss. For determining ovulation, check out:
- Transparent vaginal mucus- similar to egg whites.
- Cramp pain on either side.
- A slight rise in body temperature.
- Detection of LH(Luteinizing Hormone) on pregnancy-kit tests.
Possible Difficulties
The American College of Obstetrics and Gynecology recommends conceiving within six months of a miscarriage. This reduces the risk of a miscarriage or premature birth. There is no significant increase in the risk of stillbirth or preeclampsia.[12]
However, the WHO suggests waiting for at least six months before conceiving. According to their research, conceiving before 6 months increases the chances of maternal anemia, preterm birth, and low birth weight.
Conclusion
The recovery rate of your body post-miscarriage depends upon the period of your pregnancy. On average, the female body starts ovulating as ear;y as 2 weeks. Doctors advise waiting one menstrual cycle after the miscarriage- in case you want to try conceiving right away. This helps in accurately estimating the ovulation period and a precise due date in the near future.[13]
However, the
factors involved also include mental and emotional stress. The person
experiencing the miscarriage knows it best. It is best to take a grieving
period to resolve these issues.
[1] https://pubmed.ncbi.nlm.nih.gov/14508039/
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3310038/
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