Getting Through the First Trimester in a Pregnancy After Miscarriage

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If you are pregnant after a miscarriage, or if you think you might be, you may be feeling thrilled—but maybe a little scared, too. You may be wondering how careful you need to be during your first trimester compared to if you hadn't had a miscarriage.

Rest assured, while it's natural to worry, in many cases, you don't need to do anything very differently. Instead, do your best to enjoy your pregnancy knowing that the odds are that you will be able to carry to term.

When there are differences in your prenatal care, they will usually entail having a bit more monitoring by your doctor. Plus, you may experience more stress over whether everything will go well. After your pregnancy is confirmed, however, it may help to focus on taking things one step at a time.

Take a Pregnancy Test

If your period is late, it's definitely time for a pregnancy test. Home pregnancy tests are very reliable as long as you follow the instructions, which can vary by brand of test. However, typically, you can expect close to 99% accuracy if you take the test no earlier than on the first day of your expected period. (Keep in mind that some fertility medications can affect test results.)

To improve accuracy, make sure to read the package directions carefully before taking the test. Don't drink a ton of water in order to have enough urine to do the test. This can dilute your test, possibly giving you a negative reading even if you are pregnant. Use first-morning urine, and if that isn't possible, make sure the urine has been in your bladder for at least four hours.

Choose a Supportive Practitioner

You may already have a doctor or midwife in mind for your prenatal care. If you're happy with that medical professional, then by all means, stick with them. It's often comforting to have continuity of care and to work with a health provider that you know and trust. However, if you were not satisfied with your current practitioner's treatment during your miscarriage, you may want to consider choosing a new provider for your next pregnancy.

Know that you can switch medical care providers at any point. Having a doctor or midwife who you feel comfortable with can help to ease any concerns you may have about your pregnancy.

Calculate Your Due Date

If you know the first day of your last menstrual period, you can calculate an estimated due date for your new pregnancy using Naegele's rule:

  1. Determine the date of your last menstrual period and add seven days.
  2. Now, subtract three months. This is your due date.

For example, if your last menstrual period was March 7, add 7 days to get March 14. Now subtract 3 months. Your due date would be December 14.

This method of due date calculation is fairly accurate for those with regular menstrual cycles. However, if your last menstrual period is unknown, your cycles are irregular, or you conceived immediately after a miscarriage, the American College of Obstetricians and Gynecologists (ACOG) recommends an ultrasound exam to estimate the due date.

Note that you can get pregnant as soon as two weeks after a miscarriage without ever having had a new menstrual cycle. That said, a miscarriage restarts the menstrual cycle just like a period does. So you can use the first day of bleeding in the miscarriage as the first day of the last period when calculating your due date.

Understand Morning Sickness

Morning sickness usually starts before the ninth week of pregnancy. Many people dread morning sickness, but those who have had a miscarriage may feel relief upon experiencing it. This is because some research shows that feeling morning sickness may mean miscarriage is less likely.

However, keep in mind that lack of morning sickness, or even loss of morning sickness, is not a sign of miscarriage. Many people have mild, limited, or no morning sickness and still go on to have healthy pregnancies.

Grieve Your Miscarriage

Miscarriage is often a heart-wrenching experience, causing long-lasting sadness. Your grief may be magnified by silence and isolation, especially if you miscarried before sharing the news of your pregnancy. Getting pregnant again is unlikely to erase this sadness and may instead renew feelings of grief. However, studies show that focusing on being yourself and seeking connection with others can help you cope.

It's also key to take time to process your pregnancy loss. Letting yourself grieve your miscarriage can assist you in moving on—and focusing on the joy of your current pregnancy. Working through any lingering disappointment, guilt, or sadness may help you let go of stress and feel more secure about the health of your growing baby.

Of course, know that it's normal to feel some worry about carrying your baby to term. Research shows that rates of anxiety and depression are increased during future pregnancies in people who have had prior miscarriages. If you find that you are having trouble coping with your grief, consider reaching out to your support system, doctor, or a therapist.

Know What Your Ultrasound Might Look Like

You'll likely have an ultrasound during or soon after your pregnancy confirmation visit. You may end up with ultrasound photos, as well. If you're curious about how your ultrasound pictures compare to others at the same point of pregnancy, it can be fun to compare them to other first-trimester ultrasound pictures. You can easily view pictures online from singleton and twin pregnancies, ranging from four to 12 weeks gestation.

Watch What You Eat

When you're pregnant, you're more susceptible to food poisoning. Additionally, food-borne infections can be more dangerous during pregnancy than when you're not pregnant. An example is listeriosis, which typically causes only mild symptoms in non-pregnant people but can lead to miscarriage, stillbirth, and other pregnancy complications when contracted during pregnancy.

Don't panic, however, because avoiding food-borne illness is relatively easy as long as you take precautions. Wash all fruits and vegetables before eating, cook meat to medium or more, and avoid soft cheeses, deli meats, high-mercury fish, and sushi. You can also ask your doctor about foods to skip during pregnancy. Additionally, be sure to take prenatal vitamins to make sure you get all the nutrients you need.

Have Sex If You'd Like

Many couples are afraid of having sex during pregnancy, particularly after having experienced a miscarriage. However, there is no existing research evidence linking sexual activity to miscarriage.

There are certain conditions in which sex may not be advisable, but these are very uncommon. Your doctor will make you aware if there are any risks for your situation. If you have any concerns about your sex life during pregnancy, don't hesitate to bring them up yourself.

Announce Your Pregnancy

It is completely up to you to decide when to let others know that you are pregnant. Depending on your personal circumstances and comfort level and how people reacted to your miscarriage news, if you told them, you may decide to announce your pregnancy immediately or wait until you finish the first trimester or later.

This is a very personal decision and there is no right or wrong time to announce your pregnancy. You can also tell some people earlier and wait until later to inform others.

Start Planning

You may feel it's too early to be thinking about baby names and baby showers quite yet, which is completely understandable. But there is some planning that you can and should start during the first trimester, such as watching your nutrient intake, exercising appropriately, and avoiding alcohol and cigarette smoke. If you're a planner, making a first-trimester checklist can help you streamline your pregnancy preparations accordingly.

A Word From Verywell

Pregnancy after miscarriage is often seen as a blessing. However, it can come with some added stress as well. Getting through the first trimester can be a challenge emotionally. Once you reach the second trimester, you'll likely feel more relaxed and confident in the health of your pregnancy. In the meantime, focusing on tackling the various steps and stages of early pregnancy can help you cope. Be sure to contact your doctor if you have any questions or concerns.

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13 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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