Trying to understand recurrent pregnancy loss is often taxing. There are a lot of questions but very few answers. You are overwhelmed with curiosity about what may happen next while also navigating the grief of the loss you’ve just experienced. It’s a lot. The load can get heavy pretty quickly if you’re one of the women who have navigated two or more miscarriages in a row.
“It is always important for couples to recognize the level of grief and anxiety that occurs with each pregnancy loss,” explains Dr. Sandy Goodman, a board-certified OB/GYN and fertility specialist at The Reproductive Medicine Group. “Many couples benefit from either therapy or support groups to help them process and cope with their losses. Others find techniques such as meditation, yoga, and other positive forms of self-care to be helpful in dealing with the emotional aspects of recurrent pregnancy loss.”
In addition to self-care and mental health support, processing the aftermath of multiple miscarriages can also include a physical checkup with an OG/GYN or fertility doctor for a recurrent pregnancy loss workup.
What you should expect from a recurrent pregnancy loss workup
According to the American College of Obstetricians and Gynecologists, anyone who has two or more miscarriages in a row is considered to be struggling with recurrent pregnancy loss.
After a second or third miscarriage, your doctor may recommend seeing a reproductive endocrinologist fertility specialist, also known as an REI specialist. But, even if your doctor isn’t taking the lead in referring you to a specialist, Dr. Goodman suggests taking the reins and asking for a specialist yourself.
While it may feel overwhelming, pursuing a specialist and recurrent pregnancy loss testing may lead you one step closer to determining whether there is a specific reason behind your losses. For instance, in some cases, polyps, polycystic ovarian syndrome (PCOS), or even diabetes have been shown to impact early pregnancies.
Fertility specialists will turn to recurrent pregnancy loss workups — a series of tests and an evaluation of past medical history — to help narrow down possible reasons behind back-to-back miscarriages.
“Evaluation for recurrent pregnancy loss includes discussion of the patient’s medical history, physical examination, as well as cervical cultures, bloodwork, and radiologic procedures,” explains Dr. Goodman. “Bloodwork will include hormonal evaluation and testing for chromosomal, immunologic, and blood clotting disorders. Radiologic testing will include evaluation of the uterus and fallopian tubes.”
Such in-depth testing can be both emotionally and physically taxing, especially as many grapple with recurring, probably recent, losses.
How to take care of yourself amid recurrent miscarriage testing
As Dr. Goodman mentioned, recurring pregnancy loss is straining both mentally and physically. Navigating additional testing to get a picture of your health after recurring pregnancy loss is important, but it can also add more stress to an already tender situation.
In the lead-up to your specialist doctor appointment, Dr. Goodman suggests narrowing in on what you can control. For instance, she encourages you to bring any relevant medical information, bloodwork, or testing to your initial appointment so that your new medical team has a head start on who you are.
It’s also important to hold onto hope as you navigate the rollercoaster of emotions that is recurrent pregnancy loss. As the American College of Obstetricians and Gynecologists writes, “Even if no cause is found, the chances of having a successful pregnancy without special treatment are good. About 65 in 100 women with unexplained recurrent pregnancy loss have a successful next pregnancy.”
Vivian Nunez is a writer, content creator, and host of Happy To Be Here podcast. Her award-winning Instagram community has created pathways for speaking on traditionally taboo topics, like mental health and grief. You can find Vivian @vivnunez on Instagram/TikTok and her writing on both Medium and her blog, vivnunez.com.