Finding out and coping with early pregnancy
Finding out you are pregnant after a miscarriage, ectopic or molar pregnancy* can bring a challenging mix of emotions.
This can be especially difficult in early pregnancy when you haven’t had any scans and can’t feel reassuring movements yet.
At this stage, you are living with a high level of uncertainty without any way of telling whether everything is ok (and usually without any support from health services).
Not all fears are rational but this doesn’t always stop them from taking over. On this page, we have information about medical and emotional support in early pregnancy.
“I was terrified. Taking the pregnancy test made me feel dizzy, as I wanted this baby so much, but couldn’t even contemplate another life-changing loss.”
We asked people what they found difficult during the first part of pregnancy after loss. We know not everyone will experience all of these, but recognising your experiences can help you feel less alone.
- Strong feelings of anxiety or panic that start as soon as you have a positive test but a long time before you can get any support or reassurance from healthcare services.
- Finding the presence – or absence – of physical symptoms is difficult to manage, especially cramping or spotting.
- Feeling unable to trust your body.
- Checking due dates and imagining the future while still keeping your expectations very low.
- Living on high alert, for example checking for blood whenever you go to the toilet and fearing any feeling of wetness in your underwear.
- Dealing with grief for your previous loss or losses alongside fear and hope for this pregnancy.
- Feeling guilty or worried about forgetting your lost baby or babies.
- Feeling unable to cope if things go wrong again.
- Having a different experience of pregnancy and feeling isolated as a result.
- Having a strained relationship with friends or family because you find it difficult to cope with positive or excited reactions.
- Not wanting to tell people in case things go wrong but finding it difficult to manage without their support, whether at work or with family and friends.
- Feeling sad you feel this way or as if the joy of pregnancy has been taken away from you.
If you have conceived after fertility treatment, you may feel strongly that you need additional care in this pregnancy, especially if the time leading up to it was filled with appointments, scans and tests. It can feel very isolating if this support doesn’t continue now you are pregnant.
Listen to Erin, Laura and Clare talk about their experiences of early pregnancy after loss. You can read the transcript here.
* Please note that we often use the term ‘pregnancy loss’ to include miscarriage, ectopic and molar pregnancy. But sometimes, using the word ‘miscarriage’ for all three makes it easier for people to find the information they’re looking for online when using a search engine.
Medical support in early pregnancy after miscarriage
In some cases, you should be able to access additional support in early pregnancy.
Spotting or bleeding
If you are spotting or bleeding in early pregnancy, and have had one or more previous miscarriages, NICE Guideline NG126 says you should be offered progesterone. You may still have to wait until you are at least six weeks pregnant and have had a scan to confirm the pregnancy is in your uterus.
Most women who have had an ectopic pregnancy do go on to have a healthy pregnancy. However, you do have a higher risk of another ectopic pregnancy than someone who hasn’t had one. You should have an early scan at around six or seven weeks to check if the pregnancy is in the right place. If the scan shows a developing pregnancy in the uterus then you are unlikely to need any further tests or special care. Even so, you may still be anxious about something going wrong again. Unclear scan results can be very stressful.
People who have experienced three or more miscarriages in a row (recurrent miscarriage) are usually eligible for investigations. If you had a diagnosis and are receiving new treatment in this pregnancy, you might feel more positive about the outcome.
Taking part in a clinical trial of a new treatment may mean you have extra care and attention in this pregnancy. This can be very supportive, even if you don’t know whether you are having the trial treatment or the placebo.
“I was prescribed medication which I would take every morning. That morning ritual helped me to manage my anxiety – that I was doing something different this time.”
If you had a problem identified for which there is no treatment, or if tests didn’t show up any obvious cause, you probably still feel very anxious. You may be seen more regularly during your pregnancy, perhaps in a specialist clinic. You may also find it helpful to know that when no cause for recurrent miscarriage has been found, the chances of having a successful pregnancy are good.
While it is possible to have a second molar pregnancy, you are much more likely to have a healthy pregnancy this time round. Specialist molar pregnancy centres usually advise having a scan at around 8 weeks if you are pregnant after a single molar. Unless you have had treatment or more than one molar pregnancy, you are unlikely to need any other follow-up. You can always contact your treatment centre for advice.
Extra checkups or scans on the NHS
If all is well, a scan can offer you reassurance, although most people say this is only short-lived. Some people feel that the stress of a scan isn’t worth the level of reassurance they receive and they would rather wait or be scanned as little as possible.
Some doctors or Early Pregnancy Units may be willing to refer you for extra scans or support on the NHS. However, this can depend on the policies of individual hospitals or the understanding of the medical staff you see.
It can feel very difficult if you are not offered any additional care early in pregnancy. Some people choose to have one or more private scans.
If you had a missed miscarriage that was diagnosed at your dating (12-week) scan last time, you may want to have a scan to find out sooner if there is any sign that anything is wrong. The sonographer will usually advise you to contact your doctor or hospital if they have any concerns.
If you do choose to have earlier private scans, it’s important to choose a provider who is regulated by the Care Quality Commission.
Our page on coping with scans when pregnant after miscarriage has more information and support.
Medication in pregnancy
Doctors take great care to only prescribe medication during pregnancy if it’s considered the safest option for you. If you were taking medication during your previous pregnancy, you may worry that it caused your loss. This is highly unlikely. Most losses occur because of a problem with the egg or sperm cell rather than anything you have done or taken.
Some women tell us they want to make changes in their new pregnancy. It can be reassuring to feel you are doing things differently this time. But it is not usually safe to stop any medication suddenly.
Talk to your doctor if you want to try reducing or coming off medication. It’s important to understand both the potential risks (if any) to your baby of taking the medication and also of not taking it and therefore not treating any conditions you have.
You may find it helpful to look at the BUMPS (Best Use of Medicine in Pregnancy) website. If you cannot find information about a specific medicine on bumps, you can ask your doctor, midwife or pharmacist to contact the UK Teratology Information Service (UKTIS) for advice on your behalf.
Some women take non-prescription supplements or medicines during pregnancy. While well-known pregnancy preparations may be a boost to your diet, some herbs and medicines may be harmful. It’s probably best to ask for advice from your GP, midwife or practice nurse.
Your booking-in appointment
Your booking in appointment usually happens between around 8-11 weeks of pregnancy.
If possible, explain your situation to your midwife. You might want to ask them to put a prominent note or sticker on the front of your notes. This should inform anyone reading them about your situation and may mean you do not have to keep referring to your previous loss in appointments.
Make a list of any questions and concerns so you don’t forget to ask when you are there. Some people talk to the Miscarriage Association on the phone, via live chat or on our Facebook groups beforehand to plan what they would like to ask. This may make you feel more confident and prepared.
Emotional support in early pregnancy after miscarriage
In this section we include some ideas and suggestions to help you look after your mental and emotional health in the early weeks of pregnancy.
There are things you can control and things you can’t. As much as possible, try to focus on the things you can control.
Looking after yourself
This is a difficult time emotionally and physically. It’s important to be gentle and look after yourself as much as possible. There are some suggestions to help you on this page.
Some people find practicing mindfulness can help them recognise and endure difficult emotions more easily. Mindfulness takes practice. If you would like to try, it may help to start doing mindful meditations early in your pregnancy. Some places offer specific pregnancy mindfulness.
Finding a community
Pregnancy after loss can be very isolating, especially when it doesn’t feel as if other people understand. Have a look at our suggestions for ways to find a community on this page. You may find it helpful to look for people who are at the same stage of pregnancy as you so you can navigate the journey together.
It’s up to you who you choose to tell about this pregnancy and when. It isn’t always an easy decision. You might feel as if you will ‘jinx’ the pregnancy by telling people. Some people find that the pressure of raising other people’s hopes is too much.
Here are a few things other people have found helpful to do or think about. Try and focus on what feels right for you.
- Some people didn’t tell anyone at first. “For my own preservation, I didn’t tell anyone I was pregnant because I didn’t want to go through the cycle of telling and un-telling yet again.”
- Some people chose to tell only a small group of people. “I created a small WhatsApp group of people I knew would be supportive with whom I could share day-to-day fears and concerns.”
- Some people chose to celebrate their pregnancy with everyone around them. “I wanted to celebrate this pregnancy while it was happening for however long it lasted.”
- It may be helpful to tell your manager at work, especially if you need more time off for scans and appointments. Some people also find that their anxiety about this pregnancy affects their ability to work. Our information on miscarriage and the workplace information explains your rights.