It is normal to have very mixed emotions about trying for another baby after an unexplained stillbirth. The grief process can take a year or more, and most people find that they never ‘get over’ the loss.
Some couples will decide not to try for another child. Other couples will begin to make plans for another baby. If you are thinking about another pregnancy, here are some guidelines to help you.
Do we face risks of another pregnancy loss next time?
It is very difficult to give an exact answer to this question. For a start, you will be older (even though this might only be a year or so) and risks of such events as miscarriage, Down syndrome, and diabetes, for example, increase slowly with age.
The true risks of an adverse outcome in the next pregnancy after an unexplained stillbirth are not known at the moment. However, here are some guidelines:
There is no evidence that a woman is at increased risk of another stillbirth in the next pregnancy after she has suffered an unexplained stillbirth. This does not mean that there is no risk – it means that the risk is no greater than would be expected for other women of your age and with similar health and pregnancy histories.
There is a greater chance of diabetes being diagnosed in the next pregnancy.
There is a greater chance that the next baby would be delivered before the due date, and would be smaller than average.
There is an increased chance that labour would be induced, and that the birth would be by caesarean section or instrumental delivery.
What should I do if I am thinking about having another baby after an unexplained stillbirth?
It is very important that you discuss your wishes with an obstetrician or midwife with whom you feel comfortable. Here are some suggestions to help you:
Make sure that both you and your partner are comfortable and ready for another pregnancy. If there are unanswered questions from the pregnancy you lost, speak to those doctors and midwives who were involved in your care and have your questions answered. Remember, though, there may not be answers to give.
Ensure that your general health is the best it can be – stop smoking, try to get your weight into the normal range, and make sure you exercise regularly. Don’t use non-prescripton (illicit) drugs or medications. If you have any ongoing health problems, have them attended to by your family doctor or obstetrician. Since diabetes is more common in this situation, it might be wise to have a check for diabetes performed before trying for pregnancy. Make sure your partner is as healthy as possible too.
Make sure your Pap smear is up-to-date.
Begin taking Folic acid.
Attend a pre-pregnancy counselling service if possible. There may be tests that might have to be performed in light of the previous unexplained pregnancy loss. Examples include checks for auto-immune diseases such as lupus, or a tendency to clot (a ‘thrombophilia’).
Double check that there are no health problems that run in the family, and if there is any doubt, let your doctor know.
Keep a track of your period dates, to allow accurate dating of the pregnancy.
