Give your body time to recover. Only you can tell when you are ready to ‘try again’. This includes both a physical readiness (is your cycle back to normal?) and an emotional readiness (are you ready to go through loss again, should it occur?). Talk to your spouse about this and decide together if you are ready. Be aware that you will be reminded each time your period starts of your loss and that you are not pregnant. This can be a very sensitive time for you. Confide in your spouse that it’s ‘that time’ and talk to him about how you feel. It’s ok to be disappointed if you are not pregnant and it’s perfectly normal to feel anxious if you are. Be gentle with yourself and ask the saints to pray for you, particularly Our Lady, St Gerard Majella and St Monica.
Seek Medical Assistance
After a miscarriage many people will say to you it was for the best, there may have been something wrong with the baby. This may be true, but there may be other reasons why you miscarried. It is a good idea after a miscarriage to have follow up tests to check that there are not other risk factors which you did not know about. These might include: insufficient progesterone or HCG; insulin resistance (especially if you have had gestational diabetes during a previous pregnancy); genetic anomalies; folate deficiencies; autoimmune issues; hormonal imbalances; structural anomalies; low sperm or egg counts; egg quality (especially for older women); Polycystic ovarian syndrome (PCOS); endometriosis. Physicians trained in NaProTechnology (https://fccau.org/find-a-centre) can help guide couples through various morally acceptable diagnostic tests and treatments. If you are not already doing so, recording each day your fertility indicators can be a useful way of seeing if everything is working normally- is there any mucus (describe it)? Were you dry? Was there any bleeding? What colour was it- red, pink, brown? How much of the day did you see the most fertile sign? Methods such as Creighton, Billings, Symptothermal can help you do this. These methods are about learning your own fertility cycle so that you can optimise or avoid conception in the future.
If there is no NaPro practitioner near you then GPs can check many of these things if you ask for it. Tests that would indicate some issue include:
- Complete Blood Count (CBC)
- Comprehensive Metabolic Panel (CMP)
- Glucose tolerance test with insulin testing
- Day 3 of cycle estradiol; progesterone; DHEA (precursor hormone) testing
- Peak day plus 7 estradiol and progesterone
- Peak +3, 5, 7, 9, 11 progesterone
- Ultrasounds of the ovaries, uterus and vagina to look for anomalies, cysts and to track follicle development
- Thyroid and liver health
- Sex Binding Hormone Globulin (SHBG)
- Vitamin D
- Vitamin B
If you have had 3 or more miscarriages, you and your husband are entitled to genetic testing to look for genetic anomalies which may be related to your miscarriages. There may be a small charge for this test. Your GP can arrange this for you. The regulations in Australia have just changed so that the miscarriages do not have to be concurrent to receive this testing.
Sometimes the interventions recommended by practitioners can be burdensome or overwhelming. You may find yourself in a place where you ask, do I have to do absolutely anything I can to conceive? The answer is no. It is entirely up to you when these interventions are too much or too burdensome for you, your marriage or your family. For example, injectables to support ovulation require regular ultrasounds as well as the time needed for the injections themselves. This can be disruptive to family and/or work and time consuming; clomid (also used to support ovulation) can cause severe mood changes and fatigue; surgeries for fibroids or endometriosis require abstinence and a time of recovery which may be too burdensome for your family. Procreation (children), St Augustine says is a good of marriage, but this is not the only good, unity of the couple and fidelity are also goods of marriage. If trying to attain one good (a child) puts pressure on the other goods, then it can lead to the breakdown of the relationship. You and your spouse must prayerfully discern what is and is not an acceptable intervention for you and your family.
As the stories of Rachel, Sarah and Elizabeth in the Bible tell us, God can do all things. It is important to always remain open to the possibility that you will conceive, however, there is a temptation to false hope that the next cycle will be successful. This can be damaging to your mental health as you may be disappointed cycle after cycle if that hope does not become a reality. Pray instead that God’s will be done and that if it does happen, it will be a healthy pregnancy and if not, that you will find peace in His will for your family.