After losing a baby many couples worry about the prospects for another pregnancy. Dr Howard Lee suggests strategies for coping with miscarriage and trying again

A miscarriage can be devastating. There's a feeling that somehow what happened was your fault, that something you did may have triggered the loss - exercise, a minor fall, sexual intercourse.

This is rarely the case. Some women also worry that a previous abortion has affected them and may have caused their miscarriage, but there's no evidence to back this up either.

Research suggests that one in four pregnancies will end in miscarriage, and that 80 per cent of those miscarriages will occur during the first 12 weeks of pregnancy.

The aftermath

Sometimes a D&C (dilatation and curettage) has to be carried out after a miscarriage to make sure that the womb is completely clear. This procedure, also known as a 'scrape', involves a general anaesthetic and a short stay in hospital.

It won't weaken your cervix or make you more likely to miscarry in subsequent pregnancies. Your doctor and midwife should be sympathetic and understanding, but there aren't any tests that can help to determine what caused the miscarriage.

Focus on the fact that serious medical problems are rarely to blame and it's very likely that your next pregnancy will be successful.

Should you have a second miscarriage - and many women do miscarry more than once in their lives - you may be referred to a specialist. However, even sophisticated tests may not produce any reasons for successive miscarriages.

Coping with the grief

You never forget the experience of losing a baby. As well as the grief, your body will undergo some profound hormonal adjustments, which may make you feel emotionally vulnerable and volatile.

Although it's difficult, it may help to tell family or close friends how you feel. If you'd like to talk to other couples who have been through a miscarriage, you can log on to our message board or get in touch with local support groups in your area by contacting the Miscarriage Association: www.miscarriageassociation.org.uk Helpline: 01924 200 799 (Mon-Fri 9-4pm, then answer phone).

Each woman will have her own way of handling the situation, but the days and weeks following a miscarriage can be extremely difficult. A sense of shock, grief, depression, fatigue or failure may set in.

Some couples feel isolated and withdrawn, others want to talk about their loss. But remember that not everyone is going to understand your emotions. To outsiders it may just be 'another miscarriage'.

Is it important to wait before trying for another baby?

Some couples decide that they want to begin trying for another pregnancy right away; others feel that they need time to get over their loss. It's up to you.

Many health professionals suggest that you should wait between three and six months after a miscarriage before trying to get pregnant again - most recommend that you have at least one normal period.

Research suggests that the risk of miscarriage in the next pregnancy is about one and a half times higher if you don't allow yourself one normal cycle before you try again.

However, don't worry if you find yourself pregnant again before you have a period.

The risk of further miscarriages

Having a miscarriage does not necessarily mean that you have a fertility problem. Most women go on to have healthy pregnancies later. Even after repeated miscarriages (three or more in a row) you still have a 70-80 per cent chance of carrying another pregnancy to term.

Unfortunately, if you had a miscarriage that was associated with an ectopic pregnancy, there is a 20 per cent risk that a further pregnancy could become ectopic and this may affect your fertility.

How to prepare for pregnancy after a miscarriage

• Take regular exercise
• Eat a healthy diet
• Try to keep your weight within reasonable limits
• Lower your alcohol intake
• Reduce your intake of high-caffeine drinks, such as coffee
• Stop smoking
• Take folic acid to help the development of your baby's nervous system
• Avoid any unnecessary medication
• Rest as much as possible during the first few weeks of pregnancy

Easier said than done - but try not to get over anxious

Stress is known to release certain chemicals in the brain that can interfere with the production of your normal pregnancy hormones.

If you're worried, talking to others who have had similar problems does help, so log on to our message board and share your feelings.

Above all, try to remember that most couples that have a miscarriage go on to have a healthy baby.