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Getting pregnant again after a preterm birth or loss entails both physical and emotional readiness. Emotional readiness should be achieved first before physical readiness. You and your spouse may need grief counseling since you lost the experience to carry a full term baby and you will need someone to help you address the feelings associated with that loss. When both you and your spouse are emotionally prepared, it is best to consult with your doctor to confirm that you are physically ready to get pregnant again. He or she will provide recommendation on the timing of your next pregnancy. This will depend on the mode of delivery (natural or Cesarean) and the gestational week when the baby was delivered or miscarried. Risk Factors If you receive the doctor’s green light to get pregnant, there are certain risk factors to remember to prevent future preterm delivery or loss: 1) Getting pregnant too soon after the baby - A doctor would recommend you wait at least 18 months after preterm delivery or loss to get pregnant again. This period should give your body time enough to recover. 2) Health conditions like diabetes or high blood pressure - Make sure your doctor knows about any health condition you may have as these not only can increase risks of miscarriage, but may also cause complications and birth defects. 3) Being overweight or underweight - Being overweight can also increase chances of developing gestational diabetes, preeclampsia, labor problems; while being underweight can not only cause premature birth but may also result in a baby who is underweight. 4) Smoking, alcohol, and illegal drugs - Smoking exposes the baby to harmful chemicals. Also, infants born to women who smoke during pregnancy tend to be smaller than those born to nonsmokers. These babies are also more likely to have asthma, colic, and childhood obesity, as well as an increased risk of dying from sudden infant death syndrome (SIDS). Drinking alcohol is also not advised since alcohol can enter through the placenta and into the baby’s liver, which will not be developed enough to break it down. The various effects that can occur on a baby whose mom drank alcohol during pregnancy may include physical, mental, behavioral, and learning disabilities. Three or more drinks per occasion or more than 7 drinks per week is considered as too much alcohol during pregnancy. Illegal drug use (includes the use of heroin, cocaine, methamphetamines, and marijuana and use of prescription drugs for a nonmedical reason) can cause birth defects and interfere with fetal growth that can lead to preterm birth or miscarriage. 5) Infection during pregnancy - Make sure to wash your hands thoroughly with soap and water, to keep your genital area clean as well, and to use a condom to prevent contracting an STD. How to Prevent Preterm Delivery or Loss There are procedures your doctor can recommend to help prevent preterm birth for loss - but choosing the ideal option for you will depend on your previous delivery. Some options include: 1) Cervical cerciage - A stitch is used to enforce the cervix of women with poor obstetrical history or a history of procedures that have weakened the cervix. Studies on this procedure indicate a viable birth rate of 70-90 percent with this option. 2) Cervical monitoring - An ultrasound measures the length of the cervix every 2-4 weeks for women with poor obstetrical history or a history of procedures that have weakened the cervix. Bed rest is recommended along with cervical monitoring - although data has not proven that bed rest is successful in preventing preterm delivery. 3) Progesterone supplementation - This is recommended for women with history of preterm labor. The progesterone is administered weekly via injection beginning at around the 16th-20th week of pregnancy and continuing until the 34th-36th week. This procedure has been shown to decrease the risk of preterm delivery for women who have had a previous preterm delivery. Sources: - http://handtohold.org/resources/helpful-articles/pregnancy-after-preterm-birth-or-loss/ - http://www.marchofdimes.org/pregnancy/thinking-about-pregnancy-after-premature-birth.aspx - http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-and-obesity/art-20044409 - http://www.acog.org/Patients/FAQs/Tobacco-Alcohol-Drugs-and-Pregnancy