When trying again after a pregnancy loss, it makes sense to have your medical care plans in order before you are pregnant again. But do you need a specialist, and if so, what type? The answer depends on your situation.
Here are some pointers to keep in mind when determining the type of medical care you need based on the type of loss you had:
One Miscarriage
If you had a first-trimester miscarriage or ectopic pregnancy, have no other chronic health issues that you are aware of, and you have no prior history of pregnancy loss, you probably don't need a specialist at this time. You can continue seeing your current midwife, family doctor, or OB/GYN, assuming you are satisfied with that person's care.
If you do have diabetes, thyroid disease, or another underlying health condition associated with risk of miscarriage, you may need to stay in contact with a specialist in that condition during your next pregnancy.
Recurrent Miscarriages
If you have had two or more miscarriages, your odds are higher of having an underlying condition behind the pregnancy losses and you may want to have some tests done to look for possible causes. Thus, you should see a doctor who is experienced with recurrent miscarriages.
Most OB/GYNs are familiar with the proven and accepted causes of recurrent miscarriages and will know how to run the standard tests, so you may wish to continue seeing your current doctor. But a reproductive endocrinology specialist might be more up to date with emerging research on recurrent miscarriages and will generally be spending a greater portion of his time handling complicated situations than would the average OB/GYN. Having a supportive practitioner may reduce the risk of another miscarriage in women who have had recurrent miscarriages. Regardless, a side benefit of seeing a specialist is that when you arrive for your appointments, you will have less likelihood of being stuck in a waiting room full of pregnant women.
Late Pregnancy Loss or Other High Risk Pregnancy
If you experienced a pregnancy loss in the second trimester or later, or if you have any medical condition that leads your pregnancies to be labeled high risk, the best route is probably to see an OB/GYN who can consult with a specialist in maternal-fetal medicine, or perinatology. A perinatologist will usually not be the primary go-to person for prenatal care but will consult with your OB/GYN to perform extra monitoring throughout your high-risk pregnancy in the hopes of preventing and/or catching any problems early.
Source:
American College of Obstetricians and Gynecologists, "ACOG Educatioon Pamphlet AB012." Accessed 10 Jul 2008.
