How long after perinatal death should couples try again?

June 1, 2010

A physician survey finds that two-thirds of obstetricians approve of trying for another pregnancy less than 6 months following a perinatal loss.

Two-thirds of obstetricians endorse trying for another pregnancy less than 6 months after a perinatal loss, according to a physician survey about attitudes toward a subsequent pregnancy after fetal death

Of the 804 obstetricians asked what advice they give parents about when to start trying to conceive another pregnancy, 27% reported that they advised parents to try "as soon as they feel ready"; 10% recommended waiting for at least 1 normal menses; 33% were in favor of 2 to 5 normal menses; and 31% advised waiting 6 months or longer. Results of the survey were reported in the American Journal of Obstetrics and Gynecology.

Using a series of follow-up questions, investigators tried to distinguish between physician advice that reflects accommodation of parental emotional needs and advice that reflects medical needs after a perinatal loss. Asked when they believe parents are emotionally ready to try for another pregnancy, 45% of physicians replied at least 6 months; 40% answered "as soon as they feel ready"; 1% reported the need for at least 1 normal menses; and 13% expressed the need for 2 to 5 normal menses.

Authors of the report noted that because the short interpregnancy intervals endorsed by most survey respondents are associated with elevated risk of poor outcomes, survey findings warrant additional exploration of the factors that might influence physician recommendations on this issue.

Gold KJ, Leon I, Chames MC. National survey of obstetrician attitudes about timing the subsequent pregnancy after perinatal death. Am J Obstet Gynecol. 2010;202(4):357.e1-e6.