Do I need to take extra Folic Acid after 3 Miscarriages?

After having my daughter in 2009, I have since had 3 miscarriages and am now 7 weeks pregnant again. After the 3rd miscarriage we had blood tests done and all came back normal. I’ve heard of a lot of women being advised to take 75mg aspirin (even with no clotting disorders) and a much higher dose of folic acid but have not been advised to do anything. All I am taking is Pregnacare as I have been for a couple of years. Any advice?

Thank you for your question. Sorry to hear about your problems with having another baby.  Having had 3 consecutive miscarriages, you are classified as having had a recurrent miscarriage problem.  You have probably been referred to a specialist for investigation.  The fact that all your tests are normal is very reassuring.  It means that statistically your chances of having a successful pregnancy are probably very good and not much different from any other women in your situation.  At this stage in your pregnancy it is probably 70-75% likely you will have a successful outcome. It might be a good idea for you to have a viability scan now and your doctor or midwife should be able to arrange this at your local EPU.

There is no evidence that high doses of folic acid will have any particular benefit in your situation – 400mg per day is all that is required until 12 weeks.  There is however some evidence that progesterone treatment may improve the chances of a successful outcome.  This is a safe medication that can be taken as either suppositories or vaginal pessaries and it can help support early pregnancy where there is a history of early miscarriage. These would need to be prescribed by your doctor.

As far as Aspirin is concerned, although it is generally a safe drug, it is not without slight risk of upsetting the stomach or causing internal bleeding. In view of the normal clotting test you have had done, there is no particular reason for you to take Aspirin even though it is available over the counter. I think you should get booked into your maternity unit as soon as possible for some expert advice.  I do hope things go well for you.