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Helping Women Give Birth After Recurrent Miscarriage

Louise Carpenter has written a brilliant article about miscarriage for the U.K.’s Observer, focusing on Lesley Regan, who runs the Recurrent Miscarriage Clinic at St Mary’s Hospital, the largest miscarriage clinic in the world.  Regan’s aim to is to help women “who have had three or more consecutive miscarriages and women who miscarry after 12 weeks” discover why it is they can’t carry a pregnancy to term – and, if possible, to fix it.

The RMC is responsible for identifying Primary Antiphospholipid Syndrome, commonly known as “sticky blood,” a condition affecting 15% of women suffering from recurrent miscarriage.  Sticky blood, or PAPS, “concerns the implantation and effectiveness of the placenta.”  Treating women with PAPS has resulted in a 70% increase in their ability to carry a pregnancy to term.  Regan says, “The quality and depth of how the placenta implants is a major factor in how your pregnancy progresses.”

Yet, despite all of the advances Regan and her colleagues have made, half of recurrent miscarriages remain unexplainable.  Carpenter writes that, “35% could be down to hormone levels (a trial is ongoing as to the value of taking progesterone), infection, structural abnormalities of the womb correctable by surgery “cervical incompetence” or immune disorders.”

It seems miraculous to me that women are able to have corrective surgery on the womb, resulting in – for at least one woman profiled in the piece – two live births.  The article never makes mention of how much these types of services cost or to what extent British public healthcare covers them, but it does touch on the changing expectations women have of what these unexpected treatments can do for them.

Ruth Bender Atik, national director of the U.K.’s Miscarriage Association says the triumphs of reproductive medicine have made women feel as though they should be able to get pregnant – and stay that way – at will.  Given that such a large number of miscarriages still go unexplained, a successful pregnancy for anyone who wants one is not yet (and may never be) realistic. 

Bender Atik blames earlier pregnancy detection for dashing women’s hopes so frequently, saying, “In the early 80s, women had to wait until they had missed two periods before they went to their doctor.”  Today, says Carpenter, “a pregnancy which might have gone undetected and unmourned is now flagged up perhaps too early which, of course, does not make the loss any easier to bear.”

I was thinking recently about the implications of all of the medical and scientific advances we’ve seen in the last 50 years, determining that though they’ve made our lives easier in some ways, they’ve complicated them in others.  Most notably, I was examining the life of my father’s mother, who lived to be almost 87 years old.  In her lifetime, she lost a son and a daughter; her son died in middle age of cancer, but her daughter was stillborn.  I wondered how that must have affected her, assuming it had hit her profoundly since the baby is buried next to her with her name, Ann Marie, engraved on the headstone.  When I mentioned to my mother that stillbirth must have been a terrible thing for Gram to have endured, she suggested that women dealt with that sort of thing differently “in those days,” because stillbirth was much more common years ago.  In other words, even horrible experiences aren’t so bad if they’re not unusual.

Miscarriage, as Carpenter notes, is not unusual, but it is still a taboo subject among women, something we don’t know yet how to address even amongst friends.  Since 20% of pregnancies end in miscarriage, those who have suffered one should know they are not alone.  And as Lesley Regan has proven, even women who have lost multiple pregnancies don’t have to lose all hope.

Photo: sundaykofax via Flickr

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