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Pregnancy After Miscarriage

I was feeling funny and my period was late, but I chalked it all up to the miscarriage I'd had just eight weeks before. It had been my second lost pregnancy in less than a year, and I knew that it could take a while for my menstrual cycle to become regular again.


Nevertheless, I did a home pregnancy test. But I was so sure the results would be negative -- my husband and I had made love only once since this last miscarriage -- that, after a phone call interrupted the waiting period, I actually forgot to check it. When I did, and I saw the bright pink plus sign indicating that I was pregnant, I must have stared at it for a full minute.


As joyful as I was about this third chance at becoming a mother, I was also terrified. I wasn't sure I'd be able to handle another loss.


Although the pregnancy proceeded normally, I teetered between two extremes throughout it: On one hand, I tried to avoid imagining what my baby would look like or what I'd name her, for fear I might miscarry again. On the other, I was keenly attuned to each little symptom: I welcomed the nausea, fatigue, and tender breasts as signs that my baby continued to live within me. And I circled two dates on the calendar: the day she was due, and the day I estimated she'd have a chance to survive outside the womb if she was born prematurely.


When Addie arrived full-term and healthy, I thought I'd finally heave a sigh of relief. But it took several more weeks for me to accept that she'd made it, safe and sound, and almost a full year passed before I stopped worrying that she could die at any moment.


Common Occurrence, Unique Heartache


As many as 10 to 25 percent of all pregnancies end in miscarriage -- defined as a pregnancy lost before 20 weeks. (After that it is considered a stillbirth.) Most losses are due to abnormalities in the fetus. Other reasons include anatomic problems in the woman, such as an abnormally shaped uterus, a hormonal imbalance, or an infection of the genital tract. Yet many miscarriages are followed by successful births -- the chance of having a baby is generally greater than 50 percent, even after several miscarriages.


Even if you're aware that miscarriages are common, this knowledge may do little to assuage the grief, depression, sense of failure, and anxiety about subsequent pregnancies that can be triggered afterward. For some couples, going on to have a successful pregnancy can help resolve these feelings; for others, the loss is mourned forever.


"Miscarriage robs pregnancy of its innocence," says Gerri Wismer, R.N.,the perinatal bereavement coordinator at Lankenau Hospital, in Wynnewood, PA. Whether it was a first pregnancy or a third, a miscarriage often means never again taking for granted that a pregnancy will lead to a baby.


That sense of lost innocence has spiked sharply with the introduction of home pregnancy tests. Because they allow you to discover whether you're pregnant at a very early stage, they also make you aware of an early miscarriage. "25 years ago, the technology simply didn't exist for women to find out early on whether or not they were pregnant unless they went to a doctor," says Ron Feinberg, M.D., Ph.D., a miscarriage expert at Reproductive Associates of Delaware in Wilmington. "As a result, what many assumed was simply a heavy period may in fact have been a pregnancy loss."{C}


Searching for Answers


As common as miscarriage is, few people want to think about the possibility. When couples who are ready for a baby learn they're pregnant, they may eagerly tell the world their big news and thumb through catalogs for baby gear.


Then, a spot of blood, a round of cramps, the averted eyes of a grim-looking ultrasound technician, or the eerie silence of a Doppler device against a still-flat belly...and it's over, almost before it began. But not too soon to have profoundly altered an expectant couple's world. Physically, for a few short weeks, they were on the road to being parents; emotionally, many were already there.


"I miscarried only two weeks after I found out I was pregnant, but my whole life changed in that time," says Becky Baker, of Somerset, PA, who now has two daughters, Victoria, 6, and Allison, 20 months. "I fell in love with my baby. I imagined how I'd feel when she got on a school bus for the first time and how I'd help her learn to like vegetables. When I lost her, I felt guilty. I wondered why I couldn't do what every woman is supposed to be able to do."


Blaming oneself is a common reaction, experts say. Despite the random nature of miscarriage, myths persist that support the idea that a woman may have done something wrong. Routine exercise, lovemaking, ambivalence about the pregnancy itself -- all have been blamed for miscarriage, but none have any merit. "Most miscarriages are caused by a genetic abnormality," says Dr. Feinberg. "No one is to blame."


Nina Chase (not her real name), of San Diego, who lost three pregnancies before the birth of her son, remembers grasping for some reason for her losses. "At one point, I decided that I'd jinxed them because I'd told people about them too soon," she says. "I really needed to believe that I had somehow caused the miscarriages, because that would've meant I had some control over the situation."


Team Effort


Sarah Smith, of Plano, TX, also blamed herself for the five miscarriages she suffered: four before giving birth to her son, Dylan, age 7, and one before the birth of her second child, Logan, now 2. "I shut down emotionally and stopped communicating with my husband. When he'd ask me what was wrong, I'd say everything was fine. He began to worry that I didn't love him anymore, which couldn't have been further from the truth." It wasn't until they went to counseling that she discovered how much her self-esteem had been ravaged by her miscarriages. "Our marriage has matured," she says. "I feel lucky -- a lot of couples might not have been able to go through what we did and stay together."


In fact, say experts, the emotional aftermath of a miscarriage is often the first time that the "for better or for worse" part of a marriage vow is tested. Steven and Elizabeth Peckham, of Memphis, discovered that weathering their miscarriage made their relationship even stronger. "As awful as our two miscarriages were, we see now that they made us closer because we learned how to lean on each other for support," says Steven, now the father of an 18-month-old boy. "It's also brought us closer to our families and church community, because we've shared our pain with them, and they've prayed for us every step of the way."{C}


Healing Through Action


Just a few decades ago, miscarriage was a subject discussed privately in hushed tones, and women who'd been through it had few resources to turn to. Even now, many women try to minimize what they've been through by jumping back into their old routine as soon as they feel better physically. But buried emotions inevitably find a way to surface. "I've counseled women who, when they finally deliver a healthy baby, cry not tears of joy, but of sorrow for the child they never mourned," says Wismer.


Now there are support groups, counselors, and even Internet chat rooms and websites (see "Help Online"). Lisa Girdy, of Ashbourne, VA, who had four miscarriages in between the births of her two sons, ages 7 1/2 and 1, located a pregnancy-loss support group online, and found compassion from strangers who had been through the same experience. "Their comments were more comforting than what friends who'd never lost a baby said to me," she recalls. "My friends said things like, 'It's all for the best -- just try again.' They had no idea what I was dealing with." Some women, like Lorraine Robertson, of West Chester, PA, find that talking to a counselor is the best therapy.


"Counseling wasn't something I thought I'd ever need," says Robertson, who sought out Wismer after her miscarriage. "Gerri became a mother, a best friend, and a savior." Some couples find comfort in naming their lost baby; others change doctors, or hunt down information about miscarriages and then make whatever changes they think may boost their odds of a successful pregnancy.


"My previous obstetrician's office was the pits," recalls Smith of her first miscarriage. During her first pregnancy when she started to bleed at six weeks and called to make an appointment, she says, the doctor's staff seemed unsympathetic. "Since I was so early, maybe there was nothing to worry about," she says. "But I had never been through this before, and I was scared. I sat for what felt like an eternity in the waiting room, surrounded by pregnant women and mothers with newborns, feeling awful." Since then, Smith has switched to a practice that she feels treats her concerns more seriously.


"It's taken a while, but I think the medical community is changing how it views very early lost pregnancies," says Michael Berman, M.D., clinical professor of obstetrics and gynecology at Yale University School of Medicine and founder and of Hygeia Foundation, Inc., and Institute for Perinatal Loss and Bereavement, a website for parents who have lost a pregnancy. "We used to say to patients who miscarried at five and six weeks, 'This wasn't a fetus  -- just a chemical pregnancy. You'll be fine. Go try again,'" he says. "Now, we know that women bond in pregnancy at a very early stage, and can grieve its loss as intensely as they might that of a full-term birth."


New Outlook


If there's one thing couples who have been through a miscarriage should keep in mind, it's that the loss doesn't necessarily mean a successful pregnancy isn't in their future. "The joy in my life now balances the pain and sadness that my husband and I went through," says Chris Gusmano, the mother of a 5- and a 3-year-old, in the Chicago area, who had several miscarriages.


My love for my daughter also overshadows the sorrow of my lost pregnancies. While they taught me profound lessons -- not to take anything for granted, and that my time on earth will be valid whether I'm a mother or not -- this new life that toddles toward me gives poignant context to those lessons. And so I've come to regard my lost pregnancies as gifts: unexpected, yes, and painful to accept, but gifts nonetheless, presented in precious packages I'll never forget.


Ronnie Polaneczky is a freelance magazine writer.