Miscarriage After Heart Beat at 7 weeks

QUESTION

Dear Midwife,
This is my 2nd miscarriage. Last time I miscarriaged at 5 weeks without hearing a heartbeat, this time I miscarriaged at 7 weeks after hearing a heartbeat with a hcg level of 76,179 and progesterone of 31. I ended up having a D&C on my birthday, the worse birthday gift I could ever have. I was seeing a fertility specialist who was monitoring my belly on a weekly basis and said he saw the pregnancy progressing well. I heard the heart beat when the baby was 5 weeks 6 days, it was only 85bpm but it was a great relied. A week later the heart beat was 115bpm, all normal according to the doctor. A week later I miscarried.

The doctors said that usually a pregnancy lost at this time, is because of chromosome abnormalities. The doctors did a fetus analysis and had the audacity to tell me that it was a “Female” fetus with no chromosome abnormality. It was a baby girl!!

My husband had a Karoyotype testing that reflected no chromosome abnormalities. My fertility doctor is not worried. He said for me to try again and he will monitor it again. He expects to see no problems, and continues to tell me that miscarriages are common, not to worry. My GYN recommended that I start taking 81 mg baby aspirin as soon as I am pregnant next time.

I am terrified of going through this again for the 3rd time. I don’t know what to do any advice will be greatly appreciated.. I think there is something wrong with me which does not give the fetus what is needed to survive. What should I do? What should I test for?

ANSWER

First, the good news. Even with *three* miscarriages, the chance of carrying the fourth normally is still 80%, which is why your doctor is so casual about all this. Which totally ignores how it is for you and your husband. There is a huge battery of tests that can be run, and I wouldn't recommend taking baby aspirin or anything else without a diagnosis based on facts. Many doctors don't run all these tests until after the third miscarriage (oh joy!), but I'd suggest finding someone who will do them now and get to the bottom of this. VERY rarely, the woman has a condition that means that this will keep happening, in which case it's better IMHO to know that and then consider other plans (surrogacy or adoption) for becoming parents. But much more often, the source of the problem is identified and can be treated. Let's hope that happens in your case!
-- Cynthia, CNM. PhD.

Cynthia Flynn

Cynthia Flynn, CNM. PhD, is the General Director of the Family Health and Birth Center which provides prenatal, birth, postnatal, gynecological and primary health care to underserved women and their families in Washington, D.C. Recently Cynthia served as Associate Professor of Nursing at Seattle University. There she not only taught, but remained in full scope clinical midwifery practice at Valley Medical Center where she cared for pregnant and birthing women, and practices well-woman gynecology, family planning, and treatment of sexually transmitted diseases.

Cynthia founded Columbia Women's Clinic and Birth Center, where she took care of pregnant women and infants up to two weeks of age and attended both birth center and hospital births. Before Cynthia earned her CNM, she worked as a registered nurse in labor and delivery and postpartum and is a certified Doula and Doula trainer.