Recurring Miscarriages & Subsequent Pregnancy Worry

QUESTION

Dear Experts,
My husband and I just started trying to have a family last November. We were excited to find that the first month was a charm. In just a few short months after finding out, at 10-11 weeks our baby died without us knowing until our 12 week prenatal visit to the doctor showed no heart beat. Our first pregnancy ending with a miscarriage was inconceivable for us. We found ourselves pregnant again in May, only to be followed with spotting and yet another miscarriage at six weeks. I didn't believe that this could be happening. Surely it could not happen a 3rd time. Sure enough in August we conceived again only to lose it at 4 weeks.

We knew that we were lucky that conceiving was not the problem, however, keeping a healthy baby was. Our plan at the doctor's office was to take a number of blood tests, (all which came back negative) followed by a plan of action as soon as I knew I was pregnant. I quickly was put on Met-formin (SP?), (Although my sugar tests were completely normal, this apparently is a common prescription for any fertility issue). My Physician also put me on Progesterone suppositories to use as soon as I found out I was pregnant. I conceived around September 5th and am now at 7 weeks. Four pregnancies in one year has to be a record.

Obviously our pregnancy is considered "high risk." To add one more "risk," at our last ob visit we found out we were having twins! We were shocked and are still shocked and too excited to guard our emotions. When you see two heart beats, two bodies, all you can do is begin to plan and become excited. We understand that the Great Physician is in control, but I am scared and concerned.

Should I be looking for a specialist at this point? I do think our doctor is capable, but he seems to have so many patients and is so busy. I just don't want to make the wrong decision now. He has not put me on bed rest, but I am under no circumstance able to lift anything, for fear the sac could pull from the lining of my uterus.

I am high risk! Should I seek someone else? And how do I calm my fears? I am scared and concerned, and much too excited to be able to lose this pregnancy too. Please help!

Angie

ANSWER

Dear Angie,
Yes, you should be looking for a high-risk obstetrician perinatologist to follow this pregnancy. You've been through too much to rely on your regular obstetrician. Plus, you are carrying twins, which also makes you a candidate for special care by a professional who is up on the latest knowledge and tools. A high-risk doctor will also give you the time and attention you require and deserve.

As for calming your fears, first, recognize that your fears are normal, given what you've been through, and what you are facing. By now, you certainly have a sense of how little control you have over your reproductive fortunes, and you may feel particularly vulnerable to tragedy, and therefore very anxious about the babies you are carrying now. Identifying your feelings, and knowing that they come out of your experiences can help you cope with them. You might also look into the book, Embracing Uncertainty: Breakthrough Methods for Achieving Peace of Mind When Facing the Unknown, by Susan Jeffers (St. Martin's Press, 2003.) It is a comforting book that explains how to let go of the outcome and trust the process when you are facing change or entering uncharted territory; accepting your destiny, finding treasures in adversity, following your intuition, finding meaning and purpose in whatever journey you take.

And there are two books that have extensive information on coping with subsequent pregnancy. First, Empty Cradle, Broken Heart, by Deborah L. Davis (Fulcrum, 1996), which has several chapters specifically on the emotional aspects of pregnancy after experiencing the death of a baby, as well as lots of support and information around grieving, which can add to your coping ability. Second, Trying Again, by Ann Douglas (Taylor, 2000) which looks at subsequent pregnancy from timing it through delivery, with some on the emotional aspects, as well as lots of medical information that you might find helpful as you progress through the different trimesters and decisions about prenatal care. This book is written especially for bereaved mothers who need a pregnancy book that takes care of their special needs for reassurance and understanding.

We wish you the best with this pregnancy!
-- Debbie and Mara
The Childbirth Complication Expert Team

Davis and Stein

Deborah L. Davis, Ph.D. and Mara Tesler Stein, Psy.D. are the authors of Parenting Your Premature Baby and Child: The Emotional Journey, a 2004 National Parenting Publications Awards "Gold Award" winner. They also collaborated on Parent: You and Your Baby in the NICU (2002), as part of the nationwide March of Dimes NICU Project. They.ve been invited to regularly contribute to Advances in Neonatal Care, a neonatal nursing journal; their first article appears in Spring 2005. They are the founding members of Partners in Perinatal and Pediatric Consulting, which promotes developmentally supportive care for babies and parents, as well as collaboration between families and health care professionals.

Dr. Stein is a clinical psychologist in private practice, specializing in the emotional aspects of coping with crisis and adjustment around pregnancy and parenting. She is regularly invited to lecture and give workshops on these issues throughout the country to conferences of physician and nursing groups, doulas, and lactation consultants. Since 1997, she has been consulting with organizations and providing training to health care providers, guiding their efforts to improve the level of psychological support and developmentally supportive care to families during and subsequent to perinatal crisis.

Dr. Davis is a developmental psychologist, researcher, and writer who specializes in perinatal and neonatal crisis, medical ethics, parental bereavement, parent education, and child development. Dr. Davis is the author of four books for bereaved parents, Empty Cradle, Broken Heart (Fulcrum, 1991; 1996), Loving and Letting Go (Centering, 1993; 2002), Fly Away Home (Centering, 2000) and Stillbirth, Yet Still Born (PILC, 2000). She is also on the Board of the Pregnancy Loss and Infant Death Alliance (PLIDA.org) and is regularly invited to write articles for professional periodicals and parent support materials.