An Obstetrician’s Experience With Recurrent Pregnancy Loss

 

By age 31, Jaime was newly married and in her second year of private practice as an OB/GYN. A year later, she and her husband Ted, a military family practice physician, decided to start trying for a new addition to their family. Jaime went off birth control and they were pregnant right away. Unfortunately, shortly after seeing the fetal heart beat on an ultrasound, Jaime miscarried at about 6 weeks gestation. Being an OB/GYN, Jaime had dealt with this many times with her own patients, so she reminded herself that this does happen and tried not to get too alarmed. She and Ted decided to wait about 6 months before attempting to become pregnant again. After only two months of trying, they were pregnant a second time. However, at about 6 weeks gestation, Jaime woke up with vaginal bleeding and went to the ER where she was told the pregnancy was lost.

Shortly after their second loss, they moved to another city to start new jobs. At this time, she was also studying for her OB/GYN boards and her father was ill, so they weren’t really actively trying to become pregnant. About a year after their move, however, Jaime and Ted found out they were pregnant a third time the day after he father passed away. Again, at 6-7 weeks gestation, Jaime lost the pregnancy. After this third loss, Jaime knew that she needed to see a doctor. She went to see a reproductive endocrine and infertility specialist, or REI, where a full work-up was initiated. Labs to check for antiphospholipid antibody syndrome were drawn, an ultrasound of her uterus was done, and Ted was checked also. Both Jaime and Ted also had a karyotype done to make sure their chromosomal make-up was normal. In addition, due to a family history of autoimmune disease (her mother passed away from scleroderma), additional work-up was done. Finally, a hysteroscopy, was recommended to evaluate the lining of her uterine cavity. Much to Jaime’s surprise, the hysteroscopy revealed that she had a uterine septum, or a piece of abnormal tissue that divides the uterine cavity in half. It was removed at the time of the hysteroscopy without any complications.

Immediately after the uterine septum was removed, Jaime and Ted became pregnant. Although her laboratory workup for antiphospholipid antibody syndrome was negative, her doctors decided to treat her with blood thinners and baby aspirin based on her three prior early pregnancy losses. Overall, her pregnancy was uneventful, and at the age of 35, she delivered a healthy baby girl.

Looking back, Jaime realizes that she likely put off having the appropriate testing done to investigate why she was having miscarriages. However, during this time, Ted was deployed and she had changed jobs, moved to a different state and lost both of her parents. Being an OB/GYN, she convinced herself not to stress after the first miscarriage. After the second, she was worried and upset, but she had so much going in her life that she tried not to let herself get carried away with concern. She simply kept reassuring herself because that was what she did for her own patients who had experienced pregnancy loss. After the third time, the hurt finally set in. She recalls Ted asking her, “What if something IS wrong?” She realizes now that she was reluctant to take that first step to find out. She was afraid she would be told that something WAS wrong and she would not be able to have children. Because so much was going on in her life during this time, it was easier to be in denial and avoid the situation at hand. It was easier to neglect her own needs and focus on what was going on around her.

When asked what advice she would give to a couple going through the same experience, Jaime says that communication with your spouse should be a priority. Although the woman is the one who physically suffers the pregnancy loss, pregnancy loss is hard on the man in different ways. She says she tried not to get caught up in the fact that the pregnancy losses happened to her. They happened to Ted as well. He was very supportive and tried to be strong, but his feelings sometimes got lost amidst all of the heartache.

Since her experience with recurrent pregnancy loss, Jaime feels that she has become a better doctor. She remembers that before her own experiences, she never quite understood the grief her patients felt when losing a pregnancy at such an early gestational age. Now she feels that she has more compassion and not only better understands the words she uses to counsel her own patients, but truly understands how they feel when they have suffered a loss. She also learned that because she was an OB/GYN, she could not focus on all the bad things that could happen during her pregnancy. As an obstetrician, she was used to dealing with all the complications, and it was hard to leave work at work and just be a normal expectant mom. It wasn’t until a friend told her, “Don’t miss your pregnancy worrying about your pregnancy” that she finally relaxed and felt the joy of being pregnant. She was so grateful to be able to carry her daughter, and she feels her experiences with pregnancy loss have allowed her to appreciate being pregnant even more.

For more information on recurrent miscarriage/pregnancy loss click here or here.

For more information on uterine septum and hysteroscopy click here.