Handling miscarriage is one of the most challenging clinical situations for both the patient and the provider. Although miscarriages are common, they are devastating for a patient trying to have a baby.
What is recurrent pregnancy loss?
There are different definitions of “recurrent pregnancy loss”; however, most prominent organizations, such as the American College of OBGYNs and the American Society for Reproductive Medicine, define recurrent pregnancy loss as two or more consecutive losses with the same partner.
In some progressive states, such as Massachusetts, recurrent pregnancy loss is recognized by state law as a form of infertility, and insurance companies include it in the list of conditions that are covered. Several tests have been found to be evidence-based approaches to evaluating recurrent pregnancy loss. When the full evaluation is complete, the underlying cause can be found in roughly 50% of patients. This makes the discussion with the other 50% of patients difficult because determining the problem is key to fixing it.
For patients, each pregnancy loss is a reminder of infertility in many ways. Even though pregnancy can occur, a healthy baby does not result. There are natural feelings that something is wrong or that being a parent was not “meant to be.”
The emotional impact of recurrent pregnancy loss
Patients can start questioning if they should continue trying because each loss is so emotionally painful. Instead of being hopeful and excited, each pregnancy is wrought with worry and, finally, the confirmation of a bad outcome when a miscarriage occurs. This is made worse because supporters with good intentions may constantly be pressured to “keep trying,” even though it is hard to imagine enduring another miscarriage.
Patients with recurrent pregnancy loss are especially vulnerable to gimmicks found through online searches that claim to be the reason for their miscarriages. However, these treatments are often not recognized by professional groups due to a lack of data and can be extremely expensive.
Next steps
Infertility and recurrent pregnancy loss are complex. Overcoming recurrent pregnancy loss requires a team, so being surrounded by supportive family and friends can be empowering. Patients need to work with a fertility specialist who is well-versed in this condition to provide the most comprehensive and appropriate recommendations. Patients are often surprised by others who share similar stories when they join support groups, which are very common in most communities. It is important to ask your fertility specialist about these resources so you remain connected early in the process.
For more emotional support resources, listen to the Egg Whisperer Podcast featuring Dr. Dana McQueen, titled “Healing After Miscarriage.”
