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Miscarriage and Infant Loss Awareness
What You Can Do
By Jane Gregorie - October 21, 2019
October is pregnancy and infant loss awareness month. Having gone through two pregnancy losses myself, I know how difficult it can be—how it feels shocking at first, then like an emptiness that can’t be filled, then like grief that will stay with you forever. It can also feel lonely, since few people talk about it and friends and family might not even know about the early pregnancy at all. Miscarriage and infant loss feel like experiences of the shadow realm since those who haven’t gone through that particular dark night of the soul don’t seem to get it and aren’t comfortable talking about it. Or even worse, they might talk about it, but say the wrong thing like, “at least you can get pregnant.”
I’m passionate about helping women feel less alone through this experience by giving them a space to speak of it openly and honestly in the treatment room. I’m also passionate about honoring and remembering the babies who were with us briefly but will always be part of us. Whether this means speaking their name, creating a ritual for the anniversary of their passing, or just welcoming their presence into a quiet, contemplative moment together, it’s important to me to acknowledge these babies. In Japan, these beings are called mizu-ko or “water-children” and offerings are made in their honor to the Bodhisattva Jizo-sama, their guide and protector. We could use more ritual in our culture to allow us to fully grieve these losses and honor these beings who passed from us too soon.
In terms of clinical issues around pregnancy loss, if you’ve had more than two miscarriages, it’s standard of care to get a workup with your OBGYN or a reproductive endocrinologist. Most miscarriage, especially those in the first trimester, are due to chromosomal abnormalities or aneuploid (abnormal) embryos. I heard a statistic at the ASRM conference once that stated that up to 64% of all fertilized embryos stop developing even before a woman would get a positive pregnancy test. Of those losses that occur during the first trimester, around 75% are from chromosomal defects. Other causes of miscarriage include clotting disorders, uterine abnormalities, genetic issues in the parents (like translocations), thyroid issues, autoimmune disorders, diabetes, or infections.
Many women who’ve had miscarriages get diagnosed with subclinical hypothyroidism. While there is wider range for normal TSH in the general population, it’s ideal for fertility and in pregnancy to have TSH levels between .45-2.5. It’s frustrating that not all physicians recognize that a slightly high TSH level can lead to miscarriage. In terms of uterine issues, a uterine septum can cause miscarriage if the embryo implants on the septum instead of the endometrial lining. Clotting disorders like Factor V Leiden can cause clots which cut off blood supply to the fetus and can also lead to loss in later trimesters. While autoimmune issues are rare, they can also cause recurrent losses. And if a parent carries a genetic defect like a balanced translocation, they can pass that on to the embryo repeatedly. Doing IVF with CCS preimplantation genetic diagnosis is one way to deal with genetic defects that could be repeatedly passed down.
A typical workup for recurrent pregnancy loss would be a basic clotting panel that includes autoimmune factors like ANA, APA, and ACA, karyotyping of both parents to check for genetic issues, an HSG, SHG or hysteroscopy to check uterine contours, bloodwork for TSH, and a basic fertility panel (Day 3 FSH, LH, Estradiol, AMH, Prolactin). Some doctors also test for uterine infections like mycoplasma and ureaplasma by running cultures.
In terms of what you can do naturally to prevent pregnancy loss, I recommend getting acupuncture to improve blood flow to the ovaries and uterus (ideally up to 3 months prior to conception for optimizing egg quality), avoiding BPAs and plastics around food, taking prenatal vitamins with methylated folate, fish oil, vitamin D3, as well as antioxidants for cellular health like Ubiquinol, PQQ, and Acai berry. I’ve seen many women with histories of recurrent loss conceive naturally and have healthy babies, but I always recommend getting a full medical workup to rule out any causes that require medical intervention (like surgery for a septum, or blood thinners, or thyroid support).
At Acupuncture Denver, we’re very familiar with any red flags we might see in labs or based the detailed history and intake we provide. Don’t hesitate to reach out to us if you have questions about how we can help!