October is Pregnancy and Infant Loss Awareness Month. This is an opportunity to talk about a topic that too many women, one out five according to the March of Dimes, deal with year-round and is often kept in the shadows.
Ronald Reagan proclaimed October as a time to provide support, education and awareness around miscarriage, ectopic pregnancy or stillbirth. These four weeks also serve as a reminder to the public they know someone (whether the person has shared it with them or not), who has had a pregnancy loss.
In the past year, celebrities like Carrie Underwood and Gabrielle Union have shared their experiences with multiple miscarriages. While on the surface this may not seem like huge news to the rest of the world, it can be incredibly helpful to those not in the public eye who have gone through similar experiences.
We’ve all heard the phrase, “You’re not alone”. Even though a pregnancy loss can feel isolating, when you hear someone speak about their loss, it reminds you that you truly aren’t alone. Perhaps their experience is similar to your own or maybe they articulate something in a way you couldn’t. It’s comforting and reminds you that something that felt so isolating is, unfortunately, a loss others have endured.
As an infertility advocate, I worry when I hear celebrities share how they have had several miscarriages, but they don’t mention any medical testing around it. I’m not a doctor, I have no medical training, and even though I have a B.A. in theater, I have never played a doctor on television. However, I feel confident that many in the reproductive field would agree when I say that having more than two miscarriages isn’t something that should be dismissed. Recurrent Pregnancy Loss is a diagnosis and a real concern.
When I watched Carrie Underwood’s interview on CBS News, again, I truly appreciated her sharing her story, her candor and how much I knew people were going to relate. It especially struck me that while she is currently pregnant for the fourth time, she expressed how she felt like she couldn’t feel confident or joy because she felt like the pregnancy may suffer the same fate as the last three. That’s the cruel thing about infertility and pregnancy loss. It can kill hope. Truly. You feel like you can’t relax or get enthusiastic about anything as it may be taken away from you in a moment.
What I couldn’t help think though was, I wish there was more talk around what her doctor thought may have been the reason. Had she had autoimmune testing? Had she had her anti-mullerian hormone (AMH) tested? Would IVF plus either PGS or PGT-A have helped her? When you have had three miscarriages, that’s three miscarriages too many, and looking into all of your medical options seems warranted.
For example, Gabrielle Union, who had a jaw-dropping 8 or 9 miscarriages, only recently found out her medical diagnosis. It was adenomyosis and, in her words, “The gag is I had it in my early 20s.” In her case, she felt doctors were dismissive of her symptoms and, even if they weren’t, it’s hard not to wonder if they could have spared her from an incredible amount of heartache with proper testing.
My point is that while miscarriages aren’t (unfortunately) out of the ordinary, having more than one or two isn’t something that we should dismiss… even if your current doctor wants to. It may not be just ‘bad luck’. There may be an underlying medical issue that, if properly diagnosed, could be addressed.
While we spend this month as intended, offering support, breaking the silence and raising awareness, I hope the conversation will also encourage patients to be their own advocates. We should feel comfortable speaking to our doctors about digging a little deeper (if both the patients and doctors discuss it and feel it is warranted. Every patient’s treatment and protocol should be tailored to them because each patient has their own needs. Your doctor is there to work with you; should you have concerns or feel there’s still a question you have that hasn’t been answered or something you’re unclear on, you should feel confident in speaking with him or her about it. As they say, “it takes a village”, and when it comes to fertility treatment, that’s incredibly true. While no one wishes to go through IVF or any kind of reproductive assistance, it provides you with the benefit of having a team of nurses, embryologists, reproductive endocrinologists and fellow patients to support you. Ask questions, educate yourself and get answers, or at the very least, options you feel good about.