A Discussion of Miscarriage, Infertility and Early Pregnancy Loss

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miscarriage and infertility millions of women experience it but it's difficult

to discuss openly and honestly today a candid conversation about both I'll be

sitting down with two of the three sisters collectively known for their

blog forever freckled to discuss these sensitive and emotional topics later

we'll learn more about early pregnancy loss from OBGYN dr. Cohen plus one

patients emotional story i'm ereka vetrini access health starts now

studies have shown anywhere from 10 to 25 percent of all clinically recognized

pregnancies will end in miscarriage although many women experience it it can

still be devastating to process but hopefully the more candid we are the

less alone we will feel it's important to keep the conversation alive so I

invited our freckled sisters to discuss not only miscarriage but infertility and

postpartum depression we're gonna talk about a topic that I think is sensitive

and sometimes a little too hush-hush infertility I I personally I went I

didn't struggle I had some bumps in the road but nothing major but all of my

best friends a lot of my family members struggled with infertility

did you guys struggle at all we did we were twins actually and we both had

trouble getting having children for me I was able to get pregnant very easily but

I wasn't able to keep the pregnancy so I had my son and in between my son and my

daughter actually had three early pregnancy losses I actually had trouble

getting pregnant so it was really challenging for me because I just wasn't

getting pregnant so I went through a lot of fertility treatments and IUI

until I had all three of my children I know I think as a 20 the 20 year old

version of myself thought this is the way that it goes but it doesn't work

that way so emotionally how did you feel Alison what did how did that affect you

yeah so for me I I had a really hard time with it because I'm a very plan to

personally type-a and everything kind of goes by my schedule and when I was

finally ready to have my family I I wasn't able to get pregnant on my

timeframe so that was really challenging for me to just kind of have to adapt to

that also the uncertainty of not knowing if you're going to have a family right

will I be able to work into it yeah these treatments and the hormones is it

even going to work out for me am I going to be able to get

ha really family and so that was took a very emotional toll on me was the doctor

ever able to sort of tell you why you were struggling so in my my journey to

have a family nothing they could never diagnose anything and I think that is

actually one of the most common reasons is there anything that any advice you

can give to anyone out there who's dealing with it I I think even as a

physician and knowing the medicine behind early pregnancy laws I still

internalized it yeah and you really put a lot of pressure on yourself and your

body and go through you know the motions of trying to figure out what it was that

went wrong but it's so important for women to understand that the most common

reason for an early pregnancy loss in the first trimester is chromosomal

abnormalities so genetically the baby just wasn't sound and it wasn't ready

and you know it's it's not if this is not meant to be and it will happen you

know just keep have a positive emotion about it and try your best not to blame

yourself infertility it's so common people need to realize that if they're

right after people get married or with what they're working on their second

child to maybe be a little sensitive yeah maybe we should have a little bite

to eat because our topics are gonna get over when we come back more of my

conversation with Katie and Alison

miscarriages I've unfortunately had too many people I unlucky but it

doesn't make it whoa sorry just because it just happened to a friend of mine so

and just to see how they suffer from it physically is crazy it's and you know

what it is to even wouldn't somebody else you imagine because you couldn't be

in that place and think god forbid that happen

so what happen when you go through it yourself and you hear like you know I

gone I had children earlier than Allison did and I had obviously gotten through a

few miscarriages and then when Allison had her miscarriage is the same emotion

you just feel so horrible for that person and you just want to make it

better for them and you just know how disappointing it is and how hard it is

to get through it for me I had one miscarriage and it was very

disappointing because I was trying so hard to get pregnant and then you

finally you get that positive pregnancy test that you've been working so hard

and wanting so badly and and when you lose it it's devastating I think that

that's really hard as when you put all that pressure on yourself

did you just start not telling people when you were when I had that first

miscarriage I mean I waited til I was well into that 12 first out of that

first trimester before I was like very open and excited so obviously having a

miscarriage is extremely emotional but what were some of the physical side

effects you initially have the cramping and the bleeding which is really hard

but then and what I don't think people realize is it takes a while for your

body to get back to its natural cycle and so you can start trying again I was

at the lowest I've ever been after having my dogs clean your body has

completely changed right you're completely sleep-deprived yeah your

hormones are crazy busy and suddenly you're fully responsible for the tiniest

most precious thing and it's hard and it's hard and I think that you know you

have this this image of motherhood being amazing and every magic every moment

being magical but it's not always that way and you're gonna have a bad day and

that's okay and you're gonna have those moments when you're not feeling magical

and you've spit up on you and you haven't slept in you know days and you

haven't gotten out of your PJs and that's okay but I think the important

thing and they take-home message is that there's hope out there and that you

don't have to suffer in silence so now having been through everything that

you've been through how does that affect your parenting as

how do you feel now yes I mean I have a crazy life it's definitely a circus I

can't sit here and say that having 1 year old twins and a 4 year old is not

extremely stressful so it's it's very easy to come home from a long day at

work and your your toddlers are crying and your 4 year old is having an

accident and you know and feel overwhelmed and stressed with that I

work as well we all work remember how fortunate we are to look at that moment

and not try to move past it but yes day in it is really hard I felt very

fortunate when I was able to have my children and look at them and you know

it's just it's such a special time and it's a really special bond that you have

and so it's really enjoyable and to be able to have that and you know not

everybody gets that not everyone gets to go through IUI and IVF and it's not

always successful so just being able to see your children and knowing that you

you were able to start a family is and that you're not changing diapers anymore

and that for more information about EPL go to american pregnancy org and for

more sisterly advice visit forever freckled com when we come back we

continue our discussion of early pregnancy loss stay with us

being pregnant can be a joyous and exciting time in a woman's life hearing

your baby's heartbeat for the first time picking out their name designing the

nursery and even planning their future it can also be very nerve-wracking you

want nothing more than to protect this new life you are creating I'm a mother

to two girls Arianna is 11 years old and Victoria is 10 years old over the past

couple years I've been kind of yearning to try again for possibly a little boy

when I found out I was pregnant I was a little nervous because I'm a little bit

older cuz I'm over 35 but I felt really positive about this pregnancy at the

nine-week appointment dr. Cohen showed me the baby's heartbeat so I was really

excited about that the same week I began spotting the spotting started for about

a day it started to increase in intensity I called dr. Cohen's office

and they told me to come in and they'll do ultrasound courtesy to make sure that

everything was okay the ultrasound technician I was asking her questions

and she didn't want to answer any of the questions she was telling me that I need

to talk to the doctor so they put me in the waiting room and I waited and I

started really getting nervous about everything and on my way back into the

room I saw my chart on the door and there was a little sticky note on it and

the sticky note said she doesn't know yet I immediately kind of already knew

what was gonna happen and that they were going to tell me that I miscarried and

at that point I had a lot of emotions I didn't know what to think but I knew

whatever it was the doctor was gonna tell me it couldn't have been good

early pregnancy loss or EPL can be heartbreaking and can affect a woman not

only emotionally but physically as well after finding out that she had

miscarried Carlin was given three options watch and wait which allows the

miscarriage to happen on its own take medication which allows the miscarriage

to happen sooner or have a D&C performed which allows the doctor to remove the

pregnancy after being given the three choices I wasn't sure what I wanted to

do so I told the doctor that I was gonna go home and do some research to figure

out which option would work best for me I didn't understand why this happened or

how something like this could happen I asked the doctor and the doctor informed

me that these things can happen in that miscarriage especially in the first

trimester is common pregnancy loss is defined as loss during the first 13

weeks of pregnancy it can be either intentional or unintentional there are

many causes of unintentional early pregnancy loss around 50% of the time

it's due to chromosomal whether it be micro deletions deletions or an

unexplained chromosomal anomaly that may occur there's maternal indications

whether there is hormonal infection or there's an underlying autoimmune

disorder within the patient and also we have our alcohol abuse drug abuse

excessive caffeine intake smoking malnutrition improper or abnormal

implantation of the fetus and also advanced maternal age

before I could make a decision my body kind of made that decision for me after

a few days I started to believe very heavily and I was passing clots and I

was in a lot of pain the cramping in the bleeding was so severe in the middle of

the night I felt a very full feeling like a lot of pressure and I ran to the

bathroom stepped inside of the bathtub and all of the blood just started coming

out some of the physical effects that are associated with early pregnancy loss

include moderate to severe cramping bleeding rarely fever a patient may

continue to bleed within 48 hours or 72 hours after a loss if a patient

continues to bleed where she's going through as I tell them I've had an hour

is important that they seek care either by their healthcare professional or to

an emergency room it's important to educate your patients and to let them

know if the ability persists and it's hard for them to even get up and walk to

the bathroom because of dizziness or they feel like they're gonna faint these

are signs and symptoms that the patients may be having an increased amount of

blood loss and they need care immediately in our office all our

patients when they come in with suspected or with early pregnancy loss a

hemoglobin has checked in our office that tells us pretty much how much the

patient has been bleeding or how much blood they've lost during this type of

miscarriage why is that so important because we really don't want to send a

patient home if her hemoglobin is low with the risk of possibly needing a

blood transfusion or passing out while they're driving home or having an

accident at home it will also dictate our management at that time whether we

need to do something immediately whether it be in the office or in the hospital

such as a DNC or if the patient's blood volume is stable we could send them home

with medication dr. Cohen then asked me to come in for ultrasound I was informed

that I still had some tissue remaining so then I was again given the same

choice as to whether or not I wanted to take medication to help

with passing the tissue or if I wanted to have a DNC procedure completed to

have the tissue removed I decided to go with the medication he prescribed me a

tablet called methergine the methergine tablet helped to slow down the bleeding

and it also helped me to expel some of the tissue that I still had left inside

of me but in the end I still ended up having to get a DNC procedure bleeding

due to early pregnancy loss or EPL warrants expectant management to avoid

complications methergine a uterotonic along with another medication

misoprostol is commonly used for early pregnancy lost emmerich methods and

tablets have a rapid onset of 5 to 10 minutes is in an appropriate first-line

agent to manage early pregnancy lost Amerige I was really excited about being

a mom again my girls wanted another little sister

but I really really wanted a little boy of my own but I will never know whether

I was having a boy or a girl one of the toughest things our patients will deal

with is early pregnancy loss whether it be in the first trimester or the last

trimester a loss is a loss and it's to be dealt with that on an emotional level

it is up to us to help our patients get through these tough times not only

physically but also mentally and even if you do go through something as terrible

as a miscarriages what I went through if you want a baby definitely go after your

dream go after what you want because in the end what you will gain is is far

more than what you lost for more information on EPO you can visit

methergine com or just log on to access health TV what is methergine used for

methergine is used just after a baby is born to help deliver the placenta also

called the afterbirth it is also used to help control bleeding and to improve

muscle tone in the uterus after childbirth who should not take

methergine if you suffer from hypertension high blood pressure if you

experienced one of the common complications of pregnancy called

toxemia sharp rise in blood pressure leakage of large amounts of the protein

albumin into the urine and swelling of the hands feet and face if you are

pregnant if you are allergic to methergine how

should I take methergine one tablet three or four times daily for a maximum

of one week what should I avoid while taking methergine grapefruit and

grapefruit juice may interact with methergine and lead to unwanted

side-effects discuss the use of grapefruit products with your health

care provider what warning should I know about

methergine do not breastfeed within 12 hours after taking methergine methergine

may pass into breast milk in small amounts and could affect a nursing baby

in some cases you will need to use this medication for up to one week after your

baby is born you may need to use a breast pump to establish and maintain

your milk flow until your treatment is finished if you use a breast pump during

this time throw out any milk you collect inform your doctor if you have kidney or

liver problems since these conditions can adversely affect methergine activity

if you have a heart disease coronary artery disease smoke are obese have

diabetes or high cholesterol you may be at a higher risk for methergine to cause

narrowing of the arteries which may lead to a heart attack what other medications

might interact with methergine there are a number of drugs affected by or will

affect the way methergine works tell your doctor about all medicines you use

including prescription over-the-counter vitamins and herbal products what are

the possible side effects of meth agen the most common side effect is high

blood pressure associated with seizure and/or headache other possible side

effects include low blood pressure stomach pain caused by uterine cramps

nausea and vomiting tell your doctor if any of these symptoms are severe or do

not go away call your doctor immediately if you experience seizures chest pain or

discomfort slow or fast heartbeat difficulty breathing

dizziness swelling of the foot or leg skin rash swelling of the eyelids or

around the eyes face lips or tongue these are not all possible side effects

of meth agen and others may occur if you notice other effects not listed above

contact your doctor or pharmacist you may report side effects to the FDA @ww

FDA govt forward-slash MedWatch or call one 800 ft a ten eighty eight or contact

lupin pharmaceuticals inc at one eight hundred three nine nine two five six one

for more complete information about methergine and your specific health

needs talk with your doctor pharmacist fda-approved labeling can be

found at wwm Etheridge ENCOM I want to thank Katie and Allison for their honest

discussion today and we also want to thank Carlin for sharing her personal

story and of course dr. Cohen for his expertise and knowledge for more

information on any of the topics we discussed today you can go to access

health TV see you next time