This is part one of a two-part blog. Read part two here.
Oasis International Hospital has begun offering a pregnancy loss support group. It’s an issue which affects the lives of many women: up to one in four women deal with the loss of a pregnancy in their lifetime. We spoke to two of Oasis’s staff members, Dr. Juliette Kinn, who obtained her MD and OB/GYN diplomas in France, and is a full time OB/GYN at Oasis, and Sylvia Huang who holds a masters of social work degree from the U.S. Lead by Sylvia Huang, the group is limited to four to five people per session. Meetings take place at Oasis, and are free to attend. Contact sylvia.huang@oasishealth.cn for more information.
Getting over pregnancy loss can be difficult. What are some common reactions for women?
Huang (M.S.W.): Pregnancy loss can often trigger feelings of loss. Many women who lose their babies become suddenly afraid of losing everything else, be it their sanity, other relationships important to them, their faith in the world, or any hope for the future. Many, many women who go through this loss feel a deep need to grab onto other things in their life for fear of losing those, too. Also, it is normal to feel triggered into sadness in seeing other pregnant women, babies, holidays and anniversaries, playgrounds, doctor’s offices, advertisements for baby-related items. They may bring you to tears even when you feel strong.
What are some common reactions for partners and other family members?
Dr. Kinn: The partners are often supportive although they are grieving too. Some family members might put pressure on the woman, but as long as the woman is open to talk about it, e.g. the mother in law could have been through miscarriage too, she will understand that she is not alone in this situation.
What is miscarriage? What are some common misconceptions about miscarriage?
Dr. Kinn: Miscarriage means loss of an embryo or fetus before the 20th weeks of amenorrhea or, according to the World Health Organization (WHO), loss of an embryo or fetus less than 500g. Most miscarriages occur during the first 14 weeks of pregnancy. Women may blame themselves for pregnancy loss. They feel guilty and think that they are punished for what they did wrong. Some women may feel useless or cheated by their bodies.
In general, is there anything a woman can do to prevent pregnancy loss?
Dr. Kinn: Low levels of folic acid had been linked to miscarriage, so we usually prescribe folic acid or prenatal vitamins with folic acid as a dietary supplement to prevent miscarriage but not only. After three consecutive miscarriages, we will prescribe tests to find out if there are other factors such as Hughes Syndrome, lupus, thrombophilia, etc. Adapted treatment would be given according to the disease.
What are the risks of having a miscarriage?
The frequency of the miscarriage is between 12 to 15 percent. First trimester miscarriage is the most frequent
– 31.9 percent before 7 weeks of amenorrhea
– 52,3 percent between 8 and 11 weeks of amenorrhea
– 11.1 percent between 12 and 15 weeks of amenorrhea
– 4,7 percent after the first trimester
Quenby, S.M., Farquharson, R.G. (1993) Predicting recurring miscarriage; what is important? Obstet Gynecol, 1993; 82:132-138.
Risks for miscarriage increase with the gravity (number of children) and mother’s age
10 percent at 25 years old
30 percent at 35 years old
50 percent at 42 years old
Striat, G.M. (1990) Recurrent miscarriage: definition and epidemiology. Lancet 1990; 336:673-675
When can couples try for another baby?
Dr. Kinn: There is no proof for the best date to try again. Some doctors give contraceptive pills for three months to facilitate endometrial renewal, and allow the couple to try again after three months. I used to do the same but I don’t anymore because there is no proof and according to my experience, it doesn’t change much. I will suggest to my patients to wait at least until after the next period to try again and I prescribe Folic Acid if they hadn’t already been taking it.
What can couples do to improve their chances for next time?
Dr. Kinn: Eat healthy, stay relaxed, avoid smoking, drinking alcohol, and stress, and take Folic Acid.
Photo: Courtesy of OASIS International Hospital