Coming to Term: Uncovering the Truth about Miscarriage
by Jon Cohen
Summary
After his wife lost four pregnancies, Jon Cohen set out to gather the most comprehensive and accurate information on miscarriage-a topic shrouded in myth, hype, and uncertainty. The result of his mission is a uniquely revealing and inspirational book for every woman who has lost at least one pregnancy-and for her partner, family, and close friends.
Approaching the topic from a reporter’s perspective, Cohen takes us on an intriguing journey into the laboratories and clinics of researchers at the front, weaving together their cutting-edge findings with intimate portraits of a dozen families who have had difficulty bringing a baby to term. Cohen also scrutinizes the full array of treatments, showing readers how to distinguish promising new options from the useless or even dangerous ones.
Excerpt
On a brilliant, warm San Diego Saturday in the spring of 1996, my wife, Shannon, had her first miscarriage.
Our baffling, heartbreaking journey into the world of what doctors call “spontaneous abortion” began with a phone call. We were having a lazy brunch with my parents on our front porch, pine trees shading us, the Pacific Ocean visible in the distance. Our daughter, Erin, nearly six, was chattering with her dolls in the pine needles. Paging my way through the newspaper, I struggled to dodge conversation with my folks, who were visiting for the weekend and would rather talk than read. Then the phone rang, and Shannon excused herself to answer it.
Shannon is close to my parents, but had grown weary, as had I, of my mother’s well-meaning but insensitive probing about our reproductive status. Any luck? my mother would ask, month after month, noting that a cousin of mine recently had succeeded with in vitro fertilization. You really shouldn’t wait. You really should have started earlier. Maybe you should see a specialist. Maybe there’s something wrong with your sperm. Maybe you should do IVF. I’ll help you pay for it. You two should have another. It’s a shame. For Erin’s sake. She shouldn’t grow up alone. My kids always had each other to play with. There must be something you can do.
So it was with great delight that a week earlier, we had Erin phone my mother and tell her that Shannon, then thirty-seven, was pregnant. She was only four weeks along, too early to see anything with an ultrasound scan, but a blood test already had confirmed the positive urine test we had done at home. We even had a due date. My mother squealed, really squealed, with joy. She advised us not to tell anyone else until the baby was three months along, but at every opportunity she exclaimed, “Finally!”
A few days after sharing the news, we [had] Passover dinner at my aunt and uncle’s house…[B]ecause Shannon’s pregnancy with Erin had gone so smoothly, we ignored my mother’s warning, celebrating our good fortune with all fifty of my relatives. Shannon also confided to my uncle, a doctor, that she had been spotting blood, but that her obstetrician had said it was common and usually means nothing. My uncle agreed. “Everything is probably going to be fine,” he said.
Shannon’s spotting continued, and we read everything we could find to help us understand first-trimester bleeding, which doctors often refer to by the frightening phrase “threatened abortion.” Sometimes, when the embryo implants itself in the uterus it causes bright red bleeding for a few days. But this blood was brown and had continued staining Shannon’s underwear for several days….
Shannon saw her obstetrician, who took a blood test. A six-week-old embryo should secrete increasing levels of the hormone human chorionic gonadotropin, or hCG. Home pregnancy tests turn positive when a woman’s urine contains a high enough concentration of hCG…The doctor told Shannon that if the embryo was healthy, hCG levels should double every two to three days.
The phone call that Saturday morning was the doctor. “I’m really sorry to tell you this, but your numbers have plateaued,” the doctor told Shannon. “It’s not viable. You’re going to miscarry within twenty-four hours.”
Reprinted with permission of Rutgers University Press. http://rutgerspress.rutgers.edu
Reviews
"[O]ffers an important education about…miscarriage, and investigates all its facets--including the most personal, human pain"--New York Post
"If you or a loved one has had a miscarriage, this book will help you overcome the fear, confusion, and grief that comes with the experience"--Carl Zimmer, author of Soul Made Flesh
Author's Biography
Jon Cohen won the Science in Society Award from the National Association of Science Writers for his previous book, Shots in the Dark . He currently is a correspondent for Science and has written for the Atlantic Monthly, the New Yorker, the New York Times, and other publications.