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misc.kids FAQ on Miscarriage, Part 3/3

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Archive-name: misc-kids/miscarriage/part3
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See reader questions & answers on this topic! - Help others by sharing your knowledge
		    Misc.kids Frequently Asked Questions
			    Miscarriage

			    Part 3 of 3

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Molar Pregnancies
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This is what I know, for starters:

Most miscarriages are of the types "fetal demise" (where the fetus dies) or
"blighted ovum" (an egg is fertilized, and a placenta starts growing, but
the fetus fails to grow, so there is only a placenta and an amniotic sac).
Much rarer are molar pregnancies, which are a type of blighted ovum where
an abnormal spongy mass grows on the placenta. Partial moles much rarer
than full moles.

When a molar pregnancy has been diagnosed (the tissue extracted during the
D&C is sent to a pathology lab), the first course of action is to make sure
all the growth has been removed. This is done by doing weekly, then monthly
pregnancy blood tests. This is cruel test to do to a woman who is dealing
with the aftermath of a miscarriage (personal opinion). Three negative
weeks in a row means going to monthly tests. Three negative months is a row
means the patient is "cured". If the test do not go to negative, this
indicates that the growth mastesised (spelling?) and that there is tissue
growing elsewhere in the body. According to my doctor, the usual course of
treatment is then chemotherapy. It is therefore imperative that the patient
not become pregnant again until declared "cured" (since obviously a
subsequent pregnancy would make it impossible to determine if there was any
other growth). It is usually recommended that you wait at least a year
before attempting another pregnancy.

I am hoping that someone out there has gone on to have a successful
pregnancy after a molar pregnancy, since I could use some encourage- ment
when we get around to trying again.

Thanks for your sympathy. As many people are aware, a miscarriage is
certainly a painful loss. Dealing with a non-viable pregnancy is hard, too
(I often felt like I had no right to cry over a baby that never was).
Dealing with the additional issue of whether chemo will become necessary
while dealing with the other parts is hard, too. Especially when a lab
technician just knows you need a pregnancy test and starts making small
talk on the assumtion that you are hoping for a positive.

Later Addendum:

Since the time that i wrote the original letter to Tracy, i have completed
a successful pregnancy (and she'll be 2 on Sunday!) So, I really don't need
encouragement at this point, but if anyone reading the FAQ has had a molar
preg. and would like to correspond, I would be glad to be the moral support
end of an exchange.

Maureen Busch mbb@world.std.com
Mom to Jody(7/27/86), Sean(11/1/88), and Rachel(8/6/93)
misc.kidding since '87; '95 PA pg 25, '94 PA pg 18, also in '93 PA

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How Long to Wait Before Trying Again
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Another reader posted a message to the net asking for advice on how long to
wait after a miscarriage before trying again. The following is a
compilation of her responses. Please remember that this is only opionion,
and that you should first and foremost follow your doctor's advice...
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In reading misc.kids during the year since my wife's miscarriage, I've
decided there just isn't any consistency in the advice.

My wife was 34 last year when she miscarried. Our doctor told us to wait
until she had had one period before trying to conceive again. We did
exactly that. That was her only period. She got pregnant again right away.
That baby boy, our second, was born January 21, 1994, and appears to be
perfectly healthy. More healthy than our first, in fact, who is missing a
kidney.
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I want to tell you, that I had 3 miscarriages since 1992, and I had to have
4 D&C's since then. I had a appointment with an endocrinologist, and he
told me to wait at least 1/2 a year before the next try. First I couldn't
understand and I started as soon as possible with all the testing. Now I
feel that this 1/2 year is not too long to get the emotional healing that I
needed so much.
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The "three month wait" is sometimes suggested because it can take your body
a little while to get back on a regular menstrual cycle. If you wait three
months your physician has a better chance of coming up with a reasonable
due date. But it isn't always necessary, and if there's any doubt about the
due date now they can clear it up with ultrasound. So if you were told you
didn't have to wait three months, it's perfectly all right to start trying
again as soon as you're ready. (This was what my doctor told me.)

I got pregnant again the first month after, and despite a difficult
pregnancy, there was never any threat of another miscarriage. And my baby
is six weeks old now, a healthy beautiful little boy. There didn't seem to
be any problem caused by getting another baby started so quick.
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The standard waiting period of three months (for the first miscarriage--if
you've miscarried before, the waiting period goes down--I'll explain later)
was designed mostly, IMO, for the expectant parents to deal with their
emotional grief. Waiting for one cycle makes very good sense medically in
terms of waiting for the uterine lining to completely heal, etc., and so
that if you get pregnant, it's easier to "date" the fetus from LMP. If you
jump right in, generally, ultrasounds, etc. need to be performed in order
to get a correct dating for the fetus.

I have miscarried twice. The first time, my OB said "wait three months." (I
was 29 at the time.) The second time, just this past summer, at the age of
33, I was told to wait 2 cycles, though 1 cycle would suffice. Friends of
mine who have infertility problems are told not to wait at all (that is,
not to wait for a complete cycle; they should at least wait until the
physical cramping, etc. is gone) because it's so difficult for them to
conceive anyway that waiting just prolongs the agony.

I hope this helps. You have my complete sympathies on your miscarriage.
It's never easy, especially after you've daydreamed about life with baby,
etc. I do know, from my experience, that the second one was easier
emotionally (though tougher physically, because it required a D&C) because
we have a healthy son.
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As far as I know it's all folklore. It's one of those "might help, can't
hurt" things. Different doctors, different suggested waiting periords... my
gyn suggested two months.
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Ah, yes, confusion. I know it well. Here's one example for you:

I lost a pregnancy at 8 weeks while on vacation; the older OB at the
hospital there said to wait for three normal periods before trying again.
Since I wanted to time the next baby so that I'd be home in the summer when
my older kids are out of school, that would have meant waiting a whole year
-- and at 33 I didn't like that idea. So I asked my regular doctor when I
got home. She said that the wait wouldn't make much difference, except for
trying to estimate the due date! So we did try again, and lost another just
8.5 weeks after the first. That ended hopes for a maternity leave the next
summer. Now aiming for the following spring/early-summer, we waited 10
months, conceived in August, lost again in September, and conceived in
October. Ultrasound done in December resulted in an estimated due date in
early July, suggesting the conception had occurred just 3 weeks after the
spontaneous abortion. Another ultrasound in June revealed a very low lying
placenta which would have made a normal delivery dangerous, so a c-section
was scheduled. The result - a healthy baby girl, quite well developed for
the estimated gestational age.
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I have had two miscarriages. The first was at 11 wks LMP and then I was
told to wait until after two menstrual periods. The Dr said that this
helped in knowing when conception occured because I would know how long my
cycle was and when my LMP happened. I had the same Dr. after the second
miscarriage (3 months after the 1st), and he gave me the same advice. Due
to selling the house and moving, we didn't try for about 6 months. The
third pregnancy carried to term and now Kenneth will be two in June.
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I had a friend, mid-thirties, miscarry her first baby. The doctor told her
to wait a few months to give her body a rest. She wanted to wait because it
had been traumatic emotionally, and she wasn't ready to risk that just yet.

Well, she and her husband are not good at birthcontrol. She didn't get her
next period, and she delivered a beautful baby girl nine months later.

Every woman is different. I think (as a mechanical engineer and general
busybody) that the correct time to wait is as long as you need. If you are
ready to try again and your body is healthy, I say go for it.
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In response to your posting about how long to wait after a miscarriage... I
had miscarriage 10/1/93 at about 9 weeks. I did have a D&C though. My
doctor advised waiting 2 periods. Luckily, my period started exactly 4
weeks after. The dr. had said it could be 4 to 10 weeks! So I waited 2
cycles and started trying again. Some people I spoke with thought 2 months
wasn't enough, but my Dr. did so I took his advice. I am now 9 weeks
pregnant and am pretty nervous, but I'm taking it one day at a time and
hoping for the best! Good Luck, I know how difficult it is.
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I am sorry about your miscarriage. I too miscarried at about 6.5 weeks (in
September, 1991) & was concerned about how long to wait before trying
again. I was 32 at the time I miscarried. Like you, we received various
recommendations, even from different doctors. After reading up on it and
talking to my brother (who is a general practitioner & does a fair amount
of OB-GYN work), I concluded that the recommendations to wait are based
more on the need for time to recover psychologically than the body's need
to recover physically. I had suffered from infertility & it had taken me
over a year to get pregnant, so I didn't want to wait any longer than
necessary. I did wait until I had one period (which was 7 weeks after the
miscarriage) to try. But then, much to our surprise, I became pregnant
again right away. Our healthy son was born a little less than 11 months
after my miscarriage.
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I was told two periods. When I asked the doctor if I could move that up, he
said it probably wouldn't hurt anything but recommended that I take
multivitamins or better yet prenatal vitamins (and to eat healthily) right
away to make sure that my blood had enough time to recover.

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Other Resources
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The three best books I had were "The Well Pregnancy Book," "A midwifes
Guide to Pregnancy and Childbirth," and "Preventing Miscarriage: the Good
News."
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Well, I don't know if this will be helpful. There is an organization called
Pen Parents, who provide resources and support for all kinds of pregnancy
and subsequent loss. Their address is as follows

Pen Parents
P.O. Box 8738
Reno, NV 89507-8738
1-800-484-1033 code 7332

In their "synopsis" that I recieved, there is a brief description of
several other groups that also provide resource and support. One of them is
called HOPE (Helping Other Parents Endure) and the address is listed as...

C/O Pauline Montague
4833 Straume Ave.
Terrace, BC
V8G 2C8
Canada

The description of HOPE that follows is..." A newsletter by and for parents
who have lost a child through miscarriage, stillbirth or neonatal
death...."

Another one...

Pregnancy and Infant Loss Center
1421 E. Wayzata Blvd. #30
Wayzata, MN 55391
(612) 473-9372

"The PILC is a non-profit organization offering support, resources, and
education on miscarriage, stillbirth and infant death..."

There are more listed, if you would like me to post them. Am sorry to hear
of your situation. Please keep me posted...I'd like to know if you've found
any help through these sources.
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Add to your list of books

``Coping with Miscarriage''

Unfortunately, I don't have the author's name, and it was a library book,
but I found it very reassuring after my miscarriage.

Lynn las@ai.mit.edu
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The best book I found on pregnancy loss was "Ended Beginnings". There are 2
authors, one of which is Cathy Romeo, the other I can't remember now. It
was stronger in terms of positive possabilities for emothional healing than
other books I read.

Jan Stetson mailto:jstetson@bbn.com
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I have a book on preventing miscarriage that tells stories of women who had
up to 8 miscarriages before giving birth to healthy babies. In case you
care, the name of the book is "Preventing Miscarriage: the Good News." It
details all sorts of things. One thing the book mentioned that I had never
thought of was that sometimes the same problems that make it hard for a
couple to conceive also make it hard for the mother to carry to term. I
found it interesting reading, but sometimes the words that were meant to be
encouraging did not encourage me.

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