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Beyond Miscarriage

Just as I became increasingly aware of the mediocre and even misguided care we received, I similarly became deeply skeptical about many of the supposed causes of miscarriage that receive media coverage.

A close reading of the scientific literature and interviews with the world's leading miscarriage researchers have convinced me there is hardly anything a woman can do to cause her own miscarriage.

_____Live Discussion_____
Transcript: Dr. John Larsen, a specialist at George Washington University Medical Center, answered questions about high-risk pregnancies.
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Studies have yet to find solid evidence that smoking, quaffing a few glasses of ale, cranking up your engines with a grande Frappuccino, living near a chemical dump, drinking tap water, working at a computer terminal, flying on an airplane or even snorting cocaine causes miscarriage.

That's not to say that pregnant women should blithely smoke, drink, do drugs or hang out at chemical factories. All of those environmental factors can harm babies, they just don't seem to lead to losses. That should give comfort to any woman who has blamed herself for a miscarriage.

Looking Ahead

Fortunately, miscarriage research is becoming ever more sophisticated, and new diagnostics are on the horizon that may dramatically clear the fog around many critical questions.

In one cutting-edge example, researchers have begun testing whether genes isolated from a uterine biopsy can detect hormonal imbalances that lead to implantation problems. If this test pans out, doctors at long last will have a valid means to evaluate the worth of progesterone and other interventions that many long have believed -- but none have proved -- can correct this problem.

Not everyone who wants to carry a baby to term will benefit from that kind of research. That's a sad fact. But I have interviewed more than 100 people who have had their lives turned upside down by miscarriage, and almost everyone I met who wanted a family eventually created one. Some turned to adoption. Others have tapped the wonders of technology, transferring their own biological embryos to a surrogate or using a donor egg to create a viable embryo that they carry themselves.

Yet for most people who miscarry -- even those who suffer multiple losses -- the odds are in their favor that, eventually, they will carry to term. Their odds increase if they seek expert care and inform themselves about what to do and what to avoid.

And my own remarkable reproductive fate should serve as a beacon of hope for many couples caught in this storm. On Oct. 13, 2002, Shannon, then 44, gave birth to our third child, Aidan.

So we now have one in diapers, one learning to read, and a built-in, 14-year-old babysitter. That's what scientists call a good outcome. •

Jon Cohen, a correspondent for Science, is author of "Coming to Term: Uncovering the Truth About Miscarriage" (Houghton Mifflin), which was published in January.

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