From CANFP
Evaluating Risk of Miscarriage
By Sheila St. John
Oct 10, 2008, 16:11
Question
I recently found out I was pregnant in August and went straight to the doctor when I found out. I was not sure of the exact day of my LMP so my doctor and I were guessing how far along I was. I was thinking I was only about six weeks. The first ultrasound showed only 5 weeks and 5 days but my doctor said no worries. We may just have our days wrong so come back in a week for another ultrasound to make sure the baby grows..if not there may be a problem. My husband and I went in for the next ultrasound and the baby was still 5 weeks 5 days. My doctor told me my pregnancy would end in miscarriage and that it was very normal and common in first pregnancies. I was completely devastated and could not believe this was happening. She gave me two weeks and then wanted me to come back for a follow up to make sure I had the miscarriage completely. I went in September 20th and she said everything went well and she wants me to have a cycle in October and we can
start trying again in November.
The thing that is bothering me is I have repeatedly asked her if it could be my progesterone or hormone levels and she is very adamant about not checking my levels because she "feels" everything will be fine the next time around and she usually does not start checking levels until 2 or more miscarriages. This really bothers me because I DO NOT want to go through the pain and misery and depression all over again of a miscarriage before we say, hey, something is wrong.
Why does she not want to check these levels yet? I would much rather find out now but she says no doctor does this after 1 miscarriage!
Thanks,
Brooke
Answer
Dear Brooke,
I am so sorry for your loss. I think the pain of miscarriage is often underestimated, with the thought that you can just "try again". However your physician is correct that MOST doctors would not do any testing after just one miscarriage. And I am sure your doctor wants you to know you are not at fault for this miscarriage, and many women have the experience of an isolated miscarriage, and never have another.
We at CANFP have a different perspective on evaluating risk of miscarriage, for when a woman charts her cycles, it provides very specific insight into her hormonal health, and can be a tool for identifying a woman at risk for miscarriage, or pregnancy complications such as premature delivery. If these risk factors are observed on the chart, or if a woman has a history of miscarriage, the chart then becomes a tool for timing a hormonal evaluation so it is accurate, and precisely timing any necessary hormonal supplementation as well.
Even if your physician did agree to order a hormonal evaluation, if it is not timed according to your ovulation, the results might not be very enlightening.
My suggestion is that you pursue instruction in creating an accurate record of the biomarkers of your cycle, so that a more informed evaluation can be made prior to your next pregnancy. This will also provide an accurate tool for identifying the estimated time of conception, and an accurate due date.
We have a list of Professional resources in California on our site, at "Find a Local Resource", and links to resources outside of California on our links page.
A woman who charts her cycles gains an intimate knowledge of her self, and is empowered to participate more fully in her own health care, providing information that is invaluable to a physician trained to interpret it.
Sheila St. John
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