Transcription:
Baby After Miscarriage ... From Risk to Rainbow Babies

Caitlin Whyte: Here's Dr. John Alton talking about misconceptions with miscarriages.

Dr. John Alton: That's probably the most common question that is asked. And it's really a tough question because there's nothing they did. The reasons for miscarriages are really unknown.

Caitlin Whyte: Unfortunately, I've seen it all too many times now loved ones, friends and family who have suffered the unbearable loss of a pregnancy or pregnancies.

And despite this monumental loss, women are speaking out in increasing numbers, not only to address the mental, physical, and emotional tolls of a miscarriage, but also to de-stigmatize the guilt that comes with it. Was it me? Did I do this and so on and so forth. Joining us for this critical conversation on life after a miscarriage is Dr.

John Alton, a board certified obstetrician and gynecologist on the medical staff at Southwest general.

This is Southwest general health talk. I'm Katelyn white. Dr. Alton, I'm going to ask you a few questions or thoughts from a mother or parents that they might be feeling right after this experience. The first is, was it something I did?

Dr. John Alton: That's probably the most common question that is asked. And it's really a tough question because there's nothing they did.

The reasons for miscarriages are really unknown, but it's more of a random event, which the embryo is from an egg that made an embryo and it just didn't get the right number of chromosomes, kind of like a blueprint, the blueprint wasn't right. So the building made it so far, but that it couldn't stand on its own.

So that analogy holds with miscarriages because it's the blueprint that's off. It's nothing. Uh, the mom did is not from me. Too active or not active enough. It's a very difficult situation, except there's something that patients don't have a control over.

Caitlin Whyte: You kind of touched on it on my next question, but are there any underlying causes of a miscarriage?

Dr. John Alton: Really? It's very, very, very uncommon. For women to have an underlying reason for miscarriages, a woman would have to have three miscarriages in a row or two back to back to get a workup to determine if there's something underlying 99% of these workups are negative. What I recommend for patients is, you know, when they find out they're pregnant, obviously not smoking is, is very important.

So quitting smoking prior to pregnancy alcohol use docking that when the pregnancy is documented, you know, people ask that the question a lot, like, Hey, I had, it was at a wedding. I had a couple of drinks at it. No, it was pregnant yet. Did that cause a miscarriage? Absolutely not that amount of alcohol use in the first two weeks prior to the positive pregnancy test is not related to miscarriage, increase the ability of someone to accept that, uh, that they went and had fun and enjoyed themselves.

And that might've been. It is really important for patients to understand and to get past that it wasn't that activity that did it.

Caitlin Whyte: So now that it's happened, where do I go from here?

Dr. John Alton: Well, there's kind of, uh, two ways. I look at patients with miscarriages from the time it's diagnosed to the time it's resolved is one time.

And the other time is from resolution to the next pregnancy or to the, to the next decision point. The first one is very physical related medical related to that. What's the best way for the doctor to, to help the patient through the miscarriage. And there's multiple ways there. Spontaneous, which is waiting for mother nature, there's medications in their surgery.

And it's up to the doctor and the patient sit down and figure out which situation is right for them. But then after the miscarriage has medically resolved, the emotional scars for, uh, can be around for a long time. After doing this job for many years, I am still amazed at the range of emotions that. That people can have with miscarriages.

For some patients, they say it's fine. You know, they made it through no big deal for other patients that can really cause an impact on their emotions or personalize and lead to some scar emotionally. And it's the loss of the baby's terrible. I mean, it's terrible. If the baby six weeks along are 60 years old, so no one can, can understand that.

Uh, personal loss more than a person and how that person deals with it is really important to moving forward. And one person I see quite frequently in relationships, you know, one person, a couple of the, maybe the spouse I've seen him with the husbands, just as much as the father has to be just as much as the mothers, that they're very much impacted by what they could have done to help prevent it.

You know, and like we said, there's really nothing they could have done either, you know, and sometimes they're more emotionally, you know, kind of handicapped by it. I really strongly recommend for couples. If there's a difference in emotional response, is there for them to seek counseling, to talk to professionals, you know, regarding this, this issue.

Cause it can handicap some, some relationships. Hmm,

Caitlin Whyte: absolutely. On the more logistical side of things, I mean, what are the steps that occur after having a miscarriage?

Dr. John Alton: No, the most important thing is the counseling part of the patients will ask, Hey, what's the chance of this happening again? And that's the, that's the question that I get most frequently.

And the chance for a miscarriage is about 10 to 15%. Per pregnancy, it's pretty high. Once some, for sharing this information, they'll find out other friends or family members that have had losses as well. Um, some of that is dependent on age. Honestly, someone over 40 is a little higher chance for a BP miscarriage.

Um, but I tell them basically recommend counsel them that they need to emotionally be ready physically. They can get pregnant in the next cycle, they'll start oscillating and they could potentially get pregnant two to three weeks, you know, after. The loss is complete, but the emotional part of it, I think, needs to be kind of reconciled.

And there has to be some time for that grief. Like I mentioned earlier, the chance of it happening second time is, is about 10%. But at times of those happening that people haven't really, you know, made it through the grieving for the first one, that can be pretty devastating. Um, but I really recommend my patients after they have the miscarriage, you know, um, and they're ready to start trying right away.

There's no reason to wait three months. It's kind of some old school thinking. Uh, the reason it was because, uh, years ago, decades ago, you couldn't find out if this is a new pregnancy or still the miscarriage the patient had nowadays early ultrasounds and pregnancy tests. We can determine that. I also recommend that as soon as they find out they're pregnant.

No, there's really nothing that the doc can do to prevent it. You know, that's the other part of the value that could the doctor of diving. Hey, if we would've known sooner, what could we have done? And the answer is no, but the one thing I pride my practice on is making sure we can give them that reassurance as needed that early ultrasound that shows everything starting off.

Okay. Does not guarantee anything but anxiety for those rainbow baby pregnancies are very high. Rainbow baby pregnancies is, is a term that kind of just got thrown out there a while back. And I really like it. It's the, it's the pregnancy after the miscarriage, seeing that through to a viable pregnancy, a viable baby at the end of it is really, probably one of the most exciting times for moms.

It caused a lot of joy and reflection. Obviously you're still grieving the loss of their, their miscarriage, but they're, you know, pregnant again and excited about it, but also very anxious. So it was rainbow baby pregnancy, the one after we really want to make sure and do the best we can to decrease that anxiety and give them some reassurance.

Everything's going fine.

Caitlin Whyte: Now, aside from the emotional tolls of miscarriage, is there any reason a couple should wait to have sex after a miscarriage?

Dr. John Alton: No, I think that's a personal preference. Obviously, if they, you know, want to have the pregnancy was unplanned and they want to space things out and maybe not get pregnant right away, they shouldn't need to talk to their physician or a nurse practitioner about birth control options.

But after the miscarriage is complete and they have clearance from their physician, their nurse practitioner, that would be totally fine to fill activities, exercise, working out intercourse. Really no restrictions at that point. And

Caitlin Whyte: when might there be a time to try alternative treatments, IVF or something like that?

Dr. John Alton: Yeah, that's a, that's a question that went. So I mentioned earlier about this thing called the recurrent miscarriage and that's when people have three miscarriages. Now the definition of those can vary, but it's three miscarriages. If I have a patient that has had two miscarriages back to back without a live birth, having a live birth really puts a lot of reassurance in there.

So if a mom has a baby at home and it was on complicated pregnancy, and then they had two miscarriages, there's still a very, very high chance. We'll have another viable pregnancy without any issues. But if the mom has not had a baby and has had two miscarriages back to back, or three miscarriages, total, there's a workup that can be done.

Blood work on the mom, a little bit of blood work on the dad to check the chromosomes. To make sure that her hormone levels are functioning. Okay. That could support a pregnancy, make sure there's nothing wrong with the inside of the uterus. So there's a full workup. And then after that sometimes IVF or, uh, what they call super ovulation is something that can be done appropriately through a reproductive endocrinologist.

Caitlin Whyte: Great, well, doctor, a lot of great information here. Is there anything you'd like to add to this conversation that maybe we didn't touch on yet? Uh,

Dr. John Alton: no, I think we hit on everything really well emphasize. And thank you for the opportunity to talk about this because you know, when miscarriages happen, people don't expect them and.

You know, it's not something that used to happen in the dark. You know, people would have miscarriages at home. You know, I really encourage patients to talk to their family members, talk to the people they trust the people they love and speak to their physician about the miscarriage and, and keep that dialogue going

Caitlin Whyte: well.

Dr. Alton, thank you so much for being a guest and helping out families who have experienced a miscarriage with such grace and comfort. To learn more about Southwest General's maternity services. Visit us online@swgeneral.com. This is Southwest general health talk. We'll see you next time.