The AFA Blog

Lupus, infertility and pregnancy

by Corey Whelan

Lupus is a chronic, autoimmune disease, which can damage any part of the body.  While teenagers and men are sometimes diagnosed with lupus, women of child bearing age comprise the largest statistical group affected.  Like all other autoimmune diseases, lupus "tricks" the body into thinking that it needs to defend itself against it's own healthy tissue and organs.  This malfunction of the immune system creates an invasion of auto-antibodies, which attacks the immune system itself.

Common symptoms can include inflammation, joint and muscle pain, sensitivity to light or sun, debilitating fatigue, headaches, mouth and nose ulcers, weight and hair loss, and low grade fever.  Some people will experience a rash that appears in a butterfly shape across the cheeks and the bridge of the nose.  

Lupus is a chronic disease marked by flares - meaning that symptoms can flare up and worsen, and then go into remission, in an unpredictable pattern over the course of many years.  

Most patients diagnosed with lupus will experience normal fertility, however, a common drug often utilized to treat the disease, marketed under the name Cytoxan, can reduce fertility potential in both men and women.  Cytoxan can lower the sperm count and also reduce testicle size in men that have taken the drug for five years or longer.  It is recommended that men freeze their sperm prior to beginning treatment with Cytoxan.  In women, Cytoxan reduces fertility potential by speeding up the rate at which a woman’s egg supply is depleted, thus pushing her into premature ovarian failure, or early menopause.it is recommended that women with lupus only take Cytoxan when vital organs are involved, and/or corticosteroids aren't effective

Around 50% of all women who have lupus will be able to experience a healthy, normal pregnancy.  However, pregnancy can often signal a flare up of symptoms and for women with this disease, every pregnancy should be categorized as high risk.  This means that a high risk obstetrician who is well versed in lupus and its symptoms should be chosen to oversee your pregnancy.  As with most high risk pregnancies, pro active behaviors, including frequent medical check ups and getting adequate rest will be extremely important.

Additional complications of pregnancy may include:

• Miscarriage during the first trimester
• Formation of blood clots during the second trimester that can interfere with the function of the placenta or cause miscarriage, caused by a lupus antibody known as antiphospholipid antibody.   
• Pre-term birth and low birth weight babies
• High blood pressure, or preeclampsia

If you have lupus and are considering pregnancy, all of this may seem daunting.  However, it is important to remember that women with lupus can, and do experience normal pregnancies and deliver healthy babies.  The keys are timing and communication.  If you are ready to get pregnant talk to your doctor, if possible.  Your doctor will recommend against attempting conception during flare up times when your lupus is active.  Discuss your current medication protocol as well as the medications that will be recommended for you during your pregnancy.  Take care of yourself, and have hope for the future.  With careful timing, most women with lupus will be able to become moms both safely, and successfully.

For more information, click on these sources:

http://www.everydayhealth.com/lupus/pregnancy-risks-with-lupus.aspx

http://www.healthcentral.com/encyclopedia/408/118.html

http://www.targetwoman.com/articles/systemic-lupus.html

http://lupus.about.com/od/lupus101/p/WhatIsLupus.htm

http://www.wegenersgranulomatosis.net/Cytoxan_and_Fertility.htm

Reprinted with permission from Examiner.com

The dreaded biochemical pregnancy

by Fred Licciardi, M.D.

Here I will tell of a typical story about a woman who has been suffering from infertility, and finally becomes pregnant. After the relief of a positive pregnancy test her doctor repeats the test and says, “Well Lisa, it looks like your pregnancy is biochemical”.
Now I can’t completely describe what Lisa is saying to herself, but it’s probably something like this.
“What is he talking about? A biochemical pregnancy? Did I get pregnant? Am I pregnant? Biochemical? It's bad enough I have felt like a science experiment, now I’m biochemical?”
Let me try to straighten this out. The definition of a biochemical pregnancy is a pregnancy that stops growing before it is large enough to be seen on ultrasound. It’s a very early miscarriage. The causes are the same as for any miscarriage. By far, the most common reason is that the embryo is genetically abnormal, that is it doesn’t have the right number of chromosomes. And although it has the tools to grow for a while, as the embryo grows and needs to become more complex, the tools run out and the embryo can grow no more. There are other causes of miscarriage and that will be topic of a later blog.
The word “biochemical pregnancy” is a terrible term. It’s very cold and scientific and inhumane. I try not to use it, I just say it’s a very early loss. I thing the fertility community should throw out the word. I’m going to ask them if they will.

 

Surviving the Guilt of Infertility

By Iris Waichler, M.S.W., L.C.S.W.

             In a blog I recently read the author described her “survivor’s guilt”.  She  experienced two pregnancy losses and has been trying to conceive since 2006.  Her blog described her multiple attempts at intrauterine inseminations and IVF transfers without any success.  She candidly described the darkness and emotional and physical pain related to these multiple losses.  I wondered what she meant by guilt?

            She went on to explain that a life changing seminar she attended had made her recognize that it was up to her to release the emotions and sadness linked with these multiple losses.  She discovered that the sadness and guilt she had placed on herself for failing to have a healthy child had emotionally and physically caused her to be immobile.

She believes that women have a choice about how to deal with the painful episodes caused by the inability to conceive a child and become a parent.  She chooses to believe that she will become pregnant again at some point in the future.  The author thinks she lost some readers because she chose not to continue to describe the darkness she felt and is focusing on feeling positive and better.

            I was struck by an observation she made that I believe is true.  She described the gap that occurs between someone who is trying to conceive, becomes pregnant, or decides to adopt, and those that are still trying to conceive.  Her theory is that once you become pregnant there is a sense of guilt about those who are not pregnant but were there for you when you were trying to conceive.  She believes a successful pregnancy can make you feel as though you have left them behind and nobody speaks about it or understands what to say or do.  

            I led a parenting after infertility group for several years and guilt was a recurring theme.  My group participants also expressed fears that something would go wrong with their pregnancy because of past failures.  They described feeling guilty for being pregnant and having friends still struggling to get pregnant.

            This dilemma is something many have experienced.  It is a delicate balancing act allowing yourself to be happy about your own pregnancy and being sensitive to others who are still trying to get to where you are.   Anyone who has been infertile can describe the savage emotional and physical impact it has on their lives.  You become a member of a club nobody wants to belong to.  Yet, this club’s members offer each other unconditional ongoing support and understanding.  Suddenly you are not a member of that club. If you are among the lucky who eventually have a healthy child those memories are not erased.  I believe room can be made to experience the joy of conquering infertility and simultaneously sharing feelings of encouragement and compassion with those you know who are still trying.  If you have a close relationship with another person who is infertile and you feel comfortable enough to discuss this issue it can ultimately strengthen you relationship.  You both have to be willing to take that chance and express what you need from each other.  In the end this experience may be a source of comfort to all the participants.

Iris Waichler is author of Riding the Infertility Roller Coaster

Experts at UN Meeting Urge Action to Combat Environmental Causes of Cancer.

Important and significant actions designed to reduce or eliminate environmental toxins in the workplace were urged today by experts attending a United Nations convened scientific meeting.  Interestingly, many of the same toxins known to contribute to escalating cancer rates world wide have also been linked in multiple studies to infertility and birth defects of various types.  The press release appears in its entirety here:

EXPERTS AT UN MEETING URGE ACTION TO COMBAT ENVIRONMENTAL CAUSES OF CANCER.

UN press release

(New York; 18 March,  2011)

Medical experts attending a United Nations-convened scientific meeting today called for action to address preventable environmental and occupational causes of cancer, noting that nearly one in five of all cases of cancers are attributable to the environment, including work settings.

“Many environmental and occupational factors, including certain chemicals, radiation and airborne particles, can cause cancer,” said Maria Neira, the Director for Public Health and Environment at the UN World Health Organizations (WHO), which convened the meeting in the Spanish Principality of Asturias.

“These cancers could be prevented and reduced by changes in national and international policy to limit people’s involuntary exposure to these substances,” she added.

The cancers related to the environment, which comprise roughly 19 per cent of all cancers and cause 1.3 million deaths each year, are often the result of situations where people have limited control over the quality of air they breathe, the water they drink, and the level of chemical contamination in indoor and outdoor environments and at places of work.

In their “Asturias Pledge,” the experts urged governments to include environmental and occupational preventive measures in their national cancer control programmes, and ensure enforcement of national and international standards for environmental and occupational carcinogens.

They recommended that WHO lead a global effort in highlighting the importance of primary prevention of cancer, assess the impact of environmental and occupational interventions on primary prevention of cancer, and develop guidance for implementation of evidence-based interventions.

Civil society should raise awareness about practices and processes that increase carcinogenic risks, raise awareness, educate and advocate for funding to implement effective primary prevention of those types of cancers, the experts suggested.

Industry, for its part, should support and implement measures aimed at preventing the cancers. It should also contribute to policy development relating to the mitigation of occupational risks and workers’ exposures; eliminate or reduce exposure to known and probable carcinogens, and better inform workers on the risks they face in the workplace and protect them from carcinogens.

Reducing and eventually eliminating the exposure to environmental and occupational carcinogens is the most effective way to prevent a number of cancers, according to WHO. Stopping the use of asbestos can prevent lung cancer, mesothelioma and cancers of the larynx and ovaries, for example. Replacement of benzene with safer solvents will prevent leukaemia, the agency said.

 

Asturias Pledge

Environmental and Occupational Determinants of Cancer: Interventions for Primary Prevention

Asturias (Aviles and Gijon), Spain

17 – 18 March 2011

http://www.who.int/phe/news/events/international_conference/Call_for_action_en.pdf

 

Cancer is the second leading cause of death worldwide. Environmental and occupational risk factors are estimated to be a substantial contributor to the cancer burden, many of them are modifiable and often result from involuntary exposure of populations, but have yet to be seriously addressed by cancer prevention programmes. The burden of cancer is currently shifting towards heavily populated low- and middle-income countries and is predicted to increase due to a rise in life expectancy as a result of economic development. Therefore, environmental and occupational interventions are key for reducing the incidence and mortality of cancer, can be cost-effective and contribute to the overall well-being of communities.

 

In line with World Health Assembly Resolution WHA58.22 on Cancer Prevention and Control, where countries were urged to pay special attention to cancers for which risk factors are avoidable, including environmental and occupational factors, we, the participants in the first WHO International Conference on "Environmental and occupational determinants of cancer: Interventions for Primary Prevention", call for a broad, public health driven response bringing together public heath, environmental, occupational and cancer control communities in a multi-sectoral and collaborative approach, to tackle known and preventable causes of cancer, using scientific evidence to raise awareness and promote environmental and occupational interventions in support of primary preventive measures:

 

 

TO GOVERNMENTS

1. Further develop surveillance of the burden of cancer, support research and build capacities for systematic identification and measurement of environmental and occupational risk factors as part of national cancer control programmes.

 

2. Include and implement evidence-based environmental and occupational preventive measures as part of policies, legislation and regulations, creating synergies among public health programmes, with NGOs and private and public institutions.

 

3. Adopt and enforce national and international legislation for protection against environmental and occupational carcinogens.

 

4. Support campaigns for behavioural change, including in the work place, to protect individuals from environmental and occupational cancer risks, through innovative approaches and collaboration with the media, and using easily accessible public information about the risks and protection measures.

 

 

 

 

TO WHO

1. Lead a global effort to highlight the importance of primary prevention of cancer through healthy environments, raising awareness and bringing together public heath, environmental, occupational and cancer control communities.

 

2. Shape the research cancer agenda so as to take account of environmental- and occupational-related cancers, including a better characterization of causes and assessment of the effectiveness of behavioural change and environmental and occupational interventions for the primary prevention of cancer.

 

3. Encourage governments to include environmental and occupational prevention measures as part of national cancer control programmes.

 

4. Develop guidance for the implementation of evidence-based environmental and occupational interventions based on population needs assessments.

 

5. Support the implementation of environmental and occupational prevention measures in developing countries and countries in transition through technical assistance, training and other means.

 

6. To support implementation of the WHO Framework Convention on Tobacco Control and the World Health Assembly Resolution WHA60.23 on Prevention and control of noncommunicable diseases: implementation of the global strategy.

 

7. Encourage governments to provide funding to further study environmental factors as potential causes of cancer and to support primary prevention of cancer due to known environmental and occupational risk factors.

 

8. Establish a coordinated network of institutions at national and international level to support policy development and implementation of primary prevention measures for environmental- and occupational-related cancers.

 

 

TO CIVIL SOCIETY NETWORKS

1. Increase awareness raising about environmental and occupational determinants of cancer.

 

2. Advocate for the enforcement of national and international standards for exposure to environmental and occupational carcinogens and to enhance protection of workers.

 

3. Further develop innovative campaigns and strategies to raise awareness about individual behavioural change to support primary prevention of environmental- and occupational-related cancers.

 

4. Strengthen involvement in policy development and implementation related to the mitigation of environmental and occupational risks.

 

5. Advocate for research on environmental- and occupational-related cancers and on effectiveness of prevention measures, including those related to behavioural change.

 

6. Advocate for funding to tackle primary prevention of environmental- and occupational-related cancers, including support for awareness raising, education, and wider implementation of measures known to be effective.

 

7. Support the development of a global network of international environmental-, occupational- and health-related NGOs to advocate for the introduction of environmental and occupational aspects to the global cancer agenda, and with other actors to engage with the media in support of primary prevention of environmental- and occupational-related cancers.

 

 

TO INDUSTRY AND THE PRIVATE SECTOR

1. Incorporate measures for primary prevention of environmental- and occupational-related cancers into existing corporate initiatives and business management programmes.

 

2. Where necessary, develop substitutes, products, technologies and processes to eliminate the use of carcinogens, evaluate their effectiveness and support international technology and information transfer.

 

3. Provide information to governments, workers and consumers about hazardous substances and products, ensure clear labelling and responsible marketing.

 

4. Train workers, suppliers and sub-contractors in preventing exposures to carcinogens and establish prevention and mitigation measures.

 

5. Partner with governments and civil society groups in support of primary prevention of cancer.

 

Villain or victim? An analysis of the Pettway kidnapping case.

by Andrea Mechanick Braverman, Ph.D.

When Ann Pettway kidnapped Carlina White only three weeks after her birth, she began a family based on loss and deception.  Carlina’s biological parents suffered untold anguish at the loss of their daughter, compounded by the uncertainty of her fate.  Was the kidnapping of baby Carlina an act of desperation by a woman who suffered multiple pregnancy losses and feared that she would never be a mother? Or was the kidnapping one of villainous self-interest and cold calculating entitlement?  Is Ann Pettway someone who deserves our pity and understanding or does she deserve our condemnation and scorn?

 We cannot help but have a preconceived judgment about Ann Pettway.  Even if a woman has been through multiple miscarriages, it is the rare woman who steals a baby from another.  How do we begin to understand the tidal wave of emotions that could ever allow a woman to consider such a heinous act?

 There are an estimated 72.4 million infertile women globally and, of that number, many have experienced miscarriage.  Women (and men) typically develop coping strategies, seek out medical help, and get support to get through these terrible losses The fear that infertility will always place the individual on the sidelines watching friends and family experience the fulfillment of raising a child leads to moments of utter despair:  that a pregnancy will never happen; that the dream of a long wanted biological child will be forever unmet; that the most important life goal will never be reached.

 So the nerve Ann Pettway touched was the one similar to the moments of desperation individuals and couples experience on the infertility pathway.  Many infertile women and men have observed that they have indulged in the fantasy of just taking a baby, but, quite obviously, they would never think of actually acting on that wish.  Just as the frustrations of caring for a newborn 24 hours a day can lead parents to fantasize about shaking the baby, such feelings would serve only as a marker of a need for more sleep or help.   Similarly, someone who has been through multiple miscarriages or infertility will recognize that the fantasy of taking a child is perhaps an indicator of a willingness to consider raising a non-biological or non-genetic child through adoption or gamete donation.

 By processing the feelings encountered through loss or infertility, these couples then often seek resolution through adoption or egg, sperm or embryo donation.  They have the appropriate empathy to understand that taking another’s child would leave its parent empty and grieving.  As a result, they build their family in a positive way and not on one based on loss and deception.  Because, as Carlina White proved when she sought out the truth, families built upon lies simply don’t work.  Ann Pettway clearly had something else operating in her beyond what a typical woman experiences when having multiple losses and that “something” allowed her to close down the normal processing of right and wrong; her empathy evaporated.

Most everyone knows someone personally who has experienced a miscarriage.  For some, it was a single loss and may not have had a long lasting impact. as another pregnancy was achieved and emotion and energy was focused on the successful pregnancy.  But for others, multiple miscarriages involve one devastating loss after another without the infrastructure we usually rely upon for such losses.  If public discourse would turn from the sensational aspects of the Carlina White story to one of understanding that many women experience emotional trauma after a pregnancy loss or the experience of infertility – the accompanying grief and fear – then Carlina’s story has a positive ending that extends beyond even her remarkable reunion with her parents.

 We need to support our family and friends who experience pregnancy loss and infertility.  We need to make it safe for those who are grieving to share this grief and the  typical ways we support the bereaved  assist them through their difficult journey.  We must not trivialize any loss with hard words like “it wasn’t meant to be” or “there was probably something wrong with the baby so it’s better it was never born” or “you were only a few weeks pregnant”; no one ever feels it is better to lose a child.  These words seek to paper over the pregnancy and loss when in fact many parents seek to honor the memory of that lost baby.  When a pregnancy begins, so begin the dreams and hopes and love for that unborn child.  So whether a pregnancy lasts a few days or weeks or months, or if the child is lost full-term, we need to let the bereaved hopeful parent know that their grief is real and legitimate and respected. 

 As Ann Pettway faces the (inevitably) very public courtroom proceedings, let us hope that we can step out of the court of public opinion and step into one of public education and better understanding of those 72.4 million infertile women as well as the infertile men who must endure the journey of fear, hope and uncertainty about becoming a parent.  Let Carlina White’s legacy not be one of simple loss and reunion, but rather also one of enlightenment and education.

Dr. Braverman is a health psychologist specialist in medical health management, infertility counseling, third party reproduction issues and diabetes care.

 

Why You Should Like Infertility

by Merry Armentrout

I have a confession. I don't want anyone to know what I'm about to share, but feel the need to do so to prove a very important point. Let me start from the beginning...

As Director of Communications for The American Fertility Association my job is to spread the word about our organization. This involves working with the media, including the emergence of social media. I created a Facebook Fan Page for The AFA a few months ago, and I'm proud to say it rocks. The fan page includes 15 HD videos on a variety of topics, including Endometriosis, PCOS, Recurrent Miscarriage, In Vitro Fertilization and Reproductive Options for Gay Women, to name a few. The videos featured on our fan page come from The AFA's online library which includes Video Fact Sheets, informational fact sheets featuring a top expert in the fertility field on video. The best part, the videos are only a small fraction of our fan page. You can find pictures from our outreach events across the country, information on The AFA's board and staff members and daily posts and discussions on relevant topics on family building.

I've said it once, and I'm not afraid to say it again- our fan page rocks!

You would think I would be the first person to "Like" the own fan page I created, but I wasn't- I hesitated. That one small moment of hesitation shows there's a huge problem with the negative stigma associated with infertility. I didn't want to become a "fan" of The American Fertility Association because I didn't want my 550 "friends" on Facebook to think I was infertile. It doesn't matter the people who are closest to me, about 50 or so, know my husband and I haven't tried to have a baby yet, but it was the 500 other "friends" I was concerned with. The people I haven't seen since high school graduation, the people who I haven't talked with in years, it's those people I didn't want to think I was struggling with infertility.

If I saw a "Like" button for such organizations as Livestrong, a group that fights cancer, I would have no hesitation becoming a fan. In fact, thousands of people wear a yellow bracelet showing their support for fighting cancer. Cancer does affect more people, but infertility is one the rise. The latest statistic is one in 6- that's how many couples in the United States are facing infertility.

People who are coping with infertility have enough on their plate, so the least we can do is be supportive.  How can we do that? The AFA is working tirelessly to normalize the conversation about infertility in the mainstream. Our goal is to remove the shame and embarrassment many people feel when dealing with infertility. I'm hoping my confession might help us towards that goal.

I'm urging all of you who are reading this blog to "Like" The American Fertility Association on Facebook. Become a fan. Email the link to your friends and family.  Urge them to "Like" The AFA.  The more fans we have the better. Everyone facing infertility should know they're not alone. Cheesy, but true- one in 6 remember.

Don't do what I did. Don't hesitate. Our mission is too important. Help us spread the joy of family.

New Year's Resolutions

by Merry Armentrout

I've noticed a pattern in my New Year's Resolutions- they're always the same. Eat healthier, lose weight and exercise.  I'm already justifying my bad eating habits over the holidays with the promise for a new year, new you attitude.  I've made a decision. This year will be different. I mean it!

It started this morning over breakfast.  Instead of using the holdiays as an excuse to eat unending calories, I chose egg whites, wheat toast and fruit instead of the french toast with real Vermont maple syrup and whip cream...not an easy thing to do.  Don't get me wrong, I've had my fair share of rich and delicious food choices over the holiday, but enough is enough.

There are a number of articles citing the importance of health and fertility. The female body is most likely to conceive when it is within 15% the ideal weight. So if you're looking to get pregnant, losing weight shouldn't be just a New Year's Resolution- it should be something to strive for year round.  

As 2011 approaches, end 2010 on a positive note. Don't use the last few days as a pig fest, use it as a way kick-start your body and health.  During infertility, so many things are out of your control.  That's why it's important to control the things you can- your health, mindset and mood.  It's important to make sure you're getting adequate vitamins, including folic acid- for your health, and your future baby's health as well. Folic acid supplementation is particularly important since studies have shown that adequate stores of folic acid can greatly reduce the risk of neural tube defects in the fetus.  It's best to get vitamins through food- focusing on lots of fruits, vegetables, grains and lean protein can help you get the nutrients you need.  A vitamin supplement is always a good back-up plan.

If you're a smoker, than a perfect New Year's Resolution is to quit!  The Attain IVF website has a great article on the 5 Facts About Smoking and Infertility.  Bottom line, it's bad for you, your fertility and a baby.  Smoking also effects infertility treatments- such as IVF, and smokers have an increase risk for miscarriage. 

The New Year is a great time to focus on a new you.  This year I'm forgoing a resolution.  I don't have to wait until December 31st to eat healthy- I will start now.  Here's to a Healthy and Happy 2011!

 

Consciously Creating Signs of Hope

by Connie Barrow, MPA

 "Hope is the thing with feathers, that perches in the soul, and sings the tune without words, and never stops at all."     ~American Poet Emily Dickinson

 These final days of 2010 bring a time for reflection of the past 12 months and plenty of prognosticating about the next twelve.  As for all of us on our fertility journey, the burning questions on our minds are…

 

• ·       "Will this finally be the year that I become a mom/dad?"   
• ·       "Will I finally get pregnant?" 
• ·       “Will I finally be able to adopt?”
•          "Will I finally connect with my child?"

 When the answer is not yet evident, yet to be revealed, that is the time to look for a sign to keep hoping, to keep going, not to give up.  The real test for every single one of us is to continue placing one foot in front of the other.  Hope holds the power to propel you from where you are now to a new place with new possibilities.  By consciously creating signs of hope wherever you find yourself in the present moment, you shine a light on the path ahead.   

 Some of you may be hesitant, fearing that you are just going to be disappointed by creating "false hopes."  I will be the first to tell you that there is no 100% guarantee in anything (except of course the ole "death and taxes" adage).  Yet, there is nothing like seeing the power that hope brings to allow the spirit to persevere, to continue despite present circumstances.  Over my 5-year fertility journey, hope was what got me through every month, every miscarriage, every failed fertility treatment, and every poor prognosis.  Hope was my anchor.   

 If we only expect more of what has happened in the past or that which appears highly probable in the future, we limit ourselves not only in the end but also in the experience of the journey itself.  Every experience in our life is here to teach us something.  The lesson that is available to each of us in the "preconception/pre-adoption waiting room" is the opportunity to grow our capacity to be hopeful…to believe that we will connect with our child! 

  Here's the Bottom Line...If hope is what it will take to sustain you from where you are now to the possibility of a "Yes!" to connecting with your little-one-to-come, then focus on ways that you can consciously create hopefulness in your life. 

 If it feels comfortable for you, you can get started by trying some or all of the following activities and exercises this week:

 1. Create an altar in your home as a special place for you to connect with the Divine and your little-one-to-come through such activities as prayer, meditation, lighting of candles, inspirational reading, journaling, and guided visualization.  Place special objects that have meaning to you on the altar.   

 2.  Create a vision board with pictures of yourself being pregnant or with your adopted baby, as a family, by taping pictures of your face over pictures of others cut out of pregnancy or family-related magazines.  Look at it every day, just after you wake up and right before you go to sleep.

 3. Connect with one song that resonates a hope-filled message to your heart and let it become "Your Baby's Song."  Enjoy listening to it often!

 4. Create a sign or token for yourself intended to remind you to be in a hope-filled perspective.  This can be something that you put in your pocket or car or near your computer, something to hold and see often.  

 5. Write a letter to yourself dated the last day of next year (December 31, 2011 in this case).  Take some time to meditate or quiet your mind prior to writing.  In the letter, write as if it is December 31, 2011 and include reflections on the year--what has happened, insights gained, dreams that have come true, and any messages that you have for yourself one year from now.  Place it somewhere that you can read at least once a month and then finally, one year from now.

 Here’s to your 2011…May it be a year filled with Hope!

Connie Barrow is a Life Coach and President of Fertile Possibilities LLC.  Ms. Barrow herself experienced a  5-year fertility journey which included flunking out of fertility treatments, suffering multiple miscarriages, and receiving a prognosis of a less than 5 percent chance of ever conceiving on her own. She lives in Stafford, Virginia, with her husband and daughter and is currently writing a book about the divine lessons learned while on her fertility journey.

Floating feather photo: Runar Brunslid and Anne Siri Eriksen. Christmas Butterfly photo: SortaCrunchy. New Year's Eve Ball photo: TimesSquare.

 

Miscarriage and the Sense of Personal Failure

by Kim Kluger-Bell, MA, LMFT

Lisa Ling, the former View host, revealed this week that following a miscarriage at 7 weeks into her first pregnancy she felt like a failure, and that she also felt very isolated and alone because no one talked about it. For this reason, she is speaking out and has created a website where women can anonymously share their experiences with miscarriage called Secret Society of Women.

 Ten years ago, when I wrote “Unspeakable Losses: Healing from Miscarriage,Abortion and Other Preganancy Losses” I felt exactly the same way. The silence surrounding miscarriage only makes you feel more freakish and alone. Here is what you need to know about miscarriages:

 Miscarriages are Common

 Approximately one in 5 pregnancies in the US end in miscarriage every year. That means hundreds of thousands of women experience miscarriages every year. And most of those miscarriages occur in the first 12 weeks of pregnancy. In fact, your chance of miscarrying after that time is only 3%.

 Having One Miscarriage Doesn’t Mean You’ll have another

 Most miscarriages, however, are usually random and isolated events. Having one miscarriage only slightly increases your odds of having another one.

 The Emotional Impact can be Devastating

 For many women, the attachment to the child she is carrying begins at the moment she knows she is pregnant. That is when we begin dreaming about the baby we are carrying and imagining how our lives will change in only nine short months. Few of us hold back our excitement due to fears of a first trimester miscarriage. Instead, we start taking extraordinarily good care of ourselves—eating right, getting plenty of rest and avoiding alcohol, caffeine and tobacco products. When a loss takes place despite all of these preparations, you can feel like you did something wrong. Even the word—miscarriage—seems to imply that you did not carry your baby properly.

 It is Not Your Fault

 In many, if not most cases, the cause of your miscarriage will never be known. Again, most miscarrages are random and isolated events. Doctors now believe that at least 60% of miscarriages are caused by chromosomal abnormalities in the developing embryo or fetus, and that another 10% are caused by various uterine abnormalties (most of which can be corrected with surgery). The remaining 30% of miscarriages may be cause by immunological factors, infections or environmental factors (including smoking and heavy alcohol use).

 Recovering from Miscarriage Takes Time

 It is often more difficult to recover emotionally from a miscarriage than it is to recover physically from one. Even if you had to have a D & C, the emotional fallout from a miscarriage can stay with you for months afterward. Guilt, shame, sadness, anger, and a feeling of powerlessness are very common emotions. So is a sense of generalized anxiety and the fear of another loss. It is not uncommon, especially if you are not able to become pregnant again quickly, to have an ongoing awareness of  how far along in the pregnancy you would have been if the loss had not occurred. Many women feel particularly grief-stricken around the time of the due date of that pregnancy. Miscarriage is a traumatic experience—it takes time to heal from a trauma of any kind.

 It is important to be gentle with your self and find people to talk to who are compassionate and will not judge you for the intensity of your feelings. It is also important not to blame yourself, or to isolate yourself too much. It may be impossible to spend much time around pregnant friends or those with babies or young children, but if you don’t have people in your life who are willing to share their own experiences of pregnancy loss with you, there is a large group of people out there who have been through a miscarriage, and there are many on-line resources and books available to you that can help you feel less alone.

 Websites:

• Facebook page, “Whisperers”
• www.nationalshare.org
• www.missfoundation.org

 Books:

• Empty Arms by Pam Vredevelt
• Empty Cradle, Broken Heart by Deborah L. Davis
• Unspeakable Losses by Kim Kluger-Bell
• Miscarriage: Women Sharing from the Heart by Marie Allen, Shelly Marks

Kim Kluger-Bell is a psychotherapist and marriage and family therapist in private practice in Berkeley, California. She specializes in helping individuals and couples heal from such reproductive crises as infertility, pregnancy loss, and abortion. She lives in Albany, California, with her husband and son.

 

 

Sisterhood

By Jamie Schenk DeWitt

"For there is no friend like a sister – In calm or stormy weather.” Alexander Muir

  Sadly, I have just learned about two couples who suddenly and tragically lost their unborn babies.  Both couples were expecting twin boys and both had undergone IVF treatments.  I am very close with the first couple.  The second couple I do not know, but heard about their story through my multiples club.  

 The subject of my friend's email was Sad News. As soon as I saw this, I lost my breath.  I quickly read the first line: “We have some very sad news to report and while we wish we didn’t have to share it via email, we are not in any shape to talk about it in person yet.” 

 The rest of his email explained how at 17 weeks, his wife had complications that led to the loss of their twin baby boys.  It was sudden and devastating. He explained how they were coping with their grief through the support of their families, but that they were not ready to talk about it with anyone else.  

 By the end of the email, I was gasping for air and sobbing.  Just two weeks prior, I was on the phone with them congratulating them on their pregnancy and hearing all about the details of their IVF journey to parenthood.  This was their third try at IVF and they felt so blessed, as we all do, to actually be pregnant and having a healthy pregnancy. They were so excited to share their news with me because I was one of their only friends to have twins through IVF.  There was a bond between us and it was amazing to be a part of this with them. I told them that I would tell them all about raising twins and connect them with a multiples group in their city.

 In my wildest dreams, I never imagined that this would be the outcome of their story.  She was 17 weeks pregnant.  She had a CVS and the results came back completely normal.  How does this happen to people who sacrifice so much to have a baby/babies?  

 Days later, I got an email from my multiples group that had in the subject line: Very Sad News.  Again, my heart sank.  I glanced down the page and started to read: “It is with a sad and heavy heart that I share with you the events of the past few days.   Please only read this if you want to know the details of these days.” 

 This mom’s email continued to explain how over the course of five days she lost both of her baby boys due to premature labor. Her boys were just not developed enough to survive.  As I read her email, I felt such inexplicable pain and empathy for this mother, for this woman.  She had spent nearly ten years of her life undergoing fertility treatments and now her babies were gone.  Yet, she also amazed me because in the midst of her suffering she found the strength to thank all of the people who nurtured and supported her on her journey to motherhood.

 In rereading her email, I am still tearful, especially by a sentence that she writes near the end of her email.  Her words haunt me to this day. She writes: “I fear that this may end my dream of motherhood.”  Her sadness touched my heart as it touched the emotional core of so many women in my multiples group.  Emails of condolences poured in from women who wanted to express their love and support. 

 While all of our expressions of concern cannot bring back her babies, fertility treatments bind us to one another in ways that are meaningful and powerful.  We have all shared the pain of failed fertility treatments and the loss that goes with it.  With each unsuccessful IUI or IVF cycle we have all experienced a small death.  Again, I am not equating experiences, but I do believe that there is a sisterhood that connects all of us.  This brings me back to my opening quote.

“For there is no friend like a sister – In calm or stormy weather.”

                                                                                    By Alexander Muir

 To all of my sisters out there, thank you. Thank you for the love and support that you have shared with me during my journey to motherhood.  Thank you for being some of the strongest, most dynamic, loving and beautiful women who have risked everything, body and soul, to be mothers.  I am honored to be a part of this community with you.  You amaze and inspire me.