At a Loss

It was May 2005, and I was quietly excited.

I believed I was 7 weeks pregnant. My doctor wasn't so sure. The embryo on the ultrasound wasn't big enough, and he didn't hear a heartbeat. I looked closer to 5 weeks along. This revised timing seemed unlikely -- I was sure of the exact date sperm met egg. But I wasn't going to let pesky details get in the way of my party. "Great!" I said. "When's the new due date?"

I'll say this for myself: The denial came from an honest place. I was 33. My husband, Scott, and I had been married for almost a year. We'd just bought our first house, in Los Angeles, with an extra bedroom (for a kid) and a sun-dappled backyard (also for a kid).

Our tangerine tree sagged with fruit. Hummingbirds sipped nectar from our flowers. So when the doctor said not to worry, I'd probably see a heartbeat at my next ultrasound in a couple of weeks, I didn't. I cheerfully filled my prenatal vitamin prescription. I began a list of baby names. I checked out pregnancy Web sites, including one that advised women who'd had ultrasounds like mine to "enjoy being with her pregnancy." I snickered, but put a hand on my belly and felt the presence of a baby. Tears filled my eyes, as crazy as that sounds.

Today, I'm grateful for my Hallmark moment. It was the only time I stepped away from fevered planning and enjoyed things as they were -- the finest minute and a half of my pregnancy. Two weeks later, the repeat ultrasound showed an empty gestational sac where a heartbeat should have been.

Surprise, Surprise

Every pregnancy is different. So is every miscarriage, though no one tells you this.

Books, Web sites, even physicians gloss over the subject. What to Expect When You're Expecting, which finds space for questions like "Is it necessary to shave your pubic hair before labor?", devotes only a few pages to miscarriage. These resources don't prepare you for the grief, guilt, and self-doubt that take the place of excitement.

And they don't fully describe the physical experience. They do mention that miscarriage can cause painful cramping and bleeding and sometimes requires intervention with drugs or a procedure called dilation and curettage (D&C), which involves dilating the cervix and removing the "products of conception." This sounds scary, but it's a piece of cake compared with what they don't warn about.

***

Related links:

The Smart Girl's Guide To Birth Control

Breast Cancer: Support The Cause

The Best Vitamins for Women

The Pursuit of Happiness: The Instruction Manual I was more apprehensive about my D&C than the cramps that followed, which I'd heard would feel like a "bad period." Ha. I called my sister, who'd had two miscarriages, to complain that Advil wasn't helping. When I told her I took two, she laughed. "Try six." I panicked when my spotting lasted 4 weeks instead of several days. My doctor said I could be active within a week or so, but I didn't feel energetic enough to work out for more than a month.

I gained 10 pounds, which meant I weighed more after my pregnancy than during it. Sex was supposed to be okay after a couple of weeks, but... ugh. It took a good 4 months to shake the feeling that sex = pregnancy = miscarriage.

For more health tips, check out the latest issue of Women's Health, on shelves now!

Alone in the Crowd

I didn't tell many people about my miscarriage -- my parents and sister, my in-laws, and a friend -- so afterward I felt really alone.

Wacko hormones probably played a role. When you lose a pregnancy, estrogen and progesterone levels plummet, similar to PMS, says Dr. Robert Anderson, director of the Southern California Center for Reproductive Medicine in Newport Beach.

But it's ironic that isolation was such a big part of the mix, because anywhere from 10 to 25 percent of confirmed pregnancies miscarry. And in most cases, it's pretty much out of your hands. The March of Dimes estimates that as many as 70 percent of miscarriages result from one-time genetic glitches you can't control that make it impossible for the embryo to survive. Age affects genetic health: A 35-year-old is twice as likely to miscarry as a 25-year-old. But 10 percent of pregnancies in women under 30 fail too.

As for miscarriages not related to genetics? They can't always be traced to a specific cause -- most women get pregnant again after miscarrying once, so doctors don't bother with tests. But possible factors include diabetes, polycystic ovarian syndrome, and thyroid disease. A 2003 study found that women who have the common vaginal infection called bacterial vaginosis are nine times more likely to miscarry than those who don't. Research in British Medical Journal linked miscarriage to using nonsteroidal anti-inflammatory drugs (like ibuprofen) and aspirin around the time of conception. (All of which could freak a girl out, so see a doc as soon as you know you're pregnant.)

Booze, cigarettes, illicit drugs, or copious amounts of caffeine put you at risk too. But that espresso or glass of merlot you had before you peed on the stick probably isn't the cause. Something else to feel good about: factors proven not to cause miscarriage include sex, exercise, and your quest for a paycheck.

***

Related links:

The Smart Girl's Guide To Birth Control

Breast Cancer: Support The Cause

The Best Vitamins for Women

The Pursuit of Happiness: The Instruction Manual I wish people talked more about miscarriage, so women who've gone through it would feel less alone. But I completely get why they don't.

"We're talking sex and death," says Jon Cohen, author of Coming to Term. "Who do you want to bring into that part of your life?"

Plus, the old standby platitude "It was for the best" is true but dismissive. Even my husband, usually a sensitive guy, blew it. Dealing with his own disappointment, he tried to console me by insisting that I "hadn't really been pregnant." I would have strangled him if I hadn't been, you know, grimacing in pain at the time.

The trick to moving on, I guess, is striking a balance between mourning the loss of a baby and taking solace in knowing that miscarriage is so common. For me, letting time pass was a good first step. I eventually started posting on a message board on indiebride.com -- there are many such sites, each with its own flavor -- and found lots of other women in the same situation. After a couple of months, telling friends stopped feeling awkward and started to be comforting. Deciding to write about it was also an important step.

Six months later I was back to my old self. Occasionally I'd see a pregnant belly and be tempted to flee before anyone noticed the greenish tinge creeping over my skin. But most of the time I'd try to channel my Hallmark moment. I'd remind myself that I like sleeping late on the weekends in a house with no poopy diapers. One day I'd have a kid, and things would never be the same.

Eryn Brown writes editorials at the Los Angeles Times. Her house is no longer diaper free -- son Will was born last fall.

What Are the Chances?

When it comes to miscarriage, says a new study, some surprising stuff matters:

A sense of purpose: If your pregnancy is planned, your chances of miscarriage are 40 percent lower than average. That's because you're more likely to make healthy lifestyle choices and to avoid known risk factors like smoking and drinking.

Praying to the porcelain god: If you have morning sickness, your risk is 70 percent lower. Healthy embryos send protective proteins into the mother's bloodstream that trigger nausea to ensure she doesn't digest something harmful.

Someone new: If you're pregnant by a new beau (after having a kid with someone else), your risk is 60 percent higher. It may be related to the new dad's antigens, substances that help the body fight germs and other invaders.

***

Related links:

The Smart Girl's Guide To Birth Control

Breast Cancer: Support The Cause

The Best Vitamins for Women

The Pursuit of Happiness: The Instruction Manual An apple a day: Eating fresh fruit and vegetables daily when pregnant cuts your risk in half. A healthy lifestyle always wins.

Chocolate chomping: If you're a Cadbury fiend while knocked up, your risk decreases by 20 percent. Experts aren't sure why, but we like any research that gives us more good reasons to indulge in our favorite treat.

***

Related links:

The Smart Girl's Guide To Birth Control

Breast Cancer: Support The Cause

The Best Vitamins for Women

The Pursuit of Happiness: The Instruction Manual