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Coming to Term: Uncovering the Truth About Miscarriage Review
This is by far the best book available on miscarriage. I found it invaluable for these reasons:
1) It provides detailed information about why/how miscarriage occurs which I have never read elsewhere despite (unfortunately) countless hours spent researching the subject. Cohen (who is a science writer) interviewed experts in genetics and recurrent miscarriage and scoured files and viewed slides collected in miscarriage studies. This book presents far more information than a typical book on pregnancy loss provides, and Cohen does a commendable job of making some really complex biology accessible to the average reader.
2) The book explains why there is so much controversy surrounding miscarriage treatments. In short, to prove a treatment really works, doctors need to design a trial that shows the treatment is more effective than doing nothing at all. But women miscarry for many different reasons and a treatment that might help a woman who miscarries due to hormonal problems obviously won't help one who has a structural problem with her uterus, for example. One scientist quoted says miscarriage is a "malfunction," not a sickness, so a study of miscarriage treatments is more difficult to design than a study of say, diabetes treatments, where patients are much more alike. There's also, Cohen says, little financial incentive for the pharmaceutical companies to do them, but that's another issue. The result is VERY FEW treatments are actually proven to work--they might or they might not, nobody has much data to show.
3) The book explains why doctors are so apt to tell you "just try again." This is the good news promised on the cover: Even women who have had 4 miscarriages in a row are likely to carry a baby to term with NO intervention whatsoever. The book includes anecdotes of women, including Cohen's wife, who miscarry again and again and then have a healthy baby, both with and without medical intervention, along with the science to explain how and why this can happen.
4) Cohen debunks the link between most environmental factors and miscarriage and raises serious questions about certain immunological treatments (if not the goodwill) of famous miscarriage doctor Alan Beer.
What I found a little frustrating about this book is that Cohen adopts--somewhat--the "it's best to do nothing" attitude shared by many MDs. Apparently there is science to support this up to 4 miscarriages but for those of us in the 5+ group, what's the answer?
However, it's not Cohen's fault that they're aren't lots of proven treatments, and his reservations stem from genuine concern for women's health (the DES chapter is a cautionary tale on the dangers of overconfidence).
Cohen approaches the topic with a sensitivity born of personal experience and the professionalism you would expect from a science writer. The book will help you become a more informed patient and give you hope grounded in fact.
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