A few, short weeks ago, I blogged about actress and Britain's Got Talent presenter Amanda Holden's decision to keep the news of her pregnancy private for the first six months. It happened that Amanda and her husband Chris Hughes were being particularly careful in announcing their pregnancy, because they had suffered a miscarriage in the 4th month of pregnancy earlier in the year. At the time, Amanda was quoted as saying that the miscarriage had been utterly devastating, completely unexpected and the lowest point of her life. Tragically, their nightmare repeated itself this weekend.
There is news today that Amanda and Chris have lost their baby son, due in March, at 7 months. She gave birth this weekend to a seemingly perfect, but stillborn, son after going to hospital because she had not felt him kicking or moving at all during the day. A cause for the baby's stillbirth has not been released publicly and the couple has retreated to grieve outside of the glare of public scrutiny. Much like in the British singer Lily Allen's late miscarriage, there will be speculation about whether the demands of work in the entertainment industry was in any way to blame for Amanda's loss. I would stress here, as I did then, that these two women reportedly wanted these babies very much, had access to excellent medical supervision and took every precaution to maintain and protect their pregnancies.
It is heartbreaking to lose a much-wanted baby at any stage of pregnancy, but must be multiplied a thousand times for the woman who felt that baby move inside her. The timing and vigour of that activity leads the mother to attach certain characteristics to the unborn baby, helping her to know him and await his birth with expectations of his personality and energy. It creates a special bond between mother and child during the second and third trimester, but also between other family members and the baby who witness and experience external signs of the baby's very real life in the womb.
For a woman who has miscarried previously, the signs of life in the womb carry even greater significance. Until she feels the baby move, she may not trust the health and longevity of a subsequent pregnancy. This was certainly the case with my full-term pregnancies, in which I felt jittery and lacking in self-confidence about the pregnancy until I reached the halfway mark. How could I trust my body to nurture this baby, when it had failed the others? I didn't dare to believe.
Like Amanda Holden and her husband Chris Hughes, my daughter was 4 years old when we had our son. She was old enough to ask questions about why her friends had siblings and she didn't, why I was going to the Dr all the time (secondary infertility and IVF) and eventually about the baby in Mummy's tummy. We had waited nearly 5 months to tell her our news, conscious of how confusing and sad it would be for her to expect a brother or sister who might never be born. Thankfully, in our case, my last pregnancy went full term and I was able to give my daughter the brother she wanted. My heart goes out to Amanda and Chris, who apparently did everything they could have done to be sure of this pregnancy and to protect daughter Lexi in the same way, but to no avail.
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Last week, I was fortunate to be present at a talk given by Prof Lesley Regan, Director of the Recurrent Miscarriage Unit at St Mary's Hospital, Paddington, and the founder of Charm, The Charity for Research into Miscarriage. It was an overview of the latest developments in the treatment of recurrent miscarriage, however, it was Prof Regan's discussion of late miscarriage that interested me most. Ironically, the audience was made up almost entirely of Orthodox Jewish women, who tend to start their families at very young ages, relative to the general UK population. Nevertheless, it was of great interest to me and my work with older women.
I don't suppose it will surprise anyone to hear that after the age of 35, fertility drops drastically and miscarriage rates increase. Between 1994 and 2004, there was an enormous increase in the number of births in the UK to women in the age range 35 - 39 years old, and a 94% increase in the 40 - 44 year range. Now, 35% of the women seen by the Recurrent Miscarriage Unit at St Mary's now are over the age of 35 and 25% of them are over the age of 40. Even though these women are conceiving and giving birth, many of the pregnancies and births aren't without complications, such as pre-eclampsia, restricted growth and premature delivery. Still, stillbirth is very rare; the UK rate being only 7.6 per thousand live births (2008).
As an older mother myself, I know the chances I was willing to take in order to have my own children. However, given the choice, I would never have been in that position. I married my husband at the age of 35, without any predictors for my miscarriages and secondary infertility. Had I been better educated back then about the difficulties and risks inherent in conception, pregnancy and childbirth after the age of 35, I may have chosen to become a mother earlier, through the use of donor insemination. It's easier to think in hindsight, knowing several women now who have successfully gone down that route, that I might have been that courageous. Now, however, I would recommend that a younger woman who is in a committed relationship and has a desire to have a family some day, seriously consider the implications of waiting too long for lifestyle reasons. This is one of the reasons I advocate that young women (young men too) be provided with fertility facts alongside their Sex Education at school. Knowledge is power; it brings choices into perspective.
My heart goes out to Amanda and Chris. Recurrent pregnancy loss is such a heart-breaker and I can't even imagine losing a child at that stage in the pregnancy. I hope and pray they can find an answer.
ICLW #19
Posted by: Kristin | February 24, 2011 at 06:14 AM
RPL is a horrible thing... I am deeply saddened for Amanda and Chris. Even now, after the birth of our daughter, I don't know that I will ever trust my body completely.
I think fertility in general should be taught as a part of sex education. There are so many things about my fertility, about my body that I had no clue about until we started dealing with RPL and IF. Instead of being about scaring kids out of having unprotected sex, it should be about educating them about their bodies.
ICLW
Posted by: Mrs. Gamgee | February 28, 2011 at 05:39 PM