Finding a Link

Finding a Link Between
Stress and Miscarriage

By Kelly Burgess

Nancy Grandle of San Francisco, Calif., is almost halfway through a high-risk pregnancy. She's considered high risk not because there's anything wrong with her or her fetus, but because this is her fourth pregnancy in 6 years. The first three ended in miscarriages before the end of her first trimester. She's currently in her fifth month, but she still can't relax. "For the first three months I was completely insane," says Grandle. "If I even felt a little twinge, I would run to the bathroom to see if I was spotting. Every night I would dream that I was having a miscarriage and wake up terrified. My husband thought I was going to have a breakdown."

Her doctor recommended that Grandle "just relax." Instead, Grandle called a number that her husband's insurance company provided through a program promoting mental health. The counselors urged her to see a therapist and provided several referrals in her areas. The therapist has been showing her some techniques to help her stop obsessing. Now that she's past the point where her previous miscarriages occurred, she's been able to relax, but she admits that she still worries more than is probably normal.

Instead of casually dismissing Grandle's concerns, her doctor would have been better off if he took them seriously. Dr. Mark Leondires, reproductive endocrinologist, says if you take women who have had more than 2 or 3 pregnancy losses, you'll find a reason in about 50 percent of the cases. In the other 50 percent, you don't, but if you take those women and administer what he calls "TLC therapy," 70 percent will go on and have a live birth. "There are 4 studies that support that, and I can tell you on the physician's side that the most stressful time is when they've had their previous miscarriage," he says. "A little extra reassurance decreases the cortisol levels and probably does a lot of other things as well. It doesn't take much on anyone's part, but it soothes the woman, and it works."