From one of the foremost doctors in the field and a woman who has experienced miscarriage herself comes a comprehensive, encouraging, and accessible guide on both the causes and, more important, the prevention of miscarriage.

Though one in four American women will lose her pregnancy, this heartbreaking experience remains a taboo subject, fraught with myths and misinformation. But with the right prepregnancy evaluation and ongoing care, for many women miscarriage can be prevented.

During forty years of practice, Dr. Bruce Young has treated hundreds of women who experienced the heartbreaking loss of miscarriage and helped them bring babies to term. Now he has teamed up with one of his patients who experienced miscarriages herself, Amy Zavatto, to write this informative, compassionate guide that combines the medical facts with insights from the patient’s and doctor’s viewpoints. Dr. Young thoroughly explains the basics of pregnancy and miscarriage, and provides in-depth answers to the questions: Why did this happen to me? and What can I do to prevent it next time?

Including case studies of patients who’d experienced recurrent miscarriages, Dr. Young illustrates a variety of reasons for pregnancy loss—from diabetes to genetics, from hormonal deficiencies to autoimmune disorders—explaining why each miscarriage occurred, as well as how to diagnose and in many cases treat the underlying problem.

Providing the most up-to-date information on physical and mental health, nutrition, and technology, Miscarriage, Medicine & Miracles is a proactive tool and comforting resource—from an expert with real-life reasons to give every woman hope for a successful pregnancy.

"Dr. Young and Amy Zavatto have produced the most comprehensive patient-directed book on the subject of miscarriage and pregnancy loss that that I have seen. It presents complete and scientifically sound information on the causes and prevention of recurrent miscarriage and does so in a fashion that does not require a medical education to understand….It will be an excellent guide for women and their partners who have experienced these problems."—Richard H. Schwarz, M.D., FACOG, FRCOG, Vice Chairman for Clinical Affairs, Department of Obstetrics and Gynecology, Maimonides Medical Center Professor of Obstetrics, Gynecology and Reproductive Science, Mt. Sinai School of Medicine

"This book deals with an issue that is not much talked about. It offers solutions in a down to earth manner that is easily accessible to everyone….I wish this book had been around when I was having the personal experience of multiple miscarriages."—Rebecca Lisa Shiffman, MD, Director of Obstetrics and Vicechair, Department of Obstetrics and Gynecology, New York Methodist Hospital

"Miscarriage is among the most common and most misunderstood aspects of all modern medicine. Dr Bruce Young, a pioneer and international leader in perinatal medicine, and Amy Zavatto, a patient who has experienced a miscarriage, have teamed up to write a comprehensive and compassionate analysis of this subject. All women who anticipate getting pregnant would benefit from this invaluable and unique text."—Frank A. Chervenak, M.D., Given Foundation Professor and Chairman, Department of Obstetrics and Gynecology, New York Weill Cornell Medical Center

"Comprehensive information on the causes and preventions of miscarriage."—Miami Herald

Bruce Young, MD., is internationally known as a leader and innovator in obstetrics and gynecology. He developed the first obstetrical intensive care unit and founded the Division of Maternal and Fetal Medicine at NYU Medical Center. He is the Silverman Professor of Obstetrics and Gynecology at NYU Medical School and is listed among America’s Top Doctors and in New York magazine’s Best Doctors 2008.

Amy Zavatto is a writer in New York City. Her work appears on Planned Parenthood’s Teen Wire website, as well as in New York magazine, Food & Wine, and Plenty.

Introduction: xiii

SECTION I — THE BASICS — 1

one — Preparing for Pregnancy: Understanding Your Body — 3

two — Nutrition and Pregnancy: Feeding the Baby — 15

three — What Is a Miscarriage? — 25

four — Recurrent Miscarriage — Lightning Strikes Twice (or More) — 41

five — Diagnostic Evaluation for Miscarriage: What You Can Expect Step-by-Step — 53

six — New Technology for the New Age — 63

seven — Miscarriage Myths — 73

SECTION II — ANATOMY IS NOT DESTINY — 89

eight — Cervical Insufficiency: Competent Woman, Incompetent Cervix — 91

nine — Asherman Syndrome: Scarred and Scared — 103

ten — The Abnormal Uterus: Shaping Up — 111

eleven — Ectopic Pregnancy: Misplaced Trust — 119

twelve — Fibroids: Unwanted Guests — 131

thirteen — Multiple Pregnancy: Less Is More — 141

SECTION III — MALFUNCTIONS: SYSTEMS FAILURE — 157

fourteen — Severe Maternal Illness: Blindsided — 159

fifteen — Endocrine Causes of Miscarriage: Yes, It's Hormonal — 169

sixteen — Diabetes: It's About Control — 179

seventeen — Inadequate Corpus Luteum: Tired Ovaries — 187

eighteen — Blighted Ovum: A Bad Start — 197

nineteen — Auto-Immune Disease: When the Body Fights Itself — 209

twenty — Blood-Clotting Disorders: Too Much of a Good Thing — 219

SECTION IV — ENVIRONMENTAL HAZARDS: WHEN NATURE DOESN'T NURTURE — 227

twenty-one — Infections: Germ Invaders — 229

twenty-two — Toxic Agents: Greening Your Pregnancy — 241

twenty-three — Trauma: Danger Zones — 255

twenty-four — Stress, Psychology, and Pregnancy — 263

SECTION V — UNDERSTANDING — 275

twenty-five — Grieving, Coping, Hoping — 277

twenty-six — FAQ: Your Questions Answered — 285

Glossary of Terms — 303

About the Authors — 331