ML Interest Tag: surrogacy

Understanding Miscarriages: 7 Questions Answered by a Doctor

By Dr. Alan Lindemann

Miscarriage is quite common, yet regardless of that simple truth, it remains a challenging and emotionally complex experience for women to navigate. It is often something women deal with privately with their partner, but fortunately some women in the public spotlight have begun to share their experiences more openly.

Meghan Markle, the Duchess of Sussex, recently opened up about her miscarriage last summer, paving the way for women everywhere to connect and feel less alone. She and Prince Harry also announced that they are expecting another child (a baby girl)—a great reminder that pregnancy is very possible after miscarriage.

Whether you are dealing with loss due to a miscarriage yourself, acting as a support person to someone who has experienced this loss, or simply wanting to educate yourself about this all-too-common occurrence, here is a Q&A to help you through this process.

Miscarriage: 7 Questions and Answers

1. What is a miscarriage? Miscarriage is defined as a pregnancy loss prior to 20 weeks. If the pregnancy lasts beyond 20 weeks but is unsuccessful, it is termed stillbirth.

2. Am I to blame for my baby’s death? Miscarriage is traumatic for all pregnant women and their partners. If you have had, are having, or will have a miscarriage, remember this: Miscarriage is NOT your fault.

Inherent in miscarriage is the experience of death, and often feelings of failure as well. This death is very real, and it is normal for women and partners to experience the five stages of grieving and guilt (described in Elizabeth Keebler Ross’s landmark research in “On Death and Dying”):

  • Denial (It didn’t happen.)
  • Anger (Why is this happening to me?)
  • Bargaining (Oh, please God, I’ll do anything to have a successful pregnancy.)
  • Depression (I must have done something wrong.)
  • Acceptance (I have to get on with life one way or another.)

Allowing yourself and your partner to go through this grieving process is the most important part of a miscarriage.

3. How soon can I get pregnant again after a miscarriage? I always suggest waiting for at least one regular period before getting pregnant again. It can then be determined with more accuracy when you are due. In addition, having a normal period signals your body is done with the miscarriage process.

4. Who is likely to miscarry? Anyone can miscarry. The most often quoted numbers say 10-to-20 percent of all pregnancies end in miscarriage. When the miscarriage rate includes those fetuses lost before the missing of a period, the high-end rate increases up to 40 percent.

5. How do I tell a period from a miscarriage? There is cramping with miscarriage, often like a period, but sometimes more severe. Most of the time, bleeding will be heavier than a period, but seldom requiring a blood transfusion. 

6. What if my doctor can’t hear a heartbeat? With a Doppler, I can hear a heartbeat at about 11 or 12 weeks. It is easier to see the heartbeat with an ultrasound at seven to eight weeks. If I can’t see the heartbeat at seven or eight weeks, out of reverence and concern for the fetus, I recheck in one week. If I can’t hear a heartbeat, most women prefer to wait for a spontaneous miscarriage which usually follows after one or two weeks. If one or two weeks go by without a miscarriage, I recommended misoprostol (Cytotec) by mouth.

While it is possible to use misoprostol without waiting the two weeks for a spontaneous miscarriage, it would not be my first choice because aggressive treatment can interfere with the grieving process. I prefer to allow a wide margin around guilt, blame, and shame.

7. What happens when someone has repeated miscarriages? Miscarriage, before there is a beating heart, is common, and is usually a chromosomal mutation. These are not preventable. However, once the heart is beating, several conditions can lead to a miscarriage. Many of these repeated miscarriages are preventable. If you have had more than two miscarriages, it’s time to look at the list of treatable conditions that are known to contribute to miscarriage in some women (i.e., Strep B or methylenetetrahydrofolate reductase—MTFHR).

The keys here are remembering that you are not alone in experiencing miscarriage, and that is normal and healthy to grieve your loss. In cases where repeated miscarriage occurs, your doctor may be able to help you isolate the condition that is causing it so you can go on to have a healthy pregnancy.

Dr. Alan Lindemann
Tinybeans Voices Contributor

An obstetrician and maternal mortality expert, “Rural Doc” Alan Lindemann, M.D. teaches women and families how to create the outcomes they want for their own health and pregnancy. In nearly 40 years of practice, he has delivered around 6,000 babies and achieved a maternal mortality rate of zero! Visit LindemannMD.com

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Newborn, Maternity & Cake Smash Photos: Capture Milestones with a Virtual Photo Session!

by Mimi O'Connor

Did you or your partner get pregnant during the pandemic? Looking to stay safe but hoping to capture your pregnancy or newborn with a photo shoot? No problem! NYC area family photographers are stepping up to help your family capture these important events while you’re keeping close to home. Book a virtual photo shoot via Zoom, FaceTime, etc. Read on to learn how it all works, and see actual pictures taken via remote sessions!

Pivot!

Michelle Rose Photo

Like so many other businesses, photographers have taken things online. The modified professional photo shoot involves a pro serving as a consultant and guide to a client before, during and after a photo session."We plan out the shoot from top to bottom: decorations, outfits, locations you name it!," says Michelle Rose of Michelle Rose Photo, who launched her remote milestone shoots in April of last year. "They send photos of their space for me to take a look at and I point out where the best spots would be to take photos, just like I do when I enter a clients apartment for the first time."

Yes, in most cases you are the one taking the actual photo (probably with your phone), but it's with the input of a professional via Zoom, Facetime, etc. Perhaps not the ideal situation for your big shoot, but the good news is that probably not surprisingly, rates are significantly less than those for in-person sessions. 

In addition to guiding you during the actual shoot, these photographers will help you style your shots, recommend colors and/or props and retouch your favorites to make them super pro. Sessions are typically about 30 minutes to an hour, and basic tech needed is a phone and a wifi connection. 

Karen Haberberg Photography

Karen Haberberg Photography

Karen Haberberg is doing maternity, birthday and infant shoots virtually, providing a portfolio of three to five retouched photos from the sessions.  For her photo shoots, she is the one actually taking the photo, capturing frames via FaceTime, while she coaches parents on elements such as angles and lighting. 

Haberberg was also moved to do pro-bono portraits for essential workers and their families over the last year as a way of saying "thanks." Learn more about that project here.

Online: karenhaberberg.com

Michelle Rose Photo

Michelle Rose Photo

For her remote shoots, Rose schedules the sessions to take advantage of when an apartment is receiving the best natural light. And, she makes sure you're prepped. "The day before the session I send over a checklist for each client individually so they have everything they need the next day for the shoot. Nothing is out of the ordinary and should already be in the home, except for maybe some cake smash decorations and the cake." (Order in, folks!) 

Contact Rose for rates, which are significantly reduced from those for IRL sessions.  

Online: michellerosephoto.com

Stylish & Hip Kids Photography

Stylish Hip Kids

This photo from Stylish & Hip Kids Photography proves the yes, you can get a lovely newborn shot (with an assist). For all remote sessions, owner Mariliana Arvelo consults with the parents about outfits, lighting in the home, and the basics of setting up a camera; she also provides a gallery of images to use as a reference. Sessions are 30 minutes and produce a gallery of 10, retouched photos. The cost is $300, a significant break from the standard rate of $900 for an in-person session. 

Online: stylishhipkids.com

Featured image: Karen Haberberg Photography
—Mimi O’Connor

Essential, Cool & Unusual Delivery Services To Make Your Life Easier

Online Parenting Classes: Birthing, Breastfeeding & More

Our Complete Online Virtual Event Calendar

 

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Suffering from Anxiety While Pregnant? Here’s What You Need to Know

By Dr. Alan Lindemann

If you are one of the millions of women who suffer from clinical anxiety, you may be wondering how best to navigate it during your pregnancy. Here are answers to some of the most common questions pregnant women with anxiety are curious about. As with any pregnancy advice you read, be sure to connect with your key care providers to help support you through your unique pregnancy journey.

1. Are many pregnant women bothered by anxiety? Anxiety is the most common psychiatric disorder, and women are twice as likely as men to be diagnosed with it. If you historically suffer from anxiety, you are likely to need strategies to deal with it and keep you and your baby happy and healthy during your pregnancy. Onset of new pathologic anxiety during pregnancy is not common, but communicate with your care provider if this is your experience so you can get additional support as needed. (Normal pregnancy-related anxiety is common, and doesn’t need any treatment.)

2. Does anxiety carry risks to my pregnancy? Anxiety and other stresses in pregnancy are associated with miscarriage, preterm delivery, and delivery complications. If you are suffering from anxiety and become pregnant, it’s important to work with your care provider to create an action plan so you can optimize your pregnancy outcomes.

3. What are some natural (drug-free) ways to deal with anxiety during pregnancy? Enlist the help of your partner in creating and maintaining a calm pregnancy environment. You can also try yoga, meditation, and walking. Be sure to talk to your obstetrician as well. If s/he doesn’t feel comfortable helping you with your anxiety, ask for a referral to a counselor

4. Is it safe to take anxiety medications while pregnant? Taking anxiety medications during pregnancy does carry some risks to your baby (depending on the medication), including cleft lip and “floppy baby syndrome” (i.e., hypothermia, lethargy, poor respiratory effort, and feeding problems). Your infant may also suffer from withdrawal from certain medications. Be sure to consult with your prescribing physician and understand all the risks before making your decision.

5. What if I’m on anxiety medication when I get pregnant? Work with your prescribing physician to slowly decrease dosage over a period of about three weeks until you can wean yourself off. While some anxiety medications can be taken during pregnancy, they all cause some risk to your baby, and it is best to go off the medications if possible.

In the end, the decision needs to be weighed from the perspective of where the greatest benefit will be compared to the greatest harm. If not taking your medication could result in self-harm, for example, your physician may recommend you continue taking it in spite of the potential risks to your pregnancy.

Dr. Alan Lindemann
Tinybeans Voices Contributor

An obstetrician and maternal mortality expert, “Rural Doc” Alan Lindemann, M.D. teaches women and families how to create the outcomes they want for their own health and pregnancy. In nearly 40 years of practice, he has delivered around 6,000 babies and achieved a maternal mortality rate of zero! Visit LindemannMD.com

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Tiny Birth Stories: Full of Surprises

by Danielle Rizzo

Our new series, Tiny Birth Stories, is aimed at sharing real-life stories from our readers to our readers. In just 100 words or less, we’re bringing you the raw, the funny and the heartwarming stories you’ve lived while bringing babies into the world. Here are five stories that will have you laughing, crying and nodding your head in solidarity. 

Interested in telling your birth story? Click here.

Pregnancy with a broken uterus by Christina F. 

My uterus is broken. I have a bicornuate uterus, a condition that’s present in only 0.1%-0.5 of American women. What makes my reproductive organ even more rare is that it functioned completely “normally” and grew to full-term my two beautiful children. You see, a bicornuate uterus put you at higher risk of infertility, miscarriage, extremely premature baby, and needing a c-section. And yet, with both my pregnancies (each in different “horns” of my uterus), and both my babies, we conceived within a few months, we luckily did not miscarry, we made it to 40 weeks, and I delivered vaginally!

The stomach flu brought on my labor by Erica W.

What my husband thought was food poisoning at work was actually the stomach flu. I wasn’t due for 7 more days and at my appointment the day before this kid was nowhere near dropping. The next day the stomach flu hit after what everybody can imagine vomiting and sitting on the toilet for hours started contractions. We rushed to the hospital and the contractions were closer too dehydrated for an epidural I labored for 14 hours. Finally I got an epidural and it made me shake, so I they gave me propofol after that Demerol pretty much the opposite of natural birth. Have a very loose birth plan.

A wonderful double blessing by Dawn L. 

I was 29 years old when I had my first baby. When I was 37, I found out that I was pregnant with my second child in the month of August. Unfortunately, at 11 weeks I found out that the baby stopped growing around 8 weeks. Many doubts and why’s came to pass. The very next summer in July I told my mom if I don’t get pregnant by December that God has given me the one child that I was meant to raise and I was going to be content. In the month of August (freaky timing) I found out that I was pregnant this time with twins. My “Double Blessing”!!

Big baby surprise by Tracey S. 

Ever since I became pregnant, I was terrified of giving birth, especially to a large baby, as my husband and I are both very tall. My doctors kept assuring me that due to my stomach size, the baby would not be big. The day that I went into labor ended up being one of the more painful days of my life! The contractions were very strong from about 6 am until I went to the hospital at 1:30 pm. In the hospital, I was able to get an epidural rather quickly and was pain free! Three hours later, I was 10 cm dilated, and ready to push. I pushed for 40 minutes, and couldn’t feel any of it. Not long after I started pushing, out popped my beautiful, 9 pound, 9 ounce baby boy. So much for not having a big baby!

My husband caught our son, in our living room by Jessica P. 

Labor started slowly. As we were preparing to leave, I had an incredibly strong contraction. My husband tried to call 911, my water broke, and I started to have another contraction. In a voice much calmer than reality, I said ‘Honey, I either need to go to the bathroom or we are having a baby.’ A quick check made clear our baby was crowning. I looked for a place to lie down quickly, then decided squatting was a perfect position. He put out his hands and caught our son, about 10 minutes after that first contraction, in our living room.

The Guilt of Being an Older Mom of a Single Child

By Lisa Skene

I was 42 years old when I gave birth to my son.

Why 42 years old?

There are several reasons:

  • I only got married at 33 years old.
  • I had a demanding career that involved lots of travel.
  • We lived in South Africa and unfortunately, did not think it was a safe environment to raise a child.
  • We eventually emigrated to Australia, which involved finding new jobs and settling into life in a new country.

Of course, there is never a perfect time to have a baby, but there was another reason I waited so long….I am not what you would call naturally maternal.

Do not get me wrong, I love children. I dote on my nieces and nephew. When they were little, I would have them over for sleepovers, take them to the zoo and the circus. They are teenagers and young adults now, and I still enjoy spending time with them.

I just did not have this overwhelming desire to have a child.

Until I turned the big 40.

Suddenly I worried I would look back on my life and regret not having a child. I know my reason for deciding to have a child may seem almost unnatural to some people. But my reason for having a child does not make me love my son any less, and I could not imagine my life without him.

So, there I was at the age of 40 trying to get pregnant with my first baby. Understandably at my age, this was not without some heartache, and after three miscarriages we decided to turn to IVF. I consider myself extremely blessed that after only one round of IVF, I was pregnant with my son.

When my son was around 18 months old, we decided to try for a second child, as I did not want him to be an only child. One of the driving forces behind this was the fact my mom was an only child and hated it. She would recount stories from her childhood about how lonely she was and how much she disliked going on holiday with just her parents for company.

Another reason was that as we had immigrated, and we did not have any family close by. I knew my son would not grow up surrounded by grandparents, aunts, uncles, and cousins. He would not know the joy of large family gatherings and ultimately, I did not want him to be alone one day.

Unfortunately, after another miscarriage and five failed IVF attempts, I had to accept that a second baby was not going to happen.

I had to face the fact that my son was going to be an only child.

I admit it was tough.

I worried my son was going to be on his own one day with no siblings for support.

I worried he would not get to experience the joy of a sibling relationship.

I worried he would hate being an only child as my mom had done.

My husband, on the other hand, was more pragmatic. He pointed out that we had tried and told me our son would be fine. Part of me knew this was true, but it did not stop me from feeling guilty.

Not being able to give my son a sibling is the one thing I feel most guilty about. I have a close relationship with my brother and sister. Whenever I see siblings playing together, I feel that painful pang of guilt. I know my son will never experience the close bond; you can only share with a sibling.

My son is now seven years old; he has never once asked for a sibling.

In fact, he has told us many times that there is no way he wants a brother or sister because apparently, this would mean:

  • He would have to share his toys.
  • He would not get us (his Dad and me) all to himself.
  • There would be a baby in the house crying all the time.

One day I will tell my son about how he was conceived and how we tried to give him a sibling. I try to focus on the positives, my son is happy, well adjusted, exceptionally bright, and has lots of friends who regularly come for play dates at our house.  

As parents, we put way too much pressure on ourselves, we worry and feel guilty when we should not. And whilst I would not say I am entirely over all my guilt, it has eased. When I see his smile, hear his laugh or when we are dancing around the house together like crazy people, I am thankful for my little miracle.

I am married to Brandon and am the proud Mum of a beautiful son. My mission is to help busy parents navigate the critical milestones of their child’s life. Children are truly phenomenal and can achieve amazing things when given the opportunity to Play, Learn and Grow.

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The Other Parent: Second Parent Adoption

By Jess Ader-Ferretti HBIC at Shit Moms Won't Say

I’ve never wanted to be pregnant. The thought of essentially carrying an alien inside of me is the type of thing that could put me right into a padded cell. I truly mean that. I’m not sure if it’s because I don’t feel feminine enough or that I can’t stand the idea of people touching my stomach, but something about it weirds me out. I digress. I’m glad we got that out of the way.

I could talk about my clinical aversion to pregnancy all day, but that’s not why I’m here. I’m here to talk about Second Parent Adoption and the mental toll it takes. I suffer from something called “homosexuality.” When two people of the same sex fall in love, they make gay people. I lucked out in my queer journey in finding an incredible wife who loves me. I also lucked out that my wife really wanted to be pregnant. While there are lots of ways to have a baby, the easiest way is to have a participant who’s willing to get pregnant. In 2018, we were ready. After purchasing about $7,000,000 worth of sperm (exact number not confirmed) and 4 IUI’s, we were pregnant. I learned a lot during that time: How to link a monitor to my cellphone without crying, the feeling of actual fear, and how critically important it would be for me to pursue Second Parent Adoption.

For those who are unfamiliar, let me explain: There are places in our country that don’t view me as my daughter’s legal parent because I didn’t carry her. From a legal standpoint, my name is on her birth certificate and I am legally married to my wife. From an emotional standpoint, she’s my freakin’ kid. Because same-sex marriage is ubiquitously legal in the United States, people forget how complicated things get when kids come into the picture. Here’s how it works: If we were traveling somewhere that didn’t view me as my daughter’s legal parent and something happened to my wife or daughter, I wouldn’t have decision-making power for my daughter. Meaning, if my wife were incapacitated for whatever reason, I wouldn’t be able to make medical decisions for my own kid. If my wife, god forbid, died, my daughter would be placed with my in-laws (who would give her right back to me…so, you know, suck on that).

This issue lives on the periphery of society. It’s most often met with thoughts and prayers ::shudder:: and not any actual help. It’s a lot of “That’s terrible!” “Oh, That’s not fair!” and my favorite, “I’m here for you.” Even my lawyer friends have zero knowledge on the ins and outs of where these legal lines begin and end. It’s infuriating. There is currently only one way to combat these worst-case scenarios: Enter, Second Parent Adoption.

Second Parent Adoption is exactly what it sounds like, I’m the other parent and I’m adopting my own kid. You know, there’s really no greater kick in the balls than signing paperwork to have legal ties to someone you would literally die for. To have my position as a mom questioned has taken a part of my spirit that I’ll never get back.

It’s an indescribably bad feeling that I’ve attempted to put into words on social media a few times. It’s never gone well because social media is a notoriously kind place. Recently, I got into an argument with a very well-educated straight woman who told me that she couldn’t understand what the big deal was and that all stepparents have to legally adopt their spouses’ kids. It knocked the guts out of me. This chick, who I’ve never met, viewed me as a stepparent. Now, there’s nothing wrong with being a stepparent. In fact, all parents who fully take on their spouses’ children should have parades thrown in their honor. That’s not what I am, though. Not even close. Stepparents come into the picture along the way, I’ve been on this train since it left the station. I was there for every injection, every checkup. I cried when we thought my wife had a blighted ovum and I cried even harder when we saw my sweet little girl’s wild heartbeat. I stood at the end of the hospital bed and held my wife’s leg to help push. I saw and held my daughter first. I live in a perpetual state of worry over potential bullies saying anything remotely mean to my baby and envision myself reaming them. I watch my daughter’s chest go up and down at night to make sure she’s sleeping as soundly as she deserves to be. I am not a stepparent. I am a mommy; I am Lillie’s mommy.

The Second Parent Adoption process is clinical and yucky. We’re currently in a place where we’re awaiting a court date. Paperwork is filed, no update. It’s been months. Once a week, I send an email asking for an update—No update, waiting on a date. Prior to this holding pattern, I had to get a physical exam, pay filing fees, and obtain a slew of documents that no human should ever have to keep track of. Our lawyer is a nice enough woman who doesn’t understand the emotional magnitude of the process. To her, we’re just another filed case that’s she’s waiting to close out in her books. It’s better that way. To have another person with an opinion weigh-in would be too much to handle. This process has made me question my validity as a parent and as a human. Learning that my parental status is completely optional to our legal system is a bag of emotions that I’ll be lugging around for the rest of my life.

There are 1 Million–9 Million (actual Googled statistic…we should probably work on closing the gap between those two numbers, yeah?) children being raised by a queer parent in the United States. I’m no mathematician, but that sounds like a lot of people who might be in the same boat. Let’s tie our boats together and storm the bastille. In the meantime, I’ll keep sending my weekly email, pummeling imaginary bullies, and fighting with people on the internet.

Jess Ader-Ferretti HBIC at Shit Moms Won't Say
Tinybeans Voices Contributor

Jess Ader-Ferretti is the creator and host of the growingly popoular web series, Shit Moms Won't Say. Jess is a born and rasied New Yorker who lives with her wife, Katie and their daughter, Lillie. Tune into Shit Moms Won't Say every Monday at 8PM EST on YouTube. 

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Tiny Birth Stories: Joyful Endings of IVF Success

by Danielle Rizzo

Our new series, Tiny Birth Stories, is aimed at sharing real-life stories from our readers to our readers. In just 100 words or less, we’re bringing you the raw, the funny and the heartwarming stories you’ve lived while bringing babies into the world. Here are five stories that will have you laughing, crying and nodding your head in solidarity. 

Interested in telling your birth story? Click here.

How Salt N’ Peppa helped me “push” him out by Jen T

After 7 years of “unexplained infertility” we finally had success with IVF. Due to preeclampsia I was induced at 37 weeks. Everything was going smoothly until the power went out in the hospital. During this time I started to feel nauseous and started throwing up and getting the shakes. Soon after, the power came back on and it was time to push. My baby’s heart rate was spiking so more nurses rushed in while the music I had playing coincidently started Salt N Peppa’s, Push It. This motivated me to get him out quick and that’s what we did.

The hardest 2 and a half years of my life by Joann C

After 15 months of silently struggling and a diagnosis of PCOS we reached out to a Fertility Specialist. We went through 3 medicated IUI’s before we moved onto IVF where we got pregnant on our 3rd round. Fast forward 8 months and I was admitted to the hospital and told I wouldn’t be leaving until I had my baby. After 30 hours of labor my doctor decided to perform a C-Section. At 28 years old and my first pregnancy I was scared and had zero time to prepare. This was happening! Our baby was born 15 minutes later and is now a happy, healthy toddler. It was the hardest 2.5 years of my life to get pregnant but if it comes down to having to go through every shot, medication, test and tear there’s no doubt in my mind that I would do it all again!

Success by the numbers by Amoreena A

Numbers can be cold but can also bring clarity. 2: babies I was carrying after IVF 25: weeks I was pregnant when Baby B’s water broke 31: days I was on hospital bed rest when Baby A’s foot protruded out of my body and caused an emergency c-section 78: days we spent in the NICU teaching these boys to eat 109: combined days we spent at the hospital while also caring for our 2-year old 2,836: days since my boys entered the world prematurely and I wouldn’t trade any of it for the world

IVF was meant to be for us by Tania A

“Ask me again in 5 years” – our standard answer from day 1of marriage. Seven years later it was a tired song, especially after TTC for two years. After multiple tests, ultrasounds, and shots pursuing IVF we were finally expecting! Our sweet baby made our hearts grow beyond measure, and her frozen brothers joined us less than 2years later. The pain of not being able to conceive naturally and the un-needed sensitivity to others’ critical opinion of IVF will always stay with us but our children are blessings that remind us our IVF was meant to be!

How we are now living our dream by Samantha M

Our story begins with a dream. My wife, Megan, and I always wanted children. We were married in 2007 after dating for 2 years. We started the process of trying to have children in 2013. We first interviewed different fertility doctors, got information from our insurance company on what would be covered and started looking for the best cryobank. With the support of family and friends we made our decision on all of the variables needed and started with intrauterine insemination, IUI. After tracking cycles, many doctors appointments and 2 IUI attempts, we were told our levels showed we were pregnant. Unfortunately, a few weeks later we miscarried what we had found out had been twins. Following that loss we had another 2 cycles and drove the miles that are the equivalent of driving from our home in NJ to CA. Finally we had our rainbow baby, our son Maxwell. Twenty two months later, after only one cycle of IUI, we celebrated the birth of our daughter, Matilda. Our children have been our biggest accomplishment.

Struggling to Get Pregnant? Your Progesterone Levels May Be to Blame

By Amy Beckley

Editor’s note: Any medical advice presented here is expressly the views of the writer and Red Tricycle cannot verify any claims made. Please consult with your healthcare provider about what works best for you.

When I started to suspect I had an ovulatory disorder that meant my progesterone levels weren’t rising properly after ovulation, I went to my doctor and asked for a supplement. Although he was reluctant, he prescribed it for me. A couple of cycles later, I was pregnant and gave birth to my beautiful daughter who is now 6. But after my experience, I discovered there was a significant lack of knowledge in women’s health surrounding low progesterone and supplementation. Many women and their doctors did not understand or believe in the power of progesterone.

Unfortunately, some misconceptions are still common today. Read on to understand more about progesterone, why it’s important, and two common misconceptions that could be preventing women from uncovering what could be an easy fix.   

Why Is Progesterone Important?  

Progesterone is the hormone released after ovulation. It is required to prepare the uterus to receive an embryo, should conception have occurred and is essential to have adequate levels of progesterone for a long enough period of time after ovulation for a successful pregnancy.

What is misunderstood, however, is that a common problem with ovulation typically manifests as progesterone deficiency. Many doctors question if low progesterone is a real diagnosis and whether or not adding progesterone supplements can actually help.

Misconception #1: Studies Show Progesterone Supplements Don’t Help Fix Problems with Ovulation.

When I asked my doctor for a progesterone supplement, he gave it to me—not because he thought it would work, but because taking the supplement wouldn’t harm me. This lack of faith in the effectiveness of progesterone supplements stems from a study conducted in 2016. This study followed 836 women. When a woman got a positive pregnancy test, half were given vaginal progesterone and the other half were given nothing. Live birth rates were only 2% higher in the progesterone supplement group. So, the study concluded that progesterone supplementation didn’t really help.

But this experiment was flawed. Basic biology tells us that progesterone is required to prepare the uterine lining for implantation—which is why it is released by the ovary right after ovulation. So, by the time a woman got a positive pregnancy test, the embryo had likely already implanted. Providing progesterone after confirmed pregnancy was almost “too late” since progesterone is critically needed to prepare the uterus for conception. This study was highly publicized when it was published, so the information spread widely to doctors and women.

In 2017, another study was published. In this experiment, women were given progesterone at the start of their luteal phase (3 days after ovulation) so that they were able to have high levels before implantation and getting a positive pregnancy test. The results of this study showed a 17% increase in live birth rates. 

In fact, there are many studies that show progesterone supplementation starting after ovulation increases live birth rates. So when supplementing, it’s important to mimic the time when the body would have released progesterone as well—which is right after ovulation, not after implantation has already occurred. 

Misconception #2: A Blood Test Is the Best & Only Way to Confirm Ovulation. 

If you suspect you have a lack of ovulation or suboptimal ovulation (i.e. a progesterone deficiency), your doctor may order a day-21 progesterone blood test. A day-21 blood test aims to measure progesterone at the point in your cycle when it should be the highest—seven days after ovulation (given ovulation occurs on day 14). However, there are a few reasons a blood test can fall short. 

First, a day-21 blood test assumes you ovulate on day 14 of your cycle. But, every cycle is different in length, so one woman may ovulate before or after day 14. When this happens, progesterone still should be high seven days after ovulation, but that may not necessarily occur exactly on the 21st day of your cycle. This means that you could get a negative result when in reality, your progesterone is fine. Additionally, a one point in time measurement doesn’t always show the full picture. In my case, progesterone levels would rise, then fall a bit too quickly to be considered “healthy”. I would get a positive day-21 test and doctors would think I was fine, but my progesterone levels weren’t actually adequate over time. 

Second, progesterone is secreted into the blood in pulses. Studies have shown that serum progesterone levels can fluctuate eight times in the course of a single day. So, progesterone can range from 3-30 ng/ml, depending on what time of day you draw blood. This makes it extremely difficult for doctors to know if the amount of serum progesterone in your blood draw is actually enough to support successful conception. At 8 a.m., your progesterone levels could look great, but at 4 p.m., they could be low. 

So, what does this all mean for you? 

The most important thing for you to do is stay informed and ask your doctor the right questions. The good news is that there are other ways to confirm successful ovulation at home so that you can understand this important piece of the fertility puzzle! 

After progesterone circulates through the blood, it is then passed into the liver where it is metabolized and secreted into urine as PdG (Pregnanediol Glucuronide). Studies have shown that PdG levels, first thing in morning urine show an average of the serum progesterone levels from the day before. Because PdG shows an average, this makes it a better way to measure the overall progesterone production after ovulation. Add to this, testing PdG through urine is non-invasive, it’s simple to track levels over several days, allowing for a more complete ovulation picture. 

Understanding the importance of progesterone and the most effective ways to test for it can empower you with valuable information and help your better advocate for yourself on your TTC journey.

I'm Amy Beckley. After my experiences with pregnancy loss and IVF I used my PhD in Pharmacology to create MFB Fertility, Inc. and invented the Proov test in my basement, which now allows women to confirm successful ovulation by tracking PdG in 5 minutes, at home. I want to empower women.

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What Is on Your Family’s Coat of Arms?

By Gay Cioffi

When parents take my parenting workshop, one of the most popular exercises when parents create their family’s coat-of-arms. They are asked to think of values that they want to impart to their children to put on an imaginary shield, just as families in the past did for their kin. My family likes to tease me about the aphorisms I am famous for spouting or would display as our family heraldry if I could. Here are some of my favorites:

Find work you love.

Your failures sometimes teach more than your successes.

Be kind to all people.

It isn’t what happens; it’s what happens next.

It isn’t every day that I get to see these values play out in real life. But, that is exactly what happened last week as I tuned into a panel discussion that my daughter, Cinematographer, Mia Cioffi Henry, participated in. The panel, “Through Her Lens: Creating a Truly Inclusive Film Industry,” was sponsored by Panavision and award-winning non-profit, Made In Her Image. It featured a round table discussion about the inequities in the film and television business, through the lens of six women of color, who are behind the camera.

Listening to my daughter’s contributions to the discussion filled me with a myriad of emotions. First and foremost was an appreciation for her passion for her work. Indeed, she has found work that she loves! She is both a natural storyteller and a visual artist, so being a cinematographer plays to her strengths. But just as importantly, she is a teacher and a collaborator, also essential attributes when it comes to filmmaking, which is the ultimate collaboration.

When she answered a question about the obstacles she has faced as a black woman in the industry, she was brutally frank about the challenges. She spoke honestly and bravely about the injustices present for women and people of color, from only being considered for projects about black folks, to being mistaken for the talent or a food service worker upon her arrival on set.

Yet, despite these experiences, she has persevered and thrived. When asked by an audience member about fear of failure, her encouraging advice: to be courageous, do your homework, and don’t give in to your fears…mentioning how much one has to learn from their mistakes, made me proud!

She emphasized an openness to others and a commitment to make the most from every opportunity. Citing the recent cancellation of the SXSW Film Festival, where she was to have her first feature film “The Surrogate” premiere, she explained the importance of “what happens next.” The disappointment and frustration she felt were strong emotions to get through, but a quick pivot by the Director, Jeremy Hersh, and the entire filmmaking team allowed the film to be successfully reborn on Vimeo and other streaming sites.

When your children are young, it is hard to imagine their future journeys—which will be theirs alone to take—but communicating to them what’s important to you, will go a long way in helping them to create their own mottos and mantras.

While I may have witnessed the embodiment of values that I believe in, my daughter gets all the credit for working hard and going out into the world with courage, curiosity, and a positive attitude… words she could proudly display on her own coat-of-arms!

I am a parent and grandparent with over four decades of experience in early childhood education. I share my passion, wisdom and experience, with parents and the people who care for and about children at Little Folks Big Questions, where we're out to answer the questions parents face in today's world.

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