Coming To Term: Uncovering the Truth About Miscarriage

by Jon Cohen, Sandra Ann Carson (Foreword)

After his wife lost four pregnancies, Jon Cohen set out to gather the most comprehensive and accurate information on miscarriage – a topic shrouded in myth, hype, and uncertainty. The result of his mission is a uniquely revealing and inspirational book for every woman who has lost at least one pregnancy – and for her partner, family, and close friends.
Approaching the topic from a reporter's perspective, Cohen takes us on a surprising journey into the laboratories and clinics of researchers at the front, weaving together their cutting-edge findings with intimate portraits of a dozen families who have had difficulty bringing a baby to term. Couples who seek medical help for miscarriage often encounter conflicting information about the causes of pregnancy loss and ways to prevent it. Cohen's investigation synthesizes the latest scientific findings and unearths some surprising facts. We learn, for example, that nearly seven out of ten women who have had three or more miscarriages can still carry a child to term without medical intervention. Cohen also scrutinizes the full array of treatments, showing readers how to distinguish promising new options from the useless or even dangerous ones.
Coming to Term is the first book to turn a journalistic spotlight on a subject that has remained largely in the shadows. With an unrelenting eye and the compassion that comes from personal experience, Jon Cohen offers a message that is both enlightening and surprisingly hopeful.

Genres: Nonfiction, Self Help, Parenting

276 pages, Hardcover

First published January 1, 2005

About the author

Jon Cohen is the author of Shots in the Dark and Coming to Term. He is a correspondent at the internationally renowned Science magazine and has also written for The Atlantic, The New Yorker, The New York Times Magazine, The Washington Post, Discover, Smithsonian, and Slate. He lives in Cardiff-by-the-Sea, California.

[source]

Reviews

[Kimberly · Rating 4 out of 5]

Three weeks ago today I had a D&C for my second miscarriage within 6 months. To endure one is difficult, but two in a row has been extremely emotional. Reading this book definitely helped me as I've been grieving and worrying about the likelihood of this happening a third time. Thankfully, the pathology reports from my D&C were all negative which gives me a little more hope for the future. Reading this also helped give me hope because it made me feel like we were just very unlucky twice in a row, but I have a 70% chance of carrying to term without any intervention.

Although this was not a quick read because it is full of information about various studies and treatments over the last century, it definitely gave me a better understanding of pregnancy, miscarriage, and infertility.

One statement that really stuck out to me was that helps to explain why my husband doesn't understand how difficult this is for me is that men only observe miscarriage and women live through it. I know that seems so simple, but I'd never thought about it in that way.

So even though it was a little dry at times, it was also fascinating and helpful.

[Becca · Rating 4 out of 5]

This is not a book on how to cope with miscarriage. Instead it is a book about the scientific studies and their findings about what causes miscarriage, what doesn't, and which treatments work and which don't. I found it very interesting. Finally, some facts! I read it in just two days. I was surprised at how often miscarriages happen, and yet how low the odds are of it per pregnancy. I am now convinced that there is very little that we can do to 'cause' a miscarriage. And the statistics are very encouraging for a successful pregnancy, even for those who have had many miscarriages.

[Cheryl-Lynn · Rating 4 out of 5]

A Fabulous book about miscarriage- and especially recurrent miscarriage. Lots of interesting info. Definitely gave me a different perspective with what the "average" doctor (RE) will recommend- ie a lot of it is worthless or not necessary. Especially if tests come back normal. One size fits all just doesn't work for most rpl patients. Too bad there is so little motivation for drs to study miscarriage more. Too bad I don't live in Chicago so I can go see Dr. Stephenson. There were some technical sections that wouldn't relate to many of us which is why I didn't give it a full 5 stars. Lots of hope/acceptance of the hand we are dealt in this book!

[Mo · Rating 4 out of 5]

I read this book after my 4th miscarriage and found it to be very inspiring. It's not really a book about coping with a miscarriage as it is a book about the facts behind why miscarriages happen and what treatments exist to prevent them. I would recommend this book to anyone suffering a miscarriage.

[Joyce · Rating 3 out of 5]

Interesting and well researched book about recurrent miscarriages. Bottom line? There are lots of different treatments available, but if you get pregnant, you are either going to have a baby or a miscarriage. Even without medical interventions, it's probable you can have a baby even after several miscarriages.

[Kristina Cowan · Rating 5 out of 5]

I read this book after I miscarried my first daughter. It was a source of comfort and useful information, and helped me better understand just how common miscarriage is. Not unlike mental health, the loss of a child--whether in the womb our out--still carries too much stigma. Bravo to Cohen for using his excellent writing and reporting skills to shed light on something deeply personal to him and his wife.

[Bill Williamson · Rating 5 out of 5]

Wonderful for anyone who has dealt with miscarriage

Amazing look into the world of recurrent loss and the progress and lack there of in research over the years.

[Maruša · Rating 5 out of 5]

Even though this is an outdated book, the spirit of it is very much needed.

[Q2 · Rating 4 out of 5]

Recently I picked up the book Coming to Term: Uncovering the Truth About Miscarriage by Jon Cohen. Sometimes I haunt the Baby Center discussion boards for other moms to connect with and this book was recommended more than once. It's a good book--it's realistic, comprehensive, and very well-written. Plus, I like this Cohen Guy. ;)

Cohen is no stranger to miscarriage: "With each successive miscarriage, Shannon and I became increasingly frustrated with the mumbo jumbo we kept hearing from the specialists about what had happened, what we should do, and how we should view our prospects for having more children. Not only did different doctors give us wildly different explanations, but when I pressed for scientific studies that we could consult no one had anything to offer, and some had the audacity to shift into all-wise-M.D. mode, counseling us to accept the losses and try again. We wanted facts, and one day it dawned on me that I make my living ferreting out scientific facts." And so he wrote a book.

A tangential tidbit I learned from Cohen's research: early pregnancy tests involved injecting a woman's urine into lady rabbits; if the rabbit developed a mass in its ovaries, then the woman was pregnant. All the rabbits died.

!

Anyway.

Cohen sifts through the many possibilities for causes of miscarriage, plus the various treatments tried for each. These various 'causes' include old eggs, chromosomal abnormalities (in which early miscarriage is actually a good, normal thing), auto-immune diseases, hormonal imbalances, a few nasty environmental toxins (mercury, BPA, and nitrates), uterine abnormalities, and stress. Peppered throughout the book are personal stories of sadness and triumph.

A few hopeful sound bytes:

"Already, many clinicians recognize that, in healthy mothers, miscarriage is as common as birth...miscarriage...often represents a sign of hope."

"...in study after study, women who have had up to four miscarriages and become pregnant again typically carry to term."

"Deciding to do nothing, in an informed way, often constitutes the most prudent way to do something. Women and men who want babies, especially those who have tried and failed, would benefit if they recognized how their intense desires can lead them to take unnecessary risks....Most women who miscarry, even three or four times, will carry to term if they become pregnant again."

Particularly thought-provoking (for me) is the overall conclusion that most environmental toxins probably aren't to blame for recurrent miscarriage: "Can you use miscarriage as an index of environmental exposure?...It's very, very tough to figure out whether environmental effects are real" and "Miscarriages...rarely occur because of what a woman eats or drinks, where she lives and works, or what air she breathes. More than half of all miscarriages have abnormal chromosomes, mainly because the mother's eggs do not properly execute meiosis."

Cohen gives a good reminder to us all not to put too much stock in current reproductive trends or miracle infertility treatments: "Science is provisional. What appears real today may, based on new evidence, seem naive tomorrow."

[Karah Spahn · Rating 4 out of 5]

After experiencing my second consecutive miscarriage, I was grasping for any kind of explanation or answer to why this could have happened to me twice. Every doctor, every website, everything I read said the same basic thing: nobody knows. There are theories out there and some slim proof, but nothing certain really exists about why miscarriages occur. Yet, I couldn't just peacefully accept that answer. I turned to this book as a means to learn more about the science and studies and theories surrounding recurrent miscarriages.

Jon Cohen's wife endured four miscarriages before giving birth to their second child, and miraculously had a third unplanned healthy pregnancy. Because he so closely experienced the emotions of miscarriage, his writing is heartfelt and empathetic. However, he also writes with the pen of a journalist, and tediously describes many scientific studies that have concentrated on miscarriage.

Overall, I don't feel like reading this book provided me with more answers about why miscarriage happen, but it definitely opened my eyes to the frequency in which miscarriage occurs and the emotions that almost all women experience when dealing with them. The book also explains why miscarriage research is so difficult-- from the fact that most women don't know they're pregnant until weeks into their pregnancy to the other fact that if given the choice to receive medication or placebo no woman is going to choose a placebo over a possible treatment. I did skim over some of the meaty data/ statistical portions of the book, but that didn't take away from the message of the book.

I love how the book ended, with stories of hope and examples of "miracle babies" that had come to term. Of course, after reading this book, and realizing how many things have to go right-- from the timing of conception to the perfect dividing of millions of cells to the normal growth of placenta and umbilical cord, to a healthy & uncomplicated birth-- it's just amazing that our species is even reproducing!

[Katie · Rating 4 out of 5]

**This is not a self-help book, so I'm not sure why it's categorized that way.**

I really enjoyed this book. I had a miscarriage last summer, and since I've been surprised by how many people have come to me to say they've also had one or more. I've met many people with recurrent pregnancy loss, which is particularly heartbreaking, who have pursued a variety of infertility treatments, honestly without much success. I've been very curious what we really know about miscarriage or about how truly effective most of the treatments are. This book confirmed a lot of my suspicions: we don't know much about why miscarriages happen, and many of the treatments we do have are not very effective and are not targeted at people who have trouble staying pregnant.

Cohen excellently wove the history of reproductive medicine with stories of parents facing various challenges to having a living child. It was fascinating, at times upsetting, and very frustrating to find how very early we still are in solving this medical mystery. My only real complaint is that the book is almost 8 years old, and I'm curious to know what has changed in the last 8 years. Based on what many of my friends with RPL are going through, it doesn't seem like much has.

[Dawn · Rating 2 out of 5]

This book may be helpful to some women, but it didn't provide any answers or hope for me. I've had 2 chemical pregnancies and 2 missed miscarriages. I've been deemed unlucky as all my testing has been normal except that my 2 precious baby girls had two different super rare chromosomal abnormalities and never should have survived implantation. #stillprayingformyrainbow

[Star ☔️ · Rating 5 out of 5]

As someone who has had recent miscarriages, I found this book very informative. It's part scientific research and studies on the subject and part personal stories. I thought it was interesting to hear this book from the point of view of a husband that has been through 4 pregnancy losses with his wife. I cried through some parts of the book and some of the loss stories ripped my heart out. This book was published 10+ years ago, so I am sure there have been some scientific developments since then, but the emotional journeys of couples going through this pain remains the same (hope, excitement, disappointment, grief, fear, etc...). I thought the chapter talking about Love Canal was super interesting. What a disaster that was. This book was an emotional read for me, that I really did not want to end. I think women who have experienced one or more pregnancy losses will get something out of this book. Highly recommended.

[Keri Troehler · Rating 4 out of 5]

I wish I had no reason to read this book, but since I do, I'm glad that I did. Cohen's conversational way of writing feels like a discussion with an informed and good friend. Since he has experienced the topic first-hand, he is compassionate and strives to tell it like it is. The case-studies he presents and the deep exploration of the latest medical interventions and preventions helps those who need it to understand that above all else, miscarriage is not one's fault and truth be told, most women will become pregnant eventually. The only thing I wish he had explored was non-western treatments and approaches to miscarriage and the issue of advanced maternal age. But, perhaps, those two topics would have required another couple hundred pages and a lot more research. As it was though, it was a healing read.

[Nicole Hall · Rating 5 out of 5]

Having suffered through four miscarriages, I was on the hunt for understanding miscarriage better. I had read a lot online and asked my doctor many questions. I was disappointed with how little there was out there and with my doctor's lack of knowledge on the subject. This book did not disappoint. This book focuses on understanding miscarriage better, so it does go through a lot of the research that has been done and science-y information. This is exactly what I needed. I feel that I have a much better understanding of what we do know and what we do not know about miscarriage and what "cures" there are out there and their potential risks. The book is written in a way that is easy to understand. This book also gives a lot of hope to those suffering from recurrent miscarriages (and especially to those that have had one or two). I highly recommend this book.

[Megan · Rating 4 out of 5]

This is a book about the science of miscarriage. There's a lot that remains unknown about miscarriage - but this book does a good job of covering what IS known, based on studies and evidence. Cohen's wife miscarried several times, which led him to research miscarriage and recurrent miscarriage. He's written in a style that's informative and well researched, yet still understandable to an average reader.

Along with Miscarriage: Women Sharing from the Heart and What Was Lost: A Christian Journey Through Miscarriage, this is one of the most informative and helpful books I've read on miscarriage.

[Tanja · Rating 5 out of 5]

I remember this book as a blessing. I had read loads of books,personal accounts on miscarriages and so on. I was lost in all of the advice, treatments and medication to help me keep a baby. And then I read this , facts actual facts about miscarriage. Well researched facts. I felt like I could finally start taking action after reading this book, which was something I needed. At times it can be dry, but I still give it 5 stars for being just what I needed in a very difficult time in my life.

Unfortunately I've had cause to read this again and it was still just what I needed. I wish it was more up to date, but that's the only thing I can say against it.

[Jessica · Rating 5 out of 5]

This was a wonderful read and exactly what I wanted and needed. The writer shares scientific information in an easily understood way, and he includes anecdotes from a variety of experiences. The three divisions work well with the stories and studies presented: Mother Nature, Mysteries, and Hope. The book provides a good summary of available information about miscarriage, its causes, and its treatments. Cohen gently cautions against extreme and unproven measures, despite the understanding of hopeful parents' desperation and desire to have a child. The book ends with stories of hope, highlighting a few stories of babies never expected to be and their grateful parents.

[Ashley · Rating 4 out of 5]

I liked this book because of the scientific research. I only gave it 4 stars because I think that there is more recent research that should be added to it and it's a bit dry however he does try to make the research as interesting as possible. It's not my favorite book for sure but I think it's a good read if you want to learn more about possible causes of miscarriage (which surprise surprise is a huge mystery in most cases) and goes on to give mothers with multiple losses hope. I would recommend it!

[Amy · Rating 5 out of 5]

This book was excellent. It was very informative an and included a lot of scientific information that was presented in an easy-to-read way.
Also, the author of the book's wife experienced several miscarriages ...so he has insight into not just the science behind miscarriages, but the emotional side as well.

[Jeannie Colling · Rating 4 out of 5]

After his wife lost four pregnancies, Jon Cohen set out to gather the most comprehensive and accurate information on miscarriage a topic shrouded in myth, hype, and uncertainty. The result of his mission is a uniquely revealing and inspirational book for every woman who has lost at least one pregnancy and for her partner, family, and close friends. It gives you hope.

[Hilary · Rating 5 out of 5]

Extremely helpful book - it was very science oriented (which worked well for me, but maybe not for all), but with a good mix of personal stories including his own. I would recommend it to anybody who has suffered pregnancy loss or is trying to understand what somebody in this situation is going through.

[Marissa · Rating 5 out of 5]

Expertly written with compassion, humor, and SO MUCH SCIENCE, this book was a lifeboat in a stormy lonely unpleasant sea. Not prescriptive or precious in the least. Recommended for the obvious folks but also anyone interested in the incredible beginnings of life--both its miracles and false starts.

[Julie · Rating 4 out of 5]

A comprehensive look at the various causes of miscarriage from a scientist whose wife experienced several on the journey to parenthood. An easy read with many case studies and examination of scientific research on miscarriage.

[Diana · Rating 3 out of 5]

This book was recommended to me by a Dr. Malpani from Bombay, India whose website I had visited and wrote to. Just from the first few pages I can say I wish I had read it a long time ago. I feel it will help me make the decisions I have to make for the future.

[Marty · Rating 5 out of 5]

This book was great. The author strikes the right balance of taking a scientific look at miscarriage while understanding what it's like for the couple. I'd highly recommend it, I learned a lot and feel a little more hopeful.

[Christy · Rating 4 out of 5]

Excellent factual information and studies I'd never read before. Infinitely more information than you'd ever get out of a doctor. They're afraid to say anything and it can be really frustrating. A great resource.

[Emily · Rating 4 out of 5]

A scientific researcher turns his eye toward miscarriage after his wife loses four pregnancies. This provides a good overview of the current research and efficacy of treatments, but is still written sensitively and provides hope for those with losses.

[Lena · Rating 4 out of 5]

An interesting read about a topic wrought with negative emotions. I liked the rational, fairly scientific approach to a topic that generates a lot of mysticism and pseudo-medicine. Well written if somewhat painful to read due to the topic itself.

[Jenne · Rating 3 out of 5]

Although a little technical with a bunch of medical jargon, it was an interesting book. It gives good info and statistics that show that there are promising outcomes. It is nice to know you are not alone in your struggles and to know that there is hope.