Multiple miscarriages scar hearts

KANSAS CITY, Mo. -- Jennifer Freeman aches to have another baby. But she's worried. What if it doesn't work, what if she miscarries -- again?

"I just don't trust my body," she said.

Who could blame her? The first time Freeman, 27, became pregnant, it was joyous and seemed so easy. She was 23, married for a year to her husband, Chris, an accountant, and living in Olathe, Kan.

When tests confirmed the pregnancy at four weeks, they were so thrilled they quickly ran out and bought a crib, told all their family and friends and picked out a name. If the baby was a boy, he would be Alexander Elijah.

Then, at eight weeks, the pain twisted inside her.

"I went to the emergency room," Jennifer recalled. "I was at work when it happened. It was a Saturday. The whole experience was horrible.

"A doctor, somebody, he said to me, 'A lot of people have miscarriages and they think it's so tragic; they think that it's like losing a baby.' To us, it was losing a baby."

Then she got pregnant again. In April 2005, when their son was born (named Alexander Elijah, in honor of their lost baby), the Freemans figured the first miscarriage was a fluke.

But then came a second miscarriage. And last June 7, the worst of all: the premature birth at 32 weeks of another boy, Josiah Scott, who died two days later because of a frequently fatal chromosomal abnormality called trisomy 13.

Jennifer cradled Josiah in the hospital as he died.

"As soon as I held him, he calmed down," Jennifer recalled. "He knew I was his mom. I got to sing to him, 'Hush Little Baby.'"

Now, as the anniversary of Josiah's birth and death approaches, the Freemans are in a situation familiar to a growing number of women.

Having already suffered what doctors call "recurrent pregnancy losses," they plan to try again very soon. But they're wary, anxious not only about why they continue to lose pregnancies and whether it will happen again, but also about their emotional reserves.

"It makes me very scared, the thought of going through that again," Jennifer said. "If I didn't have faith," she said of her and Chris' bedrock Christianity, "I think I would have lost it."

More than we know

To be sure, the rates of single miscarriages (as opposed to recurrent) have remained steady for decades: 15 percent to 20 percent of all "recognized pregnancies" -- typically those after six weeks of gestation -- end in miscarriage before the 20th week. If pregnancies before six weeks are included, the number rises to 50 percent. Odds of miscarriage increase as women age.

Less appreciated, experts say, is the extent to which recurrent pregnancy loss has become a visible part of the societal fabric.

Multiple miscarriages are thought to affect 1 percent to 3 percent of pregnant women, an overall rate that remains statistically unchanged. But experts say they suspect that the number of women who are experiencing recurrent pregnancy losses may be rising. The reasons are several, including better home pregnancy tests.

"Ten years ago a woman might wait past her first missed period, maybe two, before finding out she was pregnant," said physician Mary Stephenson, a professor of obstetrics and gynecology at the University of Chicago and director of its Recurrent Pregnancy Loss Center. "Now if someone misses her period by a day, she can go to the local pharmacy and get a very sensitive pregnancy test."

Not only is the result greater awareness of pregnancies, she said, but also greater awareness of when pregnancies are lost.

The other main reason is advanced maternal age: the trend in the number of women waiting until their late 30s or even 40s to become pregnant.