[Homestead] Schizophrenic religious looneys
tvoivozd at infionline.net
Mon Feb 7 09:29:18 EST 2005
Religiobabblers have a knee-jerk fit if a waitress has an abortion to
protcct her children from going hungry, losing the roof over their heads
and becoming street persons (the rich don't have to pay any attention to
the religiobabblers, and don't).
The fact is (schizophrenic religiobabblers don't like any kind of facts)
fifty percent of pregnancies end in miscarriage. Do you ever hear a
religiobabbler rail against god-duh for god-duh abortions? Of course
not---that is a prime characteristic of religiobabblers, thou shalt not
blame an all-seeing, all-knowing, all-powerful god-duh for anything.
SF Gate <http://www.sfgate.com> www.sfgate.com
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* When a couple's dream fades
After his wife's miscarriages, a journalist turns to science for
answers and finds more questions
*- Reviewed by Selina O'Grady
Sunday, January 16, 2005
Click to View
Coming to Term
Uncovering the Truth
By Jon Cohen
HOUGHTON MIFFLIN; 282 PAGES; $24
If you have ever descended into miscarriage hell, you probably felt,
along with the bewilderment and grief, that every woman in the world
was having a baby without difficulty except you. Actually,
miscarriage in healthy mothers is as common as having a baby.
But we've discovered this only in the past 20 years, thanks to
ultrasound probes and home pregnancy kits that have revealed
previously unsuspected miscarriages. So what was once a late
menstrual period we now mourn as a lost baby, as science journalist
Jon Cohen discovered when his wife miscarried at six weeks.
Cohen accompanied his wife down the harrowing road of four
miscarriages, then wrote the book he wished they had been able to
read during that journey. If you want a self-help book on coping
with the grief, or a magic cure for the problem of recurrent
miscarriages (Cohen's main concern), this book is not for you.
Instead, Cohen has mixed his own and others' experiences with his
assessment of the current state of our knowledge. Astonishingly, he
found that we are still fumbling in the dark: Miscarriage medicine
is more voodoo than science.
This is what we do know. Half of all miscarriages are due to
abnormal chromosomes, so these fetuses could probably not have
survived. There is a clear connection between age, chromosomal
abnormality and frequency of miscarriage. And there is no evidence
to connect what you eat, drink, what air you breathe or where you
work with miscarriage -- despite the best efforts of scaremongering,
oversimplifying journalists and bad scientific research.
However, in trying to give an upbeat message, Cohen also may be
misleading us. If you have had one miscarriage, he tells us, you
face hardly any increased risk of a second. For recurrent
miscarriers, the "good news" is that if you have had as many as four
miscarriages, you are likely (one study puts the likelihood at 70
percent) to eventually have a baby without any treatment.
But the odds become worse for those who have suffered five
miscarriages and for the increasing number of women older than 35
wanting babies. Furthermore, the "good news" applies only to women
who have had miscarriages because of abnormal chromosomes. Cruel
though it sounds, these women are the fortunate ones. Their
miscarriages are due to bad luck. If they keep trying, they should
eventually win. But chromosomally abnormal miscarriages make up only
half the total. We do not really know what causes the other half,
though it is probably underlying biological problems such as an
insufficient cervix or uterine abnormalities.
So Cohen's good news for 70 percent of recurrent miscarriers turns
out to be dreadful news for the remaining 30 percent. Cohen fails
where so many science journalists fail -- to give a sense of what
the numbers mean for those living through the hell of the facts.
But why do we not yet have a cure? Why are available therapies often
little better than voodoo? Because, argues Cohen, this is an area so
laden with emotion that good research is nearly impossible. The
desperation of the women Cohen meets shrieks from the page. Like
Claire, who had five miscarriages and used three surrogate mothers,
or the 38-year-old who after 17 miscarriages is still exploring
options. In their agony, these women will believe in any type of
treatment that offers hope, and demand it from their doctor.
Faced with such agony, there is a huge pressure to provide a cure,
sometimes on the basis of a terrifyingly poor evaluation. Good
research is further hampered because these women are particularly
reluctant to take part in randomized placebo-controlled studies (the
only way to effectively test a treatment).
And that is how, with the best intentions, miscarriage medicine
becomes prescientific quackery. From bed rest, to cerclage (surgery
on a weak cervix) to uterine surgery, from hormones to immune
therapy, the unknowns outnumber the knowns. (As a scientist, Cohen
reluctantly concedes that "tender loving care" alone has been shown
to have a dramatic impact on preventing recurrent miscarriages.) He
also acknowledges the irony that the problem is compounded by his
"good news." For if most women who miscarry three or four times will
carry to term without any medical intervention, you could prescribe
chewing gum, or standing on one leg reciting "The Gettysburg
Address," and the treatment will appear to have worked.
In the face of such ignorance, Cohen offers two wise pieces of
advice, though it's advice that will be tough for any woman in
miscarriage hell to follow. Be skeptical of treatments and avoid
them if you can, especially if your miscarriages are due to abnormal
chromosomes. And -- harder still -- try to come to terms with your
biological fate, for we have less control over it than we would
like. Easy, of course, for him to say: Cohen and his wife ended
their journey through hell with three children. •
/Selina O'Grady is a writer in London./
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