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Synopsis
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 an intriguing 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 unexpectedly hopeful.
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First Sentence
ON A BRILLIANT, WARM SAN DIEGO SATURDAY IN THE SPRING of 1996 my wife, Shannon, had her first miscarriage. Read the first page
Front Cover | Copyright | Table of Contents | Excerpt | Index
ON A BRILLIANT, WARM SAN DIEGO SATURDAY IN THE SPRING of 1996 my wife, Shannon, had her first miscarriage. Read the first page
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Customer Reviews
Most Helpful Customer Reviews
22 of 23 people found the following review helpful
Format:Hardcover
I have just finished reading this book with tears in my eyes and a smile on my lips. Smiling is not an easy thing to do when you've just experienced your fourth miscarriage, but this is a book that has given me real hope for the future. This book felt more like a person to me than a hard cover with pages in between. It treated me like the intelligent, informed person I like to think I am, but with a nod to the difficult emotions that miscarriages bring. It is a fantastic resource, too, bringing together the mass of research on the subject of miscarriage, with its often conflicting results. And the author clearly and authoritatively considers all aspects of the results of the research, including its statistical significance, its clinical application and the way in which it is viewed by experts in the field. The notes at the back of the book are similarly thorough. It struck me very hard from reading this book that the science of miscarriage is still a relatively new one and there is often no answer to the question 'Why?'. This book actually encourages us to embrace that uncertainty and to stay pragmatic about supposed 'cures'. Finally, there are human stories that tug at the heart strings, many - but not all - with happy endings. This reminds us that we are not alone in what we are experiencing. I also believe that Jon could not have written this book so effectively if he & his wife had not suffered miscarriages themselves. I hope he reads this review one day because I want to say THANK YOU JON!
3 of 3 people found the following review helpful
Format:Paperback
I swallowed up this book in about 3 nights. Having clocked up my 3rd miscarriage and found little help on the internet as to what this subject is really all about, Jon Cohen does it all for you, and more.
His research is profound and helps you to get to the nitty gritty of miscarriage. His story and the other stories he tells are heartrending and likely to have you reaching for a tissue. He talks with compassion, but mirrors the frustration that I have felt after each miscarriage, with the exception that he has been able to open doors to find out what is and isn't going on behind the scenes in the aid of helping women like me.
I'm very grateful he wrote this book and thoroughly recommend it to anyone who's suffered miscarriage, and their partners. Its a basic instinct to want to understand the nightmare nature of this subject when it happens to you, and Jon Cohen contributes to this enormously. Well done Jon, superb.
His research is profound and helps you to get to the nitty gritty of miscarriage. His story and the other stories he tells are heartrending and likely to have you reaching for a tissue. He talks with compassion, but mirrors the frustration that I have felt after each miscarriage, with the exception that he has been able to open doors to find out what is and isn't going on behind the scenes in the aid of helping women like me.
I'm very grateful he wrote this book and thoroughly recommend it to anyone who's suffered miscarriage, and their partners. Its a basic instinct to want to understand the nightmare nature of this subject when it happens to you, and Jon Cohen contributes to this enormously. Well done Jon, superb.
Most Helpful Customer Reviews on Amazon.com (beta)
Amazon.com:
31 reviews
72 of 74 people found the following review helpful
Required Reading
4 Jan 2005
Format:Hardcover
This is by far the best book available on miscarriage. I found it invaluable for these reasons:
1) It provides detailed information about why/how miscarriage occurs which I have never read elsewhere despite (unfortunately) countless hours spent researching the subject. Cohen (who is a science writer) interviewed experts in genetics and recurrent miscarriage and scoured files and viewed slides collected in miscarriage studies. This book presents far more information than a typical book on pregnancy loss provides, and Cohen does a commendable job of making some really complex biology accessible to the average reader.
2) The book explains why there is so much controversy surrounding miscarriage treatments. In short, to prove a treatment really works, doctors need to design a trial that shows the treatment is more effective than doing nothing at all. But women miscarry for many different reasons and a treatment that might help a woman who miscarries due to hormonal problems obviously won't help one who has a structural problem with her uterus, for example. One scientist quoted says miscarriage is a "malfunction," not a sickness, so a study of miscarriage treatments is more difficult to design than a study of say, diabetes treatments, where patients are much more alike. There's also, Cohen says, little financial incentive for the pharmaceutical companies to do them, but that's another issue. The result is VERY FEW treatments are actually proven to work--they might or they might not, nobody has much data to show.
3) The book explains why doctors are so apt to tell you "just try again." This is the good news promised on the cover: Even women who have had 4 miscarriages in a row are likely to carry a baby to term with NO intervention whatsoever. The book includes anecdotes of women, including Cohen's wife, who miscarry again and again and then have a healthy baby, both with and without medical intervention, along with the science to explain how and why this can happen.
4) Cohen debunks the link between most environmental factors and miscarriage and raises serious questions about certain immunological treatments (if not the goodwill) of famous miscarriage doctor Alan Beer.
What I found a little frustrating about this book is that Cohen adopts--somewhat--the "it's best to do nothing" attitude shared by many MDs. Apparently there is science to support this up to 4 miscarriages but for those of us in the 5+ group, what's the answer?
However, it's not Cohen's fault that they're aren't lots of proven treatments, and his reservations stem from genuine concern for women's health (the DES chapter is a cautionary tale on the dangers of overconfidence).
Cohen approaches the topic with a sensitivity born of personal experience and the professionalism you would expect from a science writer. The book will help you become a more informed patient and give you hope grounded in fact.
1) It provides detailed information about why/how miscarriage occurs which I have never read elsewhere despite (unfortunately) countless hours spent researching the subject. Cohen (who is a science writer) interviewed experts in genetics and recurrent miscarriage and scoured files and viewed slides collected in miscarriage studies. This book presents far more information than a typical book on pregnancy loss provides, and Cohen does a commendable job of making some really complex biology accessible to the average reader.
2) The book explains why there is so much controversy surrounding miscarriage treatments. In short, to prove a treatment really works, doctors need to design a trial that shows the treatment is more effective than doing nothing at all. But women miscarry for many different reasons and a treatment that might help a woman who miscarries due to hormonal problems obviously won't help one who has a structural problem with her uterus, for example. One scientist quoted says miscarriage is a "malfunction," not a sickness, so a study of miscarriage treatments is more difficult to design than a study of say, diabetes treatments, where patients are much more alike. There's also, Cohen says, little financial incentive for the pharmaceutical companies to do them, but that's another issue. The result is VERY FEW treatments are actually proven to work--they might or they might not, nobody has much data to show.
3) The book explains why doctors are so apt to tell you "just try again." This is the good news promised on the cover: Even women who have had 4 miscarriages in a row are likely to carry a baby to term with NO intervention whatsoever. The book includes anecdotes of women, including Cohen's wife, who miscarry again and again and then have a healthy baby, both with and without medical intervention, along with the science to explain how and why this can happen.
4) Cohen debunks the link between most environmental factors and miscarriage and raises serious questions about certain immunological treatments (if not the goodwill) of famous miscarriage doctor Alan Beer.
What I found a little frustrating about this book is that Cohen adopts--somewhat--the "it's best to do nothing" attitude shared by many MDs. Apparently there is science to support this up to 4 miscarriages but for those of us in the 5+ group, what's the answer?
However, it's not Cohen's fault that they're aren't lots of proven treatments, and his reservations stem from genuine concern for women's health (the DES chapter is a cautionary tale on the dangers of overconfidence).
Cohen approaches the topic with a sensitivity born of personal experience and the professionalism you would expect from a science writer. The book will help you become a more informed patient and give you hope grounded in fact.
39 of 41 people found the following review helpful
Invaluable information unavailable elsewhere
7 Feb 2005
Format:Hardcover
For anyone who has experienced a miscarriage (or, even worse, miscarriages), this is a must-read book. From Cohen's extremely detailed but easily understandable descriptions of how eggs and sperm are created and how they meet to create a human being to the debunking of common myths (still held by most doctors), you won't be able to stop reading.
One's first surprise is how humans ever manage to reproduce at all when approximately seven out of every ten conceptions fail. The next surprise is that early home pregnancy tests can be as much a curse as an announcement of happy news. By now knowing just days after conception that they are pregnant, most women will likely "experience" early miscarriages that would have gone unnoticed or been regarded as simply late periods a mere ten years ago. More of these women will believe they have a problem conceiving when what they are really experiencing is the body's very normal method of maintaining only those fertilized eggs most likely to develop into healthy babies.
Cohen describes extremely intriguing cellular studies of conceptions from the first moments of fertilization to weeks after implantation to demonstrate what really happens when sperm meets egg and the many things that can go wrong. Almost all of the early failures are due to either problems with implantation (often hormonal or a matter of bad timing) or chromosomal defects that occur at the very first stages of cell division, which are infinitely more common than anyone knew before. Even more surprising is the finding that it's not the age of the woman's eggs that causes the development of more babies with chromosomal defects (most commonly Down's Syndrome caused by an extra copy of chromosome 21) but rather how close the woman is to menopause (something she probably wouldn't even know without a uterine biopsy). In other words, and most beneficial to women looking for answers, it's not the woman's fault. A miscarriage is not caused by that glass of wine she had at the office party or the 5k race she ran last weekend or the shocking news that a loved one suddenly died.
In addition, the author explains, through many double-blind scientific studies, that many, if not all, of the "treatments" physicians offer for recurrent miscarriages are useless except as "something to do". The only "treatment" shown to have real, repeatedly verifiable, effects is a warm and nurturing relationship between the woman and her healthcare givers throughout her pregnancy. The good news is that even for women who have experienced up to 8 or more miscarriages, almost all will eventually bring a healthy pregnancy to term.
And, finally, Cohen acknowledges that, for most women who experience even one miscarriage among several successful births, losing a pregnancy, even it's just a week or two after conception, is an emotionally sad event that can be vividly remembered one's entire life.
One's first surprise is how humans ever manage to reproduce at all when approximately seven out of every ten conceptions fail. The next surprise is that early home pregnancy tests can be as much a curse as an announcement of happy news. By now knowing just days after conception that they are pregnant, most women will likely "experience" early miscarriages that would have gone unnoticed or been regarded as simply late periods a mere ten years ago. More of these women will believe they have a problem conceiving when what they are really experiencing is the body's very normal method of maintaining only those fertilized eggs most likely to develop into healthy babies.
Cohen describes extremely intriguing cellular studies of conceptions from the first moments of fertilization to weeks after implantation to demonstrate what really happens when sperm meets egg and the many things that can go wrong. Almost all of the early failures are due to either problems with implantation (often hormonal or a matter of bad timing) or chromosomal defects that occur at the very first stages of cell division, which are infinitely more common than anyone knew before. Even more surprising is the finding that it's not the age of the woman's eggs that causes the development of more babies with chromosomal defects (most commonly Down's Syndrome caused by an extra copy of chromosome 21) but rather how close the woman is to menopause (something she probably wouldn't even know without a uterine biopsy). In other words, and most beneficial to women looking for answers, it's not the woman's fault. A miscarriage is not caused by that glass of wine she had at the office party or the 5k race she ran last weekend or the shocking news that a loved one suddenly died.
In addition, the author explains, through many double-blind scientific studies, that many, if not all, of the "treatments" physicians offer for recurrent miscarriages are useless except as "something to do". The only "treatment" shown to have real, repeatedly verifiable, effects is a warm and nurturing relationship between the woman and her healthcare givers throughout her pregnancy. The good news is that even for women who have experienced up to 8 or more miscarriages, almost all will eventually bring a healthy pregnancy to term.
And, finally, Cohen acknowledges that, for most women who experience even one miscarriage among several successful births, losing a pregnancy, even it's just a week or two after conception, is an emotionally sad event that can be vividly remembered one's entire life.
18 of 19 people found the following review helpful
Very good read. Well researched. Compassionate.
1 Mar 2005
Format:Hardcover
I browsed a few books on miscarriage after my first. Not very helpful books. Had a second miscarriage, and just a few weeks ago, a third. I have no children (yet!).
After reading reviews of this book, I thought that it would be worth a read. And it was. I had little or no hope that I'd ever carry a child to term. I wanted to move on to adoption, while my husband wants to continue trying to conceive, through in vitro fertilization.
Well, this book has given me hope again. I learned that it's not just "a miracle" when a woman with repeat miscarriages has a healthy kid.
It's a well-written and compassionately written book. It helps so much when people have experienced this unbearable pain of miscarriage write these types of books.
After reading reviews of this book, I thought that it would be worth a read. And it was. I had little or no hope that I'd ever carry a child to term. I wanted to move on to adoption, while my husband wants to continue trying to conceive, through in vitro fertilization.
Well, this book has given me hope again. I learned that it's not just "a miracle" when a woman with repeat miscarriages has a healthy kid.
It's a well-written and compassionately written book. It helps so much when people have experienced this unbearable pain of miscarriage write these types of books.
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