Something has been bugging me recently

When I found out I had these two genetic mutations--the prothrombin mutation and the MTHFR mutation--I immediately invoked my scientific training and started searching for journal articles on the topic, reading anything I could to try to understand the news I'd just been presented with.

Of course, my reading all of these articles is what caused the problem when I visited the perinatologist, who, I soon found out, was not as on top of the literature as I was and who believed these mutations were really not so much to worry about. The doctor also seemed to take it personally that I wanted to discuss the literature with him, as he'd expected this to be a one-way conversation, where he'd pat my head and reassure me that there was nothing to worry about.

It is true that some people have these mutations and have no trouble conceiving and delivering healthy babies. But it also seems to be true, from the studies that are out there, that there are people for whom these mutations cause serious problems. The distinction lies, for me, on the individual level. Yes, for some people these mutations do not have any measureable impact; for others, they have a significant and very scary deleterious effect.

Which brings me to what is bugging me today. There has been a rash of later pregnancy losses on one of the Bump boards. I don't know anything about these women, and I am not pretending to understand their highly-personal situations. But it's refocused me on a key finding that I had read in the literature: these blood clotting mutations do not only cause early miscarriages. In fact, there is significant evidence that they are implicated in second and third trimester losses, as well as significant interuterine growth retardation.

How can anyone believe these mutations are not serious when faced with the evidence? Why do doctors seem to understand so little about the field of pregnancy loss? About the field of women's health in particular?

It is for this reason that I pushed for the Lovenox for if and when I do become pregnant again. Truth be told, I am not 100% excited about having to inject myself daily. I had dreamed of this low-intervention birth, whereas the I will now be induced at 39 weeks. But when I weigh the risks, the possibilities of what could happen, I don't know how I could not take this route.

What weighs on my mind is that I had to push for this. How many other women are out there who don't have the scientific background that I do? Who don't have access to the literature? Who have no choice but to believe their doctors when told that these mutations are really no big deal? How many women go through needless suffering?

This is haunting me today.