Braving a miscarriage

Ms Julie Aloshious' tears flow freely when she recalls her pregnancies - and losses.

In all, the staff nurse conceived eight times. The first five times, between 2001 and 2006, ended in miscarriages within the first 12 weeks of pregnancy. She was 23 when she lost her first baby. The sixth time, she had a healthy baby boy, Gerard Jofi, now six.

During her seventh pregnancy in 2010, ultrasound scans showed a normal baby boy. But she went into premature labour at 20 weeks. The baby could not be saved.

"It's still difficult to talk about it. He looked like his older brother," says Ms Aloshius, 36, tears rolling down her face. Her husband, Mr Jofi James, says softly: "We held him for a few minutes. I could feel his heartbeat come slowly to a stop."

Overwhelmed by their grief then, the couple did not think to name him - or the others.

When Gerard, who was four at the time, noticed his mother's missing baby bump after a couple of months and asked about it, they told him the "baby was with Jesus".

Ms Aloshious' obstetrician and gynaecologist Dr Koh Gim Hwee says: "Miscarriages in the second trimester, after 12 weeks, are less common and are often very traumatic experiences for women as they can see their babies on ultrasound scans."

The Catholic couple turned to their faith for strength, says Mr Jofi, 43, chief operating officer in a manufacturing firm.

Fifteen months ago, after Ms Aloshious' eighth conception, Gabriella was born.

Though hers has been a particularly hard journey, miscarriages are not uncommon.

Worldwide, they happen in 15 per cent of known pregnancies in women under 35 and usually within the first trimester, doctors tell SundayLife!. Women between 35 and 40 years old face a 20 to 35 per cent chance of miscarriage. Beyond that, the risk goes up to 50 per cent.

Associate Professor Tan Thiam Chye, head and senior consultant, inpatient service of the department of obstetrics and gynaecology at KK Women's and Children's Hospital, says the more common causes of miscarriages include medical conditions such as uncontrolled severe diabetes, thyroid disease, multiple pregnancies and bacterial infections.

According to Associate Professor Tan Hak Koon, head and senior consultant of the department of obstetrics and gynaecology at the Singapore General Hospital (SGH), more than 75 per cent of babies that are miscarried are inherently abnormal, with chromosomal, genetic abnormality or severe defects such as severe congenital heart disease. "The survival rate for such foetuses is low and many are not carried to term," says Prof Tan.

In Ms Aloshious' case, Dr Koh says tests on the foetus from her fifth miscarriage showed a 47th chromosome - one more than the normal 46.

She saw Dr Koh, 53, who has a special interest in early pregnancy complications and infertility, at Raffles Women's Centre in November 2005 after the first four miscarriages at two other hospitals.

Ms Aloshious and her husband, who had undertaken checks at previous hospitals after her repeated miscarriages, found their chromosomes were normal, he says.

Regardless of the parents' conditions, it is vital that their family members or friends do not heap guilt on the mother. SGH's Prof Tan says: "Most of the pregnant women look after themselves well and it is not that they have done something wrong. For instance, it is not because of the usual housework, wrong food intake or having sex during pregnancy.

"Almost all women who miscarry feel immediately traumatised on learning that they have lost their babies. About 25 per cent feel sad for up to three months and about 10 per cent grieve for up to a year."

Ms Tey Hui Ru is an exception: She picked herself up within three weeks after a miscarriage during her second pregnancy.

The 29-year-old nurse, who is pregnant with baby No. 3, says: "I accepted it faster, though it wasn't easier. I was just getting over it when someone asked, and I broke down while talking about it."

She has a three-year-old daughter with her 35-year-old insurance agent husband.

Unlike Ms Tey, talking about her miscarriage with someone else helped Malay-language teacher Noraini Washil, 43. She confided in a colleague who had also lost a baby.

During the first of her two miscarriages, in 2009 and 2010, she was 38, had been married for 12 years and was ready to be a mum. "I couldn't bear seeing women with huge tummies. It was not because I resented them for being pregnant but because they reminded me that I couldn't reach that stage."

When she became pregnant in March 2012 through in-vitro fertilisation, she was so determined to carry the baby to full term that she saw not one but two gynaecologists.

Her regular doctor, who delivered her baby boy - Hadi Luqman Azlan - in October that year saw her every month.

The second gynaecologist, who knew of her first doctor, saw her in between the monthly appointments. "I wanted to do something to assure myself that the baby would grow well," says Ms Noraini, who is married to a 44-year- old technician.

Meanwhile, she also took traditional Chinese medicine (TCM) in 2011 to strengthen herself before beginning in- vitro fertilisation by brewing packets of herbs. "I drank one packet over two days and stopped on the third," says Ms Noraini. "It tasted terrible."

Mr Chang Wee Lee, head of education at the Singapore College of Traditional Chinese Medicine, advises that the "optimal" interval between Western and TCM medicines is two hours so that they do not clash.

The 53-year-old says TCM physicians check the state of a woman's energy (qi) and menstrual blood to determine if she should have brews to strengthen deficiencies in one or both areas.

Doctors usually advise mums, after a miscarriage, to let the body rest for three months to a year before trying again for a baby. They prescribe supplements such as folic acid, which helps to build new cells.

A year's rest is what Ms Felicia Tan, 36, who runs a graphic design business, will take this year. Married to engineer Low Lieneng, 40, she tried in vain to conceive for six years before undergoing fertility programmes between July 2011 and May 2012.

She conceived twice but miscarried both times. Blood tests showed she had borderline diabetes and bacteria might have irritated the cervix, causing it to prematurely dilate in her second attempt.

Looking back, she says: "If someone had advised me to wait, it might have been a different story. I might not have rushed into the second pregnancy."

She and her husband named the first baby Dominic; the second pregnancy was twins, whom they called Elvis and Louis. She recalls: "I felt so guilty. What had I done, or not done, to lose three kids in a year?"

She expunged her sorrow by writing two books documenting her journey of loss and finding faith. The first, To Baby With Love, was released in February 2012, when Dominic was due to be born. The second, Lost And Found, was published last year.

Ms Tan, who advises mums to steel themselves physically and mentally, is rediscovering the joys of taking long drives in her Hyundai Electra and shopping with a younger sister.

Mr Low took her to Macau last year for a week's holiday. He says he "pretty much" lets his wife have her way in, for instance, publishing her books, as his way of supporting her.

On his wife's choice to wait out the year before trying for natural conception, he says: "Maybe it will be good for both of us physically and mentally."

Get a copy of The Straits Times or go to straitstimes.com for more stories.