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A fertility doctor’s personal perspective on life after miscarriage

Catch Dr. Nataki Douglas, Modern Fertility’s own repro-endo par excellence, on an intimate, generous, and science-filled episode of Shelly Mettling’s Life After Miscarriage podcast. Dr. Douglas talks chromosomes and statistics, empowerment and self-advocacy in women’s health, and shares her own deeply personal story with pregnancy loss.

After surviving four miscarriages, Shelly Mettling felt compelled to write about her experiences. Her book, Life After Miscarriage, has spawned a podcast as well as a YouTube channel. Shelly is also a mom now, and she's on a mission to share her story of heartbreak and resilience. Her podcast offers “an inside look into what life is ACTUALLY like after miscarriage through the stories of those who have experienced it.”

She recently invited Dr. Nataki Douglas onto her show. Dr. Douglas is a reproductive endocrinologist, infertility specialist, and the Chair of Modern Fertility’s Medical Advisory Board. Her professional mission is to empower women to self-advocate in their medical and fertility lives — “to put the power of fertility knowledge directly in the hands of women."

Doctors are trained to observe and listen. They seek information — data — from their patients in order to diagnose and to treat. They are not trained to self-disclose, to be vulnerable at work, or to tie their professional identities to their personal experiences — especially not experiences of struggle. So, it's particularly impactful when a person of science opens up and says, “Yes, I am a doctor and a scientist, but I am also a person having a human experience.”

On the podcast, Dr. Douglas talks to Shelly about fertility medicine — speaking as a researcher and clinician. But then Shelly asks if she’s willing to share her personal story. “Nataki, I know you have a story, yourself, that gives you some of what I call ‘street cred,’ in this whole miscarriage world,” she prompts. And, with the frankness that comes from a career talking about bodies and the steadiness of someone who has walked through grief and come out on the other side, Dr. Douglas shares her own story: a second-trimester pregnancy loss, one that she didn’t see coming despite her extensive and specific medical training.

“I had an 18-week miscarriage," says Dr. Douglas. "Given everything I know, I was pretty confident my pregnancy was going to go well, because I had made it out of the first trimester. And then, all of a sudden, I went for a checkup and found that the baby had no heartbeat. I couldn’t quite understand how this had happened.”

Dr. Douglas talks about how she recovered medically (she had a surgical procedure to remove the pregnancy, as well as subsequent procedures to remove scar tissue in her uterus) and emotionally, grieving the loss for several years after her subsequent full-term pregnancy and motherhood. She also offers the perspective of "benefitting from being able to go into doctor mode", stressing that she "took it in the stride of, okay, I know this happens."

The takeaway is twofold. First, an old cliché made new: Knowledge is power. Knowing the facts and statistics about pregnancy, miscarriage, and your own body brings an empowerment that both Shelly and Dr. Douglas return to over the course of the interview. The second is that miscarriage is not uncommon. It happens in 10% of first-trimester pregnancies and 1–3% of second-trimester pregnancies result in loss. It happens more than people talk about and it hits harder than people publicly acknowledge.

This could feel like a dark fog of fear and negativity on the fertility horizon, unless we're careful to recognize Dr. Douglas’s strong and informed sense of hope — as a doctor, as a miscarriage survivor, and as a mother — when she says, "Many women go through miscarriages, it’s incredibly common... but when we can identify the problem the overall chances of success for having a baby [in a subsequent pregnancy] are really high." Even when doctors cannot identify the reasons for which miscarriages occur, most women who continue to try to conceive after their losses, will have a baby.

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M. K. Steines

M.K. Steines is a writer based in Tucson, where she is an MFA candidate in nonfiction at the University of Arizona. Her work can be found around the web and in print. Instagram @redstateblues

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