Posted by My OB said WHAT?!?.
Jan
14
Posted by My OB said WHAT?!?.
“I Have Never Had A Client Miscarry After Stopping Progesterone.”
“I have never had a client miscarry after stopping progesterone.” – OB to mother who was spotting after she discontinued progesterone.
There are 9 comments to this post.
..and I’m trying very hard not to be your first, doc.
@Nicole…the literature isn’t nearly that straightforward, and most of it is based on a study done on a general population of women, not on women with recurrent losses. REs are currently divided about this very thing, actually. There’s some reason to think that at least some RL moms benefit from transitioning off progesterone at 15 or even 16 weeks because of autoimmune concerns, for instance. But a great many doctors are sure that progesterone does nothing, that it’s only a panacea for worried mommies, and that 10 weeks is sufficient (because “healthy” women’s ovaries are producing progesterone by then.
Personally, I’m more comfortable with the more comon 13-ish week cutoff, but if mom were spotting, I’d want her back on, at least a low dose, and I’d transition very very slowly, and monitor blood levels (though, depending on what form of progesterone she’s taking, it may or may not show up in the blood, so there’s that consideration, too). I’m also not a fan of prophylactic progesterone for the general population of pregnant women, either…I think it makes better sense to treat the people that are most likely to benefit from it.
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Holly Stewart had this to say,
Jan 14, 2012 @ 4:10 pm (Quote)
This is me.
The literature is NOT that cut and dry on progesterone supplementation, by any means.
This was said to me after stopping my progesterone at week 12. I immediately started spotting and cramping. When I came forward with my concerns, the doctor told me this, as well as “It’s just a coincidence” and that the only use for progesterone after 12 weeks was to stop pre term labor… (which, wouldn’t bleeding and rhythmic cramping be considered labor signs?) for someone farther along, yes. But they don’t care for someone who is only 12 weeks. I got back on the medicine immediately, because I had extra. All bleeding stopped. Tried to come off it again later, and same thing. I ended up having to wait until 16 weeks and wean myself off it slowly before I had no complications.
Also, this pregnancy started off doomed from the beginning. I had a progesterone level of only FOUR. They told me my baby was dead, they told me there was no point to supplementing. I started bleeding and everything. I demanded the medication and my baby survived. Progesterone DOES do something. If low progesterone is your only true issue (no other complications with the baby) than there is reason to believe it can save a life. My baby is proof.
I am now 21 weeks pregnant. 
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IF Survivor Reply:
January 14th, 2012 at 5:00 pm (Quote)
Good for you for trusting your gut! I don’t know if you were following Dr. Hilger’s protocol or not but even my regular OB respects his work and didn’t want me off progesterone after my levels took a nose-dive just past 13 wks. http://www.naprotechnology.com/progesterone.htm
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IF Survivor Reply:
January 14th, 2012 at 6:36 pm (Quote)
Sorry, I mis-wrote that. My regular OB DOES respect Dr. Hilgers’ work. He doesn’t usually use his protocols but totally respected my wish to do so.
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Add Your Comment.
First time for everything, isn’t there, doc? I know spotting is considered normal and may be nothing, but is there any harm or serious risk to getting mom back on progesterone to be sure?
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Nicole Reply:
January 14th, 2012 at 8:05 am Nicole(Quote)
Maybe. There isn’t any evidence either way, since it’s really hard to study those types of effects without controlled studies, which we can’t do because, well, it’s just not ethical to maybe mess up a baby forever to know if a drug is safe or not, you know?
Anyway, not only is progesterone a class C drug (meaning we don’t know if it’s safe or not), but there is also absolutely zero evidence that it prevents miscarriage in the first place. In fact, what evidence we DO have shows that it doesn’t. It doesn’t change the miscarriage rate at all.
So, it MAY have harmful effects, and it doesn’t help anything. It’s not evidence based care. Basically when doctors prescribe it, they are doing so for the woman’s peace of mind, not because it benefits the pregnancy.
And I say all this having KNOWN it and still chosen to take progesterone through my first trimester with my son lol. So I’m not saying mom shouldn’t take it, it’s her choice. Just saying that if we’re going to recommend evidence based practices, which is really best for mom and baby, progesterone need not be part of the equation.
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