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A major controlled clinical trial indicates that taking progesterone doesn’t prevent miscarriage in women at elevated risk.

Miscarriages can be devastating 鈥� especially for women who experience recurrent miscarriage, defined as three or more in a row. Doctors used to give these women supplements of progesterone, a hormone that helps maintain a healthy pregnancy. However, a recent study has confirmed that these supplements don鈥檛 improve pregnancy outcomes. For those who experience recurrent miscarriage, the best solution may be to simply keep trying.

Ask the doctors

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Q. My daughter is 38 years old and pregnant with her first child. Her due date is in two weeks, and her doctor has recommended that she have labor induced a week early. Why can't she just allow nature to take its course?

A. Having a baby when you're "older" can have some advantages鈥攚omen may feel more secure with them-selves, their relationships, or their careers. However, expectant moms 35 or older鈥攁nd their babies鈥攈ave some increased pregnancy-related risks.

For women having children over age 35, the decision to induce labor is usually based on an increased risk of stillbirth. The duration of labor also factors into the decision, as does the possibility that induction could increase the chance of a cesarean birth, though current medical evidence does not necessarily support this assertion.

The CDC recently advised all sexually active women of childbearing age, and who aren’t on birth control, to avoid alcohol completely because of potential harmful effects to an unborn child. The science behind the recommendation is sound, but the way it was delivered has raised quite a few eyebrows. In this piece, Dr. Ricciotti examines where the message fell short and describes how she emphasizes shared decision-making and autonomy when she counsels her patients.

The U.S. Preventive Services Task Force has recently updated their guidelines on depression screening to include pregnant and postpartum women, which will be a great help to the many new moms who experience mood changes that go beyond the “baby blues.” The updated guidelines offer other benefits, too, that help improve everyone’s access to mental health care 鈥� especially those who can’t currently afford it.

Ask the doctors

Q: I'm expecting and want to have a vaginal delivery, but many of my friends have had cesarean sections lately. Is this a preference, or are there medical reasons to have a cesarean?

A: The health of the mother and baby, the family's personal preferences, and the hospital in which a woman delivers her baby play a role in determining whether she has a cesarean. Common medical reasons for cesareans include fetal malpresentation (when the baby is turned so that its feet or buttocks will come out first), pelvic disproportion (a birth canal that is unusually shaped or too small in relation to the size of the baby), and a past cesarean. A study published in the Journal of the American Medical Association in December 2015 suggests that such commonly cited medical issues may account only partly for high cesarean rates.

The U.S. Preventive Services Task Force recently updated their guidelines on screening for depression. This time around, they recommended widespread screening through primary care practices, plus gave special attention to women who are pregnant or recently gave birth. These matter-of-fact, achievable guidelines and goals have the potential to reap enormous health benefits.