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Not Broken: An Approachable Guide to Miscarriage and Recurrent Pregnancy Loss
Not Broken is a comprehensive, thoughtful resource for understanding all aspects of first trimester miscarriage and recurrent pregnancy loss.
Whether you're personally struggling with miscarriages or are a medical provider for patients with recurrent pregnancy loss, Not Broken will broaden your perspective as a compassionate lens to evidence-based findings.
As a leading voice in fertility medicine, Dr. Lora Shahine provides a detailed overview of Western medicine's typical approach to miscarriage – including evaluation and treatment – while shining a light on Eastern approaches to care, emotional wellness, and lifestyle changes to decrease risk of miscarriage.
You will finish this book feeling empowered to advocate for your care and more hopeful than ever to continue towards your family goals.
“I have one word to describe this fabulous FINALLY. Women with recurrent pregnancy loss have been needing this book for years.” – Dr. Alice Domar, associate professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School and author of Conquering Infertility and Finding Calm for the Expectant Mom
Lora Shahine, MD, FACOG, is a reproductive endocrinologist, founder of the Center for Recurrent Pregnancy Loss at Pacific NW Fertility, and clinical faculty in the OBGYN department at the University of Washington in Seattle.
Dr. Shahine contributes to the fields of infertility and miscarriage with clinical research, writing, speaking, and educating in peer-reviewed journals, her own books and textbook chapters, and many forms of media, including an active social media presence and as host of the Baby or Bust podcast.
Whether you're personally struggling with miscarriages or are a medical provider for patients with recurrent pregnancy loss, Not Broken will broaden your perspective as a compassionate lens to evidence-based findings.
As a leading voice in fertility medicine, Dr. Lora Shahine provides a detailed overview of Western medicine's typical approach to miscarriage – including evaluation and treatment – while shining a light on Eastern approaches to care, emotional wellness, and lifestyle changes to decrease risk of miscarriage.
You will finish this book feeling empowered to advocate for your care and more hopeful than ever to continue towards your family goals.
“I have one word to describe this fabulous FINALLY. Women with recurrent pregnancy loss have been needing this book for years.” – Dr. Alice Domar, associate professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School and author of Conquering Infertility and Finding Calm for the Expectant Mom
Lora Shahine, MD, FACOG, is a reproductive endocrinologist, founder of the Center for Recurrent Pregnancy Loss at Pacific NW Fertility, and clinical faculty in the OBGYN department at the University of Washington in Seattle.
Dr. Shahine contributes to the fields of infertility and miscarriage with clinical research, writing, speaking, and educating in peer-reviewed journals, her own books and textbook chapters, and many forms of media, including an active social media presence and as host of the Baby or Bust podcast.
- GenresNonfictionHealth
207 pages, Kindle Edition
Published July 4, 2022
154 people are currently reading
228 people want to read
About the author
Lora Shahine
7 books4 followers Dr. Lora Shahine is a board certified reproductive endocrinologist currently practicing at Pacific NW Fertility and IVF Specialists in Seattle. Originally from North Carolina, Dr. Shahine graduated with a bachelor of science in biology from Georgetown University in Washington, DC, and completed her training in medical school at Wake Forest University School of Medicine, residency in obstetrics and gynecology at the University of California at San Francisco, and fellowship in reproductive endocrinology and infertility at Stanford University.
As Clinical Faculty at the University of Washington and Director of the Center of Recurrent Pregnancy Loss at Pacific NW Fertility, she is committed to providing excellence in patient care, teaching the next generation of women’s health providers, and continuing research in the fields of fertility and recurrent miscarriage. She has published over 50 peer-reviewed research projects and is an active member of the American Society of Reproductive Medicine, Pacific Coast Reproductive Society, and Seattle Gynecology Society.
Dr. Shahine enjoys writing, is a regular contributor to the Huffington Post and other blogs, and has authored two books. In 2015, she co-authored “Planting the Seeds of Pregnancy: An Integrative Approach to Fertility Care” with Stephanie Gianarelli, LAc. In 2017, she published "Not Broken: An Approachable Guide to Miscarriage and Recurrent Pregnancy Loss.".
She lives in Seattle with her husband and children and enjoys travel, skiing, camping, great food and time spent with friends and family.
As Clinical Faculty at the University of Washington and Director of the Center of Recurrent Pregnancy Loss at Pacific NW Fertility, she is committed to providing excellence in patient care, teaching the next generation of women’s health providers, and continuing research in the fields of fertility and recurrent miscarriage. She has published over 50 peer-reviewed research projects and is an active member of the American Society of Reproductive Medicine, Pacific Coast Reproductive Society, and Seattle Gynecology Society.
Dr. Shahine enjoys writing, is a regular contributor to the Huffington Post and other blogs, and has authored two books. In 2015, she co-authored “Planting the Seeds of Pregnancy: An Integrative Approach to Fertility Care” with Stephanie Gianarelli, LAc. In 2017, she published "Not Broken: An Approachable Guide to Miscarriage and Recurrent Pregnancy Loss.".
She lives in Seattle with her husband and children and enjoys travel, skiing, camping, great food and time spent with friends and family.
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Displaying 1 - 27 of 27 reviews
November 11, 2018
I was recently diagnosed with RPL (recurrent pregnancy loss) after suffering a third miscarriage and have been feeling lost and broken. My husband got me this book and it’s been a real blessing. It’s helped me understand what our fertility journey may look like moving forward and offered the support I was hoping to find in reading. Dr. Shahine provides readers a layman’s overview of potential causes and treatments without it ever feeling condescending. It really opened my eyes to the advancements in reproductive medicine and the ways in which women’s health is finally garnering the attention (and resources) it deserves. Dr. Shahine speaks with a care and compassion that is so necessary when broaching the topic. I will forever feel a deep sadness when I think of each of our losses but this has made me feel much more hopeful for our future. Highly recommend this book.
April 17, 2022
If you're in this particular situation of having passed the "official" testing benchmark of three losses, I would read this first before it starts with the egg. What this book does better than starts with the egg is walk through why pretty much every theory and treatment for RPL is controversial, and why OBs can seem so cavalier and just tell you to try again and maybe take an aspirin. This book walks through all the popular treatments and explains the pros and cons of each: progesterone, Prednisone, aspirin, genetics, and immuno-therapies.
Also this book helped me understand DOR and why IVF is not the magical solution to RPL, although it does not discourage you from it, just sets realistic expectations of this treatment option, if that's what you choose to do.
Also this book helped me understand DOR and why IVF is not the magical solution to RPL, although it does not discourage you from it, just sets realistic expectations of this treatment option, if that's what you choose to do.
April 27, 2017
Reviewed for readers favorite
Not Broken by Dr. Lora Shahine, a board certified reproductive endocrinologist is a well written comprehensive guide to understanding all aspects of miscarriage and first trimester pregnancy loss. Dr. Shahine explains medical terms and with compassion and care, understanding the emotional impact multiple miscarriages can have. She highlights not only the advancements in Western medicine such as IVF, but Eastern ones as well along with lifestyle choices that could help decrease the risk of miscarriage. Throughout the book Dr. Shahine reveals herself as a strong advocate for pregnant women, reassuring them that such early losses are rarely the mothers fault and empowered with the knowledge detailed in Not Broken they can feel more hopeful than ever about continuing their family goals.
The title for Not Broken by Dr. Lora Shahine is based off of kintsugi, a Japanese art form in which broken pottery is repaired with gold or silver.
It is a philosophy that embraces the cracks as something that should be highlighted, not hidden. Such a sentiment is the foundation of Dr. Shahine's work and in a world where every aspect of pregnancy from the sex of the child and beyond is blamed solely on the mother, Dr. Shahine breaks that misconception and works to ease the burden of guilt as well as provide practical easy-to-understand solutions.
She writes as someone who is in the readers corner, and Not Broken is sure to be an excellent well of information whether it's a couple struggling with pregnancy, or anyone looking to gain a wider range of knowledge.
Not Broken by Dr. Lora Shahine is a great resource to have.
Not Broken by Dr. Lora Shahine, a board certified reproductive endocrinologist is a well written comprehensive guide to understanding all aspects of miscarriage and first trimester pregnancy loss. Dr. Shahine explains medical terms and with compassion and care, understanding the emotional impact multiple miscarriages can have. She highlights not only the advancements in Western medicine such as IVF, but Eastern ones as well along with lifestyle choices that could help decrease the risk of miscarriage. Throughout the book Dr. Shahine reveals herself as a strong advocate for pregnant women, reassuring them that such early losses are rarely the mothers fault and empowered with the knowledge detailed in Not Broken they can feel more hopeful than ever about continuing their family goals.
The title for Not Broken by Dr. Lora Shahine is based off of kintsugi, a Japanese art form in which broken pottery is repaired with gold or silver.
It is a philosophy that embraces the cracks as something that should be highlighted, not hidden. Such a sentiment is the foundation of Dr. Shahine's work and in a world where every aspect of pregnancy from the sex of the child and beyond is blamed solely on the mother, Dr. Shahine breaks that misconception and works to ease the burden of guilt as well as provide practical easy-to-understand solutions.
She writes as someone who is in the readers corner, and Not Broken is sure to be an excellent well of information whether it's a couple struggling with pregnancy, or anyone looking to gain a wider range of knowledge.
Not Broken by Dr. Lora Shahine is a great resource to have.
May 23, 2022
Best miscarriage/recurrent miscarriage book I’ve read and highly recommend to anyone who is a part of this awful club. My own OBGYN bought it when I showed it to her. It Starts with the Egg is another book I’d recommend to compliment this book as well. The advice is very similar, but ISWTE goes more in depth and gives a supplement plan for different scenarios.
April 19, 2024
Extremely informative and a great resource for those on this journey. I definitely recommend reading this as soon as your journey begins so you have that much more knowledge when talking with your doctor. Knowledge is power.
October 25, 2024
Excellent synopsis of current medical literature regarding the subject of miscarriage and recurrent pregnancy loss.
April 9, 2017
Reviewed by Sarah Rollins of Readers' Favorite
Not Broken, An Approachable Guide to Miscarriage and Recurrent Pregnancy Loss by Lora Shahine appealed to me immediately as this is a subject area that is close to my heart. What I found reassuring and compelling about this book was that the author, a specialist in this field, does not use jargon and complex terms, but she provides simple explanations to help her readers understand what is miscarriage, and what they should be asking their doctors and specialists if they are faced with multiple losses. A resource like this book is so incredibly invaluable, as so many women go through pregnancy loss with no answers and too many question marks.
Lora Shahine has a very straightforward writing style, which should appeal to a broad range of readers. In Not Broken, An Approachable Guide to Recurrent Pregnancy Loss, she sections the chapters effectively, taking the reader from definition, to key facts and what is known by the industry, right through to lifestyle factors and coping mechanisms for a woman or couple who is searching for answers. As a practitioner and author, she takes a humanistic approach to a devastating issue faced by many women, and her empathy to the plight of women faced with pregnancy loss is obvious through her tone and commentary. This is a resource that should be on the shelf of any fertility clinic and I highly advocate that anyone who has faced pregnancy loss read this book. I highly recommend Lora Shahine’s Not Broken as a resourceful book on a subject matter that desperately needs more attention.
Not Broken, An Approachable Guide to Miscarriage and Recurrent Pregnancy Loss by Lora Shahine appealed to me immediately as this is a subject area that is close to my heart. What I found reassuring and compelling about this book was that the author, a specialist in this field, does not use jargon and complex terms, but she provides simple explanations to help her readers understand what is miscarriage, and what they should be asking their doctors and specialists if they are faced with multiple losses. A resource like this book is so incredibly invaluable, as so many women go through pregnancy loss with no answers and too many question marks.
Lora Shahine has a very straightforward writing style, which should appeal to a broad range of readers. In Not Broken, An Approachable Guide to Recurrent Pregnancy Loss, she sections the chapters effectively, taking the reader from definition, to key facts and what is known by the industry, right through to lifestyle factors and coping mechanisms for a woman or couple who is searching for answers. As a practitioner and author, she takes a humanistic approach to a devastating issue faced by many women, and her empathy to the plight of women faced with pregnancy loss is obvious through her tone and commentary. This is a resource that should be on the shelf of any fertility clinic and I highly advocate that anyone who has faced pregnancy loss read this book. I highly recommend Lora Shahine’s Not Broken as a resourceful book on a subject matter that desperately needs more attention.
April 17, 2019
As a lifelong reader and writer, when I need something (anything! --not only answers, but company, etc.) I turn to books. This one helped to satisfy that desperate & impossible need I had for explanation/information, which with loss/RPL are not possible without a team of doctors, as we all know, and EVEN THEN not always possible. So NOT BROKEN was helpful to me to know that even if I didn't have the answers for me yet, there were a bunch of possible answers, even if one of them was "we don't know." I since have recommended this to other women who have suffered pregnancy loss and RPL, and I hope those who pick it up find some questions to ask in order get answers. I found it extremely educational and easy to read, and I appreciated that it was geared towards patients and doctors trying better to understand where patients were coming from.
April 25, 2017
This book lives up to its title and manages to summarize a lot of information about recurrent loss into an easy to understand guide. I really wish I had this about a year ago. I liked that she discusses relevant physiology, tests, statistics, risks, treatments, benefits and drawbacks of currently controversial treatments, as well as the psychological impact of multiple loss on both partners.
June 10, 2017
I'm glad someone finally wrote this book, but I wish no one needed to read it. It focuses first trimester recurrent loss.
November 2, 2025
I think every woman who experiences several miscarriages and still is trying, should read this book. This comes from an expert, but it is written in such language that average person can understand it easily. It describes all the known causes and how to test on them, it describes also topics where experts to not agree, it explains statistics around the miscarriages. Sometimes scientific evidence is clear: there were several test trials, and they all have the same conclusion and then official medical associations give certain recommendations what to do. But sometimes, different scientific trials are not all showing the same result, so experts don't know what to do. In such cases, different doctors will give you different advice, this book explains why.
Now the favourite part: what this book gave to me. After 3 miscarriages normally woman feels that the chance of successful pregnancy is 0%. This book reveals that the statistic does not confirm that. Chance is much higher, so here statistic brings real hope, based on scientific facts. Then, by explaining in details possible causes of miscarriage where scientists themselves do not agree, she explains in detail why some say that some cause should be considered and tested, while others don't think it should be taken into account. Sometimes they take into account cost, emotional impact or physical consequences that some aggressive method would have if applied. This can help. When you are not successful in something, it can easily be that you think your doctor is to blame, although he is just trying to help you. These explanations can help patients understand their doctors better and make smarter decisions about their next steps.
Now the favourite part: what this book gave to me. After 3 miscarriages normally woman feels that the chance of successful pregnancy is 0%. This book reveals that the statistic does not confirm that. Chance is much higher, so here statistic brings real hope, based on scientific facts. Then, by explaining in details possible causes of miscarriage where scientists themselves do not agree, she explains in detail why some say that some cause should be considered and tested, while others don't think it should be taken into account. Sometimes they take into account cost, emotional impact or physical consequences that some aggressive method would have if applied. This can help. When you are not successful in something, it can easily be that you think your doctor is to blame, although he is just trying to help you. These explanations can help patients understand their doctors better and make smarter decisions about their next steps.
October 25, 2024
Not the book to read if you’re looking for any kind of emotional or spiritual guide to miscarriage, but I highly recommend for more deeply understanding the medical side of recurrent loss, especially after the initial shock and trauma of pregnancy loss has subsided.
I appreciated her holistic and approachable guide to possible reasons for loss, types of testing that can be done, and ways to overall care for your health for miscarriage prevention. I think my one criticism is it felt like at the end of many chapters she pushes IVF, even after stating many times that most women with recurrent loss will conceive and carry to term naturally. I think the Western medical system often pushes people to expensive and unnecessary “solutions” before really trying to heal the root cause of an issue, and that’s what I felt a bit with how often she mentioned IVF.
That said, she had a whole chapter written in conjunction with an Eastern medicine practitioner that focused on more holistic care and treatment options, and that’s something I almost never hear recommended from traditional western doctors.
Overall, this was a very balanced, encouraging, and helpful tool for empowering patients of recurring loss to better advocate for themselves in the medical system, and I would highly recommend for those seeking to understand what options they have after recurrent pregnancy loss.
I appreciated her holistic and approachable guide to possible reasons for loss, types of testing that can be done, and ways to overall care for your health for miscarriage prevention. I think my one criticism is it felt like at the end of many chapters she pushes IVF, even after stating many times that most women with recurrent loss will conceive and carry to term naturally. I think the Western medical system often pushes people to expensive and unnecessary “solutions” before really trying to heal the root cause of an issue, and that’s what I felt a bit with how often she mentioned IVF.
That said, she had a whole chapter written in conjunction with an Eastern medicine practitioner that focused on more holistic care and treatment options, and that’s something I almost never hear recommended from traditional western doctors.
Overall, this was a very balanced, encouraging, and helpful tool for empowering patients of recurring loss to better advocate for themselves in the medical system, and I would highly recommend for those seeking to understand what options they have after recurrent pregnancy loss.
June 24, 2025
After my second loss all I wanted was someone to walk me calmly through why this was happening and what actions I could take as next steps. But there is so much bureaucracy with getting passed between the OB and fertility, wait lists and scheduling, and feeling worried that you’ll be sold snake oil by an industry that is pretty profitable. So it was so refreshing to have a reassuring, easy-to-read and understand primer on the potential contributing factors to recurrent pregnancy loss and testing & treatments available. I love the bullet list summary at the end of each chapter and the acknowledgment of the emotional toll of multiple losses. My only wish is that a revised edition could be released, as I wonder if any of the recommendations have changed since 2017. This is such a helpful resource and deserves to be republished with updated information!
July 20, 2020
Loved it. One of the best books that I've ever read on the subject, written by one of the foremost experts, Dr. Lora Shahine. Dr. Shahine approaches the subject with compassion and deep understanding for the social, emotional, and physical trauma that miscarriages represent.
This is a book that should be in every primary care, gynecologist and reproductive endocrinologist's office.
This is the book that should be shared when a friend or a family member has a loss as well.
I couldn't recommend it more highly.
This is a book that should be in every primary care, gynecologist and reproductive endocrinologist's office.
This is the book that should be shared when a friend or a family member has a loss as well.
I couldn't recommend it more highly.
March 27, 2025
This is a great insightful and educational book for anyone experiencing recurrent pregnancy loss. The author describes different causes and treatment recommendations and even what questions to ask and what to look for in a provider. If you’re experiencing a second miscarriage and at a loss and don’t know where to turn and want some kind of guide this is your go to!! I read on Kindle but planning to purchase a physical copy to have on hand!
January 13, 2021
This is my favorite book on the subject of pregnancy loss. Dr. Lora Shahine is not only a world class fertility doctor, she is an excellent communicator and a compassionate authority figure. I recommend! Five stars!
January 20, 2025
Just experienced my second miscarriage in 1 year. This book provided honest and valuable insight into what to expect from my RPL testing coming up. I’m grateful to have found this resource amongst lots of confusing information on the internet. Easy to read in one sitting. Also a good reference.
July 16, 2018
Straight forward, science-y book without being dry. This book is like the "Expecting Better" of miscarriage, comforting and reassuring if science and facts are your thing.
February 11, 2020
Great resource for people suffering from miscarriage
April 12, 2023
This read very medical and was not so patient friendly.
August 20, 2024
Extremely informative without being overly medical. This will be a great resource I can use for my patients who have undergone a miscarriage or experiencing recurrent pregnancy loss.
November 1, 2025
Very informative and helpful if you’ve had reoccurring miscarriages. Informative but in a way you can understand.
February 10, 2019
This book is a great resource for anyone who has had a miscarriage.
The author is a reproductive endocrinologist who practices in Seattle.
The information she provides on miscarriage is recent (as of 2019), readable, concise, and above all, evidence-based. She includes a glossary and reference lists for every chapter.
I didn't realize that reproductive endocrinologists focus on issues with fertility and first-trimester loss, whereas second and third trimester losses are more the area of maternal-fetal medicine specialists.
So, this book didn't give me much new info about my own second-trimester loss, but that was okay.
It was still a great overview of the general causes of early miscarriage and testing that can be pursued, all handled with clarity and sensitivity.
I most appreciated the author's emphasis that miscarriages are generally not a woman's fault and we deserve to take care of our mental and emotional health during the difficult process of trying to have children, wherever we are in that journey.
Also, the use of kintsugi art on the cover was a nice touch.
The author is a reproductive endocrinologist who practices in Seattle.
The information she provides on miscarriage is recent (as of 2019), readable, concise, and above all, evidence-based. She includes a glossary and reference lists for every chapter.
I didn't realize that reproductive endocrinologists focus on issues with fertility and first-trimester loss, whereas second and third trimester losses are more the area of maternal-fetal medicine specialists.
So, this book didn't give me much new info about my own second-trimester loss, but that was okay.
It was still a great overview of the general causes of early miscarriage and testing that can be pursued, all handled with clarity and sensitivity.
I most appreciated the author's emphasis that miscarriages are generally not a woman's fault and we deserve to take care of our mental and emotional health during the difficult process of trying to have children, wherever we are in that journey.
Also, the use of kintsugi art on the cover was a nice touch.
February 11, 2020
A brilliant, factual, clear, and honest book. And every bit as compassionate as the author's in-person practice. We were blessed to be able to work with Lora Shahine, and this book was a great summary of the research and guidance the best medical advice has to offer.
June 22, 2021
Mostly useful, if you’re in this shit club, but frustrating — both for the lack of clear answers (not the author’s fault!) and the chapter-long digression into acupuncture/TCM that included such advice as, “Stay hydrated!” Ohh ok sure thing!
August 28, 2024
5 stars
July 4, 2023
An evidence based therapeutically educational read. Thankful for this book.
Displaying 1 - 27 of 27 reviews