Miscarriage Sucks

My grandma was ardent in her disapproval of the word “sucks.” It’s not ladylike, it’s not very professional (not that I claim to be either ladylike or professional), and out of respect and admiration for Gram I’ve always tried to avoid uttering the word.

So I was a little caught off guard when my midwife used the phrase, “it sucks” twice while we talked — through tears — about my failed pregnancy. But I quickly realized why she said it. It’s the perfect word to describe miscarriage. Miscarriage can be all at once sad and physically painful and confusing and traumatic. But none of those words captures it all. So my preference is to describe miscarriage simply as “sucky.”

I knew I was pregnant the very day I missed my period in October. My cycle had been exactly regular, and although it had barely been three months since I’d had my IUD removed, it felt like it was taking forever to get pregnant. I would’ve taken a pregnancy test that very day, but I was fresh out. (I have a tendency to take pregnancy tests willy nilly. I stock up at the dollar store then go through them like candy.) The next day I picked up a couple more New Choice pregnancy tests, then took one the minute I walked in the door. No surprise to me — pregnant! To be doubly sure, I took another test a week later — confirmed! With Soren, I had waited a few weeks following the missed period to take a test — I didn’t want to be disappointed. But when symptoms had started appearing, I felt safe to verify it. This time around, I enjoyed a few blissful weeks of pregnancy knowledge without the inevitable first trimester symptoms.

And this time around, I decided to break the rules about announcing. With Soren we waited the recommended 12 weeks, excited to keep our happy secret between us for a little while. This time, I saw no reason to keep quiet. I was a mere six weeks along when I told a mom friend at a playgroup. At church I spilled the beans to a couple of friends. My entire family knew quite early. And word got around from there. I was fully aware that 10-25% of all clinically recognized pregnancies end in miscarriage and that I wasn’t out of the “safe zone.” But I didn’t foresee miscarriage as being something I’d need to keep secret.

Around the six-week mark, the first trimester experience really began. All the books tell you a lack of nausea is a bad sign, so we were a little relieved that all those lovely early pregnancy symptoms were fully present and began right when they were supposed to. The nausea seemed to be worse than when I was pregnant with Soren, and, unfortunately, I couldn’t baby myself quite like I could when I was childless. All the food woes were just the same — nothing sounded good, but I was so so hungry, always. I would wake up desperate for cold, fresh fruit. Tim would dutifully bring me raspberries or grapes or apple slices in bed around 6 a.m. Saltines and seltzer water were permanent fixtures on my nightstand. Some days I took little naps when Soren would go down, but I generally just stayed tired all the time. I didn’t remember the night time peeing starting so early with Soren — I thought that was a third trimester thing when the growing uterus begins shoving into the bladder. But, alas, the 2 a.m. trips to the bathroom began right away this time — which is normal — but I must have blocked that from my memory after the first pregnancy. Overall, the first trimester is a drag, and the experience was reassuringly fitting into all the descriptions of a healthy pregnancy.

And just the same as with Soren, I had the usual fears about a spontaneous miscarriage or showing up at my first appointment only to learn there’s no heartbeat. My first prenatal appointment was scheduled for a few days after I’d hit the 10-week mark. I don’t remember feeling any special urgency to get in and get checked, but I was definitely looking forward to the appointment to have my fears put to rest (and plus, I have really fond memories of our first appointment with the midwife during my pregnancy with Soren). I was actually initially scheduled to go in right around nine weeks, but Tim had a meeting he couldn’t move and he wanted to join me, so we postponed by a week. At the time, this seemed like no big deal. But it ends up that the earlier appointment might have led to a much less stressful situation than the way the timing actually played out! Oops.

So we made the familiar trek to Mount Auburn Hospital, happy to see familiar faces at Dr. Hardiman’s office after my two-year hiatus from their prenatal care. Josefina made her usual jokes about Dr. Hardiman’s patients having the cutest babies, with Soren as proof of the theory. We made our way back to one of the rooms, where midwife Carrie drilled us with all the questions about our health, our family medical history, and so on. We talked some about the first trimester and how it was all going, and with everything seemingly on track she began her first attempt at finding the heartbeat. No luck. She let us know this was completely normal, since it can depend on the positioning of all that stuff inside me. After a good long try, she made a vaginal attempt. Still nothing. At this point, she said that was still “normal,” but I’d need to have an ultrasound to better detect the heartbeat. I can’t say I knew for certain at that point that the ultimate news would be bad, but I didn’t exactly have an abundance of hope. I asked her what the odds were that this would be OK, and she estimated 70/30 in our favor. She said we had the option of going down to radiology right then to wait for an opening, or we could schedule it for the following Monday. What kind of crazy person would choose to go home and hang out for a few days, wondering all the while whether the fetus was still viable? With Soren, the only ultrasound we ever wanted was the 20-week gender check. And I’m very much opposed to the superfluous ultrasounds many doctors offer or recommend to low-risk patients. A piece of me wondered if I should just go on home and wait for my body to let me know if this pregnancy was healthy or not. But I decided that if there was a chance my pregnancy was over, I had to know as soon as possible.

So we made our way downstairs, and I sent Tim and Soren home for lunch and naps. I must have been in a bit of a panic, because I couldn’t think of a single person who might be able to come fetch me from the hospital in the middle of a Thursday afternoon. I didn’t feel especially worried, but I was drawing a blank on names. Fortunately (and likely following some divine intervention), a good friend texted me right at that moment to let me know she was heading to Costco and she’d love to pick up groceries for me. After a quick call, my ride was lined up (as well as a delivery of grapes and strawberries).

The waiting room was a depressing sight. It was full and it was smelly. I didn’t have much more than my phone with me, and I was kicking myself for not bringing my laptop to catch up on work. After catching up on emails, Instagram, Facebook, scriptures, Pinterest, and a few articles in my Pocket, I was getting antsy. And I was starving. For me, skipping lunch when pregnant (or not) is a bad, bad idea, but I was terrified that if I left the waiting room I’d miss my spot. About an hour and a half in, I decided to prepare myself for what might come by Googling “no heartbeat 10 weeks.” The results were about what I expected, but it was good to scroll through the many forums and personal experiences to hear how others dealt with it.

Eventually, an ultrasound tech brought me into one of the rooms and began the abdominal scan. I hate that they’re not allowed to say anything to you about what they’re seeing. I stared at her face the entire time, trying to read what she might be thinking. But nothing. She finished up and let me know they’d need to do the vaginal ultrasound next. At this point I felt more certain that the news was bad — there is no way a healthy pregnancy at 10 or 11 weeks would necessitate abdominal and vaginal heartbeat checks and then both abdominal and vaginal ultrasounds. She performed the second ultrasound, then left me to go share the images with the radiologist, who would return with her to give me the rundown. An eternity later, I heard them approach the door, and I listened to him ask her, “So should I just tell her now?” I had already been teary off and on, but this did it for me. They both entered the room, and the radiologist — with unexpectedly good bedside manner — let me know the ultrasounds indicated a failed pregnancy. The fetus appeared to have stopped growing at six weeks — more than a month ago — and no heartbeat was detected. There were also other “suspicious” findings in the ultrasound, like an enlarged yolk sac, which is another indicator of a failed pregnancy (though a non-specific one, meaning it can’t be used as conclusive evidence). When it happens this way (not spontaneously) it’s called a missed miscarriage. The words confirmed my assumptions, but they weren’t easy to hear.

The second blow came with the news from the radiologist and the midwife that I should return to the hospital in 7-10 days for a second ultrasound to confirm everything. This was absolutely baffling to me. You tell me I have a failed pregnancy, but you want me to go home and continue to be pregnant? But their reasoning is this: With a fetus six weeks along, it’s feasible that the heartbeat wouldn’t be detected. However, I knew — and they agreed — that it was pretty much impossible that I would only be six weeks along. If a woman had had very irregular periods and wasn’t certain when she became pregnant, this might be possible. But I was regular to the day, and multiple pregnancy tests confirmed everything way back in October. I was also 100% certain it wouldn’t have been conceivable (pun a little bit intended) for me to become pregnant after the day I “thought” I missed my period. Let’s just say my first trimester experience isn’t exactly conducive to, uh, intimacy.

While discussing all this with Carrie, she agreed that I could feel confident that the pregnancy was over, and I could opt to induce the miscarriage at my leisure. But she and Dr. Hardiman couldn’t make that their official recommendation, because they have to base everything on the ultrasound results and the medical literature. This made for a tricky decision, compounded by the fact that we were scheduled to fly to Missouri in less than a week. So we talked about my options:

1) Go against the “official” recommendation and induce the miscarriage before the confirmatory ultrasound. This was initially most appealing to me. I didn’t want to be pregnant for another second. I didn’t want to continue to experience the first trimester when there would be no reward at the end of it. And I didn’t want to ruin anyone’s holiday plans. But I also felt a tiny bit of hesitation making the decision to abort without an official recommendation from the professionals.

2) Continue with our travel plans, and schedule an ultrasound in Missouri, after which I could induce the miscarriage there. Nothing about having a miscarriage at your in-laws’ house sounds attractive. I was envisioning the many walks I’d need to take from Tim’s childhood bedroom to the bathroom we’d share with his siblings, and then potentially having to wait my turn while blood is pouring out of me. And then what if I had to go in for a D&C? I know it’s a fairly routine and low-risk procedure, but doing it at a strange hospital in the middle of Missouri just didn’t strike me as a great idea.

3) Continue with our travel plans, and take care of everything upon returning to Boston in three weeks. No way.

4) Cancel our trip, hang out in Boston, and return to Mount Auburn in a week. I didn’t initially consider this option — we’d spent a lot of money on plane tickets that we wouldn’t likely get back. And people were expecting us to be in Missouri for Christmas. We knew they’d understand the extreme circumstances, but we also knew there would be a lot of disappointment and possible nudging to change our travel plans to simply work around the miscarriage.

I asked Carrie what she would do in my shoes. She knew option one was my preference. She thought about it for awhile. And then she said she’d cancel the trip. I sort of wrote this off, since it didn’t seem like an option to me. She wrote me prescriptions for misoprostol (to induce the miscarriage) and oxycodone (for the pain) in case I decided to do it at home in the next few days or in Missouri after a follow-up ultrasound. I told her I’d call her the next day and let her know what I would do, and then off I went for blood work (to get a baseline for my hCG levels).

My poor friend and ride home had been waiting for me for an hour at this point, and I was so relieved to finally be leaving. It was almost 4 p.m., so I’d been at the hospital for five hours and my extreme hunger wasn’t helping my out-of-whack emotions. This wonderful friend brought me a perfect brown bag lunch, which made everything feel a little bit better.

At home, Tim and I talked and talked and talked some more. (And I cried and cried and cried some more. Tim didn’t.) Too many decisions to make. And I hate making decisions. None of the options was jumping out as the best. I won’t prolong this by giving the play-by-play on all the thoughts I had during the evening and night about how we could make this work, but in the morning a wise friend called and gave some wonderful advice that led me to feel perfectly content about canceling our trip to Missouri. What I wasn’t even considering before suddenly felt like the best and most obvious choice. Tim was fully onboard, and so after 24 hours of super high stress levels, we had our answer and we didn’t look back.

Tim babied me on Friday and let me spend the day feeling sick and sad in bed. Each day from there got a little easier, and by the time Thursday rolled around I was desperate to move on with the physical part of the miscarriage. So much waiting! It was nice to be completely non-emotional during the second appointment so I could converse easily with the ultrasound tech (who said these situations are “wicked sad” for her every time) and radiologist while they did the two ultrasounds (again, abdominal and vaginal). Everything was just as I expected it to be — zero changes from the week before. It was quite a relief to know we could now take the next steps. I went upstairs to chat about it with Carrie and make a plan.

I had a lot of questions about how the actual miscarriage would play out. Tim and I had read online five or six detailed accounts of others’ experiences with misoprostol for miscarriage, and each person seemed to have a very different story. If I inserted the pills at night, as she recommended, would I be awake all night? How painful would it be? How much bleeding is too much? Or not enough? Would I know when I’d passed the fetus? What if I didn’t feel like I could flush the toilet? Should I eat a lot in advance in case I’m nauseous during the process and can’t eat then? Should I consider scheduling a D&C instead? How will we know if it’s successful? Will I be able to travel by Christmas?

After more blood work to check hCG levels, I was on my way and felt confident in our plan. I stopped off at Target to fill my prescriptions and to pick up a few stocking stuffers. And then home to meet Tim and Soren as they made their way back from playgroup. We had about six more hours of normal life before entering the unknown world of the physical miscarriage.

Since we found others’ detailed misoprostol stories so helpful in knowing what to expect, I’ve written up a separate account of those gory details, to be posted soon. But the one sentence summary is this: I placed the medication (and popped an oxycodone) around 7 p.m. on a Thursday, then spent the next few days laying around, reading, sleeping, watching a few shows, and bleeding. And waiting. And wondering if the miscarriage had been 100% successful. So much of this experience has involved waiting, waiting, waiting for things to happen. After those few days we still weren’t certain if everything had “worked.”

Monday — three days before Christmas — was the first day I started getting back into real life. Doctor visit for blood work, library with Soren for story time, and a little Christmas prep and house organizing (though Tim did a phenomenal job of maintaining the house while I was down). I learned my hCG levels had fallen from 88,000 on Thursday to 11,000 — a good sign, but not conclusive quite yet. On Tuesday we headed down to Virginia a bit spontaneously after getting the go-ahead from the midwife. It was wonderful to continue my recovery on my mom’s couch with loads of nieces and nephews running wild around the house. After returning to Boston, I paid yet another visit to the doctor’s office for more blood work, and my hCG level had dropped down to 586. So things are still progressing as we’d hoped, but they haven’t declared me to be fully in the clear. I’ll return again next week for them to draw blood again, and I’m hoping that’ll be the end of it.

It’s now almost exactly one month after my first appointment, and I’m feeling totally back to normal (aside from the fact that we’re not 100% the physical part is over). Emotionally, I’m totally fine. I know that some women mourn the loss for months and years (or forever) after. That’s definitely not the case for me. Sure, it was a difficult experience, but I can’t say that I’d felt any strong connection to the unborn (I didn’t with Soren, either, when I was just 11 weeks pregnant.) This has caused me to think some about whether I believe life begins at conception — in this instance, I’m not sold on the idea that there was ever a spirit in the tiny body that wasn’t meant to survive.

More than anything, the miscarriage has been an exercise in practicing patience. In my dream world, I’d have kids just a couple years apart, but as it turns out I didn’t feel ready until a few months ago. That would’ve put the two at three years apart. Now, who knows? Apparently, it’s not up to me. The other lesson learned is that being the recipient of service from good friends and Relief Society sisters feels incredible. Without anyone being asked to help, four separate church sisters brought dinner over, two long-distance besties sent groceries and a dinner delivery, one former visiting teacher scrubbed my bathroom until it was cleaner that it had ever been, a new friend came over and spent two hours playing with Soren, two other women dropped by with cookies, and a good friend and neighbor came over with a fun gift of face masks and foot scrubs and treats. It was far more than I deserved or probably needed, but it all felt absolutely amazing. I would never have guessed that so many people would have cared enough to go to such lengths to make sure I was OK.

To close out this longest journal entry ever, I must say that I feel completely optimistic about my childbearing future, and I think in the long run we’ll view this as just a tiny bump in the road of life. Overall, life is really, really great. And I’m thinking there is even more greatness in store.

Tagged: Dr. Hardiman, miscarriage, misoprostol, missed miscarriage, Mount Auburn Hospital, pregnancy