August 27, 2013 | 5
The following is a guest post from “Grace,” a fellow tenure-track professor. She wished to share her story of miscarriage, because reading the stories of others comforted and guided her as she experienced her own. You may also find my miscarriage science post When a Beginning is Not a Beginning useful (a revised and expanded version of which appears in next month’s issue of Anthropology Now).
I invite you to comment below to show support for Grace.
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At 27, getting pregnant was hard, but staying pregnant was easy. It took 17 months before I got a positive pregnancy test, but from that time on the baby developed perfectly on schedule and arrived one day before the due date. Seven years on, the child is happy and healthy. This is the motherhood story we like to hear and which is told millions of times over by delighted parents.
At 34, getting pregnant was easy, but staying pregnant was hard. We got pregnant the very first month off of birth control, but staying pregnant was… unsuccessful. At my first ultrasound, at 8 weeks, there was an embryo with no heartbeat. This is the motherhood story that we don’t often hear or tell, but happens with approximately 30% of all pregnancies. This is the story that I want to tell, because reading the few stories I could find was a key source of information and solace for me as I responded to the shock of the terrible ultrasound.
(Disclaimer: I am neither a ladybusiness anthropologist nor a medical doctor, so please consult your doctor before making your own health decisions.)
As a busy pre-tenure woman, I was thrilled when I got the positive pregnancy test 32 days after the start of my last period. The due date was near the beginning of spring semester, so I would be able to take almost 8 months “off” before resuming teaching. And I wouldn’t have to face months of crushing disappointment of my period arriving unwanted, signaling my failure to procreate. This was off to an insanely good start. But it also felt too good to be true, and, truthfully, a little surreal. It happened so quickly that I hadn’t quite wrapped my head around the possibility of my life changing dramatically in nine months.
Within days of the pregnancy test, I had the classic early pregnancy symptoms, sore breasts, a pulling, stretching feeling at the base of my belly, an aversion to my favorite tea, and the fatigue. Oh the fatigue. I remembered that one from the first time around, and I pulled out my old pregnancy journal to see when it peaked and how long it lasted. I was glad I didn’t feel really any nausea, just as I didn’t with my first pregnancy.
I called and scheduled an appointment with the local ob/gyn practice, something with a midwife in week 7. My husband and I started to toss around names. It started to seem a bit more…likely, but that surreal quality never really dissipated. And I never felt at ease about this thing growing in my abdomen. In the seven years since my first pregnancy, I’d heard a few stories, read some things on the Internet, and grown a lot more circumspect about the possible ways a pregnancy can go. My 27-year-old self seemed naïve to have told family at 6 weeks and my boss only a few hours after the first ultrasound. I was waiting on that first doctor appointment, when I would get to hear the heartbeat on the ultrasound. Then, I told myself, I would feel better and it would seem really real.
Seven weeks in and I had my first appointment. The midwife and office staff were friendly and congratulatory, and asked lots of questions about my health history and first pregnancy. And as I answered those questions, I looked around the room for the ultrasound, for that magical moment when I would hear the heartbeat and it would feel real. Then the midwife told me that this office didn’t have an ultrasound, and I’d have to make an appointment at another location, a week later, before I could hear the heartbeat. I was tremendously disappointed, but I tried to push it aside. I ordered the recommended pregnancy guides on Amazon (my old ones had long since been given away) and picked out a maternity dress to wear to a wedding I’d be attending at ~14 weeks. I silently talked to my belly in the shower, telling it how lucky it was to be arriving into such a happy family.
Eight weeks and 4 days. We drove to the next town, and I peed in a cup. We were taken into the ultrasound room, and I put on the lovely gown. The technician came in, stuck the wand up my vagina, and proceeded to move it around and measure things, providing a bit of commentary along the way. There’s my cervix. There’s my uterus. There’s something inside my uterus. To me, it looked vaguely babylike. But I noticed that the commentary had stopped. The technician asked me if I was sure of the date of my last period. I was. I asked whether the vaguely headlike thing was a head, and was told “No, that’s the sac.” Silence. I asked whether we would be able to hear the heartbeat. “There is no heartbeat.” I squeezed my husband’s hand and closed my eyes, looking away from the big screen on the wall that showed the thing that was not going to be my future child.
“You’re only measuring 5 weeks and 5 days, and there’s no heartbeat. I’m sorry, but this is not good.” A few more words of condolence, as the technician moved the wand around some more and made other measurements and I realized for the first time that the radio music was on way too loud for the silence in the darkened room. The technician removed the wand and left the room for me to get dressed before a consult with an ob/gyn (already on the schedule). I got dressed numbly and stood hugging my husband close while waiting the eternity for the technician to come back and lead us to the next room where radio played too loudly. Another eternity passed there. I refused to sit on the examining table. I was no longer a pregnancy patient.
A doctor I’d never met came in and said something sorry-like. I don’t remember all of what he said, but he told us that there was almost no chance this pregnancy would end well. I asked what happened next. He said that there was a very small chance that I’d just misdated my pregnancy, and that we could come back in a week for another ultrasound and see if there was a heartbeat. But he also talked about D&Cs, and that a miscarriage could go quickly or last for days, and making sure I knew my blood type (B+) and how I was likely to need a D&C even after a miscarriage. He said he knew it was a shock and that we would likely have other questions, so we could call him with any that afternoon, or we could reach a different doctor anytime. I think I expected to begin bleeding at any moment, even though I knew nothing had physically changed just because we’d seen the truth about the pregnancy in that ultrasound room. We made an appointment for an ultrasound 7 days later and my husband drove me home.
On the way home, I considered the doctor’s words. Could I really have mis-dated the pregnancy by a full two weeks? Was there really a glimmer of hope? No. I knew my timing and I knew my body. I’d never gone 32 days without a period except when pregnant or heavily lactating. My periods had been 22-25 days apart before I’d gone on the pill the last time. And how could I have gotten a positive pregnancy test at 32 days, and yet be off by two weeks? That would require the pregnancy test to have been positive within a few days of conception, far better than any pee-on-a-stick kit claimed to be. There was no question in my mind that pinning our hopes on an ultrasound heartbeat in 7 days was an exercise in self-delusional futility. I’m a scientist, and the data were clearly rejecting the hypothesis of a healthy but mis-dated pregnancy.
I felt like I had dull cramps, but I was sure they were psychosomatic as much as real. No bleeding, not even tiny spotting. I felt like my body had let me down tremendously. How could it not produce a thriving embryo? And how could it delude me, maybe for weeks, into thinking I had one? The sense of disappointment in my body and loss of the possibilities I had only begun to allow myself to think of was suddenly far more real than the pregnancy had ever felt.
If I was going to suck at being pregnant, it seemed unfair that I was also sucking at miscarrying. What happened to having spotting or waking up to bleeding or intense cramping? How long was this going to take to get started? Was I going to need to figure out childcare for the weekend? I gave birth without any pain medication, and as much as the thought of a bloody, crampy period-but-worse sounded unappealing, I would do this the “natural” way. But when?
I googled “miscarriage”. The top results on miscarriage didn’t say anything useful. I wasn’t bleeding; I wanted to know when it would start. The only thing those first websites told me was what the doctor had said: many women who miscarry also end up having a D&C.
I remembered Maggie Koerth-Baker’s post from last summer: “The only good abortion is my abortion.” Here was a woman, like me, who found out through medical technology rather than her body that her embryo would never be a baby. She was deciding whether to have a D&C rather than a miscarriage +/- D&C at some indefinite time in the future. But how long would Maggie have had to wait for that miscarriage? How long would I wait? I googled some more…something like “waiting for miscarriage” and read more stories. Along the way, I found the term “missed miscarriage” and learned that sometimes it can be weeks before a miscarriage starts and that it can take days or weeks to complete.
My commitment to a natural miscarriage wavered. I remembered two more women who had blogged about pregnancy loss. Isis miscarried and seemed to take it in her usual impeccably-dressed stride, but it still didn’t exactly sound like a good time. Jo(e) lost a pregnancy and wrote simply but beautifully about the miscarriage. I didn’t feel as strong as Jo(e), and the line that stuck with me was “The waiting part was the hardest, waiting to go into labor when I knew that the contractions would not lead to a birth. I just wanted to get it over with.” I read a few other stories, but most of them started with the bleeding, not the waiting.
Then I re-read Maggie’s D&C decision story. Here was another busy, professional woman experiencing a tremendous loss on an uncertain timeframe and considering a D&C as a reasonable option. It dawned on me that there was no competition or bragging rights in waiting for a miscarriage; my entry to the secret sisterhood was the pregnancy loss not the bleeding. There’s no merit badge for miscarrying in your bathtub, and even if there was, I wasn’t sure I wanted it.
I read Zuska’s account of her D&C and it didn’t sound too bad. Not fun, for sure, but significantly better than waiting uncertainly for time bleeding in a bathtub. And, I reminded myself, the bathtub was the best case scenario, a “complete miscarriage” confirmed on another ultrasound….one showing an empty uterus. Less good scenarios included a trip to the ER, followed by a D&C. Being able to schedule a D&C on my terms, walk in without pain, and leave knowing it was over was seeming like a better ending of this ugly and heart-wrenching development. The thing that appealed most about the D&C was that it gave me some sense of control in a situation where I had no control. It let me be master of the calendar, and it gave me back the body that had let me down.
The next day I got an appointment with yet another MD in the practice. I wanted to talk things over and figure out what my timetable and options really looked like. This ob/gyn had looked at the ultrasound results and and agreed with my conclusion that given what was known about the timing of the pregnancy, the size of the sac, and the lack of a heartbeat that mine was not a viable pregnancy. I asked how long I might wait to miscarry, and the doctor confirmed that it could be weeks before I did. Weeks was a timeline that did not fit in my busy summer schedule. She offered that we could schedule a D&C at the local hospital for the next day, a Saturday. Saturday didn’t work, because we needed care for my child, but could I have one on Monday? Yes. The doctor said it was very unlikely that I would miscarry over the weekend, but that if I did they could do a D&C right away to get it over with. This was a level of control I could coexist with, a timeline of days not weeks, and still an out for my body to get on with the miscarriage if it could do it soon.
On Monday morning I had a D&C at a hospital surgical center. It was very hospitally and included a healthy dose of general anesthesia, but I was home and on the couch by early afternoon. The doctor said I could work the next day, but it took me about three days before I felt well enough to get out of the house much. My back hurt a lot for a day or two, and I ate ice cream and watched my favorite movies. Remembering Isis working through her miscarriage, I also allowed myself to dive back into my research from the comfort of my couch – taking my mind off the reality of my loss. By the end of the week I was back on campus. It took more than a week before I could sleep through the night without thinking or dreaming about the miscarriage. Two weeks post-D&C, the doctor gave me the all clear without so much as an exam or ultrasound and encouraged us to try for a summer vacation baby.
Two months later I don’t think about it very much, except when I do. We only told a very few people about the pregnancy and loss, but I do find myself referring to the “time when I wasn’t feeling well” that encompasses the fatigue of the pregnancy, the days of loss and sorrow, and the recovery from the D&C. While June was a pretty crappy month, I also feel like I got off easy in a lot of ways. I got pregnant quickly, so there wasn’t months of waiting to precede the loss. And I lost the baby early and fairly physically painlessly, before I’d shown a baby bump, told many people, or decorated a nursery. Since I know that most early miscarriages are the result of chromosomal abnormalities that are incompatible with life outside the womb, I can be relieved that it happened rather than carrying a baby to term, delivering it and watching it die in minutes or months. I have a wonderfully supportive partner, and the insurance and legal ability to make my own healthcare decisions.
I feel lucky that I had stories of women who’d gone down this road before me, and that through those stories, I was empowered to make the best decision for myself. My first motherhood story was about finding the patience to wait for a baby. My second motherhood story is about finding the strength to lose a pregnancy and reassert control over a body. I don’t know what the third one will be or if there will be one at all. But I do think it is through telling stories of motherhood won and motherhood lost that we give power to our own experiences and share whatever wisdom we have gained with women who will weave their own motherhood stories. I hope that by sharing my story here that at least one woman will find information or solace for her own journey.