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[trashpersonwrites]

Talking about pregnancy loss

Listen, I don’t want to be writing this. Everything in my good WASP-y upbringing is telling me I should keep my mouth shut because it’s uncouth to air your problems on the internet, but I really can’t. I really just can’t anymore.

 As you might know, I had a miscarriage back in late January. I went to my first doctor’s appointment longing to be told everything looked great and to hear my baby’s heartbeat, but I was given no such blessing. My baby had died. Their heart stopped beating. I couldn’t do anything to save them – it was over and ever since that day I’ve lost a little piece of myself that I can’t get back.

To put things into perspective, this pregnancy had been very planned. Matt and I negotiated parenthood for years, and I held back until I felt like I was emotionally ready. I waited until I was certain I wanted it. So when I was told, “You’re measuring 8 weeks and 5 days – but there’s no heartbeat,” my world was shattered.

Of the three options I was given, none of them seemed awesome. I hated all three choices because this was a choice I never wanted to make. I could let it pass naturally, but that could take weeks and I would never know when it would start.

Let me break that down for those of you in the back who’ve never had to really consider this. I would be carrying my dead baby for an indefinite amount of time. I wouldn’t know when the end would come – just that it would come, and that could be tomorrow or a month from now. Also, there’s no guarantee that everything would pass. There could be tissue left behind that would prevent me from becoming pregnant again – or worse, make me life-threateningly ill. This option seemed like torture. If you were in my shoes, would you want to play miscarriage roulette? Would you want to wake up every morning – having to go to work, to take care of your pets, to do chores just waiting for the cramping and bleeding to come?

I’m sorry if thinking about that makes you uncomfortable. Believe me; I hated thinking about it too. That’s why I wasn’t going to choose that option.

Option number two: take medication to induce a miscarriage. The medication most commonly prescribed in this scenario is called misoprostol. This medication is also administered if someone elects to have a first trimester abortion. Taking misoprostol would have allowed me to pass the fetus in the comfort of my home without having to wait weeks for the inevitable end. Now let me tell you why I didn’t choose this option.

Pharmacists can choose not to fill your prescription based on their moral beliefs. They can deny you medical care after you and your doctor have agreed on what is the best option for you. Enter Nicole Arteaga; a 35-year-old mother who found herself in a very similar situation such as the one I was in. Her now viral Yelp review of an Arizona Walgreens was the nightmare scenario that flashed before me while I weighed my three awful options. I thought, “what if they think I’m having an abortion and they deny me medication?”

I pictured shaking in Kroger while pleading for them to just give me the drugs. I can’t tell you how hard it was to tell my husband that our baby was dead, so how in the world was I going to tell some stranger in a lab coat that my baby’s heart had stopped beating? How was I going to tell them I hadn’t elected to stop it? How was I going to have enough strength to stand my ground and tell someone, “No, God killed my baby, and now the fetus needs to come out because it’s currently decomposing in my womb”? Did I want to risk an ideological battle on top of having to go home and begin what would feel like labor only to pass my baby on the toilet? Yeah, no. I didn’t.

So I chose my worst fear – surgery. Because I figured that would be the least traumatizing option.

Now, I know what you’re thinking, “why doesn’t everyone just choose a D&C? These grieving women should just pull themselves up by their bootstraps and have their dead baby scraped out of them like you did!”

Here’s why it doesn’t work that way. Having a D&C increases the risk of uterine scarring, also called Asherman’s syndrome. Asherman’s can cause a host of complications, including infertility. It is not recommended you have a D&C more than once because each time you have one, your risk for Asherman’s goes up. Women who have multiple miscarriages (yes, it happens) would be recommended to take misoprostol or let the fetus pass naturally if they’ve already had a D&C. If I become pregnant again and I’m told there’s no heartbeat again, I would take misoprostol to end the pregnancy.

Surgery is also expensive. Despite having decent health insurance through my employer, I ended up paying somewhere in the neighborhood of $3,500 for my D&C. Not everyone has the means or the support to have surgery. If you’re put out like I was, you need someone to drive you home afterward and look after you for a little bit while you’re still at an increased risk for bleeding.

I know it’s uncomfortable, and I know it’s sad, and if you’ve never had to deal with a miscarriage, stillbirth, or termination for medical reasons, it’s really difficult to imagine. When I was pregnant, I couldn’t look at posts from women who were dropping out due to a loss on my August Due Dates subreddit. The thought of miscarrying terrified me. And then it happened to me, and I had to pull my head out of the sand and start looking at women who’d had similar or worse things happen to them after they had gotten pregnant.

The point I’m trying to make is, if your morals lead you to cast judgment on women who need to end a pregnancy, I encourage you to re-examine those morals. And if you can’t imagine a situation in which you would end a pregnancy, read up on terminations for medical reasons (also called TFMR). Pregnancies end in heartbreaking and traumatic ways. It happens more often than we like to think about and it’s sad and awful and heartbreaking and we need to talk about it. I’ve realized a lot of people don’t know how to deal with those of us who’ve had a loss. That may be partly our fault because we don’t talk about it because it often hurts too much to talk about. But I’m going to start talking about it.

For more reading:        

Walgreens Pharmacist Denies Woman With Unviable Pregnancy the Medication Needed to End It: https://www.nytimes.com/2018/06/25/us/walgreens-pharmacist-pregnancy-miscarriage.html

What Is a Missed Miscarriage?

https://www.parents.com/pregnancy/complications/miscarriage/what-is-a-missed-miscarriage/

Terminating a Desired Pregnancy for Medical Reasons or Poor Prognosis:

https://www.verywellfamily.com/termination-of-a-desired-pregnancy-for-medical-reasons-2371777

The agony of ending a wanted late-term pregnancy: three women speak out:

https://www.theguardian.com/society/2017/apr/18/late-term-abortion-experience-donald-trump

Why Misoprostol Is So Much More Than A Pill Used For Medical Abortions:

 https://www.buzzfeed.com/carolinekee/heres-how-misoprostol-works-miscarraige?utm_term=.vd6XNLDZz#.onoQPL2eD 

[trashpersonwrites]

On my miscarriage

On Love, Loss, and Vulnerability: My Miscarriage

On December 23rd 2017, I found out I was pregnant. I wish I could say my first reaction was that of immediate joy, especially since I had been trying. Instead I was in shock. It happened so fast. I’m not the mothering type. How am I going to be somebody’s mom? How am I pregnant when I feel like the trash person I’ve always been?

On the flip-side, I was excited. My body was going to change in ways it never had before. I was going to do something amazing. I was going to bring life into the world! And when Matt saw the second line appearing on the stick before I had time to return to the bathroom, I know he felt joy. I was going to bring something beautiful into the lives of my family and his family and for that I felt like one of the luckiest people on the planet.

I carried my news to Christmas like it was a big box with a puppy inside. Telling Matt’s parents Christmas eve and my own on Christmas day. I warned them it was early, but that I had been on prenatal vitamins since before I conceived and taking care of myself in preparation. I had great odds that this was going to go smoothly and that we’d have a baby by early September.

I started to feel nausea even before New Year’s. I was exhausted, I could smell things from a mile away, and I started to get emotional over nothing. The first time I cried I was driving to Whole Foods and a song came on that I liked.

In the meantime, I started to bond with it. I know it was just an embryo, and then at 8 weeks a fetus. It had no likes or dislikes, it had no personality, and it had no legal rights that surpassed my own. But to me it became my baby. I felt like it was a girl. I would place my hand over my stomach at night and wish her health, growth, love and light. She had Matt’s sunny personality and my blue eyes. She loved music. I was going to name her Melody.

My pregnancy was absolutely normal. I had no concerning symptoms and no indication that something was off. All my pregnancy tests were blaringly positive and my healthcare providers saw a 28-year-old woman who was a healthy weight and had no pre-existing conditions. My first visit to my OB was scheduled for January 22nd along with my 8-week scan. I was 8 weeks and 4 days that day. I couldn’t see my normal doctor, but I was okay with seeing one of the nurse practitioners at the practice.

I knew 2 things had to go right at that scan. I had to be measuring around 8 weeks and 4 days with only a couple of days, give or take, as room for error. I also had to have a strong heartbeat. If those two things went right, I could go forward and this would be real. I knew if I got those two things I would have a healthy baby due in late August.

The ultrasound room was darkened. There were murals of beaches on the walls. The technician had a calendar with scotty dogs by her desk. My mom and Matt’s mom were there with me. I laid down on the table with my legs in stirrups and the tech placed the ultrasound wand inside me. My mom gasped when she first saw there was something there. The NP asked for quiet while they took pictures and measurements. It didn’t take long before the NP walked over to me and said, “you’re measuring 8 weeks, 5 days. But there’s no heartbeat.”

My world crashed. My mom and Matt’s mom surrounded me, trying to protect me from the most devastating blow I’d ever received. I don’t even know when the ultrasound tech removed the wand from me. I asked questions.

“Am I not pregnant anymore?”

“You’re still pregnant, but there is no heartbeat.”

“What do I do now?”

“You have three options. Wait for it to pass naturally, take medication that will cause it to pass, or have a D and C.”

Waiting for the inevitable sounded like torture. Waiting could take a while, and there would be a risk that I wouldn’t pass everything which could cause complications in the future. I could request the medication (misoprostol, the same medication taken to induce an abortion), but I could also get a pharmacist who didn’t believe it was a miscarriage and that I was trying to get an abortion and deny me the medication. Getting into an ideological battle in a CVS on the worst day of my life also sounded like torture. I saw my baby on the ultrasound screen, I didn’t need to see it come out of me. I immediately asked for a D&C.

“I’ll call your regular doctor and see when the earliest we can schedule it is.”

“Does this mean I’m at an increased risk for this happening again?”

“Yes. If you get pregnant again we will want to see you much sooner and check your hormone levels early on.”

I started to cry and she left along with the student who was shadowing her and the ultrasound tech. I could hear my mom and Matt’s mom crying too. Both of them had miscarried before, and they knew how I felt in that moment. I’ve never been more vulnerable than I was in that moment surrounded by my baby’s grandmothers, crying, with only a glorified paper towel covering my exposed bottom half.

I collected myself enough to put on my pants, gather my things, and get papers to have blood work drawn. The NP said she’d call my doctor right away and that I’d be hearing back from her in the afternoon. Downstairs they drew 6 vials of my blood.

I left the building and got back in my car with my mom and Matt’s mom. I started to sob. I couldn’t keep my baby alive. I did everything right, and my baby still died. My mom asked if I was okay to drive. I pulled myself together. I felt like I couldn’t do the most natural thing in the world. I wanted to at least do something, so I drove home.

In the meantime, everyone who knew was contacted, including Matt who’d had a training that day and couldn’t be with me at the ultrasound. Matt sounded defeated on the phone. I felt guilty. I felt like I was causing the worst thing that had ever happened to him. Both of us have been extremely fortunate, and we’ve never had to really suffer. We have both sets of parents, both of our parents are still together, and both of us can still go to our childhood homes for holidays. We’re lucky people. I’d had people die on me before though. And I’d had parts of my childhood that were gone and I could never get back. Matt still has all of the grandparents he’s ever known.

We went to have lunch with him and on the way, we got a call from my dad who already knew about the miscarriage. On top of this, my grandma isn’t doing well. This is probably the beginning of the end. This day is shit.

I visit my grandma that evening. She has Alzheimer’s and she hasn’t been herself in years. This is a loss I’m prepared for. I feel guilty again because I’m bringing death to a dying woman. We stay for a while, but mom needs to get me home. She doesn’t want me driving right now.

Once I get home Matt holds me tight. He doesn’t hurt like I do, but he hurts because I’m hurting. This adds another crack in my already shattered heart. I ask him to drive me around. I don’t want to stay in one place. I get restless when I’m sad. As we head home it starts to storm. There is hail. It feels like the world is crying with me.

I have two days until my D and C. My doctor called earlier. She tells me she’s sorry this has happened to me. 3 months earlier I had been in her office asking her what I should do since I was ready to start a family. She could tell I was happy. She knows this is tough for me. She’s going to put me under general anesthesia for the procedure. There are risks, but they’re rare.

That night I have the first anxiety attack I’ve had in months. I’m afraid to be alone if I start to pass the baby. Matt asks his mom if she can come over. I also tell my dad I’m scared and he drops work to come stay with me that day. Matt’s mom, Matt’s dad, and my dad all watch me that day and I realize that parents never stop being parents. I also realize I’m loved. Really loved. Unconditionally loved.

Matt’s mom comes back the next day and we watch Big Little Lies. She makes me guacamole and washes Matt’s work shirts. My mom comes by that night with pizza. Everyone makes sure I’m not alone. In the midst of my sorrow I find immense gratitude. I can never adequately thank my family for being there for me when I needed it the most. They’ve gone above and beyond for me. I realize that as much as I love my baby, my parents love me and I understand them now more than ever.

It’s the night before the D and C. I haven’t been cramping or spotting. The next morning my dead baby is going to be scraped out of me. I know this sounds unpleasant because it is. I feel guilty. I know I’m not doing anything wrong. I know this way they can do genetic testing and I might be able to get some answers as to what went wrong. But it feels like an undignified end to something that was created in love. So I tell my baby goodbye.

I tell it that I love it. That I love it more than I’ve ever loved anyone, maybe even more than Matt. I tell it that even though I may have been apprehensive, I wanted it. I wanted it so badly it hurt. I tell it that it will always be my first. I tell it that it’s beautiful because it’s made from pieces of so many people that I love and have loved. It’s part of me and Matt and his parents and my parents and all of our grandparents. I tell it that I want it to be with my grandma because she will probably be dying soon. I tell it that I hope we’ll meet again, maybe in another time or universe and that hopefully next go around we get more time together. This brings me some peace.

I sleep fitfully again and wake up at 5 that morning. Matt takes me to the hospital and drops me off while he goes to park. I tell the guard at the front desk I need to be admitted for a D and C. While I wait, I see two other women being admitted. One looks about as happy to be there as I do. The other is very pregnant and is being induced. I hope that everything goes perfectly for her, but I’m jealous.

I’m admitted and taken back to pre-op. I put on the gown and pee in a cup. My main nurse’s name is Kristin. She tells me this has happened to her too. She’s kind and caring and very knowledgeable. I ask her for anxiety medication because this situation encompasses a lot of my phobias and she makes sure I get some. Her soft voice and caring eyes help put me at ease. She also had a nursing student with her doing her clinicals. I can’t remember her name, but she was warm, and did a great job taking out my IV needle when everything was done.

My doctor sees me next. She hugs me, she knows I don’t want to be here. She listens to my concerns and answers every question reassuringly. She tells me that in addition to having no heartbeat there appeared to be some abnormalities with the fetus. She lets me know that if this was a trisomy, that my odds for it happening again are no worse than my odds for it happening in the first place. She makes me feel better. She wants to do one more ultrasound to do her due diligence before she goes in, but, she’s pretty sure this is what it is and that I’m making the right call.

After I’m given Xanax, I start to feel less afraid. I make dark jokes with Matt. He knows I’m scared and he knows this is very high up there on the bad days list. I tell him this is way worse than the time I got my period in white shorts during band class. We laugh for the first time in days.

The doctor comes back in and does the ultrasound. She can see immediately that the amniotic fluid has gone down and that the placenta is closing in on the baby. The only heartbeat we can hear is mine. It’s time.

I’m given strong drugs, and I’m a lightweight. I don’t remember being wheeled into the OR, but I remember being in the OR. Between my doctor, my nurses and my anesthesiologist, I knew I was surrounded by smart women who were all there to take care of me and make sure I came out of this with the opportunity to try again if I want to.

I woke up back in the recovery room wrapped in warm blankets. I was shivering pretty hard when I came out of the anesthesia, but that’s normal. Everything went smoothly, they got everything out and I had no complications. I hurt a little so they gave me some Vicodin. Apparently, I thanked everyone profusely.  

My bleeding was minimal and by the time I left my pain was at a 0. My doctor saw me one last time and told me next time we’d get it. She’s an amazing doctor.

Recovery has been easy so far. I don’t hurt, I’m just a little tender, and my pregnancy symptoms are already starting to fade. Hopefully I’ll know more about what happened to my baby in a few weeks when the genetic test results come back.

I don’t believe much in fate, I’m not religious, and I don’t think this happened for a reason beyond that something just went wrong. I still believe women should have the choice to do what they think is right with their bodies. But I believe even more strongly that every woman should have access to quality care and compassion when she needs it. The care and compassion I received during my D and C was incredible. It was the silver lining to a day I never wanted to come.  

I also believe life is about learning lessons. When things happen to us, we need to learn from them. On a shallow note, I learned yesterday that my blood type is A-, which came as a shock since both my parents have positive blood types. In any future pregnancies, I would need RhoGAM shots since Matt is A+.  

More importantly, I’m learning that I am immensely fortunate for the family and friends I have. To everyone who has offered me their time, support, care, or kind words, I cannot thank you enough. All of you have turned one of the worst things that’s ever happened to me into something I can look back on with positivity. Kindness and compassion are some of the most important gifts you can ever give.

I’m learning that parenthood is complex and beautiful and it lasts well beyond the years you spend raising a child. I used to look at being a mom as something that would over-simplify me. It was a label I didn’t think I fit into. Now I know that’s not true. I would be honored to be a mom.

I’m also learning that my capacity to love goes way deeper than I ever imagined. As a means of self-preservation and out of a fear of vulnerability, I’ve held myself back from experiencing love as deeply as I can. I don’t think I want to hold back anymore. Not with Matt, not with family, not with anyone I care about. I know I can get hurt, but it’s okay. I know I have more than enough love in my life to heal no matter what.