On the topic of miscarriages

On September 26, 2011, I watched the monitor as the technician measured the tiny fetus inside me and somberly acknowledged what we were seeing. There had been no growth since the last time and there was no sign of a heartbeat. That was my second miscarriage in 2011 and the third of which I am aware of having in my lifetime. For a variety of reasons, my feelings regarding this miscarriage are different from my first experience having miscarriage and different still from my second. Nonetheless, each occurrence continues to cross my mind and I am writing to put my thoughts somewhere besides the auto-play cycle in my head and in hopes that just “talking” about it will do good for more than just me.

In the age where many people have spent a good bit of time preventing unplanned pregnancies and the publicity of teen pregnancy and unwed motherhood is so prevalent, it is often difficult to comprehend that it actually isn't really easy to get pregnant.

Under ideal circumstances, the average, healthy woman, during her most fertile time in life has about 24 hours, 10 to 13 times a year during which she can conceive. Most of us aren't as average as the word suggests and there is really no telling when our most fertile time will be or how long it will last.

Then add to it the fact that some doctors believe as many as 50% of all pregnancies end in miscarriages—many times the pregnant woman is unaware she was even pregnant and just thinks she’s having a period. That is not to say that statistic applies to all women or that the late period of a sexually active woman is always or even often a miscarriage. The point is conceiving isn't easy and getting a viable baby from conception isn't any easier.

However, it isn't until you are actively trying to get pregnant that this bit of very important information becomes so obvious.

I got a prescription for “the pill” when I was 18. I was in a serious relationship but I had zero desire to derail my college career with a child. The birth control had the additional fortuitous effect of regulating an obnoxiously irregular menstrual cycle; so even when the only chance for pregnancy would have been immaculate, I continued to take the pill. As I got a little older I checked with my doctors to make sure continued use would not have any negative consequences when and if I ever did decide to have children. I was assured there would be no problems.

Prior to getting married I’d imagined that I would give the marriage at least two years of fun married couple time before adding children to the mix. However, I was 33 years old by the time I got married and my husband was 40. Both of our biological clocks were ticking. We agreed to wait a year before we’d actively start trying. I think we were about 10 or 11 months into the marriage when I stopped taking the pill, a decision made after being told that the effects of the birth control could remain in the system for a month or two after ending use. I began taking prenatal vitamins immediately and I was very conscious of any alcohol intake, to ensure my body would be a healthy place for a baby to form and grow.

All that time, I thought I was in control of this biological process called pregnancy. It wasn't that I was ignorant of the potential challenges—I’d had friends who’d had initial problems conceiving (even some that had miscarriages) and even a couple of friends who went the route of adoption. I wasn't concerned when we didn't get pregnant right away. Since I’d really wanted those two years of child-free wedded bliss, I wasn't feeling too much pressure.

Once I was off the pill my cycle had gone back to its natural state of irregularity. Since I couldn't rely totally on a calendar to tell whether I missed a period, I bought pregnancy tests in bulk. One factor about actively working on getting pregnant is that you become aware of your body and your cycle. You notice things like changes in your sense of smell, sleep patterns and emotional state.

One night, on something of a whim (really more a strong feeling based on seriously sensitive sense of smell), I took a test and to my shock and delight, it said I was pregnant. A sprint down the stairs to show my husband—woohoo! Thirty minutes later I tested again and the results read “not pregnant”. Disappointment. I decided I’d test again in the morning before I made an appointment. Woohoo! The morning test results were positive. Appointment was made as soon as the office opened.

The pregnancy was confirmed and measured at 5 weeks and I got my little sonogram still shot of a tiny little pencil tip sized evidence of good things to come. I was told to come back for my first official prenatal appointment at 8 weeks. My husband and I were excited and even though we’d agreed to wait until 12 weeks to tell people by the end of the day we’d told our parents and our siblings. I’d bought healthy pregnancy and motherhood books and a “father 2B” father’s day card for my husband.

At week 8 my husband and I went to the appointment eager to see the progress of the baby. The sonogram revealed the expected alien shaped fetus and a little heart beating away. My husband remarked that he thought the heart wasn't going all that fast. I told him to hush. But the doctor said he was right it was a little slow. She took a closer look with the sonogram and drew more blood from me and told us not to fret—she’d seen that sort of thing before and it turned out fine.  She said it could be a sign that the fetus wasn't thriving but really, we shouldn't worry. We made an appointment for 10 days later and worried but tried to be positive.

I was sure we would be fine. We prayed and asked our family to put out good thoughts. I knew in my head that things could go wrong but my heart just knew it’d be fine.

We went for the follow up appointment. They couldn't pick up a heartbeat. They sent us over to the specialty radiologist. The radiologist just shook his head. Not viable. I couldn't believe it. I couldn't breathe. The obstetrician called and said they could do a D&C right away. Whatever they thought would be best, I thought. I was still in shock.

I’d chosen the OB/GYN practice based on a recommendation of a friend and the fact that it was clinic staffed by all female doctors. Their motto was “women for women” or something similar.  The OB was very sympathetic and told me how sorry she was and how I needed to understand these things happen and how it wasn't my fault. Okay, if you say so, I thought, still numb.

I called my boss to let him know I would need someone to cover my demo that afternoon. I’d let him know I was pregnant and now had to tell him I wasn't. He was amazingly compassionate.  He told me to rest and not to worry about my schedule the next day, he’d take care of it.

After the D&C, my husband and I went home. My cousin was supposed to meet us for dinner.  We’d told him the day prior I wouldn't be able to share a bottle of wine with him and why. I held it together when I called to cancel dinner. My cousin was so great about it, offering to bring us dinner if we wanted. Right after he called, my poor brother-in-law phoned to congratulate us on the pregnancy. Talk about terrible timing. Bless his heart, I actually felt sorry for him. I handed the phone to my husband and went to bed.  

I didn't want to talk to anyone. I didn't want to have to tell anyone else. I didn't want to accept what had happened. I wondered what I’d done. I wondered whether or not my husband could forgive me and whether I could forgive myself. He wouldn't get his ‘father-to-be’ Father’s Day card. I actually told my husband that if he wanted a divorce so that he could marry someone who could actually give him children, I would understand. I really said that. He really looked at me like I was crazy and said there would be no need for that, children or no children he was in it for the duration. At the time it only made me feel slightly less awful. The sense of catastrophic failure was overwhelming for me.

Fortunately for me, unfortunately for her, one of my very close friends had very recently had a miscarriage. She was not the first person I’d known who had endured one but she was the first person with whom I was close enough that we were really able to talk openly about it and how we were feeling. It helped me immensely to walk that bridge, between what you know from a logical and clinical perspective and what you are actually feeling, with someone else.

Interestingly, once you have a miscarriage you find out that every other person you know has some experience with it. People are willing to share their story when they know you've had a similar experience. Prior to that people don’t really talk about it. It’s as if you have to join the club before you can be allowed to know there’s a club to join and it’s not a club anyone wants to join. Knowing I wasn't alone helped mostly and sometimes just frightened me all the more.

Even with the outpouring of support and commiseration, I was pretty distraught and a little self destructive—I figured if I couldn't get a baby belly, I’d just get fat and since I didn't have to give up alcohol for nine months I’d have a glass or two of wine or champagne every night (ordinarily if I have that much in a week, it’s been a party week). And, wow, could I cry—about anything and everything. I was on my way to becoming a big fat, drunken, cry baby. So not cool.

Fortunately, I was able to pull out of it. Family and friends and faith are amazing resources.  Everyone’s experience with miscarriage is unique. I think, the circumstances surrounding one’s pregnancy has a significant effect on how one responds to a miscarriage. That has been my experience and from other “club” members’ stories it certainly seems the case.

I have a friend who was unmarried and debating whether or not to terminate the surprise pregnancy when she miscarried. Her response was to want to get pregnant again right away. At the time, I was not a member of the club and I thought it was an extraordinary reaction—though on some levels I could get where she was coming from.

Now, I get it even more. One of the most distressing things about the experience for me was the realization that I did not have as much control over my body or the viability of the life inside me as I expected. When her “choice” was taken away she wanted to get it back—a feeling I can relate to completely. Prior to this last miscarriage, we had gotten our heads around the idea of having three children and were excited about it.  Now that we’re back to just two, I wonder if we should actively try for a third.

One of my friends reported in a short email that she was pretty sure she had one while at work and figured it was something that was not meant to be and simply went on with her shift. Being a nurse and a person of great faith in God probably helped—understanding the science and believing strongly in God’s will can both be sources of comfort. I’m certain it also helped that she’d already had two healthy children and hadn't been aware of the pregnancy until she miscarried.

I know that was what crossed my mind with my second miscarriage, since I didn't know I’d been pregnant and I have two little ones already, it was much easier to put it aside and deal with company and a birthday party than spend time moping. And even with this last miscarriage and my excitement, it is easier to keep from drowning myself is sorrow because I have been blessed with two healthy babies. That isn't to say I wasn't sad. I was, very much so. But it is so much easier to see the positive and have faith that things happen for a reason, whether we will ever understand it or not.

Another friend of mind spoke rather nonchalantly about having had THREE miscarriages before successfully carrying her first child to term. I was both amazed at how easily she spoke about it and that after three miscarriages she continued to try. Frankly, I was horrified by her story. I was still so raw and sad that I wasn't sure I wanted to try again and was certain that if I suffered another loss I would give up entirely. At the time, I thought she was a little cold in the casual, matter of fact way she told her story. I realize, now, that my friend was two healthy children and years away from those difficult losses and time and motherhood makes it much easier to talk about these things; plus she is a very pragmatic person with great personal strength and tendency to roll very well with the punches.

I know another woman who after two healthy pregnancies, a week before the due date of her third pregnancy resulted in a stillbirth. She actually continued to try for another child afterwards. I can say with some certainty that I would never be that strong. Then again, I am constantly amazed at where people find strength, so I should never say never. And the good news in her case is that she did have another healthy baby.

Knowing that others have walked in your shoes helps for many reasons, but for me, one of the things it helped combat was bitterness. After I had my first miscarriage, I was still able to be happy for my friends and relatives who were pregnant or recently gave birth (though I can sympathize with women who have a hard time with that after a loss) but I could not bear hearing about another idiot, barely legal, unwed celebrity having another baby. And it was maddening to wrap my head around how junkies could go to term with a reasonably healthy baby when I, who had done all the right things to prepare my body for a healthy pregnancy, could not. I really wanted to punch people. Having real evidence that good, healthy people who did all the “right” things and wanted a child could still have problems was helpful.

After the first miscarriage, I went to the doctor for one of my scheduled follow up appointments—the doctor at the clinic that was “women for women.” The nurse checking me in asked me how far along I was. When in shock, I asked her to repeat the question, she repeated herself as if I was an idiot. By the time I actually saw the doctor I could barely breathe. Then the doctor asked why I was even there. I told her the appointment was suggested by another doctor in her practice. Generously, she then suggested that since I was there she would answer any questions. I told her I was physically doing fine but emotionally I was still very sad. She looked at me and said, “well, it’s been almost two months, so you really should be over it. Would you like me to prescribe an antidepressant?” I couldn't even answer. I just shook my head. So much for “women for women.”

After a reaction like that from a doctor, a female OB/GYN, no less, I can understand why women are so reticent to share their experiences with miscarriage with people who were not in the “club.” But I think the silence is one of the things that make the experience so very challenging. Outside of TV dramas, you don’t hear much about them. Culturally, we just don’t think it’s something that happens to regular people.

With all the medical understanding and compulsive sharing of too much information, a miscarriage is still a hush-hush topic. With all the books you get for guiding you through your pregnancy, few have significant information about miscarriage or still birth. A paragraph or a very short chapter is about all you can expect. I realize it’s not the best part of pregnancy and no one likes a “Debbie Downer,” but openness leads to understanding and understanding leads to better coping skills.

That said, when I had my second miscarriage a several months ago, the original draft of this essay was the first I told anyone and I only sent it to my sister. Until then, the only one who knew was my husband. The experience was different entirely, yet guilt and sadness and natural tendency toward secrecy are all still present.

I had two, beautiful daughters. My husband and I were very happy with the size of our family and we were not planning on having any more children. Between my age, PCOS and being on the pill, I wasn't really worried about getting pregnant. In hindsight, after the month I unintentionally let my prescription lapse, I should have been more careful, but I took a test before I started back on the pill and it said I wasn't pregnant. I forgot about oral contraception requiring a full month before full potency.

I didn't even know I had been pregnant until I miscarried. I had family and friends in town for a birthday celebration while it was happening and I told no one.

I waited until everyone had left to tell my husband. I was ashamed. Had I not been so careless it would have never happened. I was relieved; we really had not planned on anymore children.  And I was ashamed of my relief. The loss of something you didn't even want can make you feel extraordinarily conflicted. The guilt I felt was awful. And I was very sad. And the sadness was compounded by the memories of the first miscarriage.

I apologized to my husband again. Again, he said there was nothing to apologize for. He’s good like that.

With the news today, I am filled with a new sadness, one I am still processing. We had been surprised by this pregnancy but were not unhappy about it. My oldest daughter is a great big sister and her little sister would be too—you should see how loving and protective she is with the younger babies in her class. When I asked them what they thought about having a new sister or brother, they both clapped and my older daughter said “let’s have both!” My husband had started mapping out plans for building out a room over our garage for a playroom. I’d started thinking about names. We’d kept the news pretty close to home, knowing that it’s best not to announce too soon. Still, I’d gotten excited. It was difficult to contain such fun news. And now, as I share it publicly, it’s not even a little fun. But for me it might be necessary. If I’m not holding on to a secret then it might be easier to let go of pain that comes with it. And it’s a sucky sort of pain, so I want to let go of it.

The decision to write about this is, honestly, an indulgent and cathartic one. But it is also sourced in a desire to share, just in case there is someone out there who is quietly internalizing a similar experience and might find a little comfort in knowing she isn't alone and pretty much anything she might be feeling or not feeling is pretty normal. Despair, relief, loss of faith, renewed devotion, self-doubt, self-loathing, fear, anger, depression, guilt, apathy, mad desire to party, wanting to be alone, lack of appetite, increased appetite, compulsive exercising, power sleeping, and just about any other emotion can be experienced and often many of them at the same time. In short, it sucks. But you will get through and move past it and while the loss will not likely be forgotten the olio of emotions will pass. Know you are normal and not alone.