Nugget.

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You never arrived in my arms, but you will never leave my heart.

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It's not good    

​    “I’m sorry, that’s not an 8 week baby…”
The sonographer looks at the screen hanging in front of us and clicks around for a bit.
For a short moment, i’m confused. What does she mean?
Am I further along than we thought?
Did she accidentally enter the wrong dates into the system? 
It only dawns on me when she says: “…and it really sucks that this is the second time in a row for you guys.”
This is not good.
​
      She continues: “Look. You can see that the gestational sac is much too big, and the embryo is too small. And normally you’d be seeing a little heart beating like crazy at this point…but there’s no heartbeat at all.”

      I’m quiet for a moment, feeling everything and nothing at the same time. I swallow and stare at the screen, and I ask how old she is. A few mouse clicks tell us that the baby stopped growing at around 6 weeks. My mind flickers back over the past weeks. When did it happen? What was I doing at the time? Did I do something wrong? How could I not have noticed?
I really thought we were doing well this time.

      With my last pregnancy in April, I had very few symptoms and my HCG began to drop near the end. I miscarried spontaneously at 5+2. It was awful, though I was glad that I didn’t have to wait around in limbo. Sad as it was, it was over, it was quick, and it was clear cut. My body recovered quickly, and although I had my ups and downs emotionally, i’d say that we moved forward and were doing well.

​

       On July 10th, I found myself squinting at another pregnancy test. I wasn’t even late yet, but I had a hunch. When that second line appeared, I was equally excited as I was terrified. But what are the odds of things going wrong a second time, right? 

       This time around, I was exhausted and nauseous from the beginning, within a week my bra no longer fit, and my HCG was off the charts. Over the next few weeks, there was no indication that anything was amiss, and so I was cautiously optimistic going into that ultrasound. Only to find out that I had unknowingly been carrying my dead baby in my womb for the past two weeks.

    “Shall I quickly get this off the screen then?” She asks.

       I want to say no. I want to look at it for just a little longer. This is the first and likely the last time that I’ll ever get to see my baby. I want to know so much more about her, and if this is all I can get, I want to commit every last scrap to memory. But I don’t say that. “Can I still have a picture?” I ask…

      The sonographer hands me the picture and gives us a short but heartening talk. She informs us about the next step and reassures us that things will be ok, in the end. A few minutes later, we’re out the door. I try not to look at the pregnant women in the waiting room, the cheery receptionist and the dozens of baby-related posters plastered all over the wall. Clutching the picture tightly, we walk out of the building in silence. Nick asks if I'd like to sit down somewhere. I just want to go home. Taking my helmet out of the pannier, I carefully place the picture inside and close the lid. I hop on the back of the motorcycle in a daze, and we set off. Nick gently squeezes my leg. I hold onto him a little tighter. We’ll get through this. Again.
      When we get home, Nick places the picture on the table and lights a candle next to it. And that’s when the tears come.

Pregnancy is complicated

        Irony has it that a large part of my job consists of teaching people how NOT to get pregnant. Like most of us learned in school, they are taught that ‘egg + sperm = baby”, and that’s about the end of it. In reality, it’s quite a bit more complicated. They don’t tell you that beforehand.
       Around 60% of fertilized eggs, never even implant to begin with. And when they do, 1 in 5 of those resulting pregnancies will end in a miscarriage (of which 80% within the first trimester). One in four women will go through pregnancy loss at least once in their lifetime. One in four! And 1 in 100 women experience recurrent pregnancy loss. Most of us don’t find out about all this until we’re unlucky enough to find ourselves in the thick of it.
       You know, for something so incredibly common, we sure don’t talk about it half as openly as we probably should.

        Although I was theoretically aware of the possibility, these are statistics that I never once imagined myself being a part of. But here we are. And one of the hardest things about it, I’ve found, is having something so profound going on in my life, whilst feeling like I need to be careful not to let the very thing that’s on the forefront of my brain and on the tip of my tongue, spill out in front of other people. That’s a very lonely place to find yourself swimming around in, especially when - knowing how many people quietly share this experience- it shouldn’t be that way. 

Taboo

       For some reason, pregnancy loss remains a hush-hush subject. And when it’s brought up, it often leads to awkward silences and well-meant yet unhelpful comments. 

“Oh well, at least it was still early.”
“At least you know you can get pregnant.”
“There must have been something wrong with the fetus. Be glad your body ended it.”
“It’s just nature’s way.”
“You can always try again.”

        Ok. Yes, it was early. 
Thing is, for me anyway, the journey towards becoming a mother has been a long one. It’s something I’ve dreamt of as long as I can remember. Life threw a few hurtles at me, and once I reached the age of 34 and felt that I finally had my life in order, I gave up on looking for a suitable partner and I took steps towards becoming a single mother. Two years later, I reached the top of the waiting list for a donor…and then I met Nick. Fast forward a bit, and I’m now almost 38. I’ve found the love of my life and I want nothing more than to start a family with him. So, what can I say other than, it’s been a long time coming.
 
        Early as it was, the second I saw those two lines, everything changed. Unconsciously, I began to create a place in my heart, our life, our future. I had a very strong feeling that it was a girl this time, and wondered what she’d be like. I imagined how she would look, which traits she’d inherit from Nick and which she’d inherit from me, I imagined all the things we’d experience together. I had hopes and dreams for her. I imagined our little family, thought about what kind of mother I’d be, Nick as an amazing father. We started making plans and arrangements, because these days you need to start pretty damn early with all that stuff. And all the while, I felt my body changing as well. Some may find it hard to imagine how quickly you can bond with someone you don’t even know yet. But I did. I may have only carried her for two months, but it feels like I lost a lifetime.
      At the same time, it feels as though I've lost a piece of myself. Some sort of innocence or naivety. There's not going to be that uninhibited happiness or elation over a future positive pregnancy test, because it is now paired with a whole lot of caution and anxiety. I'm not going to have that 'magical' or 'carefree' first pregnancy experience, however silly and unrealistic it may seem to expect that. We all have our dreams and expectations coming into this, and it's a pretty rude awakening when something that's supposed to be such a happy, exciting experience takes such a drastic, unexpected turn. 

         And yes, it’s natures way. An estimated 50% of miscarriages occur due to chromosomal abnormalities. And the older the mother, the higher the probability that this is the case. I’m almost 38, I know my odds. I’m aware that this was likely the case, and that I’ll likely have to deal with a few strokes of ‘bad luck’ in my journey to motherhood. I’m also thankful that my body recognizes when there’s something wrong, and does something about it. However, that knowledge does not make it hurt any less.

     People tend to rationalize, minimize and seek silver linings when confronted with painful or uncomfortable situations. Trust me, I get it, I’m a serial rationalizer myself.
But what I’ve learned is that in that well-meant attempt to make that pain and discomfort go away, you’re only pushing it down and severing the connection. Pain needs to be acknowledged and felt to be processed. If you want to be supportive, don’t sweat it. There’s no need to beat around the bush or pussyfoot around, there’s no need for pity or velvet gloves. Just meet me where I am. Ask, listen, acknowledge, be there as I work through it. And I will work through it.

What do we do now?

      When we were told that our baby was not viable, we were told to wait it out for a week and see if my body would resolve the issue on its own. It did not. It’s almost as though my kid is as stubborn as I am. Or maybe I just wasn’t ready to let go.

After a week, I called my midwife. I was given three options:

• Wait for miscarriage to occur on its own, which could take weeks.
• Induce miscarriage with medication
• Remove the tissue with an operation

       What kind of a choice is that? I mean, all the options suck, and all of them come with risks. I don’t want any of these. Where’s the option where I get to take home my baby? 
      But a decision needed to be made. With summer break coming to an end and school starting again very soon, I didn’t want to drag this out into the new year.

     Not to mention, I found walking around with full-blown pregnancy symptoms to be quite taxing, knowing that my child was no longer growing inside me. It was a mindfuck, to say the least. And then there’s the impracticality of going about my daily business knowing that it could happen at any given time, but not knowing when that would be. And let's not forget, my biological clock is still ticking.

       And so, I was referred to the gynecologists' who had a spot for me on Friday August 16th. And let me tell you, sitting in a waiting room full of pregnant bellies as you wait to be called in to discuss ending your very much wanted pregnancy, that’s just all kinds of fucked up. 0/10 would not recommend.

      The gynaecologist called me in and ran through me options with me, while I sat there nodding as the tears rolled over my cheeks. She asked me if she should stop, but I told her no, I hear you, I just need to let this out. She did one last ultrasound to confirm, and then we decided on the medication route.
       I remember picking up the medication and feeling this strange mixture of grief and relief, being glad that I had some clarity now and it would be over soon, but also grieving the child that I’d never get to meet.

     When you opt for the medication, you usually get a combination of two meds: Mifepriston and Misoprostol. The first is to be taken 36 hours before the latter, and it is meant to block progesterone and soften the cervix in preparation of the actual miscarriage. The misoprostol is then inserted to induce contractions and hopefully expel everything from the uterus. This is usually paired with a fair amount of cramping and blood loss, obviously. Chances of a complete miscarriage are about 70%.

       I’d heard various stories of different ways people react to this medication, and not knowing how I’d respond made me very nervous. It’s often described as a mini-version of labour. Quite frankly, I’m not afraid of giving birth, but if I’m not being rewarded with a baby at the end of it, then I’d rather pass. But unfortunately, at this point, the only way out was through.

Rough ride

        If you're not comfortable with reading how the whole thing went (don't worry, I wont be too graphic, but still...to each their own), feel free to skip this paragraph.  

        I decided to start the Mifepriston on Saturday evening, and the Misoprostol on Monday morning.
I would be 9 weeks and 2 days pregnant.

       The Mifepriston went off without a hitch, I didn’t notice anything at all. I taught my classes at the gym on Sunday morning and attended a family barbecue in the afternoon. I wanted to have that weekend. To still have some sense of normalcy amidst the chaos of the situation.
 
      Then, Monday morning rolled around. Both Nick and I were nervous. Thankfully, Nick was able to work from home that day so that he could support me and keep an eye on things. We had all the important phone numbers listed in case of emergency, and I had hoarded everything that I might need in my bedroom, from painkillers to water, tissues, matrass protectors and a bucket.

        I took some paracetamol at 08:30, then the Misoprostol at 9:00, and by 9:15 I already noticed it starting to work. I felt like I really needed to use the bathroom, but when I got down there, the pain had gotten so bad that I couldn’t get back up. I had to sit on the floor for a bit and wait for a short moment of respite to drag myself back up the stairs. From what I've heard, for most women it can take a few hours to take effect, if at all. My body responded much more rapidly than I’d expected, and it was pretty rough.

         I went through two long waves of very painful contractions between 9.30 and 14.30, during which I was unable to do anything other than lay in bed in a foetal position with my eyes closed, trying to breathe my way through it. I had cold sweats, felt dizzy and weak and I couldn’t keep anything down. Thankfully there was a short break about half way through where the pain subsided for a moment and I could drink some water and take some ibuprofen. That all came back out later, but at least I tried.

        I went to the bathroom, and that’s where I think my water broke. I felt a gush of fluid, but it was clear.
After that, I started bleeding. The pain quickly started ramping up again and I had to wait for a short burst of adrenaline to get me back up the stairs and into bed. It’s times like these when a second, upstairs toilet would have been great.

      Nick was a wonderful support, letting me do my thing but checking in on me from time to time, bringing me whatever I needed and massaging me through the back-contractions.

      At about 14.30, I slowly climbed out of whatever world I’d zoned off to and noticed that the pain was subsiding. I was completely exhausted and still crampy, but I could get up and walk around, splash my face with water, have a drink, brush my teeth, then I went downstairs for a change of scenery.

        At around 16.00, I went to the bathroom and heard a ‘plop’. I had passed what I think was the gestational sac and the embryo. The cramping continued after that, but not much worse than with a heavy period.

      By the end of the day, I was feeling a lot more like myself. Exhausted, crampy, hungry and dehydrated, yes. But I was alright. I’d made it through the hard part. Nick said that I looked a lot better than I did that morning, and that he’d been worried there for a bit as I’d looked so unlike myself. 
     He made us some dinner, went out to get us some chocolate, and we hung out on the couch for a bit until we ended up heading off to bed early, completely drained after an eventful day.

      The next day, the cramping and the bleeding had decreased to what I would consider a regular menstruation. The midwife called me that afternoon to see how I was doing. I told her that I was unsure whether the miscarriage was complete. Based upon my description, she agreed that it was difficult to say for sure and it would be a good idea to call the gynecologists' and ask for advice. On Wednesday the cramping had increased again, which was an indication to me that there was still some retained tissue, so I called the gynecologists'. Initially, the assistant told me to just take a second round of misoprostol. Given how unpleasant that first experience was, I asked her if there was a possibility that I could get a quick ultrasound first to see if it was really necessary, and if so, get some better pain medication prescribed while I was at it. No use in putting myself through all that again if it's not strictly necessary, after all. Thankfully, she agreed and made me an appointment for the next day.
         The morning of the appointment, I woke up to go to the bathroom and upon sitting down, I felt and heard another big 'plop', and I passed what I think was the placenta. I felt instant relief and the cramping and bleeding I'd been experiencing prior, decreased significantly. I took this to be a good sign.
          Later that day, the ultrasound confirmed what I suspected: I had passed all the 'bigger' structures. Unfortunately, there was still some other tissue to be seen, but she wasn't able to determine whether it was part of a collapsed gestational sac, some smaller clots, or just my endometrium itself. However, based upon that scan, she didn't find it necessary to put me through another round of misoprostol (thank god!) as it was highly likely that my body would just clean this up on its own. 
​
       All in all, it was a pretty hefty experience. The pain was worse than I thought it would be, but on the other hand, the bleeding wasn’t half as bad as it had been described to me. I’m glad I didn’t run into any complications. I hope that it stays that way, as there’s still a risk that the miscarriage was incomplete or that I could develop an infection.  I have a check-up scheduled in three weeks, and I hope that comes out clean.

         At the moment, I’m still getting very positive pregnancy tests and I probably will for a while yet, which is hard to look at. I hope that my body will recover swiftly, and that I never have to do this again.

Open

        Emotionally and mentally, I’m doing alright. This will take time to heal from, obviously. At the moment, I can be fine one minute, and a blubbering mess the next. Triggers tend to pop up in the most unexpected or inconvenient places. Hearing people discussing their pregnancies and wanting to chime in, but holding myself back for fear of creating an awkward situation. People asking me how my vacation was, and not really knowing what to say for fear of making them uncomfortable. People who ask me if I have children (both yes and no feel like wrong answers). A participant at the gym who comes to inform me of her pregnancy and ask about adaptations. Targeted commercials about all things baby. Pregnant bellies everywhere. I can handle myself in the moment, but I need to find moments throughout the day/week where I can let myself feel what I feel, and let it out. The fact that my body still feels pregnant, doesn’t make it any easier. 

      I feel the intense need to talk about it, yet at the same time I feel that societal pressure to keep quiet. I’m lucky enough to have a very supportive partner and some people around me who know, including some who have been through the same thing. I have a good support system. But I can’t help but think about how many women go through this virtually on their own. Hush-hush, after all.

       I think it’s important for my own process to be open about what I’m going through, and I think it’s equally important to break that silence for anyone else out there who may, now or at some point in the future, need to know that they are not alone. I’m willing to talk. And I’d venture to say that there are many others who feel the same way.

         If you don't feel comfortable talking about it, whatever position you're in, that's ok! To each their own.
But if you want to talk, then by all means, do. Whether it's to share your experience, to ask questions, or just to let someone know that you're there. 
    You don't need to tip-toe around it, you don't need to try to fix anything, you don't need to be all insightful...Just acknowledging what is present in that moment, that alone goes a long way. If it sucks, why not just say that it sucks, right? When those feelings get the chance to show themselves and run their course without being pushed back, minimized, rationalized and all those other nifty tricks we like to do when we get uncomfortable, then we can process and come out the other end in a much better state. It's all part of the process.

       How am I?
I'm grieving, and I'm ok. 
I'll get through this, just like everything else. I know my own strength.
I will grieve, process, and move forward in my own time.

And if you find yourself in a similar position; I see you. Take care.