"A place to share sad secrets"

I’m pregnant. But at the same time, I’m not.

My body is currently housing an approximately seven-week-old embryo. But that embryo’s heart has stopped beating, probably just a few days ago, or so the ultrasound technician tells me. So right now, I’m in limbo till an appointment with my doctor in a few days, where we’ll talk about next steps. By “next steps” I mean “how we will get this dead embryo out of me.”

I don’t know why that last paragraph came out sounding so clinical. I don’t feel clinical. But I keep mentally approaching this subject from different angles, and it’s hard to find words to talk about it. I feel disappointed. I feel very, very sad. But I feel like there’s some aspect of this that I’m not feeling. Or else I’m feeling it, but because I don’t have words for it, I don’t know what I’m feeling.

I thought I’d be better at this – that I’d be more self-aware, or more capable and efficient at managing my grief -- this time around. Because this isn’t the first miscarriage I’ve experienced. I was pregnant once before Sam, and that pregnancy failed at around five weeks, something I didn’t find out till a couple of weeks later. Both miscarriages are alike in that I never experienced any of the warning signs: cramping, spotting, or bleeding. Both times I thought I was pregnant right up till the moment an ultrasound tech told me otherwise.

I hate ultrasounds, by the way. Though I feel huge sympathy for the people who perform them. What a shitty job.

Both of these miscarriages are similar in another way. Both times, I felt an acute, unaccountable, unshakeable sense that something was wrong. I didn’t feel this way when I was pregnant with Sam. That’s kind of weird, don't you think?

When I miscarried three years ago, it was at a time when I wasn’t doing any personal writing. I didn’t write about the experience, and by extension, I didn’t talk about it. I was really messed up for a long time, and I think that my silence was the reason why. So I’ve decided to be more forthcoming this time around.

When I think about why I was so quiet, a few reasons come to mind:

• Being a private person by nature (which sounds weird coming from someone who writes about their life on the internet, but some of you other bloggers will know what I’m talking about)
• Feeling ashamed and embarrassed
• Thinking that by talking about it, I was “dwelling on it” and therefore “not getting over it” – and I desperately wanted to get over it
• Not wanting to be a downer for other people
  

In retrospect, most of these reasons seem stupid or, to be a bit kinder to myself, ill-conceived (no pun intended). I don’t know what I was ashamed or embarrassed about. And it became patently obvious that not talking about it wasn’t making me feel better, so I should’ve ditched that strategy early on. And I don’t know why I worried so much about whether other people – especially my closest friends – would consider me a pill for being a tad depressed over the greatest loss I’d ever experienced.

This last point still sticks with me. It seems like I was doing my friends a huge disservice in assuming they would get tired of me and my sadness. I wonder why I wasn’t able to give people the greater benefit of the doubt. Especially since, both then and now, my friends have been universally wonderful – thoughtful, concerned, helpful, touchingly sympathetic, and offering their willing ears any time I want to talk or cry.

It also seems like, in being so quiet, I was doing other women a disservice. There’s so much silence around this subject, so few personal stories, that the statistic that one out of every five (or four, or three, depending on which source you cite) pregnancies ends in miscarriage feels like just that: a statistic. And while, yeah, I usually tend to find a certain amount of comfort in statistics, this one feels a bit hollow. (Actually, I feel completely detached from this particular statistic. When the miscarriage stat for the general population is 20 percent, and your own personal stat is 66.6 percent, you can see where the disconnect happens.)

So now, belatedly, I’m going to make my first miscarriage story part of the public record. I’ll totally understand if you want to stop reading at this point. And don’t feel guilty if you need to stop reading! I want my story to help the people who need it. If it can’t do anything positive for you, please, please don’t feel obligated to trudge through it. Also, this story gets somewhat graphic, so it’s not for the squeamish.

My husband and I decided to start trying to have a baby at the very beginning of 2004, and we were shocked and excited when we got lucky on the very first cycle of trying. In mid-February, when I was only about four or five weeks pregnant, I started to experience sharp pains in my lower abdomen. My pregnancy with Sam later taught me that these were just run-of-the-mill pregnancy pains from my uterus and ligaments stretching, but at the time I was paranoid about ectopic pregnancy, so I had an ultrasound that showed a yolk sac but no embryo, which was to be expected at the time.

At about the same time, my doctor, slightly concerned by my “weak” pregnancy test and minimal symptoms, scheduled a series of blood tests to measure my HCG (pregnancy hormone) levels. I had blood drawn every two days for a week, and at first things didn’t look so great, but then they seemed to pick up and we were all cautiously optimistic. My doctor scheduled another ultrasound at seven weeks. And this was when we found out that the fertilized egg hadn’t progressed past the fifth week. This is called a “blighted ovum” in some circles, though my doctor made a point of telling me this isn’t a medically recognized term. I’m still not sure why she was adamant about this.

At that point, I was told that I had three options:

• I could wait for my body to miscarry naturally.
• I could have a D&C.
• Or I could opt to try an at-home procedure using a vaginal suppository called misoprostol, which would induce miscarriage.

I opted for Plan A, which seemed the most “natural” to me at the time. Also, in Vancouver, you can’t just schedule a D&C. You have to show up at the hospital without an appointment and put yourself on a waiting list, and then wait in the emergency room, possibly for hours, until they can squeeze you in for the procedure. I didn’t seriously consider misoprostol at the time, because I didn’t know anything about it and because I’d been warned that inducing a miscarriage could be much more painful than having one naturally, in much the same way that induced labour can be more painful than non-induced.

So I waited to miscarry naturally. And I waited. And waited. I’ve never realized how long a mere couple of weeks can feel. During this time, I couldn’t think about anything but this misstarted life, this failure of my body not just to create a healthy new life but to reject an unhealthy one, and my growing need to just get this phase of things over with so that I could start over.

After two weeks of my body stubbornly holding onto this poor little failed egg with no sign of letting go, I was done waiting and, not wanting to endure a hospital visit, ready to skip Plan B and move right to Plan C, the misoprostol. I received a prescription from my doctor and picked it up at my neighbourhood pharmacy, trying not to wonder if the pharmacist was looking at me pityingly or not.

But in my fuzzy-headed haste to finally get things going, I misread the instructions. Believing that it would take hours for the misoprostol to work, I inserted it just before bedtime, assuming it would start working at some time the next morning. And of course I started feeling the first cramps about an hour later. At the time, I remember thinking, ‘How bad can cramps get?’ The answer is, pretty bad. Pretty horrific, actually. In fact, in comparing them to labour contractions, with labour being a ten out of ten on the pain scale (note: I’m not saying that labour is an absolute ten on the entire spectrum of pain; I’m just creating a basis for comparison), these were about an eight-and-a-half. Maybe a nine. And of course, since this whole experience seems to be a testament to Murphy’s Law, it was by now well after midnight and the strongest painkiller we had in the house was extra-strength ibuprofen. For some reason, too, I had this stupid idea that I shouldn’t wake up my husband, who had a big day at work the next day. (He’s still incredulous at this bit of reasoning, and again I’m left to wonder what purpose I saw in trying to be stoic and keep my pain away from other people.) So from about midnight until 7am, I paced the house, moaning quietly and making frequent pit stops to the bathroom, where I’d rock back and forth on the toilet, still moaning. Finally, when it was getting light out and I was completely exhausted, the worst of it seemed to be over. I went to bed and slept most of the day.

From this point, all I wanted was to have a normal period, after which my doctor told me I’d be ready to try to conceive again. So I waited. And waited some more. Weeks passed. A month. Another month. Nothing happened. During this time, I became horribly depressed, something I didn’t realize until after it was over. I didn’t want to see people. I would go to work, then come home and stay in until it was time to go to work again. I only ate what I needed to for sustenance. I slept a lot. At one point, I booked a last-minute trip for my husband and I to Cuba, thinking it would be therapeutic. We were there for two weeks, and I hardly remember anything about it. Now, when we look at the pictures from that trip, which we generally feel strangely disinclined to do, we realize how sad and lost we look.

I became obsessed with the fact that I needed to become pregnant again, that it was the only thing that would pull me out of this terrible, empty place I was in. And once again I felt that my body had failed me in refusing to let me do even this.

In late May, which marked ten weeks of waiting for my long-lost menstrual cycle, we were invited to stay with friends at their family chalet in Whistler. Thinking that it would be good to get out of the house, we agreed and made what we hope was a valiant effort to be charming houseguests. And of course, invoking Murphy’s Law yet again, THIS was the weekend my period decided to return. With a vengeance. If by “vengeance” you mean “a horrible gush of blood and tissue that soaked my pants all the way down to my shoes.” In front of everyone. Thank god these were some of my closest friends, is all I can say. I ran to the washroom, where I stayed for the next eight hours, pretty much repeating the misoprostol-induced experience of two and a half months ago. When I later described this incident to my doctor, she said that it sounds like I’d only had a partial miscarriage earlier, and that my body had decided to wait a while for the sequel.

My body is kind of a dick.

It’s taken me longer than I’d expected to tell all this, so I’ll try to wrap things up quickly and on a positive note. My normal period returned. After just a couple of cycles of (admittedly tense and rather joyless) reproductive sex, we conceived again, this time with the healthy little bundle of fun we later came to know as Sam. And believe it or not, I managed not to be a basket case. (Well, I was kind of a basket case until that first ultrasound; see above re: hating ultrasounds.) In fact, at around the twelve-week mark I developed this semi-unflappable Zen calm about the entire pregnancy. I take no responsibility for this, and am perfectly willing to assign full credit to shiny-happy pregnancy hormones. Which, let me tell you, after suffering from what, in retrospect, was probably a full-on case of clinical depression for five months, was like winning a trip to Club Med with my own personal cabana boy.

The only residual effect (I thought at the time) of this experience on my pregnancy is that, when I did go into labour, I had a very negative emotional reaction to the pain of contractions. I wonder if this had anything to do with the fact that they were so similar to the pain of miscarrying. At any rate, I was very happy with the noble efforts of my friend, Mr. Anesthesiologist, and my labour experience was actually pretty first-rate, as such things go.

I'm now realizing there are other residual effects, and I'm still trying to sort them out, which is why I'm writing this.

There are as many different miscarriage stories as there are birth stories. This one is mine. In a few seconds, I'm about to hit the "Publish" button, and I'm more nervous and anxious about it than I expected to be. If you’ve read this far, you have my undying gratitude. If I’ve caused you any sadness, I’m sorry. If I’ve helped you, I’m glad. If you've been grossed out, well, that's your problem, dude.

If you want to read a more cogent discussion of miscarriage, there's an excellent epistolary piece from Slate's archives, called "Motherhood Lost", that my wonderful friend Libby found for me. Reading it has helped me. At the conclusion of the series of letters, one of the writers thanks the other for creating a "place to share sad secrets" online. I liked that idea, and that expression, so I used it in this post title.

*As an interesting footnote to this post, and on the subject of silence, when I was typing this entry in Word, it was interesting to note how Word’s dictionary didn’t recognize many of the negative words surrounding pregnancy: words like “ectopic” and “misoprostol”. (You could argue that the last is a drug and can be excused for being omitted, but try typing “penicillin” or “Viagra” or “lithium” into Word and see what happens.) Funny.