Trigger Warning: This blog post contains a detailed account of a personal miscarriage story, including the emotional and physical aspects of the experience. It may be triggering for those who have experienced pregnancy loss or trauma. Please read with caution.
The Beginning of My Pregnancy Journey
From the moment I found out I was pregnant, my thoughts were consumed by the little life growing inside me. It had taken us longer than we hoped to conceive, but we wanted to be extra cautious, given the pandemic and my job as a hospital worker. It simply didn't feel safe to get pregnant when I was caring for COVID patients without a vaccine in sight. To complicate matters, I have a heart condition that requires careful monitoring, but during the pandemic, my cardiologist only saw patients with new symptoms or those who needed surgery.
Despite all these challenges, we were determined to have another baby. We planned her conception meticulously and with great care, knowing how much we wanted her. So when I found out she was growing inside me, I felt an overwhelming sense of joy and gratitude.
The Emotional Rollercoaster of Pregnancy
During those first seven weeks of pregnancy, I was cautiously optimistic. This pregnancy was my third. My first ended in miscarriage, and my second in preterm labor. Although my pregnancy experiences were rocky, leaving me with a sense of unease, the first ultrasound showing Abigail's heartbeat brought me great relief. Seeing her wriggle around the screen gave me the confidence I needed to share the joyful news with family and a few friends. As the weeks went by, my sickness became more intense, and I remained convinced that our baby would be healthy. I eagerly awaited the second trimester, hoping to leave the discomfort behind and enjoy a smoother pregnancy experience.
Heartbreaking News at the 12-Week Appointment
During my 12-week appointment, my world came crashing down when the ultrasound showed no heartbeat. The technician instructed me to wait in the waiting room with other pregnant women until my doctor could see me. I refused to leave, explaining that I couldn't bear to sit next to other expecting mothers while grieving my own loss. After three attempts to persuade me otherwise, the technician finally agreed to find a private room for me to wait in.
As a midwife and women's health nurse practitioner, I have guided numerous clients through their losses. My training prepared me to anticipate the process and provide support, from holding hands to explaining next steps. But my training failed me when I experienced the loss of Abigail, which was different from my previous miscarriage. A state of shock overtook me, which caused me to lose all sense of knowledge and understanding.
Dealing with the Aftermath of Miscarriage
Upon the doctor's arrival, she barely acknowledged my devastation and immediately began discussing potential options with me. She presented me with three choices: wait and see if my body would naturally go into labor, take medication to induce labor, or schedule a D&C after undergoing a check-up with my cardiologist to confirm my eligibility for anesthesia.
After considering my options, I ultimately decided to take medication at home to begin the process of miscarriage, despite knowing that the chances of success were slim. However, in the back of my mind, I was also preparing for it to not work, so I also scheduled a D&C procedure.
My doctor advised me to go home and take the medication at my own pace, ensuring that I was in a comfortable and safe environment.
She explained that after taking the medication, I could expect to begin bleeding within 24 hours.
She also informed me that the bleeding would be similar to a heavy period for a few days before slowing down and eventually stopping.
She recommended I get pads and ibuprofen to manage the bleeding and pain.
I struggled to hear her as my mind was consumed with thoughts of how I had experienced this loss. Abigail had been alive a few weeks earlier, but now I was left with a whirlwind of unanswered questions.
Did I do something wrong?
Was it genetic?
In my quest for answers, I asked my doctor for genetic testing. However, my doctor failed to provide me with the necessary container and instructions to collect fetal tissue for testing. I left unprepared to transport my fetus for testing, and amid my emotional turmoil, I forgot to request the equipment before leaving the clinic.
Navigating Grief and the Miscarriage Process at Home
Feeling disoriented and unsure of what to do next, I slowly made my way home. As I walked, a million thoughts raced through my mind.
What had happened?
Why did it happen?
What should I do next?
After some consideration, I made the decision to take the medication that day. I knew there was no guarantee that it would work, but I also knew I didn't want to wait. So I blindly gathered my courage and prepared to face whatever came next.
An hour after taking the medication, my labor started. I felt a pop, and I began bleeding. A few hours later, the bleeding grew heavier.
After passing three baseball-sized clots, I knew I was in danger. Feeling dizzy and nauseous, I called a cab and went to the hospital, where I immediately passed out, bleeding through my clothes.
Medical staff rushed me to a procedure room, where they administered morphine and attempted to remove Abigail from my body while I was awake.
When that failed, I was given two units of blood and rushed into life-saving surgery.
Recovery and the Power of Support
I was fortunate enough to receive exceptional care from the medical team that day. They provided unwavering support and reassurance that helped me feel safe throughout the process. Although challenging and painful, I drew strength from their kindness, dedication, and literal hand-holding. Physically, I recovered within a few weeks, but the emotional trauma shook me to my core. I went through a period of deep mourning and grief. I was privileged to afford therapy, which helped me navigate the emotional pain and PTSD.
Additionally, my Friendship Circle proved to be an invaluable source of comfort and support. The women in my group showed their love and care by lighting candles in Abigail's honor, checking on me regularly, and even sending a thoughtful gift. Though it was a difficult journey, I emerged from it with a newfound gratitude for the people in my life.
Sharing My Story and Supporting Others
Sharing my story is important to me, as I want others going through the same experience to know they are not alone. Miscarriage can be a very isolating and devastating experience, and it's crucial for those experiencing it to know that they have a support system in place.
In terms of medical information, there are several things to expect after a miscarriage.
Miscarriage occurs in 10-25% of confirmed pregnancies (1). It's important to seek medical attention immediately if you experience any symptoms of a miscarriage, such as vaginal bleeding, cramping, or the passing of tissue. Your healthcare provider will perform an ultrasound to confirm the loss and determine the best course of treatment.
Depending on the circumstances, treatment options may include:
Waiting for the body to go into labor naturally.
Taking medication to induce labor.
Undergoing a surgical procedure called a Dilation and Curettage (D&C) to remove any remaining tissue.
It's important to discuss all options with your healthcare provider and make an informed decision that feels right for you.
While miscarriage is relatively common, many express a lack of social support and societal awareness of the psychological impact after loss (1). 47% feel guilty and believe they did something to cause a miscarriage, but decades of research show most miscarriages are not preventable (2). Even still, 78% wanted to know the cause of their miscarriage regardless of whether it changed the outcome (2). It's natural to grieve a loss or the absence of information on why it happened. A perinatal mental health therapist or pregnancy loss support group can guide you through feelings of guilt or self-blame and help you plan the next steps in your fertility journey. It’s important to seek support from a medical professional. 90% of women want follow-up care, but only 30% receive proper attention (3). A physical and mental evaluation at two- and six-week post-pregnancy loss offers early detection to lessen the traumatic impact (3).
If you’re experiencing overwhelming emotions and flashbacks, you’re not alone. 30% of women experience post-traumatic stress disorder, 12% depression, and 25% anxiety (4). The length of time pregnant has no association with the degree of psychological stress experienced after miscarriage. Tracking changes to your mood or menstrual cycle collects valuable data to guide your healing and prepare your body for another pregnancy if desired.
If you're ready to try again following a loss, conceiving within the first six months significantly reduces the chance of another miscarriage (5).
With Ema, you don't have to do this alone. You can ask Ema questions about miscarriage, like:
What should I expect during a miscarriage?
What should I ask my provider about miscarriage?
What resources can support my miscarriage journey?
You can become part of our Trying to Conceive Friendship Circle, where you can connect with others on a similar journey. At Ema, you have the strength to heal and thrive, especially with the right resources and a supportive community by your side. By joining our community, you will have access to the empowering benefits of friendship and support, which can have a transformative effect on your mental and physical well-being.
You can download Ema here.
Citations:
Bellhouse, Clare, et al. “It’s Just One of Those Things People Don’t Seem to Talk about…” Women’s Experiences of Social Support Following Miscarriage: A Qualitative Study- BMC Women’s Health.” BioMed Central, BioMedCentral, 20 Oct. 2018, https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-018-0672-3
Bardos, Jonah, et al. “A National Survey on Public Perceptions of Miscarriage.” Obstetrics and Gynecology, U.S. National Library of Medicine, June 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4443861
Nynas, Johnna, et al. “Depression and Anxiety Following Early Pregnancy Loss: Recommendations for Primary Care Providers.” The Primary Care Companion for CNS Disorders, Physicians Postgraduate Press, Inc., 29 Jan 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4468887/
Williams, Zeb, Division Chief Columbia University, et al. “Coping Emotionally with Miscarriage.” FertilityIQ, https://www.fertilityiq.com/miscarriage/coping-emotionally-with-miscarriage
Shelley, Julia. “Miscarriage and Time to Next Pregnancy.” The BMJ, British Medical Journal Publishing Group, 5 Aug. 2010, https://pubmed.ncbi.nlm.nih.gov/20688843/