Miscarriage: One Year Later

One year ago today, my husband and I suffered the miscarriage of our first child at 9 weeks, 5 days of gestation. You can read the details of the loss here, but in summary, let’s just say that in a few short weeks we had already completely fallen in love with the child we were going to have. We did not yet know her (we did not know the gender, but have always referred to the child we lost as her because…well… “it” just seems very wrong and “her” just seems very right), but we already knew that we would love her dearly and cherish her with all of our might.

But things don’t always work out the way that you are taught that they do in sex ed class. Sometimes that egg and sperm meet, make a baby, that baby implants, grows, develops a heartbeat and…doesn’t make it. Miscarriage and pregnancy loss can happen at any stage of pregnancy, and I unfortunately know women who have suffered at every stage, from chemical pregnancies that were lost so quickly to women whose little ones were lost in childbirth. No matter the number of weeks or months, a loss is a loss, and nothing can fill the space in your being that is removed when you miscarry.

I remember that day one year ago so vividly. We had already had the ultrasound that demonstrated that the baby no longer had a heartbeat, but this was just the follow up appointment, the confirmation to go in and verify that the “tissue” (see also: human being) hadn’t passed out of my body yet. When we went to the doctor, I stood up off the examination table and miscarried directly into my hand. There was so much blood that I couldn’t see much (and at 9 weeks, 5 days, there probably wasn’t much to see), but even in the utter horror of the moment, it’s nice to know that I held my baby once, if only for a moment. She was gone, and she would never get to see us or smile at us or hear our voices, but I would get to hold her, feel her miniscule weight in my palm, and maybe she would know how dearly she was loved in so brief a time.

But this post isn’t about that day. It isn’t about how hard it is to pick up and move on, or how impossible it is to stop the “if only” thoughts from flooding your brain. This post is about every day since then, and where we are 365 days later. I still cry all the time about it. I know many people might think that’s overly emotional. Heck, some people might not think a 9 week, 5 day old ball of cells is even something to miss, but most women who’ve been through it understand how much emotion is attached to even so small a thing.

However, even though I still cry all the time about it and I still miss her so badly that it aches, I’m also glad that she existed at all. We went through months trying to conceive the first time, and there were so many “ifs” that never even were. She WAS. She might not have been for a very substantial amount of time, but for a few weeks she existed. She was celebrated and dreamed about and applauded by us and by our close friends and family. She was the subject of a lot of dreaming and laughing and conversation. She had a name, and…bittersweet as it was…Dylan Rose had a birth date. It wasn’t in August 2012 like it should have been, but January 17th was the date of her birth even though she was too perfect and innocent to walk among us.

I have mourned her death, the death of what might have been, so many times and I don’t think I’m going to stop mourning it any time soon. But today I will be celebrating her life. It was short, but it was beautiful. And I know that she was loved. In celebration of her life and in recognition of the pain that many women endure in silence as the result of miscarriage and pregnancy loss, I encourage you to share your miscarriage story (if you unfortunately have one) with others. It might be painful to talk about, but to not talk about it allows other people to feel just as alone as maybe you once did. Today I am celebrating the life of the child we lost, and I am sharing her story with you in the hopes that it might give others strength if they should be so unfortunate as to have to experience what we did. 365 days later my lost little girl has two beautiful little brothers. They were her gift to us, and we are celebrating her birthday together, even if she can’t be here to take the first bite of the cake.

Happy birthday, Dylan. We love you so very very much.

PGAL: Pregnancy after Miscarriage

After a miscarriage, women have different reactions to trying to conceive again. While some women need time to heal and mourn the loss, others feel that the only way they can heal is to get back to trying. I definitely fell into the second camp, but I know women who have felt quite the opposite.
Regardless of when you start trying and when you get pregnant again, you will probably find that this pregnancy is wholly different than the last one. The blissful ignorance will likely be gone, and, if you're anything like me, it'll be replaced by fear and paranoia. The veil has been lifted, and you now no longer believe that pregnancy equals a baby. In addition to now being more aware of miscarriage statistics (1 in 4), you may also have doubt in the ability of your body. Almost always, this skepticism is unwarranted (the vast majority of women who have a miscarriage will have a healthy pregnancy the next time around), but I personally felt little comfort in those facts. My body had failed me, or at least that's how I felt, and so when I got pregnant again, there was less celebration and a lot more fear.

After you accept that this pregnancy is just not going to be the same effusive, effervescent journey that the last one was, there are things that you can do to help ease what is referred to in the loss community as "pgal-brain" (pregnant after a loss brain).

Here are some things that helped to ease my paranoia and stress as I went through my second pregnancy:

1. Let your obstetrician know your background--if you "only" had one pregnancy loss, it's unlikely that your doctor will implement any additional monitoring during your second pregnancy. That being said, it's still important that the doctors caring for you know where you are coming from. Letting your doctor know that you're pgal will make them more understanding about those paranoid phone calls and premature trips to labor and delivery that will undoubtedly crop up along your journey. Also, talking about loss, at least for me, has made me feel so much less alone.

2. Go for Vanity Ultrasounds--since I was pregnant with mono-di twins during my second pregnancy, and therefore, I was high risk, I had no shortage of ultrasounds to soothe my paranoia. Most women, however, will not have this to keep them calm. If you're pregnancy is "normal", you'll likely have 1-3 ultrasounds, and that leaves long stretches of time without hearing the soothing sound of your little one's heartbeat. Luckily, you don't have to jump through insurance hoops to get an ultrasound. While not everyone can afford it, non-medical ultrasound facilities exist in most areas and offer scans for $50-$250. Now, as stated, these ultrasounds aren't for medical purposes. They aren't going to look for deformities, but they are able to show you a beating heart and a kicking baby. When your pgal brain is working overtime in the paranoia department, sometimes that's all you need to see. If you can afford to be scanned at one of these facilities, I highly recommend scheduling an appointment for a time when you have a substantial gap in your regular monitoring.

3. Buy a Doppler...in the second trimester--Dopplers, like the ones used by your obstetrician, are available online for about $60. These devices are a simple way to verify that your little one's heart is still beating when that pgal brain strikes you. In the later part of my pregnancy, my doppler was my best buddy, but I will caution pgal moms about a couple of Doppler faux pas that I frequently see women make and that I've made myself. First, wait to purchase your doppler until at least week 12. I know some women find a heartbeat with Doppler as early as nine weeks, but this is rare, and not finding the heartbeat will only make your pgal brain worse. I didn't start using my Doppler with my second pregnancy until I was in my fifteenth week, and I recommend waiting this long as you should be able to find the heartbeat with greater consistency at this point. Another Doppler problem is that the device usually comes with a small amount of gel. Once you run out of this, several sites say you can use any old lotion in the Doppler gel's place. I would recommend not doing this. It never worked as well for me and just served to make me paranoid. Doppler gel can be bought on amazon for less than $10, and it's worth it for a clearer audio quality. Last cautionary note: limit the frequency and length of your Doppler usage. Check with your doctor for safe usage, as I've read a few things that suggest you shouldn't be doing daily home scans for hours at a time.

4. Communicate with your partner--Sometimes it's easy to forget that your partner is pgal too. Even though they're not growing a baby inside of them, they're probably having the some doubts and phobias that you are. No one is better equipped to relate to what you're going through than this person. Sometimes I didn't want to express my doubt and lack of investment in my second pregnancy to my friends, coworkers, and parents, because I didn't want them to doubt it as well. In moments like this, it was wonderful to have my husband--someone around whom I didn't have to put on a happy and hopeful face.

5. Join a PGAL support group--for me, the pgal board on thebump.com and the Facebook group "chasing rainbows" were my lifeline. Being able to talk to people who were experiencing the same emotions I was made me feel normal and cared for. Sometimes pregnancy boards online can be a little catty (women+Internet+pregnancy hormones=drama), but I found that the pgal community tends to be largely free of these distractions and negative vibes. Maybe this is because women on the pgal board are just grateful to be pregnant and appreciate the miracle a little more than women on other boards. Anyway, I highly recommend joining a group, either online or in your community, that is equipped to relate to and support your pgal specific needs. Even lurking on these boards without posting will remind you that there is life, and hope, after loss. It's also nice to watch other pgal women successfully have their babies; it will reinforce the fact that you're probably going to be just fine the second time around.

6. Distract Yourself--Early on in your second pregnancy, distraction is really the best way to soothe the pgal brain. You'll be tempted to second guess every symptom you have and countdown the days until your next appointment. There's no way to stop this, but I really recommend engaging in some activities that are not pregnancy related to keep your mind busy. To do this, you can take on extra jobs at work, go on weekend trips, plan non-baby related home improvements, or even just pick a new (and long) television series to watch on DVD. You'll have plenty of time to be pregnant and be a mom later on...take that tumultuous first trimester to enjoy your pre-baby life. Doing so will take your mind off of all the pgal worries.

Being PGAL was one of the most difficult things I've ever had to do. After safely delivering my boys, I had more than a few good cries to release all the tension and fear I kept bottled up for nine months. I'd start shaking in sobs and tell my husband "I was just so worried for so long!". There are things you can do to make it easier, but it likely will never be easy. I was worried literally up until I looked over in the warmer in the OR and saw my boys safe and sound. My husband cried in the labor and delivery room because he was still afraid for both me and the babies. More than anything, I hope you remember that it's okay to be scared. It's also okay to be sad about your loss even as you celebrate the new life inside of you. Just be honest about your emotions, remember that statistically you're probably going to be just fine, and reach out to others when your emotions seem to be waging war against you.

You will be a mother one day; try to enjoy the journey as much as you can!

My Journey: Our Miscarriage

In May of 2011, after almost a year of hard work to lose weight, quit smoking, quit drinking and get my life back into orbit, my husband and I began our journey in, well, the usual way. I had been counting my cycle for almost a year at that point, and I even stopped in to my obgyn for a little preconception check up. He gave me the all-clear, some advice and his blessing and away we went.

I've lived a pretty blessed life, so it makes sense that I naively thought this would be an easy trip. No flat tires, no detours, no traffic jams. I thoroughly expected to be already refusing champagne at my friend's wedding in June 2011.

But the first cycle came and went and no baby. I sighed. I cried. I was impatient and frustrated with my body for being less than perfect. But I kept at it. July? No dice. August? Sigh. No. September? Still empty. October? Drank and smoked at the Halloween party. No reason not to, right? Sigh.

In my brain, I knew that five months was the average and that there was no cause for concern. Many of my friends and family have had to wait a lot longer than that for their blessed miracle. After the fifth month I started to relax a little. This wasn't going to be a short trip, so I might as well enjoy the scenery. I still counted my cycle and timed our trying, but I was a little less frustrated by negative pregnancy tests. The thoughts of my emptiness did not consume my every waking moment by October and November.

And then...in November...that blessed positive pregnancy test! I was sitting in the bathtub, casually glancing at the plastic stick on the sink. I figured it'd be a negative like usual, so I was truly a little disengaged. But then I turned the stick to meet my gaze and...that word. That beautiful word. And no, this time there was no annoying "not" stamped in front of it. I told my husband and we both squealed with glee. We were going to be parents!

At Christmas we told family and friends. Sure, we were only 6-7 weeks pregnant then, but so what? We saw our baby's heartbeat on ultrasound at 6 weeks, and the chances of miscarrying were 5% at that point, or so the internet told us. The husband and I are both poker players and we kept saying "I'd play 95% odds"...and so we did.

But at 8 weeks and 4 days I began to spot. Just a little at first, so I freaked out and called my obgyn. They had me in and did an ultrasound, which ended on a high note. Baby was there, fine and showing a heartbeat of around 150 bpm. Big sigh of relief. Even though the spotting continued, it wasn't too bad. And when it got a little pinker at 9 weeks, I called the doctor's office and was once again told not to worry. I'm a paranoid person, so I told that little voice in the back of my brain to shove it. I went on vacation and tried to enjoy myself.

My first pregnancy should have ended in the maternity ward at the local hospital on August 17th, 2012. Instead, it ended in a Las Vegas ER at 4am on January 16th, 2012. The insensitive staff made jokes about never having seen a positive pregnancy test before. They asked which hotel we were staying at and if we were having a good time. I shot my husband a "not worth it" look as he was about to throttle the staff. Our nurse in the ER congratulated me on my pregnancy. Are you kidding me? At this point I had cramps and heavier bleeding. I knew this was the end and I just wanted to be home, not 28 hours away in the desert of sin city.

They wouldn't allow my husband in the ultrasound room, which has to be illegal. And while the woman was conducting the ultrasound she wouldn't speak to me or make eye contact. I know it's not her job to tell me, but laying there and watching her face in the hopes of catching some sort of sign was even worse than just knowing. She pulled out the transvaginal wand and it was saturated with blood. I wanted to die.

The ER doctor gave us the news. Thankfully, he was an actual human being unlike his colleagues. The prognosis? The baby was still there but there was no heartbeat and my pregnancy hormone was about 10% of what it should have been at almost 10 weeks. That meant miscarriage...and it was only a matter of time before I passed the "tissue".

Thankfully, my body held out until we were back in the windy city. A trip to the obgyn the next day was only supposed to be to confirm the ER's findings. Instead, it ended up being my baby's final resting place.  When the doctor told me to undress for the examination I began to and instantly miscarried right into my hand. Blood splattered on the white tile of the examination room at the end of the hallway. I held the sac with my dead baby in my right hand and, shaking, I set it on the counter. This was the end. This was truly the end.

It took a while to make myself want to do anything except sit on the couch and stare off into space. I was angry at my body, the universe, luck. I went back to smoking for a couple of weeks because why not, right? Everything felt so unimportant compared to the loss of life and the changed outlook for my coming year.

Despite my sadness, I couldn't think of anything that would help me to heal more than continuing to try. Even though we had lost our first little one, we still wanted to be parents. In fact, I think we both wanted to be parents more than ever before. We had to wait six weeks until our follow up doctor's appointment, but thinking about the future and planning for our eventual parenthood helped the loss of our first little one seem like part of the journey rather than a horrific and depressing waste of time.