To this day, one of my greatest struggles with life after miscarriage is rediscovering an identity. When I learned that I was pregnant, I jumped in with both feet. As I mentioned in my first post, I Googled everything under the sun related to pregnancy and parenting. I started an Amazon wish list and piled on the products that fit in with my vision of motherhood. For the first time ever, I could read the mommy blogs without feeling a twinge of jealousy or bitterness. That's when I knew my identity was changing. I realized that I didn't have any reason to be jealous of anyone else's child, because I would soon be a mom, too. Mother was becoming a sure facet of my identity. It was inevitable. It would be permanent. I would always be Mother . . . until suddenly, that wasn't the case.
My first miscarriage preceded Mother's Day by about two months, and I was still completely raw when the holiday rolled around. Two months earlier I considered myself a mother, or at least a mother in the making. What am I now? They don't make Mother's Day cards for women like me. No one in my circle of family or friends knew how to react, so for the most part we all studiously ignored the occasion. I felt like it was an elephant in every room I went in that day--maybe it only felt that way to me. I don't know. What I do remember was feeling like I had been wrong about my identity as a mother. Mothers are acknowledged and celebrated on Mother's Day; it didn't seem to apply to me.
Kate Kripke wrote, "Identity shifting is a huge piece of the postpartum experience for every new parent, and yet moms who lose their babies are not able to show the world their mother-ness. If you feel like a mom, and yet are not able to participate in the experiences that the mothers around you are included in, know that this is a shared experience and that, whether or not the world can see this, we value you as a mother too." (Incidentally, Ms. Kripke's entire post is excellent--I highly recommend you read it at Postpartum Progress). I haven't resolved my mother-ness or un-mother-ness. When your first pregnancy ends in miscarriage, you have no assurances that you were or are a mother; you just have a sort of void in your spirit that reminds you that there used to be something more there.
Tuesday, March 29, 2016
The Sympathy Card I Really Wanted
I stumbled across this sympathy card from Emily McDowell Studio while perusing Facebook. This is the sentiment I needed to hear after miscarriage.
Monday, March 14, 2016
The First Miscarriage, or Things Fall Apart*
I started this blog after a positive pregnancy test but before my world--as I knew it--collapsed. I was seven weeks into my first pregnancy. My Google search history was suddenly full of phrases like "hair color while pregnant," "eating peanuts while pregnant," and "is feta a soft cheese?" I found so much misinformation and differences of opinion that I decided to document my pregnancy experience--not as a how-to guide so much as a how-I-did-it narrative. I was so excited to be writing about the early weeks of pregnancy, a topic on which I found relatively few anecdotal accounts, that I didn't stop to ask myself why so few people document that time on the internet. I wanted to reveal my decision-making process in real time, a blow-by-blow of growing and birthing a baby. It never occurred to me that I should feel apprehensive. I was in relatively good shape, I had been maintaining a healthy diet even before I got pregnant, I bought the most crunchy granola prenatal vitamins I could find. I was sleeping more. I was staying hydrated. I even tried to stop swearing in case that affected my little one's mental well-being. I was doing everything right, already owning this pregnancy thing! I knew the statistics about miscarriage, but it never crossed my mind that I should be prepared for that possibility. It was a sort of arrogance that makes me cringe in hindsight.
I never finished my first blog post, which I started on March 4, 2015--it sat as an abandoned draft in my queue until this afternoon. My pregnancy had been completely uneventful; I wasn't nauseous or overly tired. I hadn't experienced any spotting. Then on March 8th, four days before my scheduled 8-week ultrasound, while driving the 88 miles to my in-laws' house, I was struck by a sudden, inexplicable feeling of dread. The only phrase I heard running through my mind was, "there won't be a heartbeat." I repeated it over and over, whipping myself into near-hysteria as I drove. I was sobbing by the time I exited the expressway. I pulled into a gas station to search fetal heartbeat age on my phone. The web sources were in agreement: most fetal heartbeats should be detected by 8 weeks.
My brother-in-law was the first to see my face when I climbed out of the car. He knew something was off. I told him I was just worried about the ultrasound, that I didn't feel well. He said all the things people are supposed to--everything will be fine, nothing to worry about--but I couldn't shake the feeling that something was very wrong.
I was not surprised the next morning when I saw a small clot of blood on the toilet paper after I peed. If I hadn't had the horrible feeling the previous day, I probably would have assumed the blood was normal--maybe some variation of the common spotting I had read about. Something snapped inside me when I saw it, though, because I knew without a doubt what it meant. Like any good top-of-the-age-range millennial, I took a picture of it with my phone and texted it to my midwife. She called the hospital, asking them to squeeze me in for an emergency ultrasound. I called my boss, trying to explain in a ragged voice that I wouldn't be in for work, and drove the 15 minutes to the hospital full of dread because I just knew. My mom, who works in the hospital, came to radiology to be with me during the ultrasound. We both let tears stream down our faces but neither of us spoke about it.
The abdominal ultrasound didn't reveal much, so the tech proceeded with the trans-vaginal ultrasound. I was shaking, trying to suppress my sobs, trying to be still so the image would be clear. I was watching the screen when she froze. She held the wand still, capturing first one, then another. Twins.
No movement. No heartbeats. I glanced at my midwife and saw that tears had welled up in her eyes. She knew the truth, too. She took us to an empty exam room to wait while she consulted with the OB/GYN.
The doctor wanted to take a conservative approach. With twins, fetal heartbeats can take longer to detect. Although it appeared that they had stopped developing at about 6 weeks, and I was at 7.5 weeks, the doctor thought it would be best to wait a week then do another ultrasound to confirm that there had been no further growth. I agreed, but I knew it was a long shot. My mom clung to that hope, though, refusing to accept that this is how my pregnancy would end.
So started the worst 2 weeks of my life. At my follow-up ultrasound, there had been no changes. I went back to my parents' house, where I had encamped myself since my own house was so far from the hospital. There had been no blood since that small clot the first day. I didn't understand why my body wasn't miscarrying. All I could think was that I had my own dead children inside of me, and my body was betraying me by not miscarrying. Looking back now, I think my medical team wanted me to wait longer in the hopes that I would miscarry naturally. I just couldn't do it, though. I couldn't keep waiting for it to happen. I couldn't deal with the guilt of hoping that it would happen because they were there inside of me like two little stones, unchanging and still, but so incredibly heavy.
We discussed options. I could take a medication designed to essentially force the body into contractions (misoprostol) or my doctor could perform a dilation and curettage (D&C). Though I was not thrilled with the idea of medication, as it would require more of the seemingly endless waiting, I decided to go that route because it was less invasive and had a lower risk than a surgical procedure. My midwife warned that I would likely experience heavy cramping, which could be severe. She suggested that I take my first dose of misoprostol before bed, so the heaviest cramping would occur while I was sleeping. She indicated that most women felt the effects fairly quickly after taking the medication, so I was expecting rapid results (again, my arrogance showing).
That night, I took the recommended dose of misoprostol. I also took a Norco, because that's what my midwife prescribed and I was too wrecked to object. In a strange way, I wasn't bothered by the prospect of pain. My babies had died, I felt like there should be pain. I set my alarm for 6 hours later, so I could take my next dose at the correct time. I expected to wake up with heavy bleeding and pain. But when my alarm sounded, I woke up and felt nothing physically. No cramping, no blood, no miscarriage. Second dose, same results.
I spent the next day waiting for the medication to take effect, but it never did. My midwife worked with the OB/GYN to schedule a D&C for missed miscarriage. On March 20th, I underwent a D&C. I honestly don't remember much of that morning. I remember that I was nervous about the effects of anesthesia--I had never had any surgery before and friends told me that people under anesthesia have a tendency to ramble. I didn't want my family--not even my husband--near me if I couldn't control what I was saying. It was a very dark time for me and I wanted my thoughts to be my own.
For all of the preparation and waiting, the actual procedure only took 15 minutes or so. My first moment of awareness after surgery was one of crushing sadness. I remember a nurse asking me if I was experiencing pain, and it took me a long moment to realize that I was sobbing. I tried to tell her no, but I was still confused and groggy. My doctor came over to hold my hand, to tell me that everything went as expected, but I couldn't stop crying. Though waiting in recovery was annoying, it also gave me some much-needed time to collect myself before I saw my family.
What I didn't know at the time, what it has taken me a year to fully realize, is that the real work for me didn't start until after the D&C. When there are still clinical issues to take care of, medical decisions to make, doctor's appointments, hospitalization, it's simultaneously awful but preoccupying. The miscarriage was out of my control, the failure of the medication to work was out of my control, but feeling like I was making choices for myself gave me a focus. Once I moved past the physical problems, I was left to deal with my tattered emotions.
* I will use the term miscarriage throughout this blog, though this was technically a missed miscarriage. Once the twins stopped developing, my body did not expel the tissue naturally and a medical intervention became necessary.
I never finished my first blog post, which I started on March 4, 2015--it sat as an abandoned draft in my queue until this afternoon. My pregnancy had been completely uneventful; I wasn't nauseous or overly tired. I hadn't experienced any spotting. Then on March 8th, four days before my scheduled 8-week ultrasound, while driving the 88 miles to my in-laws' house, I was struck by a sudden, inexplicable feeling of dread. The only phrase I heard running through my mind was, "there won't be a heartbeat." I repeated it over and over, whipping myself into near-hysteria as I drove. I was sobbing by the time I exited the expressway. I pulled into a gas station to search fetal heartbeat age on my phone. The web sources were in agreement: most fetal heartbeats should be detected by 8 weeks.
My brother-in-law was the first to see my face when I climbed out of the car. He knew something was off. I told him I was just worried about the ultrasound, that I didn't feel well. He said all the things people are supposed to--everything will be fine, nothing to worry about--but I couldn't shake the feeling that something was very wrong.
I was not surprised the next morning when I saw a small clot of blood on the toilet paper after I peed. If I hadn't had the horrible feeling the previous day, I probably would have assumed the blood was normal--maybe some variation of the common spotting I had read about. Something snapped inside me when I saw it, though, because I knew without a doubt what it meant. Like any good top-of-the-age-range millennial, I took a picture of it with my phone and texted it to my midwife. She called the hospital, asking them to squeeze me in for an emergency ultrasound. I called my boss, trying to explain in a ragged voice that I wouldn't be in for work, and drove the 15 minutes to the hospital full of dread because I just knew. My mom, who works in the hospital, came to radiology to be with me during the ultrasound. We both let tears stream down our faces but neither of us spoke about it.
The abdominal ultrasound didn't reveal much, so the tech proceeded with the trans-vaginal ultrasound. I was shaking, trying to suppress my sobs, trying to be still so the image would be clear. I was watching the screen when she froze. She held the wand still, capturing first one, then another. Twins.
No movement. No heartbeats. I glanced at my midwife and saw that tears had welled up in her eyes. She knew the truth, too. She took us to an empty exam room to wait while she consulted with the OB/GYN.
The doctor wanted to take a conservative approach. With twins, fetal heartbeats can take longer to detect. Although it appeared that they had stopped developing at about 6 weeks, and I was at 7.5 weeks, the doctor thought it would be best to wait a week then do another ultrasound to confirm that there had been no further growth. I agreed, but I knew it was a long shot. My mom clung to that hope, though, refusing to accept that this is how my pregnancy would end.
So started the worst 2 weeks of my life. At my follow-up ultrasound, there had been no changes. I went back to my parents' house, where I had encamped myself since my own house was so far from the hospital. There had been no blood since that small clot the first day. I didn't understand why my body wasn't miscarrying. All I could think was that I had my own dead children inside of me, and my body was betraying me by not miscarrying. Looking back now, I think my medical team wanted me to wait longer in the hopes that I would miscarry naturally. I just couldn't do it, though. I couldn't keep waiting for it to happen. I couldn't deal with the guilt of hoping that it would happen because they were there inside of me like two little stones, unchanging and still, but so incredibly heavy.
We discussed options. I could take a medication designed to essentially force the body into contractions (misoprostol) or my doctor could perform a dilation and curettage (D&C). Though I was not thrilled with the idea of medication, as it would require more of the seemingly endless waiting, I decided to go that route because it was less invasive and had a lower risk than a surgical procedure. My midwife warned that I would likely experience heavy cramping, which could be severe. She suggested that I take my first dose of misoprostol before bed, so the heaviest cramping would occur while I was sleeping. She indicated that most women felt the effects fairly quickly after taking the medication, so I was expecting rapid results (again, my arrogance showing).
That night, I took the recommended dose of misoprostol. I also took a Norco, because that's what my midwife prescribed and I was too wrecked to object. In a strange way, I wasn't bothered by the prospect of pain. My babies had died, I felt like there should be pain. I set my alarm for 6 hours later, so I could take my next dose at the correct time. I expected to wake up with heavy bleeding and pain. But when my alarm sounded, I woke up and felt nothing physically. No cramping, no blood, no miscarriage. Second dose, same results.
I spent the next day waiting for the medication to take effect, but it never did. My midwife worked with the OB/GYN to schedule a D&C for missed miscarriage. On March 20th, I underwent a D&C. I honestly don't remember much of that morning. I remember that I was nervous about the effects of anesthesia--I had never had any surgery before and friends told me that people under anesthesia have a tendency to ramble. I didn't want my family--not even my husband--near me if I couldn't control what I was saying. It was a very dark time for me and I wanted my thoughts to be my own.
For all of the preparation and waiting, the actual procedure only took 15 minutes or so. My first moment of awareness after surgery was one of crushing sadness. I remember a nurse asking me if I was experiencing pain, and it took me a long moment to realize that I was sobbing. I tried to tell her no, but I was still confused and groggy. My doctor came over to hold my hand, to tell me that everything went as expected, but I couldn't stop crying. Though waiting in recovery was annoying, it also gave me some much-needed time to collect myself before I saw my family.
What I didn't know at the time, what it has taken me a year to fully realize, is that the real work for me didn't start until after the D&C. When there are still clinical issues to take care of, medical decisions to make, doctor's appointments, hospitalization, it's simultaneously awful but preoccupying. The miscarriage was out of my control, the failure of the medication to work was out of my control, but feeling like I was making choices for myself gave me a focus. Once I moved past the physical problems, I was left to deal with my tattered emotions.
* I will use the term miscarriage throughout this blog, though this was technically a missed miscarriage. Once the twins stopped developing, my body did not expel the tissue naturally and a medical intervention became necessary.
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