At the beginning of the year, I reflected on 2013 and made some goals (resolutions) for 2014. At that point, my final goal – to grow our family – was already kind of-sort of under way. We actually decided last October that we were ready to have kids, but felt it would be better to wait a couple of months before starting to ‘try’. While we were eager to get a head start the day my doctor gave me a health check and told me to “go forth and procreate”, waiting gave me an opportunity to have a couple of last hurrahs at upcoming work and personal social events. We also felt it would be better to wait so we could upgrade our health insurance to an option that had higher premiums, but almost no out of pocket expense. Yes, medical costs factor into our family planning here in the US… we’re not on the NHS anymore, Dorothy.
Anyhow, for the aforementioned (and various other personal and practical) reasons, we decided December was going to be ‘go time’. Surrounded by my very fertile family and a handful of friends who have managed to get pregnant their first month trying, we had a somewhat unrealistic dream/expectation that we get pregnant right away. Doing so would have had a nice sentimental touch, since timing would mean conceiving our little bundle of joy in England, and birthing it in America – perpetuating our growing family trend of part-American/part-British. Unfortunately, we didn’t end up pregnant that first month, so we kept trying. Mark and I are data junkies, not ones to leave things up to chance, so there were lots of tests, temperatures and charts involved. Some last minute travel threw a bit of a spanner in the works during January, so we weren’t surprised things didn’t work out that month, but February, Mark told me he had a “good feeling”. I was a little less confident, but I did wonder one evening when I came home from work and my sense of smell had reached spidey-level sensitivity.
The following morning (a Friday), I woke up earlier than usual and decided to take a pregnancy test. I watched the test for about 30 seconds, saw nothing, and decided to crawl back in bed to listen to the rain rather than standing in our bathroom staring at a stick. A few minutes later, I remembered I needed to go check my test, so I got back out of bed, turned on the bathroom lights, and saw the lightest little pink line I’ve ever seen. While I knew “any line is considered a line, no matter how light”, I still didn’t quite believe it. I asked Mark to consult, he wasn’t convinced, so at 5:30am, I texted a photo to a friend (who was 2 time zones ahead and fully aware we were trying to get knocked up) and asked if she saw anything. “There’s a liiiiiiine! … OMG congrats! You’re preggo!” No. Freaking. Way.
Mark and I were still skeptical. We proceeded to spend our morning in Starbucks, sipping coffee (mine decaf, of course) and googling images of pregnancy tests of the same brand to assure ourselves. I was pretty certain, but also worried maybe I waited too long before checking the results, and it was just an evaporation line. That evening, our dinner plans with friends fell through, so I went home and took another test. That time, there was no question – the result wasn’t as dark as the control line, but it was very clearly a line. Again, because we are skeptical data junkies, we took a digital test the following morning which said clear as day “pregnant”. As Mark says “you can’t argue with binary”. We spent the rest of Saturday morning contacting our parents – Mark’s mum let out the loudest, highest pitched squeal I may have ever heard, and my own mum was very congratulatory. It was a great morning. We were meeting with friends that afternoon, and had decided in advance that while we weren’t going to publicly announce anything, we were happy to announce to our close friends and to anyone else with whom it came up in conversation. Since my coworkers are close and go drinking together a lot, I knew I wouldn’t be able to hide things for very long (the lack of gin in my gin and tonics was sure to be a giveaway), so I told my boss straight away Monday morning.
We spent the next few weeks excited, talking about gender preferences (turns out we didn’t have one), talking about the nursery, sleeping (I was fine in the morning, but absolutely exhausted by about 8pm every night), discussing the size of our growing little thing (and also paying tribute to its weekly size with a dish – the first week was lemon poppyseed donuts, then sesame seeds on some thai-spiced grilled chicken). One evening, I commented to Mark how relieved I was that I wasn’t having any spotting or cramping. I know they “can” be normal in early pregnancy, but I preferred not having them to keep my mind from wandering and playing Dr. Google.
But then last weekend I did start spotting. Saturday was fine. No cramping and the small amount of spotting I had was obviously old blood. Sunday, the blood looked fresh and I did notice some slight cramping. We were sure we were overreacting, but Mark and I couldn’t help feeling a little worried. Monday morning, I called the doctor to let them know, again reiterating I was sure it was nothing. They scheduled an appointment for Tuesday morning to check things out and put my mind at ease. Mark came along, since this was going to be my first ultrasound and we would potentially see a heartbeat for the first time. I didn’t have any spotting on Monday, so we were just kind of expecting it as an opportunity to see our little growing embryo early.
As the doctor’s office requested, I drank plenty of water (and decaf coffee, and a smoothie) before my appointment to help them get a better picture. The ultrasound tech was running a little behind, so we sat in the waiting room reading magazines and trying not to focus on how badly I wanted to go and relieve myself. Finally we were called in. She tried an abdominal ultrasound first, but knew that it may not show much based on my pregnancy timing. She didn’t see anything, so she was going to try an alternative method. Thankfully I was finally able to go to the bathroom before she tried the second ultrasound, so I relieved myself, returned, and laid back on the table. She started again and found what she was looking for pretty quickly. There it was, my little gestational sac on the screen. I laid there another 10-15 minutes while she took a bunch of measurements. Mark and I distinctly remember discussing the diameter of the sac; it was around 60mm, and he couldn’t believe how tiny that seemed (“just over half a centimeter – wow!”). After the ultrasound, I needed to see the nurse, but Mark went back to work. We figured the nurse was a just a formality, since we’d seen the little sac on the screen just fine.
When the nurse came in, she asked me a handful of questions about my health, and then got to the point. “I don’t see a fetal pole, which I would really expect to see at this point. It’s possible that the timing of your pregnancy is off, but the most likely scenario is that you’re having a miscarriage” At first, I froze in shock, but then I started crying. A few seconds after she handed me some tissues, I got kind of embarrassed and tried to hold it together. I had gone in knowing this was a very real possibility, but I still hadn’t expected it. The nurse told me there was a chance things would be ok, but that she wanted to be honest with me, since this is what she thought was the most likely outcome. To verify, they took a blood test to measure my HCG levels. They would take another 48 hours later, and if my pregnancy was healthy, the HCG levels would double. If they hadn’t, my pregnancy was not viable and would come to a natural end soon.
I decided to take the rest of the day off. One of the reasons I wanted my boss to know I was pregnant early on was that if anything did go wrong, I didn’t want to have to explain it all then or have jokes from my coworkers about more time off (it’s a running gag that I never work, since I managed to negotiate a pretty sweet PTO deal). When I left the doctor’s office, I called Mark. I started to break down as I told him what the nurse told me and what our next steps were. He had a lot going on at work and there wasn’t really much he could do to help me, so we decided he would stay at work, but meet me for lunch. I then tried to calm myself down, and called my boss to tell him I wouldn’t be back at work that day. He asked if everything was ok, and I flatly said no, I didn’t think so. He started apologizing profusely and told me to do whatever I needed to do, take as much time as I needed, and not to worry about work.
From there, I went to Starbucks. I was still sobbing intermittently, so I didn’t leave my car until I’d had a good cry. Then I put my sunglasses on, and went inside. I decided to get something with plenty of sugar and calories – somehow plain ole coffee doesn’t do the trick when you feel like you’ve just been punched in the gut. As I sat outside in the sunshine, sipping my drink, I emailed our parents an update. Thankfully some older women sitting next to me were talking so loudly and fussing over their dog so much that I was distracted enough to not think too much about my own situation. Half an hour later, Mark was ready to meet for lunch. Somehow being with him made me feel more composed. I guess it’s the solidarity. Focusing on ordering and eating food is probably better than sitting and letting my mind wander, too.
After lunch, I got cupcakes. Sugar is apparently my answer to grief. When I got home, I started googling. I learned that the most common type of miscarriage is a blighted ovum (aka anembryonic pregnancy), which is when the body naturally stops developing the pregnancy because of a chromosomal defect either during fertilization or when the cells are dividing. I read about the diagnosis of a blighted ovum, and Wikipedia told me:
A pregnancy is anembryonic if a transvaginal ultrasound reveals a sac with a mean gestational sac diameter (MGD) greater than 13 mm and no yolk sac, or an MGD >18 mm with no embryo.
Since I distinctly remembered my sac diameter was nearly 60mm, I was immediately aware that my pregnancy wasn’t going to end with a Little Baby Osborn. In the back of my mind, I thought maybe we weren’t understanding the measurements and everything was going to be ok, but really, I knew it wasn’t. Somehow that data helped me make peace with the situation early on. I told Mark about my findings when he got home, and together we agreed that my second round of blood tests wouldn’t give us any hope. I thought about staying home and moping for a couple of days, but I had also read miscarriages can take weeks, so I couldn’t really put life on hold indefinitely. The following day, I went to work. I got a really nice, discreet email from my boss telling me I didn’t need to be there, I could take time off or work from home, but I told him this could go on for a long time and I wanted to just carry on for the time being.
On the way to to work Thursday morning, my cramps were at their worst – coming in waves like contractions every 3 minutes. They died off for a few hours, but in the afternoon felt bad again. I worried I’d go out of my mind if I had these cramps every 3 minutes for the next few weeks. I left work briefly in the morning for my followup blood test. It was quick – 15 minutes there, 10 minutes inside, 15 minutes back to the office, but with my cramps and (now heavy) bleeding, the test still felt like a waste of time.
Friday was better. There was still bleeding, but it had tapered slightly. The cramps were also more sporadic and less intense. By lunchtime, I hadn’t heard from the doctor’s office with my results. I knew what they’d say, but I called anyway. I left a message for the nurse, and she called me back about 15 minutes later. “When we took your blood on Tuesday, your HCG was [one thousand something]. By Thursday it was down to 680, so you are having a miscarriage.” I told her I knew as much, due to the increased bleeding and cramps. We discussed how much longer the bleeding might go on for (thankfully she thought by this point, it was probably only going to be a few more days. A good friend had a miscarriage early last year, and said she bled for a full two weeks before getting to its worst!). I then asked the nurse if it was ok to resume normal activities like “exercise and drinking… really I’m mostly curious about the drinking, but I didn’t want to sound like an alcoholic or anything. I just really want a margarita”. She laughed and said yes, I could do anything I wanted, as long as I was comfortable. That I should take care of myself, and do what I wanted.
Most of our close friends found out about our potential/likely miscarriage throughout the week. I chose to announce it to everyone else (including a bunch of people who had no idea I was ever pregnant) on Facebook. I had always told Mark that was my intent if I ever miscarried. I’ve always found it sad and unfortunate that something so common (at least 25% of all pregnancies end in miscarriage) is so hush-hush. I would hope that if I’m happy to share photos of my house, an announcement of my (hopeful) future birth, and so much else with these “friends”, I ought to be able to voice one of the saddest things I’ve been through so far. So I did. I told my internet world that I had been pregnant, that I was no longer pregnant, and that I felt lucky to have so many loved ones who supported me throughout the week. The subsequent outpouring of love from comments, messages and texts was both humbling and wonderful. Friends and family from San Diego to Switzerland to Australia reached out to offer support and thank me for talking about something that is usually silenced.
I’ve had a roller coaster of emotions this week. My grief has mostly given way to rational thought and an even stronger bond with Mark. I’d lie if I didn’t feel kind of cheated about the whole thing, especially since my mom had 5 healthy, uneventful pregnancies and none of my siblings or their spouses have had any miscarriages (another 5 healthy pregnancies, although one sibling did spend years trying to conceive before having a healthy little boy). I do, however, also feel lucky that things ended so soon. I would be 7 weeks pregnant now, which is next to nothing, considering you don’t even know you’re pregnant until week 4. I would rather a chromosomal issue present itself early and allow nature take its course then than to have miscarried later in pregnancy or worse yet for Mark and I to have to make a decision about whether or not to maintain a pregnancy with a major known birth defect. The three months we spent trying to conceive also made me aware of some potential hormonal imbalances, which could have affected the viability of my pregnancy a little further down the line. Now, I’ll be adamant about having my progesterone checked early, just in case. I know my miscarriage was likely an anomaly and totally unpreventable, but I plan to work with my doctor to take every possible route for a healthy, full term pregnancy next time.
For now, we are looking forward, not back. I’m letting my body heal, and by summer, we should be ready to start trying again. It does feel a little like 6 wasted months, and I would be lying if I didn’t say I wish we’d started back in October. Maybe that egg and that sperm would have been fine. Maybe I’d be halfway through a healthy pregnancy by now. But maybe not. Maybe it would’ve just been two more months trying unsuccessfully before getting pregnant in February and miscarrying in March. Thankfully, time is on our side, and I am confident we will get there in the end.