The Extraordinary Pain of an Ordinary Miscarriage
I carried two hearts inside of me, but only one was beating.
My husband put his mouth on my nipple, and it was so sensitive that I gasped. I knew then that when I had begged him silently to say no to using a condom and he had agreed, my body must have answered with, yes you will yes.
I took a test the next day and there it was: a faint second line. My husband didn’t believe it. He demanded I take another test, but he kept smiling. He didn’t stop smiling. A baby? How could it happen so easily? He whispered to me that night. A miracle, I wanted to answer, I maybe did answer.
But I was not excited. I dreaded it.
For four years, my body had not been not mine. After trying for two years to get pregnant and finally being successful after doing one round of IVF, I had been pregnant for nine months, and then breastfed/pumped for a year. I was now weaning as we were just a week away from my twins during one. My breasts swelled out of my size 36C bras (a marvel since I was a 34A before), lumpy, and leaking milk. I found oily stains inside of my bras whenever I undressed at night. My body hadn’t been mine for too long.
Babies will take whatever they need from you, give you early osteoporosis if you don’t consume enough calcium; they’ll suck it straight from your bones, so they can live.
I was not ready to give up my new freedom. Not yet.
I decided I was going to do this pregnancy naturally.
I hired a doula, a woman trained to assist women during a natural (non-medicated) childbirth. With her help, I chose an obstetrician that would allow me to do a VBAC (Vaginal Birth After C-section) and was supportive of natural birth positions (like being on all fours instead of lying on my back with my feet propped up). Tennessee has one of the highest rates of caesarean sections, emergency or scheduled, in the country. Most OBs in the area won’t even attempt VBACs, even though they can be successful 70% of the time.
A couple weeks into my pregnancy, I started spotting. I texted the doula, and she suggested I get checked out.
I called my fertility doctor, and they brought me in for a blood pregnancy test. Later that day, I got my results: my values were over 15,000. They only needed them to be 25 for me to be pregnant. Turned out that the pregnancy test looked wrong because I was “so” pregnant that the positive line needed to pull color from the control line. The doctor prescribed me progesterone suppositories and suggested I take them daily and schedule my first ultrasound.
And this was where my ego switched on, or maybe it was my desire for this pregnancy to be different, or maybe it was because I wanted this pregnancy to fulfill what the other one before hadn’t: to be normal. To be just a normal pregnant woman, to be someone who could get pregnant normally, easily, to not have to do the suppositories, to not have to see a fertility doctor, for my body to just do what it was fucking supposed to. It had conceived naturally when before it couldn’t, so couldn’t the rest work out? I didn’t want to take the progesterone suppositories, and so I didn’t most days.
When the ultrasound at the fertility doctor came around, I canceled it and scheduled one with my new OB instead. I couldn’t stand the idea of walking into the fertility clinic waiting room and seeing all of those women sitting in chairs, their eyes filled with both sadness and fury. I’d been there, how the desperation felt like a cloud of smoke that never left my lungs. I didn’t want to be in their ranks again; I was going to be normal.
The day before my ultrasound with my new OB, I start spotting again, so in a panic, I took three progesterone suppositories in one day.
At the appointment, we didn’t wait very long before the ultrasound technician called us back.
At seven weeks, the best way to see the fetus is through a transvaginal ultrasound, which involves a wand that looks like a dildo that they wrap with a long cover (read: large condom) and insert into the vagina.
I undressed from the waist down and sat in the lounge chair with my feet in the stirrups. She asked me to move down, and she pressed my thighs open and slipped the wand in. With some maneuvering, our baby popped onto the screen.
Situated in a black blob, the amniotic sac, our baby was a tiny fixture on the left. Not much of a baby; it didn’t even look human. I thought our twins had looked like gummy bears when they were this old, but the technician said it looked on track. While I was certain I should have been seven weeks, she said we were measuring at six.
We had a baby.
She found its heartbeat, beating away at 101 beats per minute. I could tell she wasn’t happy with this number with the way she pulled her lips down, but she didn’t say anything. I looked at it on the screen and felt my palms start sweating, my heart gallop. How the fuck am I going to handle another baby? I thought as I swallowed.
But just as quickly I thought, I don’t think this one will keep, but I shook the thought away.
I waited for my progesterone results, hoping they were high, hoping I could stop taking the progesterone suppositories. When they called with the results, they were 53. The doctor would have been happy with 10. I conveniently forgot that the numbers were probably so high because I had taken three suppositories (triple the dose) the day before my blood was drawn. I left the suppositories in the fridge, unused. I don’t need them. This is a normal pregnancy, I told myself every time I saw them.
I lied to myself so much and so often I believed it.
My husband and I arrived for our eleven week ultrasound and waited together.
“How are you feeling about it?” I asked him.
“What do you mean?”
“You think things will be okay?”
“Well, yeah. I think things will be perfect,” he told me.
I wanted to believe him, but I didn’t.
The same technician that did our first ultrasound opened the door and called for us. We followed her into the room, and I undressed from the waist down. She had me slide to the end of the chair and open my thighs. She slipped the transvaginal wand in and maneuvered it. I looked up at the monitor screen.
Within a few seconds, I saw the sac, a black blob, but I didn’t see a baby inside it. I specifically remembered seeing what grew to be my daughter waving her little hand at her ten week ultrasound, but here was nothing.
I heard the technician swallow.
“Is the sac empty?” I asked.
“Yes,” she said and immediately followed that with what sounded like an accusation, “Were you taking progesterone?”
I turned and looked at my husband who was staring at the screen, his hands cupped over his open mouth.
I told her no, that my values were so high, and she nodded, continuing to look at the screen.
I turned to my husband as he continued to look at the screen as I continued to not look at the screen.
“It looks like it’d stopped growing shortly after your last appointment, so around six or seven weeks,” she said and then she slipped the wand out. The image of the empty sac remained on the screen. “I’ll give you a few minutes while I get the doctor.”
She handed me a tissue to wipe the lube off from between my legs and left the room.
Alone, we cried. I don’t even remember if we spoke much, but I know that I said, “I had a feeling. I had a feeling it would happen.”
The doctor came in. I couldn’t stop looking at his eyebrows as we discussed the specifics and next steps. My body had what is called a “missed miscarriage.” The baby (or fetus as it was now being called) had stopped growing, but for weeks, the sac had been. My body had continued to believe it was pregnant, but my body was starting to realize nothing was there to support. My hcG levels were dropping, and so was my progesterone, but my body was stupid and slow. Most women have what’s called a “spontaneous abortion” just a week or two after the fetus stops growing, but the sac inside of me had been growing on its own for three to four weeks.
“It looks like you will miscarry soon, though,” the doctor said, pointing to the not quite oval shape of the sac on the monitor. “Looks like you will very soon.”
“Should I have a D&C?” I asked.
“It’s up to you, but I’d think you’ll miscarry naturally soon enough that we wouldn’t need to worry about putting you through a surgery.”
“What will it feel like?” I asked and just as suddenly realized how ridiculous it was to ask a man that question.
“Women have told me heavy cramps, but other women have told me it’s not like cramps at all. Every woman is different, but you’ll know. Once you’ve miscarried, let us know and we’ll check to make sure it’s all passed and discuss how we can get you pregnant again.”
I shivered when I heard him say “it’s all passed.” He’d made it an “it.” Our baby, I thought. When our dead baby has passed.
I texted my mother, who was watching our children so we could get to this appointment: “I’m miscarrying.”
“Are you at the hospital?”
“No, but the baby stopped growing weeks ago. I’ll miscarry.”
“Ok,” she texted back.
And when we got home, we put our twins in a wagon and got ready to take a walk with them around the block, and my mom tried to come with us, and I told her, “No. We want to walk alone. Thanks for watching them.”
And she left and she and I never spoke again about her neverborn grandchild.
That night, I disengaged myself from my husband’s embrace to take a bath. I’d been trying to assure myself by saying all the things I could do now: I could smoke! I could take a hot bath! I could eat deli meat! I could drink as much caffeine as I wanted!
I drew myself an excruciatingly hot bath. The baby had stopped growing at six or seven weeks, but I looked almost twelve weeks pregnant. I was not ready to see my body, but I did anyway.
I slipped into the hot hot bath, and I cupped the hollowness, the winged thing inside of me that would never move or breathe or know life outside the lightless cave of my own body, and I sobbed until the water was cold.
That night and the next day, contractions rolled through me, a wrenching weathering, an inward rutting, but I didn’t miscarry and the next day I didn’t miscarry and the day after that I didn’t miscarry.
I couldn’t stand the waiting because I couldn’t stand being a carrier of the dead, to have two hearts inside of me and only one be beating.
After three days had passed, I scheduled a D&C for Tuesday, October 10th, six days after we had learned our baby was dead.
Whenever I undressed, I didn’t look down. I put my clothes on by touch only and tried not to think about my clothing’s elastic waistbands and ruching, the things that allowed for expansion that would no longer happen.
My baby is dead, I told myself, and I believed. I will be okay, I told myself, and I didn’t believe.
When I checked in to the hospital, the front desk assistant asked me if I could be pregnant.
“Yes, of course. That’s why I’m here,” I told her flatly.
“I’m sorry,” she said. “I hadn’t read that far.”
And then, later:
“What procedure are you here for today?” asked the morning nurse, the nurse who checked my vitals and asked me if I had a living will, the billing officer, the phlebotomist, the orderly who came to wheel me down to the surgical waiting room, the anesthesiology nurse, the nurse assisting with surgery, and the anesthesiologist.
And each time, I replied, “D&C,” each time it losing a little more of its emotional connotation, until I was able to say it robotically, and when I read, “reason for surgery: spontaneous abortion” on my chart, I chose to close my eyes and turn away.
When they came to wheel me back to the surgery room, they gave me a moment to kiss my husband goodbye, which I did, letting my fingers linger on his jaw.
And I drifted under easily, not remembering much more than the lights overhead and the bustle of nurses around me before I was gone and away. And when I woke in recovery, my throat sore from the intubation, I woke up empty.