This is the story of the loss of my first pregnancy. It’s an honest and fully open recount as it unfolded, and I go into quite a bit of detail of the physical and emotional things I experienced while going through pregnancy loss.
To be honest, I’m not sure why I’m writing this; if it’s more for me or more for you (does it matter?)
I thought of writing this story for a long time, but was unsure of sharing it as I didn’t want to make it all about me or my grief. So many of us go through similar losses… In the end, I found myself writing these words both to help me process it all, and also in the hope it might help others as they go through the muddy and painful waters of pregnancy loss. I remember it helped me reading others’ stories, helping me prepare for the things I might experience and feel, and giving me hope that I too would brave and survive what was happening to me, Robin (my husband), and our baby.
I also decided to write it all in the hope of helping to break the stigma and the silence around pregnancy loss.
I was just over 8 weeks pregnant when we heard the words ‘Oh I’m sorry, Sara…’ I remember hearing Robin desperately sighing, exhaling after weeks of holding his breath in. In that split second, I also remember not fully understanding why he was sighing and why the sonographer in front of me was apologising. Then the words ‘I can’t find a heartbeat’ followed, and I understood why. To my surprise, my brain turned to the rationale in it all and I asked what the odds were of a “false negative” (very, very small), especially as minutes before we’d been told our baby was the expected size for the gestational period. Now I know it wasn’t just logic trying to explain what my heart couldn’t comprehend. It was hope. I remember I didn’t cry that night. I felt numb, and in a way not surprised as from the start I had felt things weren’t quite right.
It took both me and Robin a while to integrate the news we’d just been told. It had been such a long and winding road already… We found out I was pregnant at 5 weeks, in turbulent circumstances. I had had what I thought was a normal period (although slightly lighter than my usual, but definitely not what I had seen and read about implantation bleeding), except that it lasted for longer than usual and with clots/tissue. On the 7th day I started feeling some shoulder pain, and knowing that this could be a symptom of an ectopic pregnancy together with bleeding, I came home and decided to do a pregnancy test “just in case”, as an ectopic pregnancy is not something to play with.
Sitting in my bathroom I watched speechless as the second line started appearing on my home pregnancy test. Stunned, I left the bathroom holding that stick to find Robin and uttered the words ‘I’m really sorry this is how you’re finding out… but I’m pregnant, and I think I need to call NHS24’.
After speaking to the lady on the other side of the phone, I was urged to head to the A&E immediately and to take Robin with me as I wasn’t to be left alone. Many hours, a couple of urine tests, a blood test and two consultations with a doctor later, we were told that they didn’t think I was having an ectopic pregnancy (thought they couldn’t exclude it yet) but that given the bleeding I had experienced before it was likely I was having a miscarriage. We were to return home and await a call the next morning asking us to go back in for another blood test and possibly a scan.
That night we both laid on our bed looking at the ceiling, unsure as to how to react to the happiness that – after more than a year of wishing for our baby – they were finally here within me, together with the concern and uncertainty that we might not get to share their presence for much longer.
The next morning we sat waiting for that call that didn’t come, so after 1pm I decided to call them myself. The nurse on the phone explained that they wouldn’t do a scan just yet as it was too early to see anything, but that they’d like me to go back in for another test to see how my hCG levels were developing (or not as the case may be). The following day, as we sat in that observation room, it was explained to us that with that test they were looking to see if my hCG levels were increasing at the expected rate (doubling every 48h), if they were increasing but at a slower rate (signalling a possible ectopic pregnancy), or decreasing (signalling a miscarriage). It was obvious to both me and Robin that the nurse was convinced I was having a miscarriage.
We were sent home to wait for the results which we could expect in the next 4 hours or so. As we walked through the park that connects the hospital and our home, I remember telling Robin that I didn’t believe the nurse. That I was pregnant and it was developing. My intuition was telling me so.
When the same nurse called us back to share the results, she admitted she was surprised to see that my hCG levels had doubled in less than 48h, and that they’d like me to go in to try a scan to understand what was happening. Back in the hospital, an abdominal scan was attempted which – as expected – didn’t show anything, so I was offered a transvaginal scan which I accepted. And there it was… Our sesame seed baby. With the expected size and in the right place in my womb. ‘Congratulations, you have a viable pregnancy!’ In disbelief, I asked to be left alone with Robin in the room for a few minutes so we could react to these wonderful, happy news in private and let the tears roll down our faces in privacy.
The next few days we started entertaining thoughts of our life to come with our baby, how we’d tell the grandparents, etc. I remember telling Robin and our doula (yes, I had a doula even before I knew I was pregnant!) that I still couldn’t believe it was happening. It didn’t feel real. After all, the year of longing for a baby had taught me to shield my heart.
But the happiness and excitement were soon to be re-joined by concern and apprehension. I started bleeding again. Some spotting each day, sometimes at various points of the day. I was assured that some bleeding was normal and not by itself a sign that something was wrong. But I couldn’t shake the feeling that something wasn’t right.
As the days went by and the bleeding didn’t stop, that feeling wouldn’t go away, and at 8 weeks of pregnancy Robin and I decided to book a private scan (me… who personally am not very keen on multiple scans and was already feeling uneasy with the number of tests, prods and scans we’d had already). But that feeling wouldn’t leave me and I’d rather know if it was all in my head.
It wasn’t. Our baby had no heartbeat. Our baby was still in me and incarnate, but had already left us and we didn’t even know when.
After that scan, we were to call the Pregnancy Support Centre (the unit dedicated to early pregnancy support) at our local hospital and communicate the diagnosis the private sonographer had written on a piece of paper inside the envelope we were given, together with the print of that scan (which we’d ask for). ‘Missed miscarriage’. There is so much wrong with those two words put together, I feel. The word miscarriage is difficult enough. It implies that I failed to carry my baby. It’s full of guilt and shame. And not only that but it was ‘missed’, implying that I failed to notice that my baby had died. More guilt and more shame. I wish we paid more attention to words in maternity care…
I remember calling my mother the next day, who until then had been oblivious of my pregnancy as we had planned to share the news with the family at a joint birthday celebration for both my mum and Robin. I hadn’t cried much until then. When she picked up the phone, the tears erupted, and I could barely speak the words ‘Mum… I’ve lost a baby’ (there we are again with not the best words to describe it all).
The Pregnancy Support Centre advised that the protocol in these circumstances was to wait another week for me to miscarry naturally and, if that hadn’t happened by then, they’d offer me to come in for a final confirmation scan and to discuss my options.
A week came and a week went past. The longest purgatory that was the sour cherry on top of the limbo we had already been living since day one. A week of grief and hope all mixed together. Knowing that the chances of a miracle were incredibly small and yet not being able to dismiss that ember of wishful thinking.
And so, we went into our final confirmation scan. The same sonographer that saw us the very first time and pronounced the words ‘Congratulations, you have a viable pregnancy!’ was the one to say ‘I’m sorry. I can’t find a heartbeat and I’m afraid your baby hasn’t grown in the last week’. Once again Robin and I were left alone to react to the news in private. In the same room. Like a weird dark mirror-like ironic poetry.
We were then taken to a different room to discuss our options which came down to three; go back home and keep waiting for a natural miscarriage, have a ‘medical management of miscarriage’ (meaning taking medication to bring on the miscarriage), or to have a surgical removal of my pregnancy (called a D&C, Dillation & Curetage). The head nurse who was having these discussions with us took all the time to answer my (many) questions. I wanted to know the implications of all the options, what they involved, studies, etc. After hearing her answers and information, and asking for a few minutes to discuss our options with Robin, we opted for a medical management of miscarriage. It was the right decision for us as the purgatory we were living in was only adding more to how hard each day that went past was, and we needed to close this chapter so we could heal and move on.
I was given the various medications that are offered as part of a medical management of miscarriage (anti-sickness to deal with the side effects of misoprostol, misoprostol to trigger the miscarriage, and dihydrocodeine for managing the pain). I explained to the nurse my intention was not to use pain medication as I personally am not very keen on medication. I was recommended to take it home with me “just in case”. It was also described to me what to expect (heavy bleeding and quite a lot of pain).
The next morning I took the medication as prescribed. First the sublingual anti-sickness medication that tasted like chalk and made my jaw hurt whilst waiting for it to dissolve. Then the first dose of misoprostol. I killed time by watching a movie (I chose Mona Lisa Smile, no idea why), occasionally standing up to walk or slow dance around the living room, trying to let my body know that it was okay to let go. 3.5h later nothing was happening, and so I decided to have a wee nap. I remember not fully falling asleep, more like dozing off, whilst having this feeling of rhythmic period-like cramps. Things were starting, I knew that. I was to expect the miscarriage to happen within 4h of taking the first dose of misoprostol, and if that hadn’t happened I was to take the second dose. It turns out my body was just taking its own time to let go of our baby.
I got up from my nap to got to the toilet, now with the cramps starting to feel more intense. It wasn’t a pleasant visit to the toilet as the misoprostol really played a trick on my digestive system. And then I just sat for about one and a half hours on the toilet, hugging one of those microwavable warm seed bag, in candlelight because any brighter lights felt too intense, harsh and uncomfortable. I could feel each intense wave coming on and I started making the same sounds I witness women make in birth. This was familiar and in a way that brought me comfort. I knew I could face this too.
I then felt this strong instinct to go on all fours on the floor of the bathroom, and to move my pelvis in circular motions. That seemed to help it all. Robin joined me on the other side of the door (I didn’t want company before), and knowing that he was there was comforting too. I was sick and I somehow knew the end was near. After that I asked Robin to come in, gestured for him to put something under me as the floor felt really cold. And rested my head on his lap, whilst he rubbed my lower back. Out of the blue, Robin started singing to me, and that was it. All the emotions that hadn’t been released in the week that preluded that moment came bubbling and stumbling in and I cried loudly and deeply. I think I remember Robin crying too…
And then it was all over. I stood up and went to lean over the banister of our stairs, and asked Robin to put on the soundtrack to Across the Universe (again, no idea why). And I sang. I sang openly and loudly. And it was over. I didn’t feel unwell anymore, and I was really hungry.
Robin cooked us a comforting dinner, and after eating it I curled up on the sofa and fell fast asleep for many, many hours.
I didn’t bleed nearly as much as I was told to expect, and I mostly passed clots, so I later got in touch with the Pregnancy Support Centre again to enquire if that was normal too. I was asked to come in for (yet another) scan to ensure all ‘products of conception’ had been ‘expulsed’ (seriously, we really do need to look at the language of these things!). They had. I was no longer pregnant, and there was an image in front of me of my healthy yet empty womb to seal it all.
The following days, weeks and months are difficult to explain. We felt very many conflicting emotions. We felt desperately sad. We felt afraid of trying for a baby again at the same time that we felt like we couldn’t wait. We felt relief that we were no longer in the limbo we had been for 4+ weeks. We felt numb. We felt acceptance. And, ultimately, we felt peace.
I honestly believe that speaking openly about it with our family and close friends helped us immensely. We didn’t keep it a taboo and that opened up the doors for people who love us to offer support in the form of words, a friendly ear to listen, nourishing meals delivered to our home. Our families would frequently check in on us, whilst respecting our space too, and so would our friends, giving us time to process and grieve whilst ensuring we knew they were there should we need them. No one tried to “fix it” for us, and I’m forever grateful for that. There was nothing to fix. We weren’t broken or made of glass. We were bruised and needed time and rest to heal.
I also believe that knowing the statistics around early pregnancy loss helped us immensely. Knowing that it’s far more common than we speak about (1 in 4 pregnancies), and that it doesn’t happen because of something that the pregnant person did or didn’t do, but often due to chromosomal or development issues with the baby, helped me to put things into perspective. In a twisted way, I came out the other end more certain that my body is healthy and knows what it’s doing than I did before.
I will never forget the words my good friend and doula said to me the morning after my miscarriage. ‘Have you birthed yet?’ And there it was. Recognised and seen for what it was – I had birthed our 8 weeks’ old, sleeping baby. And they will never, ever be forgotten.
Together with Sara my husband, Zak, and I had a couple of antenatal sessions to talk through our hopes for the birth and discuss any preferences. We decided that no intervention was entirely off the table and instead ranked several possible options in order of desirability. Although we would have agreed if medically necessary, I was especially keen to try and avoid the lengthy recovery time often associated with caesarean section surgery. As signposted by Sara we educated ourselves and found attending Positive Birth Edinburgh’s monthly online discussion group especially useful and informative.
In response to the coronavirus pandemic our health board had implemented a one support person only policy. I did not want to deny Zak the chance to witness the birth of his first child, yet I very much wanted the skilled support of a trained doula in the room too! I petitioned the health board to consider an exception to this rule and Sara was able to advise who to contact and we discussed how best to make a strong case. Thankfully, and I will always be extremely grateful for their decision, NHS Lothian granted our request.