Tuesday, 26 July 2016

A Missed Miscarriage

I had hoped that today I would be sharing some happy news on this blog. First thing this morning I was supposed to be going to the hospital for a twelve week scan, a first look at our third baby. But sadly that appointment had to be cancelled.


I’ve been wondering whether to write about this on the blog or not. A miscarriage early on is a complex thing to grieve for. As a biologist I know that technically there never was a baby, just an embryo. So can I say my baby died, when it never fully lived? Yet of course I do grieve for it, or the idea of it at least.  I also don’t deal well with being on the receiving end of sympathy, like compliments it flusters me. Does a blog post risk seeking that out?


But then I share or perhaps over share so much on here that it feels odd not to talk about it and for me, writing things down, doing my best to form them into some kind of narrative, is often therapeutic. Miscarriage still seems to be something people don’t really talk about. Perhaps that in itself is a reason to write about it? It is such a common, ordinary thing, something I know many people reading this have also been through. Would it make the whole sad, lonely process a little easier if we could all be open about it?


I don’t really have any answers right now. But I’m going to share something I wrote on July 16th, the day after my “Surgical Management of Miscarriage” operation. I’m also sending out love to all those who have had similar experiences, whether I know you or not, whether you told me or not. The telling of the story isn’t the important part, this is just my own reaction to events, everyone else’s will be different.


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There never really was a baby. So I can’t say I lost it, or that it died. There was a bunch of cells, perhaps some tentative, primitive form. But it’s heart probably never made a first beat, it’s brain never sparked a first thought. It hovered for a few, hope filled weeks on the blurry brink of life and then simply faded. Until all that was left was some indistinct grey pixels in a black void on an ultrasound screen.


Yesterday the surgeon, nurses and anaesthetist brought to an end that which nature had long since given up on but couldn’t or wouldn’t let go.


I’ve had three pregnancies and they have all ended in an operating theatre. The first surgery was a terrifying emergency, the second calm and joyful, but with both of those I went home with a healthy baby girl in my arms. Yesterday I was processed, slowly but kindly, from a waiting area, through forms and tick boxes into theatre and then woke up, not long after, in my designated recovery bay. But this time I was alone. These was no baby in my heavy arms and nothing was left in my womb where it had tried to grow. It was quick, efficient and, after two weeks of waiting and worrying, it was over. I was glad of that but I wished these arms of mine weren’t so heavy. I couldn’t lift them to wipe away the tears that finally came.


It is one of those great dreads of early pregnancy, the blank ultrasound, a “missed miscarriage” an “early embryonic demise”. This pregnancy had taken far longer to begin than the others and so I had paid for an early scan at eight weeks. I had a day off work anyway and I thought it would help set my pestering worries aside, that I could treat myself to a first look at our new baby. But in the smart third floor office of a Georgian town house the big flatscreen TV on the wall showed only a black hole. A small, almost empty gestational sac, no obvious baby, no flickering heartbeat.


The next morning I sat on the floor in a hospital corridor with all the other women who were tired and worried and waiting for the early pregnancy unit to open. When my turn came the scan showed just the same. But biology always evades direct questions. Perhaps, just perhaps, it wasn’t eight weeks afterall. A few days here, another few there, a test showing a little pink line a bit earlier than it should have. Perhaps, at a pinch, it was just too soon to see that flicker of a heart? The doctor said it might all be fine, I should come back in two weeks.


But I did the maths over and over again. The dates on the app that tracked my periods, the date of the tests and how early that little pink line should be possible. I tried to find hope but I also pressed a sanitary towel into my underwear when I went to work and closed my eyes for a second whenever I went to the loo, please, no blood.


At the next scan, after those two long weeks,  they didn’t show me the screen. The doctor, who seemed to be new to the department or perhaps just quite junior, didn’t want to make the call either way. There was something in the sac, strange and amorphous, but there. Yet still no heartbeat. She called for her senior consultant and I lay there, torn between hope that perhaps my maths was just rubbish and the tiny creature inside me was growing after all and the dread of more uncertainty, of another long wait.


But the consultant knew that the blob would never be anything more. It must be horrible to break that news to women over and over again. Or perhaps it stops bothering you after a while but either way she did it with kindness and certainty.


So, ten weeks into the pregnancy, I knew there would be no baby. She/he was a fantasy based on a bundle of doomed cells and the hormones still thundering through my body. The hormones that had forced me to spend the evening of my birthday layed flat on my bed as they world span sickeningly every time I tried to stand up. The hormones that made me ache to the bones with tiredness and gave me bouts of nausea only controlled by the eating that had piled pounds on my belly already. All the things I had happily accepted, believing they were good signs of a healthy pregnancy.


But signs can be misleading. I would not now have a little rounded belly when I took Miss E to her new school in September, I wouldn’t be stopping work at Christmas. I would instead have to choose from three unwanted options. Let nature eventually take it’s course, who knows when and how, take drugs to hopefully speed that up or end another pregnancy in surgery. I chose the surgery. It was at least the quickest and most certain option. But it meant a general anaesthetic, something that terrifies me. I signed the forms and went home to make arrangements.


Perhaps being a biologist helps in all this. I know miscarriages are common. That a random mismanagement of chromosomes is probably to blame and that, as far as nature is concerned, I am well past my reproductive prime anyway. I know that technically what grew in my belly never even achieved the status of “fetus”, nevermind baby and that wiser people than I have argued forever over whether something that tentative is actually alive.


I also know that, for me, it would have been worse to see that empty sack  at the 12 week scan. To have suddenly, unexpectedly started bleeding and cramping or to have lost an older, more tangible baby.
But for now, I will sit on my bed while the house is quiet. With my surgical stockings and my painkillers and write this all down. That baby will never grow in my belly or come home in my arms. It’s almost life will matter not one jot to the world and I will carry on, just hugging my girls a little tighter.

But I will grieve for the baby that could have been. Even scientists know that biology isn’t everything. That a dream can be more than the genes and cells and almost life it is based on. So perhaps it doesn’t matter that there never really was a baby. There was love and hope and they are real enough. I will cling to them and send them drifting out to the stars. To them we are all just brief moments, just flickering bundles of cells and barely tangible life.

SBx