Trying again

After two miscarriages of three babies, two surgeries, and too many scans, we may well be ready to officially start trying once again. It’s been four months exactly since I had the devastating ultrasound that showed a perfect looking little guy with an inexplicable absence of life. My heart still aches, but it is not as acute. I still think about fertility, pregnancy and miscarriage every single day, but not for hours on end. And I’ve only cried perhaps a couple of times this last month. I try and convince myself that these four months have allowed me to heal somewhat, but I cannot help feeling somewhat cheated.

I’m lucky that I have had such a supportive husband. Although he sometimes struggles to understand the depths of my grief and preoccupation with what has happened and what the future holds, he has been incredible. I’ve been upset and withdrawn more often than not and for months on end. And he has at the same time dealt with his own grief. Support is so critical after a miscarriage, I cannot stress that enough. If you do not receive the support you need from family and friends, seek it from somewhere else.

My husband and I have yet to decide what to do with our little guys in my bedroom drawer and the kitchen freezer. In some ways I am loath to do anything that would see them leave me. In other ways, I know that my husband is right that we should look to honour and commemorate them. I think I’m now ready to face that. I’m thinking of getting a tattoo of three little birds, swallows, somewhere to provide a permanent reminder that they will always be loved.

What the heck is Asherman’s?

It was two months after my second surgery that I realized something was wrong. I hadn’t had a period, or anything resembling a period. I rang BEP (my obstetrician) and asked what might be causing this. He advised that it could be what I would later term “stubborn cervix syndrome” in that the cervix had reacted badly to the surgical procedure and remained tightly shut, or it could be hormonal, or there may be a few other explanations. He asked me to have a pelvic scan to rule out anything untoward, like Asherman’s Syndrome. I didn’t ask what Asherman’s Syndrome was.

The sonographer was pregnant I noticed. She was pleasant enough, and advised that she wanted to discuss what she had seen with the resident gynecologist. I waited for a few minutes and was then ushered into a separate room. They asked me to sit down. “We don’t really know what the situation is in your uterus, there are a few lumps that could be clots, and a lot of liquid that should be coming out but isn’t.” They seemed deliberately vague. It was a Friday afternoon, and my obstetrician rang and asked if I could please see him first thing on the Monday morning. Alarm bells were ringing. Once again I cried.

Don’t ever Google Asherman’s Syndrome. When I did it produced the most horrible results. Essentially, what was primarily discussed was a risk of the uterus scarring or even fusing together post-surgery, leading to a build up of blood inside the uterus and infertility. I totally flipped out when I read this.

BEP was great. He clearly saw the worry on my face. We read through the sonographer’s report line by line and he explained to me every aspect of it. “Asherman’s Sydrome covers such a broad range of conditions, from extreme to minor, that the term is effectively redundant,” he explained. “Thank God,” I thought, “hopefully we might fall into the minor category”. He suggested that he perform a procedure to dilate my cervix, and in the event that blood came out over the next few days and months that would indicate that there was no lasting issue, but rather a case of “stubborn cervix syndrome”.

It was certainly not glamorous and involved old-fashioned stirrups, but I didn’t care. The procedure appeared to be a success. A small amount of blood came out immediately. He prescribed me a contraceptive pill for a few months to “get things back on track”.

At my follow up scan, a different sonographer spent some time taking a variety of images. She advised that she wanted to discuss what she had seen with the resident gynecologist. I waited for a few minutes with my son, anxious as anything. The same gynecologist came into the room and said, “well it’s a different story today”. I didn’t know whether that was positive or not. “Is that a good thing or a bad thing?” I asked. “Good! Definitely good.” I think I had been holding my breath until that moment. What a massive relief. “There’s some blood remaining in your uterus but if I didn’t know your history I wouldn’t have thought twice about it. Compared to last time when it DEFINITELY WAS NOT NORMAL!” She mentioned something about “products of conception”. I was a bit taken aback at her forthrightness now that everything was seemingly OK. And this was the first time that anyone had suggested that perhaps some “products of conception” remained, that is, that the surgery had not been fully successful. I felt relieved, and confused, and sad.

The baseball bat of grief

We went to the driving range after our second miscarriage. With our son in tow, which in hindsight was perhaps not the best idea. It also transpires that the harder and more aggressively you try and hit a golf ball, the more likely it is to cascade off the roof of the driving range rather than fly effortlessly through the air. Still, I think it helped and none of us was injured.

Overnight it was as though the entire world became pregnant. I would scowl at pregnant women in the park (behind the safety of my sunglasses). I would cry privately when friend after friend would happily announce their pregnancy. It is a horrible feeling when you cannot give your friends the love and attention they deserve because you yourself are too consumed by your own feelings of sadness, grief and longing. I hated feeling that way. And it lasted a long time.

I watched as one of my colleagues became more and more pregnant until she left work, happy and excited. Ten minutes before her leaving lunch, I received a text from a friend advising of the arrival of her latest baby. He was born on the same date as our first baby had been due. I had to take myself away to the bathroom, lock myself in a cubicle with a tissue, and then promptly pull myself together. At the lunch another colleague joked, “so who’s going to have the next baby?!” In my mind I right hooked her pretty fiercely. In reality, I laughed awkwardly and said, “who knows?!”

Over the following months, I cried less and thought about babies / pregnancy / miscarriage less. I still thought about it many times a day and hated that. It preoccupied my mind and I couldn’t seem to do anything about it. I know now that it is simply a matter of time and these things have to be worked through and not rushed.

In early December I was knocked off my feet again. A friend told me, “it’s going to be much harder when number two comes along in May!” That was when our twins, or at least the one that was supposed to make it through, would have been born. I didn’t hear anything she said for quite a while after that, it was as though I was in one of those weird dreams where you are there but no-one realizes and you shout but no-one can hear you. I remember that I gave her a hug and a smile and nodded, and nodded, and nodded.

Today I’m wondering whether she thought I was strange, or rude, or whether she thought nothing of it at all. It wasn’t until I got home that I completely melted down and bawled in bed. I was disappointed in myself, but the experience made me realize that I had to expect similar reactions in the future. Grief can strike you at any time (and it may be with a whopping great baseball bat).

One of the worst days

My second surgical procedure to “evacuate my uterus” was one of the worst days of my life. There was something about the experience that felt like my baby was being forcibly removed from me against my will. I sobbed and sobbed and sobbed. The nurse was caring and kind, and referred to my baby as just that, instead of the insulting “products of conception” term used by the other medical professionals. When she handed me the misoprostol pill, there was a sense of defeat that came over me. The game was up. There was no more pretending that maybe the sonographer had simply been mistaken. I sobbed and sobbed and sobbed.

Along came the anesthetist. He was an angel for me that day. His voice was calm and his big hands held mine and said that I would get through this. He told my husband and me that his wife had several miscarriages, and they’d ended up with six children. Good grief. He told me that the next time he would see me would be at National Women’s to have our second baby, and it was a glimmer of hope that I grabbed (well, clawed at really) and clung onto tightly. I sobbed and sobbed and sobbed.

I sobbed when I was wheeled upstairs. I sobbed when I came to after the surgery. What a day. I was wheeled back downstairs and met by my husband. He had sat on something on the chair in our room. It was our baby. He was incensed. I think that I was too emotionally wrung out to become more upset than I already was.

We asked to see our obstetrician. He appeared in his suit and seemed anxious to leave. He told us that he believed that the operation had gone well and to “try and not get pregnant again for a couple of months. The statistics show that there’s a 60% chance that you’ll successfully conceive next time!” With that he gave a tap on my food tray as if to say “knock on wood”, spun on his heels and left. It was that moment that led me to nickname him the BEP, or “Beedy Eyed Peepus” (‘peepus’ being a term we’d made up to describe a similar sounding male appendage). I couldn’t believe his cold hearted and brutally factual approach to such a sensitive issue. And his bloody statistics. What the hell did he know about our chances of success next time? How did anyone know when miscarriage happens so regularly but is so poorly documented? I was so mad.

A second miscarriage

Having a second consecutive miscarriage was devastating. It’s hard to know where to start when describing what happened, or how it felt and continues to feel. Perhaps I will start with the ultrasound. We were nine weeks and four days pregnant.

At about seven and a half weeks we had seen a fuzzy little splodge on the black and white screen. The splodge had a heartbeat! We then discovered that we had conceived twins, but that only one twin had struggled through the first seven weeks. The surprise I felt when hearing about twins outweighed the sadness of learning that only one had survived. According to our obstetrician, there was a 95% chance that everything would be fine.

I explained to the sonographer, a kind middle-aged man with a gangly frame, an Irish accent and a white beard, that I was worried. In weeks six and seven I was ill. Nauseous. Bed ridden on some days. But at eight weeks the nausea vanished. It was like some cruel magic trick. It’s hard to imagine any other scenario where you will yourself to feel unwell, but I did. The worry began to consume me and I wished I had booked an ultrasound sooner than the two-week wait. My sister and the few friends that knew assured me that it would be fine, “let us know how it goes” they asked.

“It seems that your premonition was right”, the sonographer said. He sighed. He didn’t smile. I didn’t want to hear these words. I looked at the screen. There was a perfect little guy peering back at me. His head, back, hands and legs were all forming just like the phone apps told me that he would be forming. But there was no fuzzy spot where his heartbeat should have been. It didn’t seem to make sense. How could I be seeing a perfect little guy, when he wasn’t alive. The sonographer said he was sorry. He said he measured about nine weeks five days, a day older than we had expected. But dead. He asked what I wanted to do, did I want to wait for the report or just go? I asked what the report would say, wasn’t it obvious? He nodded, and said the report would say, “nothing much I’m afraid”.

I passed through the waiting room. I knew my face would be blotchy, my eyes soaked in tears. I looked at each of the patients sitting in the room, wondering what their stories were. If they would go on to have wonderful pregnancies, if they shared my fears. I bumbled my way through the glass doors with my son strapped in the pram. I kept my eyes down as we turned the corridor to the bathroom. We went inside, I sat down, put my head in my hands and just bawled. My son, at 18 months, laughed. He hadn’t heard this noise before and thought his mama was being silly. I offered him a weak smile, “sorry sweetie” I said, “let’s get you out of here”.

In the car I rang my husband. I couldn’t talk coherently, and was sobbing. My husband was in a busy café. “What are you saying? Sorry I can’t hear anything you are saying? Did it go alright?” It was a disaster. He pieced things together. I knew I probably shouldn’t drive, but I drove the five or so minutes into the central city and picked him up from work. It was a tough day.

I messaged my friends, in between bouts of sobbing on the couch and pestering my husband to fetch me the tissues from the kitchen bench. I went to bed and sobbed there. My husband cried as well. He complained that it wasn’t fair. Of course it wasn’t. Bizarrely two other friends had miscarriages that same week.

Miscarriage Club

Over the months I would come to tell many of my friends about my miscarriage, usually right at the end of a catch-up after repeatedly wanting to talk about it but then losing confidence. Everything always seemed better after I had spilled my secret. And slowly, I began to learn that many of my friends had also experienced miscarriages. One of my friends had three miscarriages before her first child was born. When I told her what had happened she wisely advised me to take care of myself. Another friend told me that her colleague has experienced seven miscarriages before her first child. Seven! “What an amazing and strong woman!” I thought to myself. God, I hope that doesn’t happen to me, I don’t know if I would have that strength to keep trying.

One of my friends came out with news of a miscarriage seemingly out of the blue. I emailed her to ask how she was and her response was stark. “We had a miscarriage in March, fair to say I’m in a pretty dark place.” “Wow,” I thought. “It takes guts to email something like that.” It was evident that it occupied her mind. I realized that I needed to call her, and we talked for an hour or so that evening. She cried for most of that hour. At the time I think I was slightly taken aback that someone seemingly so strong would remain so affected by the miscarriage that had taken place three months earlier. In hindsight, I know exactly how she feels.

She told me that she’d begun bleeding late in the first trimester and had miscarried in her toilet at home. Her partner was at work at the time. “The indignity of it all,” I thought, “this must happen to so, so many women.” I was angry. At that moment I was also glad that I had been in a hospital bed, and that our little guy was sitting in a jar in my clothes drawer, rather than being lost down a toilet without that chance to say goodbye to him thoughtfully. It still bothers me.

One day several months later I sat opposite a friend at a café and sort of babbled out that we’d experienced a miscarriage but hoped to have a second baby. That was all it took for her to blurt out that she’d recently had a miscarriage, at around seven weeks, and had been rushed to hospital with the pain and bleeding. She hadn’t told anyone. I could feel the relief in her voice that she’d finally told someone. And it was a hugely cathartic experience for both of us to compare notes, so to speak.

We both realized that we’d become obsessive over becoming pregnant. We’d be monitoring every little detail of our monthly cycles trying to figure out when was a good time to try and conceive. We tried to tell each other to relax. How ridiculous. You spend decades of your life desperately trying not to get pregnant and then all of a sudden you want to get pregnant but don’t really understand how your own body works. The more I think about this, the more I think that it might be empowering for women to learn about issues such as fertility, conception and miscarriage at an earlier age.

Perhaps my most disappointing experience was when one of my good friends told me of her pregnancy and due date. I explained what I had experienced. She expressed momentary concern, but then clearly became awkward and uncomfortable and changed the topic. She has never mentioned it again. I still wonder why that is.

My first miscarriage

With my first son I was naïve. I thought miscarriage was something that would be more likely to affect woman who were older, women that smoked, overweight women, or unfit women. At twenty-nine I suppose I could not call myself a young mother, but I was certainly not an old mother in today’s terms. I had been put off cigarettes at an early age, courtesy of my mother who smoked in the car leaving me dizzy and sick. I was fit, really fit now I look back on my running, footballing, gym-ing self. I was thin but thanks to a recent holiday swamped in cheese and wine in France, not too thin.

So when I became pregnant for the first time I gave only a moment’s thought to the possibility of miscarriage. I had read that miscarriage affects twenty percent of pregnancies, but not even that led me to believe that it may happen to me. And after my twelve week scan, where everything was confirmed to be “just fine”, I presumed that was it – everything would be fine. And it was.

It was when Blake was nine months old that I sensed that I might be pregnant again. A pregnancy test confirmed it. I had mixed feelings about the pregnancy. I was anxious about the possibility of having a second child so close in age to Blake. It seemed we had barely begun to enjoy life with a baby and our sleep was broken. It was late February and I was due to start work at the beginning of April, I’d have to tell my new boss about my pregnancy within a couple of weeks of starting and that made me feel guilty, and nervous.

But as they days wore on I began looking forward to a second addition to the family. I let my mind wander. What would the new baby’s room look like? Did we need to buy anything new for our little one? It would be hectic at Christmas with four under fours at my mother’s house. We could do this; it’d be crazy but we’d be fine.

I first began spotting at around six weeks. It was so light that I convinced myself that it was no big deal, even though alarm bells were faintly sounding in the back of my mind. I did what I’m sure everyone does – I Google-d it. The consensus on all various forums was “if it’s light brown spotting and not heavy, you’ll probably be fine.” I selectively ignored the comments that said there’s a fifty percent chance that spotting will end in a miscarriage. I’ve since decided to ignore statistics about miscarriage, to me they are meaningless.

Eventually, I went to see a doctor. I first had a scan. The sonographer said that it was too early to tell whether there was a viable embryo, but there was a sac that looked normal. She said, “you might miscarry in the next couple of weeks” without so much as a blink of an eyelid. She was cold and factual, and heartless. I had tests over a number of days to ascertain the HcG levels in my blood. Everything looked great. My doctor even joked that I might be having twins there was such great leaps in the HcG readings from day to day. And at eight weeks, the spotting stopped.

In the meantime, I was ill. I only found out more recently that even if the embryo is a non-starter you might still feel sick as anything, as other aspects of the pregnancy can continue to develop, like the placenta.

It was my husband’s birthday when I went to visit the obstetrician. 11.5 weeks. I will never again schedule a scan on a birthday or anniversary. I readied myself for the possibility that our little embryo had died, but I didn’t really believe it. The obstetrician invited me to undertake a scan, which I did. On the screen there was just nothing. A sac, but nothing else to see. I can still remember the image so vividly. A gaping hole where I so desperately wanted to see something squirming. “this is what we call a non-starter, I’m afraid”, the obstetrician said with a long sigh. I didn’t cry. The obstetrician asked if I was ok, “yes, it’s ok, I know these things happen for no apparent reason.”

The obstetrician advised that I had a few options. I could wait to miscarry naturally. I could take a pill and that would “hurry things up”, or I could opt for a surgical procedure or “evacuation of uterus” as the forms clumsily described. I opted for the surgical procedure. I didn’t want to miscarry at only my third week back at work.

I arrived home. I didn’t cry. My husband was more upset than I was. I was just a bit numb really, and I think that I had been building myself up for the likelihood of a miscarriage for weeks, so perhaps I had began to grieve weeks ago.

The day of the procedure, I was feeling probably like anyone would: anxious, uncertain. I’m really glad I had an operation. It was a lot easier than waiting and fearing what might be. That moment I miscarried could have been at work, in the car, in the supermarket, in bed. Who knows what the hell I would have done if I experienced a miscarriage sitting at my open plan desk at work. I am glad that it was in a hospital.

The operation itself was fine. I began counting down from ten for the anesthetist. The next thing I asked was whether I’d had the surgery yet? “Yes, yes you have,” laughed the nurse. A few hours were spent lying with a magazine watching football on the television, then I was discharged. It was when I opened the door to our home that I was overcome with intense and sudden explosion of grief. I cried uncontrollably as I ran down the hallway to grab my one-year-old son. I held him tight. My mother in law looked uncomfortable. I took myself into bed and hid under the covers and slept.

Today I continue to debate in my mind whether we’d be having a boy or a girl. I change my mind, but usually it comes back to a boy.