My First Pregnancy
I was so nervous the moment the realization popped into my head that it might be a good idea to take a pregnancy test. Something had to be to blame for my wild mood swings and general anger towards the entire world. It was not even two minutes after I suggested this to my husband that we were halfway to Walgreens. Thirty minutes later, the results were in: I was indeed pregnant. We hadn't planned this, and we were both shocked at just how excited this news made us. I was already at six weeks according to some online pregnancy calculators. My husband and I discussed when would be a good time to start telling family and friends about our little surprise. We waited a week before telling our parents and two for friends. I thought it would be too long to wait until the traditional time of 12-13 weeks to announce our pregnancy. There was no way I could contain myself for that long.
The First Signs
All pregnancies are different. Women have different symptoms that manifest at different times and to different degrees. I spotted here and there the first eight weeks. Everything I had read and what my midwife had told me indicated that this was normal and common- nothing to be worried about. Around nine weeks, my boobs stopped feeling sore and I could sleep comfortably again. I started feeling good. I thought I must have been leaving all of my first trimester symptoms a little early and considered myself lucky. I almost felt as though I wasn't even pregnant anymore. Then, at 11 weeks, my stomach suddenly looked big! I had been waiting for any inkling of a baby bump to show up and here it was! My skin was tight and felt so full. I knew it was still early for it to be a true baby bump and that it was likely just bloating that was causing the uncomfortable stretch in my belly.
The following evening, I went to the bathroom and saw bright red blood. This was very different from the spotting I had experienced during the first several weeks of my pregnancy. It was more like an actual period flow. I estimated that it was enough blood to soak about two panty liners. I felt panicked at the sight of this. I called both my mother-in-law and my own mother only to discover that neither of them and experienced anything like what I was describing with any of their pregnancies. Off to the ER we went.
hCG Levels and Ultrasound Results
When we checked into the ER that night, the nurse at the counter asked me if I was passing clots. No clots. What about cramping? No cramps either. How many pads had I soaked? Maybe one or two panty liners, tops. These questions put me at ease. If I wasn't cramping or passing clots or even bleeding enough to soak a whole pad, everything was probably OK, right? Plus, I was right on the cusp of the second trimester when the risk of miscarriage drops substantially.
After a 45 minute wait, my husband and I were led into our room. The nurse asked me a bunch of questions about how far along I was, what prompted the visit, and had I been for a check-up or ultrasound yet. My first prenatal visit was scheduled for Monday, just four days away. The bleeding had stopped by the time I was in the room answering questions and being prepped for a blood test. They drew blood, took a urine sample and preformed both an abdominal and vaginal ultrasound. All of this took a very long time. We spent nearly five hours at the hospital altogether. The results of my blood test showed my hCG levels at around 15,000. The important thing to remember about hCG levels is that they vary wildly from woman to woman after a certain point in the pregnancy. Doctors will not (and should not) diagnose anything based solely on hCG levels. With that being said, my levels were consistent with someone closer to five weeks pregnant- not 11 weeks. I did not get the specific hCG information until after my visit when my full lab results were available in my online account. Be sure to ask your doctor for this specific information if you find yourself in a similar situation.
While the ultrasounds were performed, I could not see the screen. I knew I should have been able to see a baby at 11 weeks, but I did not ask to see anything. Part of me was too scared. After the vaginal ultrasound, I went to the bathroom to clean myself up and that's when I saw a clot of blood. This was the moment I felt like everything was over. I knew there was no healthy baby. After my two ultrasounds, the doctor finally came in to talk with me and my husband. She first asked me how I knew I was at 11 weeks. I told her that was based on the date of my last period but had not had an official prenatal visit to determine the exact gestational age yet. She told me they could see the sac that would eventually become the amniotic sac and that my uterus was enlarged, but that there was no baby showing up. It was the worst thing I'd ever heard anyone say. The doctor told me that I could be mistaken in how far along I was and that it was common earlier on to not see anything but the sac. Then she said I could have already miscarried. I asked how that could be if I hadn't passed anything but a small amount of blood. She literally shrugged her shoulders. Then, she said the baby could have implanted somewhere it shouldn't have and they just couldn't see it. There was no way for her to give me a definite answer that night. She then proceeded to tell me that if it was a miscarriage, that there was nothing I did to bring it on and nothing I could have done to prevent it. I think all doctors say this to patients learning that they are miscarrying.
I was to return in 2-3 days for another blood test and ultrasound to get a firm diagnosis.
An Emotional Roller Coaster
I did not bleed or cramp at all between that first ER visit and my follow-up visit. I read everything I could get my hands on about hCG levels and misdiagnosed miscarriages. I came up with several scenarios that could mean that there was a healthy baby growing inside of me. I went back and forth between bouts of tears and feelings of hope. It was like I was trying to will the baby back into existence. Hundreds of doctors have been wrong about what appears to be a failed pregnancy. There are so many stories of women being told there was no baby only to find a happy healthy little booger two weeks later. I wanted this to be the case so badly, but somewhere inside I knew it wasn't.
My follow-up visit gave us a clear result: my hCG levels had fallen from 15,000 to 12,000 and the ultrasounds confirmed what the first ones showed. I was diagnosed with a failed early pregnancy. In a healthy pregnancy, hCG levels should roughly double every 2-3 days and an ultrasound should show a gold sac and a fetal pole by 11 weeks. A falling hCG level and the absence of a yolk sac and fatal pole on multiple ultrasounds gave a very clear answer to the question. I was devastated. How could this happen to me? None of the women in my family or my husband's family had experienced a miscarriage. I felt broken. It was at this point that my husband broke down and cried. The reality was hitting him there, in the hospital. He later told me that this was the most difficult thing he had ever experienced.
The doctor told me there were a couple of options for managing the miscarriage. Everything would need to pass and I could either allow it to happen naturally, or take some kind of medication to speed up the process. I was never offered a D&C. The medication would have been two rounds: the first inserted vaginally then followed by an oral pill. I chose to let everything pass naturally. I am not a fan of Western medicine in general and I usually opt for the most natural route when possible. Also, there may have been some part of me that thought there might be some chance that they were all wrong. I would just wait and see.
Breaking the News
The reason many women decide to wait to announce a pregnancy is to avoid having to tell everyone about a miscarriage should it happen. I did not wait until the traditional 12-13 weeks to announce because I thought I would want to talk about my pregnancy and any potential complications. Miscarriage is really difficult and I believe it is not something you should deal with alone. When I began talking to friends and family about my own miscarriage (which was really just a failed pregnancy at this point- I hadn't yet had the actual passing of the tissue) I realized that so many women had stories to tell me. I talked with my midwife. She said that 60% of women experience at least one miscarriage during their lives. A fairly large chunk of known pregnancies (~20%) end in miscarriage but the actual number is probably much higher. My midwife advised that I could experience up to two weeks of bleeding but that every women was different. I hadn't yet started to bleed.
I was a mess of tears for days. I teach middle school and right before I went to the ER, I had announced to all of my students that I was pregnant. I felt sick to my stomach at the thought of having to break it to my kids that I was no longer pregnant.
Before I knew I was pregnant, I had plans to run my first 50 mile race. In 2016, I had discovered the world of ultra running and had completed six 50k (31 miles) races. December would be when I took it up to 50 miles. I had to cancel these plans because the risk of dehydration and overheating were just too great for a pregnant woman. Women can run while pregnant, but pushing the limits to that degree is not recommended. After learning of my impending miscarriage, I signed up for a 50 mile race that would take place in February 2017. It was my silver lining to the whole horrible mess I was in. I started focusing on things to come, rather than dwelling on my crushed hopes for a baby.
The Actual Miscarriage
About a week after the visit to the doctor that confirmed the failed pregnancy, I began feeling some mild cramps not unlike period cramps. These were accompanied by some light bleeding. The actual miscarriage had begun.
The following day, I went to school. Right before lunch, the cramping became more intense and I passed a clot that was about 2" by 2". I thought this was the entire thing. No one had really described to me what the actual miscarriage would look like. I had been told I would pass some clots and some tissue, but I really didn't know what to expect. I was only teaching a half day because my husband and I were heading out of town to visit family. I left school and during the car ride, I had to stop to use the bathroom several times because of the bleeding. It wasn't heavy, but you can't use tampons during a miscarriage because of the risk of infection. The cramping became increasingly uncomfortable.
We visited with my cousins for about two hours before I just started feeling terrible. I was spending too much time in the bathroom and the cramping was making me tired. We decided to head home early. We were about 2 1/2 hours from home. 30 minutes into the trip home, I started bleeding a lot more. We stopped at a McDonalds and went into the bathroom. I had my phone with me and kept texting my husband that I would be longer than I thought. The bleeding was just getting heavier and heavier. I was having waves of cramps every 2-3 minutes. Then, I passed some large clots and the bleeding was like a faucet. I started feeling light headed. I texted my husband and told him I would text him every five minutes. If he didn't hear from me and couldn't get ahold of me, I told him that someone needed to come in and get me. I ended up spending nearly an hour in the bathroom. I've never seen so much blood in my life. Both the doctor and my midwife told me to go to the hospital if I was soaking more than one pad in an hour. This was way more than that. I came out of the restroom and the restaurant was spinning. I felt sick. My hands were as white as paper. My husband looked startled and tried to get me to drink some soda. It was then that I realized I couldn't form words. I couldn't speak properly. Then my hands started to tingle and I couldn't move them. My husband grabbed my things and told some guy to make sure I didn't pass out. He threw my stuff in the car then carried me across the parking lots and shoved me in the passenger's seat. My legs were frozen. I couldn't move.
The Second ER Visit
Luckily, we were only about 10 minutes from a hospital. By the time we pulled up to the ER, I had regained feeling in my arms and legs, but I was still having trouble speaking and walking. No one had ever mentioned anything like this when talking to me about miscarriages. I regained my senses before ever getting into a room at the hospital, but the cramps were becoming really intense and painful. Once I was in a room, the nurse told me I was basically in labor. She had had three of her own miscarriages. She told me she was going to give me morphine because the pain was going to get worse than actual childbirth. I was supposed to get something for nausea too, since I was feeling sick to my stomach. A pelvic exam revealed that my cervix was still closed. Usually, a woman will dialate up to 2cm during a miscarriage. They did a vaginal ultrasound which revealed that I had passed a lot of tissue but there was still more. The ultrasound made the cramping so much worse and I threw up a lot. I finally got the nausea medicine after my barfing episode. I was in so much pain and asked for the morphine which I had tried to hold off on. A blood test showed that my hemoglobin levels were low, but not dangerously low. They checked my blood type to make sure that my body wasn't producing antibodies to the baby's blood. There are some cases where a mother's blood type reacts to the baby's blood type and destroys red blood cells. That was not my case. I was simply having a rough and intense miscarriage. I wasn't given any explanation for my limbs freezing up or my inability to talk. I was sent on my way in a diaper and with a prescription for painkillers.
Surely It's Over?
My bleeding slowed to what I would consider a normal period flow. I had an awful headache and I was beyond exhausted. The experience in the hospital the previous night had dug up all of the emotions that I thought I had already tackled about losing my pregnancy. The fact that I had lost something I had come to love so dearly was shoved right back into my face. I was not emotionally recovered at all.
I went back to work after a couple of days only to find that I was much too weak and upset to lead even one lesson. I kept forgetting what i was saying mid-sentences and I had to keep leaving my class to run to the bathroom. The activity seems to spur heavier bleeding. I called the principal's secretary from the bathroom to get someone to cover my class. I started cramping and bleeding heavily again and I knew I couldn't possibly spend another three hours teaching. Then, while still in the bathroom, I began to pass huge clots and the bleeding got really heavy again. I started to get scared that a repeat of what happened just four days before in McDonalds was happening again. I stared feeling light headed so i called my husband and told him I think I needed to go back to the hospital. He picked me up and I was sobbing into my jacket and my legs were acting funny and I could feel blood trickling down my leggings. In the car, my legs stopped feeling weird and I was able to walk and talk just fine when we reached the hospital. The cramping was becoming unbearable and I was a mess. When I was in a room, I started passing huge chunks of tissue. So much blood was gushing out of me and the pain reached a level I had never experienced before. I have passed kidney stone without painkillers, and I have run crazy distances while in pain so I feel like I have a fairly high pain tolerance and experience level. This was much worse. They gave me nausea medication which wasn't enough to stop the throwing up. My whole body seized into one big charley horse. I couldn't move and the pain was shooting from my toes to the base of my head. The cramps were like contractions on top it and I couldn't help but wail. The look of terror on my husband's face is one I'll never forget. They gave me fluids through the IV and then morphine for the pain. This episode was ten time worse than one four days ago. My hemoglobin levels were right on the line of requiring a blood transfusion. Again, there was no explanation given as to why I was bleeding so violently. My cervix was open this time and an abdominal ultrasound revealed that most everything had passed from my uterus.
This was the final big event (I think!) of the miscarriage. Right now, just one week after this ER visit, I am still bleeding lightly and having an occasional light cramp. It's not over but I am improving. No one could have prepared me for the physical and emotional pain of this miscarriage. Every woman I've talked to has had an experience much different than this one. It was important that I talked about miscarriages with other women because that's how I knew mine was not normal. While everything turned out alright, it was the scariest and most painful thing I've ever been through. The health, safety and peace of mind of women going through a miscarriage depend on the support of other women. It is something that we should talk about. It is not something to be handled alone. Time is needed for grieving and physical healing.