Friday, December 27, 2013

The Miscarriage Post

It seems, from the vantage point of my almost 34 year old self, that time speeds up as I get older. I am always surprised when another semester, another year is complete and have long thought that life might be like summer camp, those first few days when you are getting to know people and everything crawls by, they seem to last forever, and then before you know it, it is Friday night and you are preparing to say goodbye and go home. This past fall though, life slowed down again for a time. It started as soon as I began to suspect that I was pregnant. Once it was confirmed each day took on its own pace, I anxiously awaited for the next week to come when the thing growing inside me would reach a new size, from sesame seed to lentil, to blueberry. We dubbed the growing entity "lentil"and I suddenly had a new companion. Those who have been pregnant know that everything changes the moment you know, every decision about what you eat or drink or do carries new significance, you are making the decision for two.

I tried not to get too excited, I know so many women who miscarried in their first pregnancy. But it was hard. I couldn't stop my mind from thinking of future events, family gatherings etc where this secret that I currently held would no longer be a secret. The timing was perfect for telling the family at Thanksgiving, when I would be into the second trimester, I thought of bringing a new baby to a family reunion in June, of attending conferences with the tell tale baby bump.

I went to my first prenatal appointment alone, my husband was seven hours away, we were doing just one semester apart while he took a one year position as a physics instructor and I finished some final coursework on my phd program. We knew being pregnant while we were apart could be hard, but we had been waiting a while to start trying and didn't want to hold off any longer. I had been spotting for a few weeks before this appointment which came eight and a half weeks into the pregnancy. I had called the ob/gyn, they had sent me to get blood tests and while I was in the normal range for the hormone levels there was some cause for concern, so after going over all the information I would need moving forward in the pregnancy and receiving the big folder of pamphlets, the nurse sent me to get an ultrasound. She said the tech would probably let me hear the heartbeat if everything was ok. I knew the techs weren't really allowed to do or say much more.

Though I had been trying to prepare myself for the loss of the pregnancy almost since it began, I had a sudden surge of hope before going to the ultrasound, I wanted so badly for it all to be ok. A few moments into the ultrasound I saw the tech swallow in a way that seemed significant. I kept waiting for her to pause to listen to a heartbeat but she never did. She sent me back upstairs to the ob/gyn where I focused on the paintings in the waiting room with all my might to just stop my brain from thinking and coming to the obvious conclusion. The woman who took me back to the examining room had a sad smile on her face and once inside the room I located the box of kleenex and again, scoured the walls for anything interesting that would keep me from thinking about the thing I didn't want to think about. When the nurse, Sandy, came in, she said it wasn't good news. Everything was in tact except that what was inside the sac was malformed and disintegrating, the pregnancy wasn't going to work this time.

I left the big folder of information behind, took a lot of tissues, and drove myself home. In many ways the timing was good. Finding out that the pregnancy wasn't going to work before I actually miscarried allowed me to call my husband, who, after finishing classes that day made the seven hour drive to where I was living. He was with me the next day when the bulk of the miscarriage happened, or at least the most painful part (and I must admit I was surprised at the amount of physical pain). He had to leave Sunday afternoon, which of course felt way too soon. My mother came up the next day and stayed about 24 hours and then the even more challenging time came.

Miscarriage is something that we still don't share much about in this country. Women are sharing more and more with a lot of people blogging about it in the past few years in response to this silence. Some women are embarrassed, ashamed, guilty - it seems like something deeply private. While I did not feel shame or guilt (no woman should) there were several reasons why I didn't feel like I could broadcast it right away. One, I didn't want people to know that I had been pregnant, that we were trying. We had guarded the secret carefully and while I was looking forward to sharing my happy secret, sharing this secret seemed quite different.

We don't have a cultural script for responding to miscarriage and I read several stories about hurtful responses and when I did start sharing my news received a few well intentioned, but in the end painful responses as well. A friend asked at one point how he should respond and my advice would be to say something along the lines of "I am so sorry, I can't imagine" and then to just stop talking. It is challenging because women experience miscarriage differently. For some it is a tragedy that stays with them their entire lives, for others it is a relief, and every reaction in between and around that. Women who have multiple miscarriages are likely to experience each one differently. This response allows the woman to continue talking about it if that is what she wants or to change the subject. It also shows her (or the male involved in the miscarriage) that you understand that this can be a painful experience.

The most common response I got that was painful was one that jumped right into hoping for future pregnancies and assurances that we would be successful. I know that it is possible, indeed likely, that we will have a successful pregnancy, but at first I needed people to just understand and share the pain of this event. Sharing someone else's pain is hard, which is why I think we jump to the hopeful response, but it is also a big gift to simply be with someone in their pain.

So I shared slowly and randomly, sometimes on an as-need basis, but not knowing how I was going to react and handle everything made it hard to figure out who needed to know. This also meant that while I was recovering physically and emotionally, I spent a lot of energy going around trying to pretend that everything was fine. The most physically painful part of the miscarriage happened on Saturday and I bled for two weeks after. In some ways I was fortunate because as a grad student I don't have to be "at work" interacting with other people from 9-5 every day. I went into school for the first time on Tuesday attended meetings and a class, taught Wednesday morning and again just tried to keep going without having to share my new big secret. This was simply exhausting. There are so many small interactions every day where people ask you how you are and you smile back and say great, or good, or ok, or alright. You don't say, "Actually, I am pretty terrible, I just lost a pregnancy." At least I didn't. I wanted to keep a certain front up in my grad student/professional life and I also quickly realized that talking about it wasn't always helpful, it just made me tired. So again, I pressed on. My body eventually rebelled through asthma attacks brought on by stress and emotion, random bouts of tears and just a general functioning at about 70% capacity. It took about a week before I could wake up and not have that sinking feeling immediately afterwards, remembering what had happened. It took about a month for me to feel like I had mostly recovered and then another month to catch up on the first month when I had been in survival mode.

There are still important people in my life who don't know about all of this, not because they aren't important but because the role out of information like this is challenging to say the least.

Many people see miscarriage as a loss and what follows as a grieving process. A few people have challenged that there wasn't anything to really lose and I have pondered the same question myself. It is true, there was not a viable life inside of me, however, there was the idea and the hopes and dreams that sprang up around that idea and even though there is potential for that idea to be realized again, the loss of it this time was a true loss. The idea of "Lentil" had already taken up lodging in my heart.

Another conversation I have had many times is about pregnancy in general. Pregnancy is hard. For some people getting pregnant is a huge struggle, for others, being pregnant is painful, nauseating and uncomfortable, for everyone I know, being pregnant is a project filled with anxiety about your own health, about the health of the thing growing inside of you, etc. I had no idea going into pregnancy how intense this part would be, I have prided myself on being cool calm and collected, I keep in mind that women have been pregnant and having babies for thousands of years in all sort of places and in all types of houses or living arrangements, that this is something our bodies are designed to do etc. But that doesn't always make it easy. The public image of pregnancy is one of smiling women cradling their baby bumps, joyous births etc. Yet 1 in 4 pregnancies does not make it through to completion, some ending earlier on and some ending with a still birth.

Couples who experience pregnancy loss frequently feel as though they have to deal with it privately, I found out about a friend of a friend who, after having a miscarriage, told her supervisor she had been diagnosed with cancer to explain the extra doctors appointments and her emotional state. This just shows how extreme the pressure can be to remain silent about miscarriage. My husband suggested that I tell people I was struggling with some medical issues but I chose not to because it didn't encompass the emotional things I was experiencing, so for a lot of people I didn't say anything. I am blogging about this all now to bring it more into public conversation. It has been nearly three months since we lost our pregnancy, and I realize the helpfullness of sharing now is limited for me personally, but maybe it will help other couples know that this does happen. There are more and more resources, communities etc online for people who experience miscarriage, this is my own attempt to contribute and break the silence.