The Friday of our ultrasound…after we were told there was no heartbeat…after our nurse called and told me to stop hormones…after I called my mother and told her not to order the angel onesie…after I cried with Dan on the stairs for an hour… Dan and I were sitting on the couch when my phone started ringing and our fertility clinics number flashed on the screen. I picked it up anxiously, a part of me thinking maybe they were calling to say “oops we got it wrong! You’re totally pregnant! Sorry about that”…the rational part of me knowing that was not going to happen. I was surprised though when I realized it was our physician (mind you it was 6pm on a Friday night) calling to talk about what had happened earlier in the day. One thing that sticks in my mind about our twenty minute conversation is he never used the terms miscarriage or baby… he kept saying “the loss”. I do not know if this is something they learn in medical school, but I will always appreciate our physician for how he spoke to us that night, because Dan and I lost much more than a pregnancy that day, and I really felt like our kind-eyed doctor recognized that.
After a few minutes he said to me “We need to talk about what the plan is moving forward…” I thought he meant with the IVF (which I thought was a little insensitive…we literally just found us we weren’t going to have this baby) until he continued “We have to decide how you’re going to have the miscarriage.” Now, blame it on my shock and grief, I had not really thought about the fact that I hadn’t really had a miscarriage yet, our baby had stopped developing, but physically I had no idea. I had what is referred to as a “missed miscarriage” there are no symptoms of a miscarriage (cramping, bleeding, pain), but the pregnancy stops developing. My physician and I discussed my options…
- I could wait for my body to recognize the pregnancy was no longer continuing and miscarry naturally.
- I could have a D & C
- I could take medication to “induce” the miscarriage.
I made the decision to have a natural miscarriage. I figured my body had been pumped with enough hormones and medications over the past 6 months, I did not welcome more. I also wanted to avoid a D & C because I had enough issues stacked against us with the infertility, I feared scar tissue from a surgical procedure would affect my future fertility (I want any future embryos to have a nice, healthy place to implant!) and truthfully, I hated the idea of having anesthesia again, (blame it on the ICU nurse in me). My physician told he would give me one week to miscarriage naturally… he wanted me to come to the clinic every other day for blood work to check my HCG levels because the drop would help predict when I would miscarry and he told me if it didn’t happen within a week we needed to explore the other two options.
I went for bloodwork the following Tuesday and my nurse (sweet, kind Marsha) called that evening and said my number was low enough that they believed the miscarriage would happen within the next 48 hours, she told me to be prepared for cramping and bleeding, “the worst period of your life.” This was a cruel understatement.
The next morning I woke up with terrible cramps, but mind you I have endometriosis, terrible cramps are nothing new for me. I took some extra strength Tylenol, put on my scrubs and drove to work. (I’ve always found it helps cramps to keep moving, I figured if this was supposed to feel like the worst period of my life there is no place more active for me than a short-staffed, busy ICU.) I was about thirty minutes into my 12 hour shift when I realized this was nothing like a bad period. The Tylenol hadn’t touched my pain at all, the pain was radiating through my stomach/back so fiercely I actually found myself struggling to breath. A co-worker who works nights and was late leaving called me over to an empty room and said “You look like you’re about to pass out…what’s going on?” I broke down and explained to her what was happening, she had been a ER nurse for 15 years before coming to the ICU and she calmly told me she had seen a lot of women come in with miscarriages…and she knew there was no way I was going to survive a 12 hour shift, she looked me dead in the eye and said “if you really do this naturally, without pain medication, this is going to be the hardest 48 hours of your life… and you’re not staying here.” I am so thankful I spoke to her that day because she was the first (and only) person who really explained how difficult this was going to be.
I took my charge nurse aside, explained what was happening, and said I would try to stay through morning assessments and morning medication pass (the busiest few hours). I do not know why I felt the need to be “super nurse” that morning, (at one point I looked down and realized I was white knuckle gripping my patients bed as the pain literally felt like it was tearing through me), but I think it has to do with control. I couldn’t control anything that was happening to me… I had no control of our fertility, my body or the loss, but I could still be a good nurse (and that was important to me). I ended up leaving work around 11 AM and spent the majority of the next 48 hours going between my bed and the bathroom.
What happens during a natural miscarriage is not something I was prepared for. Your body literally goes into a modified labor in order to have the actual miscarriage. (i.e.: you dilate, you have contractions). At one point I was lying down and could see my stomach contracting…I genuinely felt like an alien had taken up house inside me and was now fighting to get out. There was more blood than I expected. And it was a lot more painful than I was prepared for. There were moments when I thought I was going to pass out from the pain (I told Dan what ER to take me to). I would wake up (from Tylenol PM induced sleep) and feel as if someone was beating me up. The worst period of my life did not even come close to what I experienced.
And then it ended. After about 4 days the bleeding stopped, the cramps subsided, the nausea was gone. My HCG level remained elevated (that would take almost a month to reach 0) but the physical miscarriage was done. And I survived.
Those 96 hours were torture…but I am also thankful for them. The physical pain (as weird as this will sound) made it very real for me…there was a baby. I never heard our baby’s heartbeat, I never felt a kick, I never saw my stomach grow or put on a maternity top… I never experienced most parts of being pregnant, but I experienced the miscarriage…that was real…and it helps me to remember that so was our child. So… after all the pain…after all the tears… I feel grateful for my ability to have that time to say goodbye to our baby.
So advice time:
If you, or someone you know, is going to experience a natural miscarriage (or really anything to do with a miscarriage): ask your physician every question you can think of… do not going into it blindly. A miscarriage is awful, you do not need to be googling your symptoms while experiencing it to make sure you’re not dying. Also, if something doesn’t feel right (and you don’t have a friendly co-worker who’s treated 100+ women experiencing miscarriages or years of medical experience) call your healthcare provider. WebMD is not your friend…your doctors answering service is…they get paid of be on call for a reason.
My greatest piece of advice is don’t be a superhero. A miscarriage (regardless of how it happens: naturally, a D&C or medication) is traumatic. Give yourself time to recovery physically from the loss, because the emotional aspect lasts a lot longer than a few days and drains you. I still wish I had taken more time to recover (I went back to work the following Monday) and worked three 12-hour days in a row…I pushed myself to be ‘super nurse’ and take care of other people, instead of taking care of myself. If it hadn’t been for Dan, my mother and one kind-hearted co-worker I would not have made it through those days, but I also put a lot of added stress on myself, that I didn’t need and you don’t need either. So allow yourself time to recover, get plenty of rest and allow your body to heal… your body is going to heal a lot faster than your heart so take care of that first.