Surviving Pregnancy Loss #4
What the fuck just happened?
Warning: This blog is about to get a lot more F-bombs.
After three years of trying naturally with zero success, we are now two for two. How the fuck is this even possible? I am grateful to have this opportunity, an opportunity I know so many people don’t get. But what the hell is going on?
And after two confirmed ectopic pregnancies and a chemical pregnancy, we finally had a pregnancy implant in the right place. This completely upsets my belief that my uterus is the problem. We even got our biopsy results back shortly after becoming pregnant which showed everything looks great. I know this is good news, but what the fuck? Do we really just have that bad of luck?
I thought our biggest challenge was getting things in the right place. Turns out, even that’s not enough for us to have a healthy pregnancy. And just why the fuck not? How many other shoes are out there, just waiting to drop?
Four feels like a lot. Maybe it’s the three strikes rule that has made this loss feel so much more significant than the last. One is too many. Four is way too many. Why the fuck does this have to be part of our story?
We were so happy. And now, once again, we are not. Why the fuck couldn’t we have stayed happy for once?
Let’s go back to the beginning.
The following is the story of my fourth loss and my first miscarriage. I want to share this story for selfish self-care reasons, because I think it’s an important part of my healing process.
I also want to share this story in case it helps anyone else. Reading about the experiences other women have endured–and survived–has been so helpful for me in navigating my own journey. I think, with how much shame and secrecy remains around pregnancy loss, it’s so important for women to write and share our stories with each other. So here’s my latest to add to the pile.
Starting to Try Again
Our second ectopic, in November 2022, was cornual. The resulting surgery actually required cutting into the uterus itself and so we were benched from trying for a while. In my take home documents, they said we would have to wait six months! But after my follow up with the surgeon in January, she suggested we could start trying a bit earlier if we were feeling ready.
So, in March, we ditched the protection. We had been stunned in November to discover that we were able to conceive naturally after three years of nothing. At the time, we were fresh out of embryos for IVF, and had been stressing over whether another round was financially viable for us. Suddenly, the burden of this question had been lifted, at least for a little while. Now that we had resumed trying, we felt like we still had a bit of time to explore whether this could happen naturally for us again.
So trying again in March felt a little different. How many times over the past four years had I meticulously tracked my cycle, only to chastise myself when the pregnancy test inevitably turned up blank? At the end of each month, I would feel foolish and ashamed for holding out hope that it could still happen for us after all this time. But then, suddenly, the story I was telling myself changed. I am a woman who can get pregnant naturally. Maybe I always have been. Maybe I wasn’t so foolish after all.
So I dug out the ovulation tests and got to work. We made a schedule and stuck to it. We were cautiously optimistic. Maybe November had been a one-time fluke. But maybe not. We were feeling ready to wait and see.
A Positive Pregnancy Test…That I Didn’t Believe
Around the time that my period was due that first cycle of trying, we had booked a trip. The first morning after we arrived, I lay awake in bed doing the math on pregnancy tests. If I tested today, three days before my expected period, would I test again on the day of or before? What if I held out and tested tomorrow? Wanting to quiet my mind, I decided to go out and buy a pregnancy test that morning. When it would inevitably be negative, I figured that would at least give me enough peace of mind to enjoy a couple of cocktails before my period showed up.
The store only had a two-pack of their house brand, so that’s what we grabbed. Back at our AirBnB, I debated again whether I should wait to test since it wasn’t going to be my first morning urine AND I was testing so early. But since I had to get a two pack anyway I figured why not. After the three minutes was up, I was surprised to see what maybe possibly could have been the faaaintest line ever. I showed it to my partner who agreed there might be something there, but not much. I didn’t want to get my hopes up. I googled the brand name and the first several results were complaints about false positives. So I chalked it up to that and threw the test in the trash.
An Undeniable Positive at the Happiest Place on Earth
Two days later, we were packing our things, getting ready for a road trip to Disney to round out our vacation. I didn’t want to pack the extra test and, after having spent so much money on pregnancy tests over the years, I refused to let one go to waste. So I took it, not expecting much. But there was that pesky faint line again. It was even just a little bit darker. But I still assumed it was a false positive and threw the test away.
I think if we were doing anything else on vacation, that would have been the end of it. But knowing we had two days planned at an amusement park, I started to worry about the small what if that was forming in the back of my mind. What if I actually were pregnant and spent the day on roller coasters? Could I live with myself if I found that out after, especially if it ended in a loss? I decided to go to a new store to grab a First Response, just to be sure. Again, there was only a two-pack, one regular and one digital, so that’s what I bought and we soon hit the road.
We arrived at our hotel later that day. We didn’t have anything planned until the following morning, so I grabbed my book and headed out to lounge by the pool for a bit. But I kept reading the same lines over and over. I was doing pregnancy test math again. If I took one tonight, I was again not using first morning urine and it was still one day before my expected period. If it was negative, I could always take the second test in the morning just to be sure. But the second test was digital, and I wondered whether it would still be too early for that. But if I waited until the morning, what if it actually was positive? Wouldn’t I want more time to react to this news? It would completely derail our plans for the following two days.
Eventually I headed back to our room. I remember it so vividly. I took a test and watched to make sure the solution appeared in the results window. If you’ve ever had a positive test before, you might have experienced starting to see the second line form even as the solution is still filling up. I thought for a second that I might be seeing just that, so I quickly set the test on the edge of the bathtub beside me, out of my direct line of vision. No way, I thought. I went to wash my hands and came back to grab the test to put on the counter. It couldn’t have been more than a minute and there it was, the strongest positive I’ve ever had.
All I could say was “Holy shit.” over and over again. My partner was in the other room asking “What? What is it?” Finally, I found my words and managed to say “We’re pregnant.” I remember I kept saying “Like, really pregnant.”
Although I had perfectly doubling HCG numbers with my ectopics, they always started low. I took it as a good sign that the test was so clear given that it was taken in the evening the day before my expected period. I couldn’t believe it. Not only were we miraculously pregnant again, but it was another natural pregnancy. And we were in the most magical place on earth. I thought for sure it was a sign that this was finally meant to be.
We had a different couple of days at Disney than we were expecting. I became the official bag holder who waited while my partner enjoyed the rides I had been so excited about. Looking back, though, I do thank our little angel for at least sparing me from having to go on the Tower of Terror. Not my scene.
A Scary Plane Ride Home
After an amazing two days at Disney, the news of our pregnancy started to settle in, and I started to worry about it being ectopic once again. What if I ruptured while out of the country? What if I ruptured during the plane ride home? With my last ectopic, my doctor sent us straight to the emergency room on diagnosis. He wasn’t comfortable sending me home, worried I wouldn’t make it back to the hospital in time if something went wrong. Surely the odds would not be in my favour if I were thousands of feet in the air.
By some miracle, I had the best seat mate on the plane who helped take my mind off my fears. Not only did he tell me his life story, but he also brought out the sweetest, one-eyed emotional support dog who basically sat on my lap, as if she knew where she was needed most. We landed after a few short hours with great relief.
A Placement Scan of My Dreams
As soon as we got home, I called the clinic and left a voicemail. I knew my HCG would likely be too low to see anything on an ultrasound yet, but I felt like I needed to at least get the testing ball rolling. They called back the next morning and, since it was a weekend, booked my first blood draw for Monday.
On Monday, I waited all day for the results. In the late afternoon, I finally received a message in my patient portal that said I had an ultrasound booked for the following morning. I remember thinking that wasn’t good. I was only 4w5d at that point. I thought there was no way my numbers would be high enough to see anything on an ultrasound, so they must be looking for something else. When they finally called with the numbers, my HCG was over 4,000! I couldn’t believe it and immediately realized the urgency in booking my ultrasound: I was dangerously close to passing the point of effectiveness for medical management of an ectopic.
Thankfully, I didn’t have to worry about that for too long. Within a few hours, we were back at the clinic for more bloodwork and a scan. I remember packing a hospital bag before heading out to the clinic, fully prepared to be told we would have to have emergency surgery straight away. Instead, we saw the most beautiful sight: what appeared to be a gestational sac in my uterus.
Still, I wasn’t fully convinced. What if it was cornual masquerading as intrauterine? What if it was heterotopic and there was another pregnancy lurking somewhere it shouldn’t? Our doctor reassured me it was looking as good as we could hope for now and recommended we come back in a week for another scan.
Our Second Placement Scan
The next week, we were back at the clinic for our follow up scan. For the first time, showing up for an ultrasound didn’t trigger as many traumatic flashbacks to my ectopic diagnoses as usual; I was a little bit hopeful. And then, there was that wonderful gestational sac again, even bigger than before. And now there was a beautiful looking yolk sac.
We were 5w4d at this point and I had hoped to see a fetal pole but they couldn’t find one. I remember being a bit nervous about this at the time, but our doctor reassured us that everything was looking great for how far along we were. For the first time, leaving that appointment, true optimism about this pregnancy set in. We finally stopped hedging our comments to each other with “If this works…”.
Bleeding and The Onset of Fear and Anxiety
I experienced two glorious days of calm optimism before I started spotting and spiraling. I immediately called the clinic and although they reassured me it was actually quite normal, they brought me in for blood work. Everything looked great.
I tried to feel relief but all I could sense was anxiety. And pregnancy symptoms. My HCG was so high at that point: over 60,000. I had been having my first real experience of pregnancy nausea and fatigue. As I lay around, struggling to maintain my daily habits amidst symptoms, my mind started to make up scenarios. What is the HCG was a sign that something was wrong? What if it was a sign that it was heterotopic after all?
I continued to spot for four more days. It was all so light and never red, but still I was worried. I called the clinic again. Again, they told me that it was normal and to wait for my next scan which was still over a week away.
The hardest part of all of this was that I had no one to turn to. My partner was not ready to share the news of our pregnancy so I didn’t have anyone to talk me through my fears and anxieties. I started to shy away from social events, scared I wouldn’t be able to hide my symptoms or, worse, that I would miscarry in front of everyone.
I was able to see my therapist once during this time which was helpful. I had also joined a support group just four weeks prior to all this. The first couple sessions were great as I shared my story of my ectopic losses. But now that I was pregnant, I didn’t know where I fit in. I didn’t feel like my fears and anxieties about early pregnancy would be welcomed by those in the middle of treatments of losses (understandably so). I tried joining the pregnancy group, but everyone was so much further along. Mine was still too new, too fragile to share with them. I felt really alone.
A Visit to the Emergency Room
A few days later, on a Saturday, I woke up and started to experience period-like cramps. Within the hour I had heavier red bleeding. I thought this was the start of my miscarriage. Seeing the blood was traumatic and I was still worried about somehow rupturing despite the scans that seemed to indicate everything was looking good. My fear about a possible heterotopic eventually brought me to the emergency department.
I felt guilty for taking up much needed resources, but–as has been my experience in the past–all of the doctors and nurses were so understanding. I got a scan after just a few hours and not only did they find a fetal pole, but also saw a heartbeat. We seemed to be measuring a bit behind, but overall things looked okay. They suspected it might have been a subchorionic hematoma and sent us home.
My partner was hopeful after receiving this seemingly good news. But I was still devastated. I became convinced that we were experiencing the start of miscarriage. At this point, my anxiety was in full control.
Not Quite Confirmation of Loss
Just two days after our visit to the emergency, we were back at the clinic for our scheduled scan. Knowing what had happened over the weekend, our amazing technician took her time. Eventually, she broke the news that the baby was still a bit too small and there was no longer a heartbeat. She went out to get the doctor to confirm.
I felt numb. I was already so convinced that this was going to be the outcome, but of course I still had been holding out just a little bit of hope for our magical miracle. When the doctor came into the room, they did a second scan. They actually found the heartbeat that time. But it wasn’t fast enough. Everyone at this point was suggesting we were headed toward another loss.
Hello, Grief, My Old Friend
Thursday morning I was home alone, basically waiting to miscarry. My partner was away at work and I felt more alone than ever. I had been trying to hold it together for weeks now, and I knew I had so much emotion still bottled up inside that had to come out. I turned to Taylor Swift’s song Bigger Than the Whole Sky and let the tears start to come.
Strangely, I think I felt most like a mother at that moment. I was Queen Clytemnestra, fallen to her knees, wailing with grief. I let the grief pour out for all my losses. After that, I picked up my phone and finally started reaching out to some family and friends.
A Loss Confirmed and More Waiting
By the end of the week, we had to return to the clinic for a follow up scan which finally confirmed there was no heartbeat. We were experiencing a missed miscarriage.
The waiting up to that point had already been so hard. So much of this infertility journey involves anxiety-ridden waiting: waiting for the results after a transfer, waiting to confirm whether it's ectopic or not, and now wanting to confirm a miscarriage. I just needed it to be over. I wasn’t sure if I had the strength to get through a natural miscarriage at home so we ended up sending in a requisition for surgery at the women’s health clinic for an MVA.
A Call from the Clinic
A few days later, the clinic called to say they had an appointment for me in two days. I was surprised to hear from them so soon. They walked me through the procedure and what I would need to do to prepare. The nurse was patient and kind as she heard my tears every now and then on the other end of the line.
All of a sudden, she started to discuss the methods of disposal. Turns out, unlike at the emergency room, the process at the women’s health clinic was to send […Oh god, what do I say here…The tissue? The pregnancy? I can’t bring myself to say the baby…] to a cemetery on the other side of the city. There would be a memorial service in the fall for losses like mine, she told me, and asked if I wanted to attend.
I almost went into shock at that news. I was no longer just a woman suffering through infertility. I was no longer a woman who had experienced four pregnancies and four losses. Now, I was a woman who had a piece of herself in a cemetery in a city that’s never really felt like home. I do appreciate that there is now a physical place to honour my losses in the world; to make them feel less like a terrible dream. But I hate that this is now part of my story.
The Procedure
I was so terrified of the surgery, the pain, and the possible risks that might only further separate us from our dreams of parenthood. But everyone at the clinic was so amazing. I remember the anesthesiologist telling me I applied my eyeliner really well, which made me laugh given the context. And one of the doctors held my hand during the entire thing. Everyone kept telling me it was very normal to cry, which I definitely did a lot of.
And, look, it was absolutely fucking painful if I’m being honest. But–for anyone currently facing this–know that it is also absolutely survivable. Honestly, as cheesy as this sounds, it felt like nothing compared to the pain in my heart in that moment.
One Week Later
Now, one week later, things feel surprisingly back to normal. I didn’t have much bleeding after, just some cramps and bloating which I took care of with over-the-counter pain meds and heating pads, along with lots of rest. I still feel sad and cry sometimes, of course.
I also feel guilt. I feel guilt over my relief to no longer have pregnancy symptoms, and to be able to go back to my regular routines. I do my best to remind myself this wasn’t my fault, but the guilty thoughts about the cocktail I had on vacation or the anxiety and stress I felt when I first started bleeding inevitably show up from time to time. I’m just about to finish The Miscarriage Map which has certainly been helpful in navigating these last few days.
This loss sometimes feels much more real than the others, having gotten so much further—literally and figuratively—with a confirmed intrauterine pregnancy. But, at the same time, it also feels so much more surreal with no physical wounds to remind me of what we’ve just been through like there were with my ectopic losses. It sometimes feels like it never even happened.
I don’t know where we go from here, but I’m grateful to at least have a here to go from. Thanks so much for reading.
