If you are anywhere on pregnancy and parenting-related social media sites, you know that October 15th commemorates pregnancy and infant loss. It is the day when parents who have lost a child to miscarriage or stillbirth replace their profile pictures with a burning candle. It is also a month almost to the day from when I experienced my first significant miscarriage and ended-up in hospital as a result, without my fetus and without most of my blood supply.
I’m not in a place where I can wax poetic and inspiring about the reality of pregnancy loss but I can wax brutally honest any day of the week so ready or not, here I come.
How much have my husband and I learned through the last 5 weeks! Miscarriage packs quite the sucker punch. Leaving aside the medical fall-out, it’s like a post-partum hormonal crash minus the baby to cuddle. One minute you think you’re holding-up pretty well, thank you very much, and the next you’re sitting in a puddle. This post is an attempt at expressing the depth of conflicting emotions that grab you when you go through the experience of miscarriage. Maybe you will read it and learn something. But maybe someone will read it and feel normal, this is my hope.
My new pregnancy happened in my new community and I had to debate whether I would seek the care of my usual midwifery team — which would involve driving into town to deliver in hospital or at the birth center — or to register with the midwifery practice for my area — which would allow me to give birth at home or at my local hospital. I really struggled with this decision. The safe course of action, given that I dilate more-or-less painlessly until 7-8cm, was to stay in my area rather than risk an hour long drive into town in transition. But despite being a rational and rather well-hinged individual, I couldn’t think rationally about it. I did get on a local midwife’s roster but when I miscarried, the lack of emotional support from my midwife was really difficult to cope with. It wasn’t her fault: we had only met once. The scope of practice of Ontario midwives is perfect for normal healthy pregnancies but it it grossly inadequate for not-so-normal pregnancies. When I started bleeding heavily, I paged a midwife I didn’t know, who didn’t know me, and directed me to the emergency department of my local hospital. I never heard again from my midwifery clinic. It’s not their fault: they have clients and jobs and no-longer-pregnant women are not part of it. I had to call to cancel lab appointments, midwifery follow-ups and ultrasounds appointments and never got a single call from my midwife to make sure I was ok.
The same scenario was repeated the following week when my family doctor asked for an OBGYN referral to the specialist who was on call when I miscarried for an unrelated issue. My family doctor got a fax back from the specialist’s desk saying: “This Patient was seen last week for a miscarriage. Is this referral still needed?” I had to shake my head: why would anyone want to follow-up with a specialist about a miscarriage anyway (insert sarcasm)? You are no longer pregnant. Next caller.
After all, an entire cast of characters saw you bleed from your private parts, stuck stuff up the same parts (u/s wand, many speculums and some pliers), washed you as if you were an infant and watched you use the bathroom at every bladder or bowel movement to make sure, in their words, that you didn’t “empty out.” I felt like I wanted to meet these people. Face to face. I wanted to show them my living children so they would know me for more than “that great grand multipara who had a miscarriage.” I received superlative and compassionate care from the doctors and nurses I met along the way, from my admittance until my transfusion and my final release from care. It still sits weird with me that these people hold such an important place in my life and memory but I’ll never be more than another patient to them. When I was the head of the students’ legal information clinic in university I used to tell my volunteers “Clients may be one in 20 people you will talk to today but their legal issue is probably occupying almost 100% of their head space. The contact you have with them might feel like nothing to you but it could be everything to them if they are caught in a difficult situation. Be compassionate and mindful of that rapport.” Now I am living what it is to be at the vulnerable end of a relation of care, where saving your life is just another day at the office. It is a terrifying and humbling vulnerability that I will never forget.
When I started bleeding more heavily, I called a friend who had had a miscarriage and asked her to tell me, no punch pulled, what to expect. I had to hang up to call my midwife and head to emerg. The last thing I told my oldest daughter as I left was “try to make my bathroom look not like a crime scene.” I lost so much blood that I was no longer able to inspect every blood clot for my fetus. When I finally had an ultrasound, I was still hoping that they would find a strong heartbeat. The hope that your baby might still be alive will just not die. But not only was my baby not alive, it was not even there. They never saw an embryo, let alone the 12 weeks fetus I was hoping to see and hold in my hand, to make it real. Being seen in a situation of emergency means that health care personnel don’t always have the time or opportunity to slip-on their kid gloves. From the doctor to the u/s technician, nobody is taking the time to explain very slowly and clearly what is happening. I had to piece it together from things I overheard and caught flying. Just before I passed out from the blood loss I asked my husband to take pictures of anything that they pulled out of me. I have phone pictures of a tiny placenta and sac with a chord extending to nothing. To this day, I’m still unsure exactely how or when I lost my fetus and whether there was ever anything to see. Many women who have experienced miscarriage have asked me if I have named the baby but how can I ? As far as know, it might have been anembryonic. Was there ever someone? Am I only grieving the idea of a baby? Is this all in my head? I still cry when I see my friends’ ultrasound pictures thinking this could be my baby, then I want to slap myself back to reality. There was no baby. Or was there? I have not named my baby. I can’t. It just feels fake.
Friends cautioned me against trying to assign blame (to myself) or find a reason why. The doctor who saw me mentioned that my age and parity were probably the reason I miscarried. But this just makes me angry. I know why I miscarried. I’ve been complaining to my family doctor about hormonal imbalance, progesterone whackiness and thyroid shenanigans since 2012. Now I’m angry. I will be recovering from this miscarriage for the next year or two. I have problems absorbing iron (probably something else that is caused by age and parity — insert even more sarcasm) and now I’m stating from something less than scratch. This could have been prevented. When I asked for a full thyroid panel, I was begrudgingly given a requisition for TSH and thyroid antibodies. When I asked for T3 to be tested as well I was told that since my thyroid dysfunction was probably due to (DRINK!!!) my family size, it was not necessary. Every complaint I take to my doctor — and I moved clinics, saw specialists, this “doctor” is a compendium of several specimen — is explained by my family size. Nobody will listen when I say that I did my Master’s in law at McGill in Montreal, commuting 2 to 3 times a week, getting an A+ average, when I had 5 children, including a 5 month-old breastfed infant. I worked full time in active politics, on Parliament Hill, with 6 children. I trained for half-marathons when I had 6,7,8 children, running 20 to 30 km a week. Suddenly my health goes haywire, I’m depressed, I have no focus, i’m shuffling rather than running, I’m gaining 5-10 lbs a month while dieting, I’m losing my hair, I’m not sleeping even when my baby does, and it’s because I have 9 children? Are you actually kidding me? You went to med school for how long to tell me that? I’ve had a big family since 2006, Bucky! What is ok with 8 that is suddenly making me unhealthy because I have 9? Can someone with a medical background please explain that to me? Because to me it sounds a lot like someone wanted to call it in today and is trying to get me off their examining table before rush hour. Being a woman is such a convenient cop-out, still today. I know that with proper healthcare I might still be pregnant today. I know that if I didn’t have any children at 41 and experienced two losses back-to-back, my doctor would be investigating the causes of the miscarriages. But I have children already, so why should I care? Could it be because the underlying causes of the repeated losses impact my overall health? I’m not trying to catch-up with the Duggars here, I just want to be healthy again. Maybe this is a coping mechanism and yet another sign that I’m just another nutcase great grand multip. But now I’m kicking ass and I’m taking names. I have 9 kids, you can’t scare me.