Wednesday, November 12, 2014

I had a miscarriage.

It's all over now, Baby Blue.  Bob Dylan 

* * * 

Fact: Up to 25% of all known pregnancies end in miscarriage ("known pregnancy" meaning the mother saw a positive pregnancy test or otherwise knew she was pregnant). So if it happens to you, you're not alone.

Fact: Most miscarriages are caused by "mismatched" chromosomes; i.e., Mother Nature messed up when playing Legos with your genes and it never would have worked out no matter what you might have done differently. In these cases, there is nothing wrong with the mother or the father; it simply did not work out, and never would have, not with all the best medical intervention in the world. Ultimately, life is at the mercy of Nature, and there's not a thing humans can do, except be grateful when life does happen. 

Fact: Most women who have miscarriages go on to have healthy, full-term pregnancies. 

Source: The Almighty Internet, which is sometimes correct. 

* * * 

On a gorgeous fall morning, I walked in the woods and talked to the life inside me. I had only known it was there for four days. I'd been too scared to become acquainted yet, just in case I had to say good-bye. If you don't say hello, you can't say good-bye, you know? But that day in the woods I knew that I had better say both, because the life inside me was leaving.

I put my hand on my belly — which, at just five weeks along, still just looked like my plain old normal belly — and said things like, "You would love it here." I described the fall woods, trying to make the best use of my writerly descriptive powers. I said it was a good thing that it was alive right now. This was on a Friday, a workday, and we pretty much had the woods all to ourselves. The woods were silent except for rustling leaves. I stood and faced a tall tree whose yellow leaves shimmered in the sun as the wind blew. I said, "Do you know what that sound is? That sound is God." 

My husband and I conceived in Nepal, during our belated (by one year) "Himalayan Honeymoon." Unless I'm mistaken, which is always likely, we conceived during one of the nights we spent at the Hotel at the End of the Universe, our "treehouse in the clouds," in the Nepalese village of Nagarkot. After trying to conceive for nearly a year, seeing "Pregnant" on the digital pregnancy test had seemed like a perfect prize from the universe (from the End of the Universe) — not just the pregnancy we had hoped for a year would happen, but a pretty cool conception story as a bonus. A burst of luck after feeling so unlucky for so long. 

I got the positive pregnancy-test result in the middle of the night. I'm one of those chicks with a pea-sized (pun intended) bladder, and I was supposed to take the pregnancy test in the morning (something about the first morning's wee being less diluted with food and drink, more prophetic somehow) but couldn't hold it that long. It was Sunday night, and I'd booked an appointment for Monday morning at my gynecologist's office so he could give me a referral to a fertility clinic. I was only taking the pregnancy test to do my "due diligence," just to make sure I wasn't pregnant, because it'd be pretty silly for a pregnant lady to come in asking for a referral to a fertility joint, I thought. 

And yet — I wasn't totally surprised to see the results. Having gotten my hopes dashed plenty of months before, I kept telling myself that my period was just late, that I'd had auspicious-seeming symptoms before, that the pregnancy test would say, yet again, as if confirming my long-held suspicions of my innate inferiority, in unambiguous digital letters: "Not Pregnant." Sitting there on the toilet still, I kept my eyes on the little test stick doing its high-tech science in there. And within what seemed like a matter of seconds, beaming out like a pardon from God, there it was: "Pregnant." 

I smiled. I didn't stop smiling for four days. 

I pulled up my pants, went down to the kitchen, and immediately downed a big glass of orange juice for the folate. 

I climbed back into bed with my husband. He was starting a new job the next morning, and I wanted him to get his sleep — I knew that neither of us would be able to sleep if I told him just then, so I waited until he was up. (In the meantime, every time my pea-sized bladder urged me awake during the night, I popped back into my office room where I'd set the positive pregnancy test on a small chest of drawers, and stared at it, as if to make sure it hadn't just been a good dream.) I'd had no special speech or presentation prepared; I simply got up, picked up the test, and showed it to him. He hugged me hard and told me that he loved me very much. He has wanted a family just as much as I have.  

I decided to keep my appointment slot, but called to ask if they could change the appointment type. ("Uh, the appointment was originally going to be for a referral to a fertility clinic, but uh... I kinda got a positive result on a pregnancy test this morning, so, yeah.") I'd haunted enough of the "TTC" ("Trying to Conceive") message forums to know the drill: First you get your "BFP" ("big fat positive" test result), then the doctor's office is supposed to confirm it by testing the levels of hCG (human chorionic gonadotropin) in your blood, in the off-chance that your drugstore test was defective. I drove to my appointment, smiling. 

Sitting in the familiar waiting room, the room I'd sat in so many times before when I'd come in for various fertility issues, with the Parents magazines on the tables and the overhead TV blaring health cautions for pregnant moms, my doctor (the only gynecologist I have ever seen, by choice, going back to 2008) popped out for some reason, happened to see me sitting there — and gave me a thumb's-up, apparently having received the message about my needing to change the appointment type.

The pre-appointment review with the nurse was surreal — she asked me about my "pre-pregnancy weight" for the records, asked if I was having any morning sickness (no, although I longed for it; I'd read that "ms" can be indicative of a healthy pregnancy), even said a cautious "congratulations." Then my doctor sauntered in, clearly happy for me, doing a quick pelvic exam, making sure I was taking my pre-natal vitamins (uh, yes — for the past year). He talked about my coming in for a follow-up to determine my "due date" (!). On his way out of the room before sending me down to their little lab for blood work, he winked. 

It all felt right, like the triumphant ending we've been culturally conditioned to expect for those who are good and strive and do the right things. 

I knew it was too early to tell people. I knew that. But my mom, and a few of my friends, had known for a while how hard and for how long my husband and I have been trying to "start a family" (that phrase isn't quite right, and sounds to me like sending off to a comic book for sea monkeys). So I drove to my parents' house (my folks live not quite half an hour's drive from where I live) with the positive pregnancy test on the passenger seat, and I had it with me when I rang the doorbell. My dad would be at work, but my mom, aside from the occasional jaunt to TJ Maxx or to get groceries, is normally home these days, having retired from her gig at Mount Vernon's gift shop. 

She didn't answer, so I rang again, then tried calling the house from my cell phone. No answer. I had to move along (this all happened before I drove to my doctor's appointment, and after that I had to go to work), so what did I do? I placed the test on a brick window ledge, and I left for my appointment. That's right I left a random-seeming positive pregnancy test on a window ledge outside my parents' house. 

Fortunately my mom was awake when I called half an hour later, so I asked whether she was dressed, or if she at least had slippers on. "I uh, left a little something for you outside, on the window ledge by Mr. Christmas Tree." (Mr. Christmas Tree is the name my siblings and I gave to the fat, squat pine who lives beside my parents' front porch.) "Oh Chris, you didn't have to do that," my mom said; she later told me she thought I'd brought her some pumpkin bagels and "schmears" from Einstein Bros. "Oh, no — it's not a present type of thing. It's a... news type of thing." She took the cell phone with her when she went out to see what I'd left, so I got to hear her response. I got to hear her joy.

I waited until the doctor's office confirmed the results the following day before I told anyone else. I called my grandmother — I reasoned that an old, legally blind, widowed lady who lives alone could use some good news. I told my dad that night, with my mom also on the phone. I told my sister, who said: 1) "I'm gonna be an aunt!"; and 2) "Can I say something on Facebook?" I told my brother, who let out a loud whoop in the upstairs of his house, alarming his wife downstairs. I told a few friends, mostly those who have also struggled with infertility issues. 

For the next three days, I could feel my body changing. My main symptom? My boobs felt as if they were full of needles. I could also feel thrilling stretching sensations going on in my belly area as my body began accommodating to fit, and feed, the life I had in me. With my immune system suppressed (Nature's way of making sure pregnant women's bodies don't also fight off their babies, which are technically foreign entities), I caught a bad cold; if I hadn't made sure to get the flu shot as soon as it was available last year and this year, I would have sworn it was a flu. But I loved it all, because I knew it all added up to: I was pregnant. I was going to have a baby. 

I left little notes in the morning for my husband: "G'mornin', my Babydaddy!" I sent him a link to a page I had found with cool nursery-theme ideas. I made myself a list of things to buy, perhaps that coming weekend: comfier bras, a pregnancy nutrition/cookbook; some looser clothes; maybe a pregnancy yoga or Pilates DVD. My grandmother mentioned a baby book she had used to raise my dad, and my mom was going to look for this ancestral baby-rearing book among the old junk stored in my parents' basement and give it to me. 

I quit caffeine cold-turkey even though most pop-health websites say up to 200 milligrams a day is OK. I ate an A+ diet — oatmeal with banana slices and blueberries for breakfast, bean stew for lunch, more fruits and vegetables in those four days than in all the rest of my life put together. I drank approximately 10 quadrillion more bottles of water than I normally do. I chugged orange juice (for the extra folate, above and beyond what was in my pre-natal vitamins) like a scurvy-ridden fiend. I took it easy, but went on a few gentle walks. When fatigue kicked in at 8 p.m., I obeyed my body's commands and went to sleep.

And here is where I wish I could end this post, like some nice, normal pregnancy story. Here is where, in another life, I would drone on about my thoughts on motherhood, what it means for someone like me (whose not-so-distant incarnations have included alcoholic club chick and nude model) to become a mother. Or maybe the theme would be "I'm not so broken after all," with some sort of redemption-tinged, upward lilt. Most likely, I would be writing the pregnancy equivalent of my short-lived "The Snarky Bride" blog, in which I try to prove that hey, you can be a mom and also be cynical and cool and like subversive things. 

Except I woke up one morning and no longer felt pregnant. My boobs didn't hurt anymore, the stretching had stopped, and I no longer felt tired. Those hopeful stirrings of nausea I'd only just started to feel were gone, too. I Googled all of this like mad, and found plenty of posts from women saying, "Pregnancy symptoms come and go! In the first trimester, your body is messing with you." My mom assured me everything was probably just fine. I told myself: "Everything is most likely OK as long as there is no bleeding or cramps."

And then I started bleeding on Thursday night.

It was just a little at first, so faint that I wondered whether it might just be my morbid imagination. A rust-colored stain. I went to bed, trying to shake off the sense of being doomed.

Then there was a rose-colored stain. Then drops of dark brown blood. Then drops of red blood. 

I stayed home from work on Friday. I called the triage nurse at my doctor's office the second I felt what could possibly be the beginnings of cramps — not pain, not even as bad as my menstrual cramps are, just twinges. She told me to come in for blood work, so they could see whether my hCG levels were going down (if so, then yes, I was having a miscarriage). The young girl who drew my blood, who wore her black hair up in a bun and had "BLESSED" tattooed across the back of her neck, asked me why I was there, and told me she had seen "bloody chunks" while pregnant with her daughter, who had turned out just fine. "Stay away from the Internet," she sagely advised. "It'll just scare you." 

After she was done with me, I looked down at the two bubbly red vials of blood in her hand and thought about how they contained the future. 

That weekend I bled heavier. It was pretty much as if I'd had a period, only with slightly less bleeding. My pregnancy symptoms were gone gone gone. I kept my poor husband in the loop, wanting to make sure he knew that it could very well all be ending, hoping the shock would feel less severe if it were gradual. My lower back radiated with pain that I tried to attribute to the flu-like cold, although I knew I was only trying to fool myself, and failing. (Lower-back pain is a classic miscarriage symptom.)

On Monday I went back to the doctor's office for what was originally going to be a routine appointment to make sure my hCG levels were "doubling" every day or two like normal. Weirdly, after I'd come in on Friday for the last-minute blood work, they'd cancelled my original Monday appointment, but I told the girl at the front desk that I'd had miscarriage symptoms over the weekend, and I needed an "actual appointment, not just blood work." I was as polite and obsequious on this day as I always am, but maybe the drained and shaken look I had about me propelled them into a hushed chain of actions, because I did in fact get an appointment with my doctor that morning.

The nurse, the same one who had congratulated me only one week before, asked me about my symptoms, and I broke while saying the words, "All my symptoms are gone," because I knew what this meant, thanks to Google and the TTC women. I tried to regain composure, to be a proper adult, while describing the rest of what had happened, the color of the blood and such, but my eyes sprang leaks, and I went for the tissues as soon as she stepped out to talk to the doctor.  

He entered the room in sympathetic mode (not in winking-and-giving-the-thumb's-up mode like before), and said he had been "given the scoop." He said he didn't want to call it a miscarriage until they knew for sure; that maybe all that dark brown blood was "old blood" clearing out of my system. He also said, referring to my blood test on Friday: "Your numbers doubled beautifully." 

Beautifully. They doubled beautifully. 

He sent me down the hall for yet another blood test. Someone would call me to tell me the results the next day. 

So I went to work. I tried to concentrate. A task that would normally take me maybe an hour to complete never got done, not in the four or five hours I was there. 

I had stopped bleeding. I thought of what my doctor had said, his "ain't over till the fat lady sings" attitude," "...beautifully." I have a close friend who went to the ER with bleeding at right about five weeks — her son is alive, and healthy, and beautiful. 

I tried to sleep. I wished for some sort of magic pill that would knock you out unconscious yet somehow also be OK for pregnant ladies to take. 

I went to work on Tuesday morning and didn't let my phone out of my sight; I had no clue what time the doctor's office might call. The results would lay out the situation with black-or-white clarity so rarely seen in life: If the numbers went up, we were OK; if the numbers went down, we were not. (Also: If the numbers went slightly up but did not "double beautifully," it could be an ectopic pregnancy, in which the baby has lodged outside of your uterus, such as in your Fallopian tube; this kind of pregnancy is not viable, must be terminated, and can kill the mother if left untreated.)

That day at work I was supposed to attend this special new "Brand-Voice Training" that my division's VP had worked very hard to develop and that was "mandatory," especially for the writers and content creators at our organization. Ordinarily it'd be something I would be excited about, right up my professional alley. We'd been asked to bring in "a communication piece" we'd worked on recently, and I had mine all picked out: a themed postcard from a creative campaign for one of our bigger clients that I'd pitched to my boss, who'd loved the idea and had even pitched it to several of our other bigger clients, for whom we created customized versions. I had a whole spiel in mind about making our content more accessible and fun, catchy and clever. 

I went down to the training room early to get a seat right by the door. I spoke with the training coordinators (two of them) to let them know that I was sorry, but I was expecting a very important medical-related phone call, so my phone was on vibrate and I had a seat by the door, and if my phone buzzed, I would have to take the call. 

The training had just begun when my phone buzzed. I took all my things — notepad, mechanical pencil, ID badge — with me out into the hall. I had a feeling I wouldn't be coming back.

My doctor's voice was sympathetic, grim. A reluctant Grim Reaper. He said the levels had gone down and that it looked like a miscarriage, but he didn't have to say anything. I knew it from the moment he said hello. 

I thought I had prepared myself. I'd been warning everyone all along — "It's too early..." "Well, we'll see..." "...if we make it that far." I'd cited the miscarriage statistics as if I were some living PSA. ("The More You Know!") I'd said my good-byes. But hearing the doctor confirm it — a doctor, a person in a position of medical authority, someone looking directly at the numbers from my blood, the voice of God — was something else. 

I walked outside the building and made the call I had never wanted to make to my husband. I got the news out of the way quick: "The numbers went down. It's over." And then I knew I had to go home. 

I had planned to simply take the call, hear confirmation of what I hadn't wanted to hear, then tough it out through the rest of the workday. It's work, after all. It's my paycheck. It's my responsibility.

Instead I walked inside, took the elevator up the six floors to my desk, e-mailed my boss's boss (my direct boss was on vacation), packed up my things, shut down my computer, and walked out the door.

On the Metro ride home, I Facebook-messaged and text-messaged anyone I had told about the pregnancy (most of whom I also warned about my symptoms of miscarriage). I kept wanting to talk about it; or more to the point, I couldn't not talk about it, in one form or another. At the next-to-last stop (I live near the end of the line in Springfield), my boss's boss called. I got off the train in order to not drop the call. She told me how sorry she was, that she wanted to make sure I was OK, that I could take as much time as I needed. After we hung up, I had a 10-minute wait for the next train home. The station was mercifully abandoned, and I cried openly there on the platform, under gorgeous fall sunshine. 

Shortly before the final stop, my boss called me from her home, where she'd been taking a much-needed staycation. She told me, too, that she was so sorry, that I would be in her prayers, to go ahead and take the rest of the week off if I needed to. 

So I did. The call from the doctor came on Tuesday; I am not going back to work until Monday. I figure if the universe is going to offer me a gift, a small act of mercy — right now I am going to take it. 

* * * 

I can imagine some worker bee at Google, assigned to analyze my Internet searches, piecing together my story from what I searched: "cool nursery ideas," "pregnancy nutrition," "early pregnancy no morning sickness," "early pregnancy breast pain gone," "five weeks pregnant spotting," "early pregnancy bleeding," "miscarriage symptoms," "miscarriage dark brown blood," "bleeding in pregnancy turned out ok," "who is the saint of miscarriages," "when is day of the dead." 

"How are you doing?" people ask. The answer: I have random crying jags at the weirdest triggers. (Last night while making pizza, it was the expiration date on the pizza sauce — August 2015, a date our would-be baby will never see.) Then I go along for hours doing seemingly OK, but it's always back there. I'm never, for a second, not acutely aware of it. 

"Is there anything I can do for you?" Yes: Tell me miscarriage stories. Tell me about anyone and everyone you've ever known who had one, but who was also able to have a baby. As you can see from the statistic at the top of this post, miscarriages are so common — yet before I started having symptoms, I could name only two people I'd ever known to have one. 

Then all of a sudden names came out of the woodwork: My mom mentioned an aunt who'd had a miscarriage before having her three kids, as well as a second cousin who had one before having her son. My friend told me that her mom had five miscarriages, but also five kids who are alive today, as well as a baby girl who was born too early. A friend told me that her sister-in-law had one, after her two oldest kids and before her youngest. I heard stories about other relatives. One friend told me his mom had a miscarriage after having his older sisters and before having him.

It is so common, but, understandably, nobody ever talks about it.  

And so I'm writing this post to do my part to change that. 

* * * 

"Miscarriage" is such an odd word. I respect its nearly Victorian subtlety, its lack of luridness or clinicality. It just sounds like some butterfingers nanny lost control of the pram while out for a stroll in the park. It hints that an error was made — "mis," as in "mistake," "mishap," etc. — but doesn't place direct blame. The baby wasn't being carried correctly. "There was a miscarriage." It almost begs the use of passive voice.

I find that I'm more comfortable with it the more I use it. And I find that the word loses its power over me the more I use it, too. 

One of the hardest things for me to deal with is the fact that, because it happened so early — I was about five weeks pregnant when I began to bleed — the word "baby" seems not to apply. It was a life; it was something living and growing inside me. It was something. I don't mind referring to it as "it;" today on another walk in the woods I talked to the memory of it, and said: "You're lucky that you don't have the baggage that comes with being one gender or the other — being a chick and disenfranchised, being a dude and feeling guilty for everything." I don't mind so much thinking of it as a free-floating, amorphous being, almost abstract. (To me this is much nicer than thinking about how any of the blood smears on the toilet paper or tiny clots in the commode were technically remnants of what would have been, had Mother Nature not messed up while playing Legos, our baby.) 

Last night before going to bed I searched around online for some sort of memento, some keepsake I could have created in honor of the life I had briefly inside me. As it turns out, "miscarriage jewelry" is a genre, and I found a woman on Etsy who makes these necklaces — a silver angel-wing charm, with a "birthstone" you can pick out. (I chose an opal-colored bead for October, the month we conceived, the month that life began to grow in me.) It will arrive in our mailbox in a few days. I won't wear it all the time, mostly because I don't want my husband to have to look over at me and keep seeing this depressing reminder. But I like the idea of having something

This Mother's Day, I am counting myself, whether we conceive again or not. Because I had life inside me. I loved it, I nourished it. I did all I knew to do for it. And when it died, I mourned for it. I am mourning for it still. I always will.  

Walking in the woods on the day I said good-bye, I told it: "You are my baby. You are my first baby. You will always be my first baby." 

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