Waiting for a Miscarriage – Expectant Management

It was a week ago yesterday, at 12 weeks that I learned my pregnancy hadn’t survived beyond 7-8 weeks.  My womb had cruelly continued to grow as though I was still pregnant but the embryo inside had died.  The first I learned that all was not ok was through brown discharge, turning to pink, turning to red spotting over 3 days.  I knew that this could be something or nothing.  I’d had some blood loss in a previous pregnancy and all turned out ok.  You can find stories on the internet that tell you the blood loss might not be a bad sign as it wasn’t for them and other stories that say actually this was the first sign all was not ok. EPU (Early Pregnancy Unit) didnt want to see me unless my blood loss was greater.  Feeling completely let down, being expected to wait, in this awful desperate state, waivering between despair and hope, I instead booked a private scan where I learned that my baby had stopped developing.  I feel grateful to have our NHS but their tick lists to determine which humans deserve to be seen come without any humanity.  Particularly when dealing with such a fragile issue that impacts so many woman.

According to the ‘what to expect’ websites my baby stopped growing when it got to around the size of a blueberry.  The scan measurement suggests it is around 5.5mms, which is just more than half a cm.  Tiny!  It will have started to form web like hand and feet structures and quite possibly developed an umbilical cord.  You wouldnt think it would be that difficult for my body to naturally pass this, but 6 weeks later my body is still clinging on, taking its time.

I’ve obviously been through all of the emotions and feelings in the past week.  Desperation, anger, sadness, disappointment and the feelings cause thoughts such as overwhelm, blame, frustration, what if’s and constant analysis of the past weeks, where my body has been holding on to a dead embryo.  Thinking back, and looking over past messages to my sister I can pinpoint the exact point that my pregnancy ended.  I suddenly lost my sensitivity to smell and the feeling of nausea at exactly 8 weeks.  There was no gradual easing of either sensation.  I just woke one day and they had gone.  I mentioned my concern at the time to my sister.  Of course these two things alone are not the sign that a pregnancy hasn’t survived, however for me, now that I knew mine had not survived, they were clearly pivotal signs.  I couldn’t believe I hadn’t been more investigative at the time, although i’m starting to wonder what I would have done differently had I learned of the loss at the time? I most likely would have given my body a couple of weeks, and then with nothing happening, most likely would have felt obliged to take the medical options available to me.

4 days after the scan showed my pregnancy hadn’t survived, I had a noticeable blood loss, with some clots.  This came away with some dull period like aches in the lower uterus, I didn’t have any inkling that it was about to happen, and it was more than a sanitary pad could absorb.  I wishfully hoped this was the entire contents of my pregnancy.  I had my follow up scan booked in 7 days after my first and 3 days after this blood loss.  The night before the EPU (Early Pregnancy Unit) called to check if either my partner or I had any COVID symptons.  I confirmed that we did not.  The lady asked if there was anything I wished to discuss prior to the scan.  I mentioned the blood loss, and the hope that this may have been the pregnancy coming away.  When I mentioned this the lady asked me if I had my previous scan report, she started to say that as they had not done the previous scan they had no records to compare my current uterus with.  She mentioned that if there was no foetus in the uterus that they might need to do blood tests to confirm the pregnancy wasnt elsewhere in the body.  I felt exasperated by this ridiculous notion that I may have attended a private scan and made up the fact that there was an embryo in my uterus.  I had to take some deep breaths to stop myself from screaming at her “if it causes so many problems for you not to have undertaken my previous scan, why did you not invite me in for a scan when I phoned, desperate to know if our baby was ok?”

Instead I composed myself and confirmed to her that I would not need blood tests.  I’ve seen the embryo in my uterus.  I have a copy of the scan report.  She then went on to say, if your pregnancy has passed, we actually wouldn’t normally scan you, we would ask you to wait for 3 weeks to give the miscarriage the usual time frame to complete.  I fell silent, causing her to hurriedly and I think with embaressment continue to talk really fast about why they would not usually scan ‘someone like me’.  I once again took some deep breaths and said “I am coming in for my appointment tomorrow, and I would like to be scanned, I need to know what is happening, whether I have more pregnancy to pass or whether my miscarriage is complete and i’m already very upset that you wouldn’t see me when I was spotting last week”.  Thankfully she agreed that I could still come to my appointment.

The scan showed that the foetus was still happily hanging out in my uterus so whatever my body had passed on Saturday was not the pregnancy in its entirety.  It felt important to know this, so I knew that there was more to come.  I was glad that I had been able to advocate this for myself with the resistance that i’d faced in the phone conversation the evening before.

The obstetrician was very quick to tell me that the time that had passed meant my body wasn’t doing what it should be, and offered my options to have the pregnancy removed.  I wanted to know all my options but still felt that I wanted to give myself more time.  My experiences of health care professionals telling woman that their bodies were not doing the right thing often left me wondering if that was an accurate summary.  In my work as a birth doula I have been lucky enough to see what an undisturbed body is capable of doing, and most often it knows exactly what to do.  What if my body was doing exactly what it should be doing?  And doing it in a way that was protecting me emotionally, hormonally?

The offer of having the physical side of my miscarriage concluded was very tempting.  I honestly completely understand why many might opt for this way of managing their loss.  Over the past week i’ve really had to tune in to what I need and what feels right for me.  I find it very hard to slow down, put myself first, to not worry about what others think of me and i’m often driven by a need to be polite, welcoming and to keep going no matter what.  So many families experience early loss and yet so often we don’t talk about it, we hide it, we sweep it under the carpet and just try to carry on as normal.  I have a beautiful house, a wonderful, loving partner, 2 wonderful boys and 3 lovely stepchildren.  I have several jobs, that I love. I have the school run.  I have a child who is home educated.  I have 3 dogs.   Life has to keep ticking on and some of my responsibilities cannot be passed over to others for very long – but I am sad and grieving and I dont want to take care of my life with a pretence that I am ok.

I’m not ok.  I want to be able to burst into tears while i’m getting dinner ready, take a bath in the middle of the day, walk my dog to the end of my field and let the tears stream down my face, be raging and angry and to let that out at the overflowing bin, the dirty pile of plates on the side, the wet washing that has sat in the drum for 3 days and other things that shouldnt and don’t really matter.  I want to feel the whole spectrum of emotions that go hand in hand with loss. I want my children to understand grief and to not be afraid of it.  I want my family to know that sometimes I need looking after too.   It has felt really uncomfortable to face this full on, and it has felt hard to be honest with people. To talk frankly that I still have a dead embryo inside me, an unsucessful pregnancy, a missed miscarriage waiting to happen.  It doesn’t always feel right to say it.  Yet there is a little fire inside me screaming ‘why should I hide my pain for the comfort of others?’ Why should womans health issues be swept under the carpet as though they do not exist? Of course some people don’t know, and when I am asked if I’m ok by some of course, I answer yes.  It doesn’t always feel right to say it and sometimes I dont have the energy or words.  What I do know is that for all of the times I have told someone it has only lead to positive things as I suffer.  Someone checking in on me every day,  a beautiful loving and gentle voicenote, written messages, care packages.  These have been beautiful reminders to me.  Knowing that I am loved and being held by many.  My partner and children have all stepped up too.  Of course my partner is processing his own grief too.  We are both trying to hold each other through.

One day my children, their partners, their friends might go through this, or be touched by pregnancy loss.  In fact its almost certain their lives will be touched by this again in some way.  I want them to be able to think back to this time and be glad that they knew, to remember that their mum retreated, rested, hid from the world a bit took time to grieve and asked for others to step up and help. They will hopefully remember that by talking about it, bought us together in a way that helped me move through this, and all of us come out the other side.  They will hopefully also see there was a pathway away from the sadness.

I’m still on my pathway, and who knows how I will feel next week if my physical loss is still incomplete.  For now i’m trying to sit with this, trust the wisdom that my body holds, breathe deeply, rest, feel all of the feelings.  I’ve sought the wisdom of others that trust in the natural process and I am using the tools that their wisdom has shared.  I’m willing my body to let go and treading carefully as I go.

Maybe next week the other options available to me may feel more compelling?  Maybe they wont? Maybe my family will need me to be moving through this quicker than my body is allowing? Maybe i’ll be further steps down the pathway?  No doubt i’ll be back here, letting the words flow, in the hope they might be helpful to someone else some time……

Writing down my thoughts has really helped me to process.

 

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