Thursday, June 3, 2010

What I've Learned About Miscarriage-

I posted this on my FB awhile back hoping to educate a little bit, or just to get it out there, but I thought I should share it on here too. Because really, it is one thing to read about the technical aspects of miscarriage, and a whole other things to experience one (or in my case three) and go through everything that comes with it.

Hopefully all the information on here is correct, keep in mind I am not a doctor- I am more focusing on the personal aspects of miscarriage here, not the technical.

This is for all the things I want to scream at the world about miscarriage, but recognize as being socially unacceptable (but hell, someone needs to scream them). I'm tired of people acting like it's something that happens and we get on with it, because it's not that simple. It doesn't happen overnight, and we don't ever "get over it". Here we go:

1. There are differences in types of miscarriage.

-My first and last ones were called Chemical Pregnancies. This means that the pregnancies never developed to the point that we could see anything on an ultrasound screen. The first one should have, but the embryo stopped growing unknown to us until I miscarried.

-My second one was a standard miscarriage. This means we did see it on the ultrasound screen, we confirmed there was no fetal growth, and when I miscarried I did pass the "products of conception" as my doctors call it- I call it "the thing that was supposed to be my baby". There is the possibility of having a procedure to remove the "products of conception" called a D&C. This has risks though so doctors try to avoid it- I almost had this with my second one because my body did not want to miscarry the baby. I wish I had pushed for it though, because it wouldn't have been as emotionally scarring as what did happen.

-There are also miscarriages known as blighted ovums, which are where the sac develops and keeps growing, but nothing grows within it. Sometimes this can be miscarried naturally, but other times it requires a D&C.

-There are also ectopics, which are heartbreaking. The embryo implants and begins growing where it shouldn't, most often the fallopian tubes. This can sometimes be reabsorbed with a shot of medicine to terminate the pregnancy, but sometimes it requires surgery. Some women have to have the fallopian tube removed during this, and this can inhibit fertility.

2. Around 1-5% of women are repeat miscarriers.

-Medically we are termed as "Habitual Aborters". There are many causes of miscarriage, many are caused by chromosomal abnormalities of the embryo. But there can be other causes, and these causes are sought if there are multiple losses. Multiple losses are medically termed as three, although some women begin testing after their second loss- especially if they are undergoing fertility treatments.

-Testing includes (and I've had all these, so I speak from experience here):
testing for chromosomal abnormalities of the mother and father- known as karyotyping
testing for clotting disorders- known as a thrombophilia panel
testing for uterine abnormalities

Simple blood work is all that is needed for testing the parents karyotyping and for the thrombophilia panel. Results for these typically take weeks. (Mine came back normal, except for one minor genetic clotting disorder. I now take a low-dose aspirin daily. If I ever get pregnant I might be on daily blood thinning injectable medication though.)

To test for uterine abnormalities they usually perform an HSG if they haven't yet, this looks at the uterus and fallopian tubes to check for abnormalities. The put saline dye in the uterus, and use an x-ray machine for this.

Depending on those test results, or bypassing it completely, they may suggest a laproscopy or hysteroscopy. These are outpatient procedures, I had them both done at the same time so I can't speak from experience for how they are individually.

When they do them together they put you completely under, cut a hole in your belly button and down on your bikini line- these are to insert the endoscopic tools. Sometimes there may be another hole or two, depending on how much access the doctor needs and what they find. They fill the abdominal cavity with gas so they can see everything, this gas can sometimes settle in your shoulders post-op and hurt. I didn't have that issue though. They check the shape of the uterus, the ovaries, and check for any abnormalities like a deformity or endometriosis.

The hysteroscopy they dilate the cervix and insert endoscopic tools to look for abnormalities like a septate uterus, polyps, or fibroids (just for example). My doctor found a septate uterus, a birth defect I didn't know I had. She took care of it while she was in there, it may or may not have contributed to my losses. I was on bedrest for a few days, and then allowed up around as tolerated for the rest of the week. I didn't tolerate much, as my recovery was much more painful than normal people since I has a lot of other work done while she was in there.

Thank goodness for Per.cocet though :)

-Sometimes hormonal imbalances contribute too, like low progesterone. That one is easily remedied with progesterone supplementation. Others aren't so easily remedied.

-PCOS contributes to repeat miscarriages and they aren't sure why exactly- the hormone imbalances, the insulin issues... it's a crap-shoot.

3. If you are far enough along to see something on the ultrasound, you are far enough along to see it when you actually miscarry.

-That experience is haunting, and terrible. I recommend gathering up what you pass during the process, the gestational sac, the small fetus, whatever stage you are at, and perform some type of ritual to mourn it. I didn't know what to do with mine, and the contractions wouldn't stop, and the pain medicine wasn't working at all- I couldn't even think straight. I regret that I didn't.

4. Which brings me to this- I don't care if you were on bedrest for two weeks waiting to see if it was viable or not, I don't care if you waited a week or two weeks to miscarry- if your doctor offers you Cytotec to help induce your miscarriage, JUST SAY NO. I wish I had taken this advice from some other women, my doctor made it sound like it would be no big thing... he LIED. If you do take it, Vi.codin is not strong enough to combat the physical pain. This medicine is an ulcer medication, which doubles as an abortion medication and labor inducing medication. It causes the cervix to dilate and brings on contractions. Strong-mother-fucking contractions-that-just-keep-coming-at-you-non-stop. I screamed the entire night- really, and truly, no exaggeration SCREAMED. The next day you will feel like someone punched your uterus from the inside out, and bruised as fuck, and empty, and exhausted. It's not worth it- just say no.

5. There aren't many appropriate words for a loss, and so many inappropriate.

-Tell the person you are sorry for their loss. Maybe offer to help them as needed. Everyone avoided me like a leper, making me feel more lonely and isolated. And while I was on bedrest, A- was feeding me fast food all the time because he couldn't cook. Probably would have been nice if someone had offered to make us a meal, especially since he was having a hard time with it whether he showed it or not.

When I was mourning freshly, I would have liked someone to sit with me even if we didn't say a word. Sitting at home, alone, day after day, thinking about what I'd lost and what I'd never have again- probably wasn't good for me. I was severely depressed and lethargic after each loss. So if someone you know loses a baby, don't be afraid of them and of "making it worse"- as long as you are sensitive and don't have a case of foot-in-mouth disease, you should be fine. Just don't be an asshat :)

-Here just a few inappropriate comments:

"At least you can get pregnant." Umm, not always so. And besides, it doesn't help to minimize their pain.

"It could have been worse." They just lost their baby, it couldn't be worse for them. Don't minimize their pain.

"Well, (insert name) had 5 miscarriages, and then they had their baby. It will happen." Don't minimize their pain (seeing the trend here?) And they aren't ready to move on just yet, they are mourning this baby, this pregnancy, this loss.

-Bottom line, don't minimize their pain. They are grieving, let them grieve. Support them through it, ask what they need from you, be there for them, acknowledge what they are going through instead of pretending it isn't happening. It's harder than most people think it is to go through this.

6. Pregnancy is never the same.

-Especially after my second one, I have been absolutely terrified of getting pregnant again. Which I'm sure is hard to tell, since I have continued undergoing fertility treatments. For me, I can't leave it up to fate of whimsy, because I quite frankly don't make eggs on my own. I am a barren field without using treatments. I have had to make the conscious choice to continue trying to have a baby, and each time I do make an egg (or two, or three) I get terrified- of getting pregnant, and of not getting pregnant. I lost that naivety, that simple joy, in pregnancy- and I won't ever get it back. It's another thing I have to mourn now.

7. Feelings towards other pregnant women change.

- I know I have trouble looking at pregnant women the same. I am both happy for them, and jealous. Jealous because I will never have that, because I lost that, because I know all the things that can go wrong that they probably aren't even aware of. I feel like the elephant in the room when I'm around pregnant women, like I am avoided again like a leper because no one wants to face what I've been through. I'm excluded from all that mom and baby talk anyways, because what would I know about that anyway- I'm not a mother (the hardest words to be told after a loss by the way) Happy for them because they don't know what it's like, and if they do I'm happy for them because they're finally in a place I have never been, and might never be. I recognize that pregnancy is a miracle more precious than people give it credit for, it is a miracle I tell you. And I am so happy that other people can have that... but so sad for me, because it's one miracle I had ripped out from under me over and over.

8. With miscarriages it is not just the lost pregnancy that has to be mourned, but all the lost possibilities that went with that baby.

-The unfulfilled due date, knowing you won't be pregnant during that big event, knowing you won't be celebrating with your baby this holiday season, all the little things you lost. And most people won't even understand.



Anyways-
I'm sure there is plenty more I could say, but I think this is enough for now.
I hope it was helpful or informative to someone out there.

14 comments:

Melis.sa said...

((HUGS))

I wish I could forward this on to all of my in-laws.

loribeth said...

This was an excellent post. I'm curious: did you get any responses on FB?? (((hugs)))

Connie's Confessions said...

So true. I have had both experiences, and the loss of my second pregnancy brought me to a place where I will never see it the way I did like the first time.

Loss changes everything. It brings you to reality of what bad can happen. Some people it takes a little longer to find this out. It did for me.

I am so sorry for your losses. Losing a baby is so hard. It doesn't matter if you lose your first, second, third, etc.

After the loss of my second pregnancy, I had a D&C and let me tell you, I still had contractions and was losing materials from the pregnancy. It wasn't as bad as what you may have gone through but it took me six weeks to stop bleeding and stop passing material. Now that I am not getting pregnant again I am wondering if I made a mistake by doing a D&C. There are risks such as scarring which can making it difficult to get pregnant. I guess time will tell.

I wish you luck on this cycle. I have my fingers crossed that you get your BFP this month! :)

WiseGuy said...

Thank you for posting this....Found it very informative....and very discomforting to know that you wrote a large part of it from first-hand experience.

Hoping for a breakthrough...for US!

Another Dreamer said...

Loribeth- not a single response. I expected as much though.

Connie's Confessions- So sorry you went through that with your D&C. I've never had one so I can only speak from the cytotec experience, and I know I would never ever do that again. I suppose that's another thing about miscarriages, always wondering what could have made it easier, did we make a mistake with our treatments, etc... (*hugs*)

Adventures in Baby Waiting said...

Thank you so much for writing all of this. I have never had a m/c before but I want to be a better support for those in my life that have suffered this terrible loss.

AL said...

Thanks for posting this - I have so many of the same feelings.

HUGS.

Kristin said...

Wow, truly an amazing post.

'Murgdan' said...

This was excellent, very well-written and well-put.

Waiting Lisa said...

I'm so sorry you had to go through this. A lot of great information in this post. Thank you so much for taking the time to write it. It's going to help a lot of women.

Amanda said...

That was such a thoughtful and well written post. I'm sorry that you have the kind of experience needed to write that. I've never had a loss but having a child has only made me more conscious of #8 on the list and it makes me afraid to ever try for another child... that is a pain I hope I never know.

Michelle said...

This is all so true! So so unfortunately true. I am so sorry that we have to know this info. I wish I could be someone that knew nothing like in the beginning. Who says ignorance is not bliss?

But thanks for the info in #4 I had no idea and I will keep it in mind for future as we know I may probably unfortunately need it...although I am praying I do not.

((HUGS))

Shanna said...

Hi. Longtime reader, first time I've replied. I also have PCOS and no children, though no pregnancies yet. My sister in law recently lost her third in a row (her first she was able to carry to term and he is a happy little boy now, but she's lost all 3 after). You know how heartless a comment her mother (my husband's mother) made? She said it could be worse; at least she has her son, she could be like us and not have any. She actually said this to her own daughter. Insensitive people. Ugh.

hopeless said...

I had 3 (three) miscarriages in a row too, the last one was 4 (four) days ago. I can't explain how I feel especially at all those times i was so alone and still so alone because even my husband always act like nothing happened. And I live very far away from parents and other families. All i have here is my husband and he always take that miscarriages are not a big deal, in fact he said "it's a waste of money to do those ultrasound". How great!