Monthly Archives: January 2015

Doling out bad news… again, and again, and again.

Argh.  I’ll keep this short, but I had an incredibly frustrating experience at work today and need to vent.  Maybe I’ll write a whole post about it someday, but one of the difficult things about second trimester miscarriage is that you don’t get to choose who to share your news with, so you wind up having to deal with a lot of clueless and insensitive responses.

I was in the department office getting a new piece of chalk before my class.  I ran into a retired engineering professor who has been working intermittently for the last 9 months or so on restoring a large and complicated piece of equipment in our department.

He was the first person at work I told about my pregnancy, out of necessity.  The day after I found out I was pregnant, I came into work and he was spraying a chemical on a piece of equipment in the hallway directly outside my office door.  The fumes were strong in my office.  I pulled him aside, told him that it wasn’t common knowledge yet but that I was pregnant, and asked if he could do any necessary chemical-spraying in some of the more isolated areas of the building.  He congratulated me, agreed to do the spraying elsewhere, and promptly told me a horror story about his daughter’s birth experience (welcome to pregnancy… everyone wants to tell you their horror stories).

Today as I was rummaging in the supply closet for chalk, I said hello — he hadn’t been in the department since the end of the summer, a few weeks before my daughter died.  Here is my best reconstruction of the ensuing conversation:

Him (brightly): “I see that you are no longer with child!”

Me: “Unfortunately my baby died when I was four and a half months pregnant.  I had a placental abruption.”

Him: “That’s very common.”

Me: “No, it’s not, actually.  There was a less than 1% chance of it happening.”

Him: “Well, maybe the specific thing that happened to you.  But a lot of conceptions end in death.”

Me: “Usually not as late as mine.”

At this point I’m realizing how bizarre it is to be arguing with this guy that what happened to me was bad.  I also need to start my class.  So I grabbed my chalk, started walking out, he expressed his condolences, I thanked him, and I went to teach my class, feeling shaky and weepy.

It’s been over four months since my daughter died.  How many times do I have to do this?!

To end on a positive note, I’m very excited that I only have to wait until Monday for the hysteroscopy to figure out what’s going on with the mass in my uterine cavity and hopefully to get it removed.  It really feels like progress, but at the same time I’m anxious about finding out what it is and how long I need to wait to heal before we can start trying to get pregnant again.  Wish me luck…

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Pregnancy, Invited Talks, and Pregnancy Loss

Braunstein-998x697Here’s an academic problem I never thought about before I became pregnant: how do you deal with invited talks?  Don’t get me wrong; it’s a good problem to have.  But much ink, both analog and digital, has been spilled about how primary childbearing years tend to align with prime career-building years, and one of the main career-building tools of the academic is the invited talk.  In my first pregnancy I turned down three invited talks that would have fallen during my parental leave, which turned out to be three huge wasted opportunities since my pregnancy ended prematurely, leaving me free to go to those meetings after all.  That’s a gap in my CV that I can’t easily explain.  But I don’t know how I could possibly have handled things differently, or indeed, how I would handle a similar situation in the future.

There are essentially two categories of invited talks: conference talks, and colloquia.  Colloquium invitations tend to go out shortly before, or right at the start of, the academic semester.  So you’re typically planning a maximum of four months in advance, and most of the time the scheduling is pretty flexible.  Colloquia are therefore not so hard to schedule around a pregnancy, since pregnancy, as I’ve noted before, is LONG.  It sucks to travel and give colloquia during your first trimester, but for me, at least, it was doable (I had a relatively easy first trimester, with plenty of fatigue and nausea but at least no vomiting).  And if you already know you’re pregnant when you get invited to give a talk, you can try to schedule it for the (relatively) easy-breezy second trimester, when the nausea and fatigue of the first trimester subside (for all but a few unlucky women).  So for me at least, colloquium invitations were not a problem, and I scheduled several of them for my second trimester, figuring I’d better get some traveling done while I still could.

Conference invitations are trickier.  These tend to be planned much farther in advance — like, six to twelve months in advance.  I was invited to give a talk in Japan right after I found out that I was pregnant, and it would have fallen during week 31, which is just before the cutoff (32 weeks) at which many travel insurance companies will no longer sell you policies.  Being an adventurous first-time pregnant lady, I accepted, and planned my trip around my anticipated heavily pregnant state: I booked aisle seats, kept the trip short so I’d be back a few days before the 32-week cutoff, and looked into travel insurance so that if I developed complications I could cancel the trip at the last minute and not be out the cost of a flight to Japan.  Those little reminders — aisle instead of my normal window seats, colleagues asking me why I wasn’t staying for the whole meeting — were painful barbs throughout the whole trip (I did a lot of crying in my hotel room).  But at least I went.

Worse were the three conference talks I was invited to give this spring, during what should have been my parental leave.  The cluster of invitations came in after the first trimester, but before our daughter died, during that beautiful 1.5-month period when I had started to trust the pregnancy and make plans for the future around being a mom.  My career is still accelerating, which means that I don’t often get bonanzas of invited conference invitations like this, and two of the three were big, important international meetings.  One of those meetings seemed like it might be barely doable; my daughter would be three months old, the international meeting was only a few-hour flight away, and my husband was willing to travel with me so that I could give the talk.  But, full of optimism and commitment to my new role as mother (and honestly some trepidation about bringing a 3-month-old on an airplane), I decided it was for the best, that this was the beginning of my efforts to navigate work-life balance, and I turned them all down.

I told the organizers why, of course; I didn’t see any reason not to.  After my daughter died, this led to some awkward interactions and decisions.  I ran into the organizers at meetings and they asked how my baby was.  The conferences I was invited to are still happening this spring, but of course they’ve already filled my talk slot… should I go anyway, and hope they’d at least give me a contributed talk slot?  But ugh, can you imagine submitting an abstract to a conference after that, and the ensuing awkward conversation among the SOC: “Wait, didn’t we invite her to give a talk?  Why is she submitting a contributed abstract?”  “Oh, her baby died…”  Ick.  I generally really like my colleagues in this field, and it’s far too late to contain the information about what happened to me, but I really don’t want to encourage that sort of talk any more than it will naturally happen on its own.  So I’ve avoided these meetings.  It’s fine; my spring schedule filled up with colloquia and is busy enough as it is… but I can’t help but think about those three invited conference talks that should have been, a loss that pales in comparison to the loss of my daughter, but collateral damage to my career nonetheless.

And… what will I do if I get pregnant and I get conference talk invitations again?  I can’t know how I’ll feel until I’m there, but at least for now my impulse is to avoid telling anyone else in my field (outside my university) about my pregnancy until it’s unavoidable.  And having been burned once, I’d have a hard time turning down talk invitations in a future pregnancy.  But what can I do… accept a talk, and then turn it down at the last minute?  “I’m very sorry, but I’m going to have to withdraw my talk from the conference because I’m suddenly 8 months pregnant and can’t travel”?  Or “I’m very sorry, but I’m going to have to withdraw my talk from the conference because I just gave birth and will have a two-month-old during the meeting”?  They’ll think I’m nuts and/or a highly irresponsible person!  Maybe there’s some middle ground, but I’m not sure what it is.  The standard thing to do would be to withdraw after the first trimester, but I tried that already and it failed miserably.  And it’s worse, because I know my prognosis for future pregnancies is not great, so (1) I should probably avoid too much travel because of the likelihood of developing complications, but (2) I have even less reason to count on a future pregnancy continuing and am therefore hesitant to plan my life around it.  But… to not travel for a year (nine months of pregnancy and three months of leave)?  Professional suicide might be a bit of an exaggeration, but not by much.  I suppose I can always give vague excuses (“I’m very sorry, but I’m going to have to withdraw my talk from the meeting because of medical issues that have made travel impossible”), but my field is small, and word gets around, and the likelihood is high that they’d figure out what happened.

Anyway, it’s a conundrum, make no mistake.  And not the sort of work-life balance question for which there’s a lot of advice floating around the internet.  This is a fairly niche question, but if there’s anyone out there who has advice, or has experienced something similar, I’d love to hear about it.

Waiting after a miscarriage

infinity_o__clock_by_garycummins-d5k7p0tI’m not proud of it, but while my 4.5-months-pregnant belly was still covered in gel as the doctor was doing the ultrasound to confirm that our daughter had died, the words left my mouth: “When can we try again?”

I wanted nothing more in the world than to be pregnant again.  Well, that’s not precisely true: I wanted nothing more in the world than to hold a living, breathing child in my arms.  It’s still what I want more than anything.  But it’s the one thing I can’t have right now.

The doctor’s answer at the time was 2-3 months.  I have since asked this question to various medical professionals (the midwife, the perinatologist, the reproductive endocrinologist, the new OBGYN I switched to after I was unhappy with my care during our loss), and I have gotten every answer from “3-6 months” to “go for it!”.  It’s a bit complicated — there’s a pretty solid-looking study that says there’s no reason to wait after a first-trimester miscarriage (and in fact that women who get pregnant in the first six months after the miscarriage have higher live birth rates than women who wait longer), and there’s evidence that you actually should wait 6-12 months after a full-term stillbirth, but our loss was in the hazy middle, the second trimester, where the statistics are particularly sparse.  We’re neither here nor there.

So… I waited for my period to come, so I’d be able to date a pregnancy if it happened.  Then we gave it a try for a month (no luck).  Then came the consult with the perinatologist, who told us that it would be a good idea to have a sonohysterogram at 3 months post-D&C to make sure everything had healed properly, so we stopped trying for the next month.  Then the sonohysterogram was abnormal, and the OBGYN told us it would be a bad idea to try again before the problem was corrected.  They wanted to schedule the surgery for the following month, so that it would be between days 5-12 of my cycle.  So I’m waiting for surgery, a week and a half from now, 4.5 months after our loss (in fact, it’ll be about a week before my original due date), and the wait is driving me absolutely bonkers.

I look back with a sort of wistfulness on those first few months of trying, before my cycles went crazy, where time ticked by in weeks, with predictable highs and lows as we tried… and then I got my period… and then we tried… and then I got my period.  Since our loss, time creeps by in months.  The days feel longer.  I watch women who were pregnant at the same time as me become moms.  I watch our friends’ kids grow, start a new school year, move up to the toddler room, gain new skills, get older every day… and we’re right where we started.  In a way we’re parents, but nobody else recognizes that, and we’ve been robbed of the experience of watching our daughter grow.  Instead, we’re waiting.

Depending on what they find in the hysteroscopy, they may or may not be able to correct it at my appointment a week and a half from now.  If I need another surgery, it might take time to get on the schedule.  Then, depending on what this abnormality is and how hard it is to correct, I’ll need to wait (perhaps months) to heal.  Then we can start trying (which wasn’t easy for us the first time).  And THEN, assuming we can get pregnant, I have to go through pregnancy again.  I already did 4.5 months of that — the first trimester was hard, and was LONG.  And as my husband bemusedly pointed out to me a couple of weeks ago, even though our September loss feels like a long time ago now, I’d probably still be pregnant if our baby had survived.  Pregnancy is LONG.  So, it sounds like we’re looking at a minimum of a year until we get to hold our living baby, and likely substantially more than that.  And we started trying a year and a half ago.  This waiting and waiting and waiting to start the next chapter of our lives is maddening.  Truly maddening.  (I’m working on getting help for that… but that’s a subject for another post.)

So that’s where we are right now.  I know some women feel like they need to wait after a miscarriage or stillbirth, to give themselves a chance to heal emotionally and physically.  I wish that were me.  I’m trying to distract myself; the semester has started again at my university, which means I’m a lot busier now than I was over the holidays, and that helps some.  I’ve made a resolution to do one fun thing per weekend with my husband this semester, since it feels like so much we do these days is so emotionally heavyweight — hopefully that will help.  Has anyone else out there been forced to wait after a miscarriage?  How did you handle your impatience, your despair, and the restless energy you wanted so desperately to put toward being a mom?

Oops, I lost it in public.

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I lost it in a room that looked very much like this one!

It’s been a rough week, and yesterday was the first time I’ve lost it and started crying in public (a VERY public place, as it turned out) — almost four months after we lost our daughter.  And surprisingly, the two toughest emotional moments this week have involved being a woman in science.  Let me explain.

Friday I went out to lunch with a few other young female science faculty.  It was great, and I really enjoyed the chance to hang out with other women with similar careers, which doesn’t happen often since I’m the only woman in my department.  That said, there was a painful moment.  We were just goofing around, trading stories about getting pulled over by the police, when a chemistry professor told a story about getting pulled over when her daughter (her eldest) was only a week old.  Her husband had called, she had answered her cell while driving (a no-no in the state we live in), had heard her daughter crying in the background, and immediately “milked” herself through her shirt.  Needless to say, she was a mess when the cop walked up to her car.  He was reportedly very sympathetic.

This highlights one of the experiences I’ve found so awkward and unsettling after losing my first baby to placental abruption.  Women love to talk about pregnancy and childbirth.  Before our daughter died, I didn’t have much to contribute to these conversations, although I was generally fascinated since I always knew I wanted to have kids and I was curious to hear the insider perspective.  Now… I actually have some stories to add (I was pregnant for 4.5 months and went through labor and delivery, after all!), but for one thing it makes me feel sad to recall them, and for another I’m always afraid that they’d be too sad and/or horrifying for me to reasonably drag into a typically polite and lighthearted conversation, so I don’t.

When the chemistry professor told the story about “milking” herself in front of the police officer, it made me remember how my milk had come in and had leaked for days from my rock-hard, swollen, hot-to-the-touch breasts.  In particular, her story reminded me of how, more than a week after I thought my milk had dried up, I had an incredibly vivid dream about my daughter.  In my dream, everything happened exactly the way it had happened in real life (going to the prenatal checkup, the midwife being unable to find the heartbeat on doppler or ultrasound, etc.), but instead it was all a terrible mistake, and my daughter was born healthy and happy.  My dream was full of love for the bright, cheerful girl I had given birth to.  When I woke up, my breasts had leaked and soaked through the front of my pajama shirt.  Looking back, I am fascinated by the mind-body connection that caused the intense motherly emotions I felt in my dream to have such tangible physical consequences.

Anyway, I didn’t tell this story at lunch, but it came back to me vividly, and I sat there lost in thought, feeling sad and wistful… and different.  It’s such a change from the way I used to feel during pregnancy/birth conversations… before, I felt like a young initiate, getting an early glimpse into the cult of motherhood that I would join in a few years.  Now, I feel very much on the outside, totally other from these magical parents with their magical, normally functioning bodies, and uncomfortable even mentioning my strange, otherworldly experiences for fear of making them uncomfortable.

That moment was painful, but it passed, and I was able to recover and rejoin the conversation.  But yesterday I finally lost it in public.

This weekend I brought some students from our college to an event for undergraduate women in physics.  For lunch, they divided the students up into about a dozen small groups, each of which had lunch with a different female scientist.  The lunch leaders introduced themselves to the whole group before everyone split up.  I watched as they went down the line, and each talked about her research and… family situation (which I always appreciate as an undergraduate, but which is particularly painful to me now).  They pointed out that everyone up there was a mom, which gave me a pang of sadness and guilt — I’ve always wanted to be that female scientist role model, who deftly juggles science and babies and dishes out advice to her students.  Last year one of my advisees mused aloud to me that even though I was a great role model in most ways to her, the young male faculty member in my department was in some ways better because he has kids (which stung a little at the time, when I was struggling to get pregnant, but now would probably utterly do me in).

To top it off, two of the women were pregnant.  One of the pregnant women was about as far along as I was when my baby died.  To hear her blithely mention that she was due in June felt like a stake through my heart.  I wanted to shout “God, don’t tell people!  Your baby could still die!” although of course I realize that the odds are overwhelmingly in her favor (which went through my head with just a touch of bitterness, since the odds were in my favor as well, and in some strange way I feel like I “took the fall” for all other 4.5-month pregnant women — irrational, yes, but honest).  And then, for the kicker, one of the pregnant women works in my field (I have met her a couple of times but don’t know her well), and she announced that she is due a month after my baby would have been born.  I looked at her hugely pregnant belly, and all I could think was “that should be me.”  As you might imagine, as this panel of introductions proceeded, I started to feel quite fragile.

Then, the other faculty member from my school, who was sitting next to me, started whispering about a change in our policy about bringing kids on campus, and how the stories these women were telling made her realize how important it was, and then my lower lip started shaking.  She eventually noticed, and said, “Are you OK?” and that was when I burst into tears.  I think I was discreet enough that only she and the student sitting next to me realized that I was sobbing, but I can’t remember EVER losing it like that in public before.  I couldn’t stop crying for several minutes.  She asked if I wanted to go to the bathroom, but imagining getting up, wading through the row of auditorium seats and walking to the exit while blubbering… it just didn’t seem like a good idea.  I didn’t want to make more of a spectacle of myself than I already had.  Eventually I got control of myself, but they sorted the audience for lunch by location in the auditorium and we got placed in the group with the hugely pregnant woman in my field, which just felt cosmically awful.  I jumped ship and switched to a different group, but even once I slipped into a group with an older woman who I knew wouldn’t be talking about pregnancy I felt myself physically shaking — shivering, like I was cold — for something like the first half hour of the lunch.  It was awful.

In the car driving back with the other woman from my institution that evening, we talked about it and she was very sweet.  She had known about my baby dying, but didn’t realize that I still had ongoing medical issues (because why would she?!), and hadn’t realized quite how fragile I still was.  It felt surprisingly therapeutic to tell someone — anyone — from my work about what was going on.  Nobody I work with has checked in about how my husband and I are doing since the first week or two after our loss, and as a result nobody at work knows about any of the complications I’ve experienced, and it feels awfully lonely to be going through so many difficult setbacks without any support at work.  So breaking that silence was the silver lining to finally losing it in public.

So, that’s my story for the day.  I’m not sure I’ve ever cried in public before — it was awful and embarrassing, but I couldn’t help it.  I was very much not in control of my emotions.  I’ve tried to think about how I might handle it better in the future, and I don’t know… I think the key is just to learn to remove myself from triggering situations sooner (getting up and excusing myself, and going to the restroom until I feel back in control).  But often these things just sneak up on you — I’m not sure I could have predicted that I would react so strongly to seeing these women, particularly the pregnant ones, and hearing their happy family stories.  In that case, I think the only takeaway is that while it was embarrassing, my colleague reacted only with empathy, which is likely to be a common response.  I never think less of the students who burst into tears in my office (it happens more than you might think!) and am often honored that they’ve chosen to discuss difficult emotional topics with me.  My colleague’s sympathetic response reminded me of the good in people, that most of my friends and colleagues really do mean well and want to support me even if they don’t know how.  I’d be happy to hear anyone else’s story of losing it in public, how you dealt with it, and how you try to avoid or deal with situations that bring up difficult emotions.

“Do You Have Kids?”

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“So, do you have kids?” “Uhhhh….”

It’s such a simple question until it’s not.

Last week I was at an academic conference, out to dinner with a grad school friend and another young female faculty member, one of my friend’s collaborators whom I’d just met.  Three gals at a hip restaurant, talking science and life in science, catching up on the one hand, and getting to know one another on the other.  And then out it popped, a question I’d been bracing myself for for months, but still somehow it caught me by surprise.

“So, do you have kids?”

For a moment, I didn’t know what to say, so I didn’t say anything.  It just stopped me cold.  That got awkward, so I said, “Nnnno.”  It came out sticky, just like that.

The situation was even weirder because my grad school friend sitting next to me knew about my second trimester loss — she’d heard about it from another mutual grad school friend I’d seen at a conference over the summer when I was three months pregnant and just starting to tell people.  Then I went back to give a colloquium at the same place in the fall, only a few weeks after our baby died, so it was obvious.  I guess word got around after that.

I was clearly being weird at that point, so I just said, “Well, [friend] already knows: I had a placental abruption when I was four and a half months pregnant this fall.”

New science acquaintance expressed her sympathy, and fortunately someone changed the subject.  I smiled and nodded for a while, feeling a little shell-shocked, and eventually rejoined the conversation.  But ugh, did I feel bad about what had happened.  Both about being so awkward as I was first meeting this cool young scientist (did she think I was a drama queen? would she forever think of me as that poor young professor whose baby died?), and about having initially denied my daughter’s existence.  There’s suddenly no good answer to that deceptively simple question.

A related question that tormented me particularly in the early days was whether or not I am now a mother.  The medical establishment is fairly ambiguous on this point.  On the one hand, I was about a week and a half shy of the dividing line between “miscarriage” and “stillbirth” (in the US) and no birth certificate was issued.  On the other hand, I signed two hospital forms on a signature line labeled “mother,” one authorizing an autopsy and the other specifying how we wanted our daughter’s body disposed of afterward.  There’s certainly no denying that I went through labor and gave birth to a baby, albeit a small and dead one, and that I briefly held her and admired her perfect tiny fingers and her still-fused eyelids.  But I’ve had none of the traditional experiences of early motherhood: the sleepless nights, the struggle to breastfeed, cleaning up explosive poop, watching the chubby limbs start to explore, the first smile… I feel a little bit like a fraud claiming to be a mother even though I do think of the baby I lost as my daughter.  I know it’s absurd to feel like a fraud, and that my identity is up to me to define, but I just wish I had had the chance to do something — anything — more for my daughter than decide what to do with her dead body.

So, we’ll see how I answer this question in the future.  I’m sure it’s not the last time it’ll come up.  Like so many other things about this experience, I am tempted to think that it will no longer be an issue in the hazy someday when I finally have a living, breathing child, but I know that’s not the case.  The trouble spots will just morph into new questions: “Is this your first?” and “How many children do you have?”  I’d appreciate any suggestions… how do you deal with these difficult questions after loss?

Teaching through a Miscarriage

Let's think

Wow, she even remembered the constant of integration!

And now for my first academia-focused post…

Google rarely lets me down, but there is just not a lot out there about going through a miscarriage while teaching at the college level.  Tons of hits on how to help your students through their miscarriages, and a few stories from K-12 teachers who got substitutes, but what do you do when you’re teaching an advanced 13-week class for college students on your own particular specialty that nobody in the department can reasonably cover for, and your life suddenly falls to pieces?  (Obviously not just a miscarriage issue…)

Here’s a little bit of an inside look at experiencing a miscarriage while being a college professor:

I canceled only one class.  I’ve mentioned before how dumb this was in retrospect, but at the time I was freaking out about lots of things, most of which were out of my control, and getting extremely far behind in my teaching responsibilities was one fear that I could actually do something about.  Also, after a few days of sitting at home slowly realizing that my baby was actually gone and sobbing inconsolably and zoning out in front of about a dozen episodes of Buffy, I wanted nothing more than to escape from my own head for a while.  Seriously, I felt trapped, and it was scary.  I have never felt that way about my brain before.  I was hardly able to focus, but when I did finally manage to force my way through grading a few problem sets, the hour or two of relief I got from the obsessive misery I was experiencing felt therapeutic.  Your mileage may vary, of course, but for me, grading was an escape.

I think about half of my students knew I was pregnant.  After the 14-week ultrasound was normal, I had made the announcement to my research group, since I wanted them to hear it from me (rather than worrying as they saw my belly start to expand, or hearing the news from a colleague) and I wanted them to know I had a plan for how to handle my leave during a semester when two of them would be writing theses and graduating.  So my research students knew, and some of the other seniors and masters students knew since it had come up at a department happy hour.  And maybe some of the others guessed or gossiped, I don’t know — I felt like it had to be obvious by the time I was 4.5 months along, especially since it was late summer and I was wearing form-fitting short-sleeve tops, but I know that (thankfully) not everybody is as attuned to my body as I am!  Anyway, I told my research group right away by email what had happened (in very few words), and I’m sure word got around to the other students.  The students who did acknowledge it were generally lovely.  Two of them left flowers and cards outside my office.  I never said anything in class either about my pregnancy or the miscarriage.  When I canceled the Monday class, I told them by email that I had had a serious health issue and had been in the hospital over the weekend, but that I expected to be back by Wednesday, and I was, and that was that.

Going back to teaching was… surreal.  There’s no other word for it. My first experience back in the department on Tuesday was to go to a seminar that one of my colleagues was leading.  I still remember sitting there, hearing nothing that he said (or at least not processing any of it), and seeing visions of my dead daughter interspersed with plots and bullet points.  It amazed me that everyone could act like nothing had happened, or that anyone cared about what we were talking about (I sure didn’t).  When I taught the next day, I just walked in there like nothing had happened and got started.  I was still dizzy, so I made sure there was a chair, and I sat in it for some of the class.  There was one point when I was writing on the board and I got a wave of dizziness.  I felt like I swayed a little — I’m not sure — and I know I stopped talking for a moment… but I was so determined to get through the class that I just plowed on.  To me, the class felt like a mess, but at the time I didn’t care.  At least the preparation, just like the grading, forced me to focus on something outside my head, something other than the disaster that had just hit our family.  I’m not sure that it was entirely healthy to try to avoid my morass of feelings that way, but there was no one right thing to do, and I just muddled through as best I could.  I spent plenty of time processing my emotions over the subsequent weeks and months (clearly I’m still doing it!)… teaching just allowed me to spread it out a little to keep it from becoming overwhelming.  It occurred to me to wonder at some point how stay-at-home moms manage, when family is so much more central to their daily lives and they have no secret identity to escape to.

The most absurd teaching day by far went like this: I rescheduled my canceled Monday class for the Friday 1.5 weeks later.  The day before the make-up class was scheduled, which was also two weeks after they had started inducing labor, I went back to my midwife to investigate the intermittent heavy bleeding and pain I’d still been having.  The midwife suggested an ultrasound, and said that the hospital would call me to schedule it later that day, and that it would take place on Friday.  She wanted to get it resolved as soon as possible in case it was something like a retained placenta that could make me hemorrhage.  So, Friday morning I started calling the hospital and my doctor’s office about scheduling, in between preparing for the make-up class and meeting with my students.  I met with my research group members in the morning, but during one meeting I had to excuse myself three times to take calls from the hospital and my doctor’s office as they sorted out the missing order and got me on the schedule for an ultrasound that afternoon.  I worked through lunch to prepare my class (just as I was putting my first spoonful of lunch to my mouth the office called to tell me not to eat just in case I had to have surgery that day), went to the hospital at 2, had an incredibly painful transvaginal ultrasound (twice, since they had a student do it the first time — normally these things aren’t at all painful, but everything was still quite tender), and then went back to finish prepping my class while I waited for the doctor to call with results.  At 3:30, my doctor called to say that the ultrasound didn’t look normal and she was recommending a D&C for retained products of conception, and that we would do it that night if I was ready.  I said yes, since I just wanted to get this all over with.  So, she gave me the pre-op instructions, and I called my husband to make sure he could drive me to the hospital after work.  Then I picked up my notes and went to teach my class, lightheaded from fasting all day, still leaking blood and ultrasound goo, freaked out about having surgery in a couple of hours, but slightly manic about it all.  I have no memory of that class whatsoever.

Somehow, I made it through the rest of the semester.  Academics tend to be fanatics about their jobs, and most of the time I think I have the best job in the world.  But for a few weeks after my baby died, I just didn’t care about anything, least of all my job, and the extreme apathy that settled over me was scary (in retrospect; at the time it was a mere curiosity, since I didn’t really care about the apathy either — that was weird).  I prepared for class only minimally; I’d copy out some notes from the last time I taught the class once and call it good (this is NOT my normal method!).  On some level I felt bad that the students weren’t getting the best professorial version of myself, but on another level… apathy.

Oddly, one useful thing that the semester taught me was that I can get away with a LOT less preparation than I normally do.  Even with everything that happened, I got really high student evaluations.  There were a few comments about how I’d botched some derivations (those classes were disasters, seriously — the embarrassment was almost enough to penetrate my haze of apathy), but a full 3/4 of the students nevertheless rated the class and my teaching “outstanding.”  It’s possible they were being nice because they knew what had happened, but I don’t think so.  My canceled class was only in mid-September, and I know that none of the students had any idea about all the complications that dragged on for weeks.  My “fake-it-til-you-make-it” approach (which has gotten me through much of the transition to professorhood, by the way) seems to have worked, and plowing through those classes was evidently good enough.

So, that’s my story.  I have very little advice for anyone going through the same thing.  I can only express my extreme condolences, and hope that your recovery is as smooth as possible.  I’d like to say that you should take as much or as little time off as feels right to you, and trust yourself to be the judge, but I remember at the time feeling like that advice was unrealistic in the extreme.  I didn’t feel that anyone else could cover for my classes (although I got a couple of offers), and I felt a strong responsibility not to let my personal tragedy screw up the educational experience of all my bright young students. And ultimately, I think that sense of responsibility, and the pressure to focus on something objective and numeric, was actually therapeutic in a way.  There is no good way through this — you just have to get through it however you can, making sure to take care of yourself and your family first, and know that from the outside nobody sees what a complete and utter wreck you are.  Your prior teaching experience will carry you through if you need to keep teaching, and it won’t look as bad to your students as it feels to you while you’re going through it.  I survived, and you can too.

What not to say after a 2nd trimester miscarriage

Thank goodness that second trimester miscarriage is so rare.  I wouldn’t wish it on my worst enemy.  But if first trimester miscarriage is taboo and misunderstood, second trimester miscarriage is even more so.  Today I’d like to write about some of the well-intentioned but in fact very painful things that people said to me, that might not have been as painful for someone who had experienced a first trimester miscarriage.

I’ve read a lot about how people recovering from a miscarriage were both shocked and comforted by the huge numbers of people (mostly women) who came out of the woodwork with stories of their own miscarriage experiences and (generally) subsequent healthy births.  My experience was exactly the opposite. I wasn’t shocked, since I’m both the daughter of a women’s health nurse practitioner and an obsessive statistics reader, so I knew that anyone with a 2- or 3-kid family had about coin-toss odds of having experienced a miscarriage.  And I was not comforted, because I felt that the physical (if not emotional) experience of my miscarriage was very different from theirs, and I know that my prognosis is different as well.  So while “Oh, honey, I had a miscarriage between kids 2 and 3 and I recovered quickly and went on to have more beautiful children” might be comforting to someone miscarrying at 9 weeks, who has every science-backed reason to believe that they *will* recover quickly and go on to bear future beautiful living children, it was not to me.  Nor was “Oh, the same thing happened to me!” (bet you ten bucks it didn’t) or “I know just what you’re going through!” (no, you really don’t).  Instead, these types of statements left me with feelings of being misunderstood and alienated, even from other people who had experienced miscarriage!

Some context: Instead of the surgical or home medical management that is typical for first trimester miscarriage, I had no choice but to have labor induced and deliver in the Labor and Delivery ward of the local hospital, which involved holding my dead baby while listening to the cries of newly-born live babies from down the hall.  I’ve been told I have a 30% risk of placenta-related complications in future pregnancies, and all my future pregnancies will be high risk; that’s not something that happens when you have a first-trimester miscarriage.  I’ve found studies (albeit with small sample sizes) that show that women with a history of second trimester miscarriage and Factor V Leiden have miscarriage rates as much as 2-3 times higher than the general population (particularly in the second trimester!); my perinatologist has offered prophylactic blood thinners for future pregnancies, which means that throughout any future pregnancy I’ll be giving myself daily injections (twice daily in the last month).  And I experienced complications after my miscarriage that are ongoing and may have further serious implications for my future fertility.  Most of these things are outside the experience of someone who has had a first trimester miscarriage — and naturally they have no idea that that’s the case.

So those are the stickiest ones, because they really are so well meaning but ultimately hurtful.  Here are a couple others that were said to me — again, I’m skipping the obviously terrible ones, and focusing on the ones that were meant with nothing but kindness yet wound up hurting bitterly.

“It’s so nice that you got to take a couple of days off!” – On Thursday afternoon I found out at a routine prenatal appointment that my baby was dead.  Friday I was in labor.  Saturday I was discharged from the hospital.  Sunday my milk came in and I was so dizzy that when I tried to walk the dog with my husband I couldn’t make it home and he had to come pick me up in the car.  Monday I was sitting at home dizzy and bleeding and icing my chest (not to mention weeping uncontrollably), and there’s no way I could have lectured for 1.5 hours.  You bet I took a couple of days off (Friday and Monday, to be precise), but it wasn’t “nice,” it was necessary, and in fact insufficient!  Frankly it was phenomenally stupid to think I could teach again by Wednesday, and a few comments on my teaching evaluations reflected my careless preparation in the middle of the semester when my job (which I normally love) was approximately the last thing I cared about.  With 20/20 hindsight, I really should have taken the week off, at least.

“You look great!” – Really?  Because I feel the worst that I have ever felt in my life.  I lost 12lbs literally overnight, and a few more in the week after that when my appetite completely disappeared, and the burgeoning belly that I LOVED with every fiber of my being was gone, also overnight.  I was one of the lucky girls who skated through teenagerdom without significant body image issues, possibly related to the fact that I have a disabled father and was always able to appreciate what my body could DO rather than what it looked like.  But for the first time in my life, my body has failed me, utterly and completely, in its most essential biological function.  I may look great (although I doubt it), but I am still gushing blood, feeling dizzy and sick, and for the first time in my life I hate my body.  Would you tell a cancer patient who lost 15lbs in a week that she looks great?  Thought not…

OK, moving on, what SHOULD you say to a woman (or a man) who has experienced second trimester miscarriage?  I can’t pretend to speak for everyone, but the most helpful people kept it simple, asked open-ended questions, weren’t pushy but left the door open for as much or as little as I wanted to talk (in reality, I was dying to talk about things, because it has been the biggest/only thing on my mind for the past four months), were kind, and didn’t make the interaction about them or their experiences.  Ideal interactions for me went something like this: “I am so sorry for your loss; can I give you a hug?” “How are you doing?  Really, I want to know.” “If you want to talk about it I’m here, but if not that’s fine too.  What do you need?”  “We made/sent you some dinner/chocolate.”  “Would you like to go for a walk and catch up?”  Crucially, the people who were most helpful kept checking in.  One of my closest friends (whose wife was due with their second within a week of my due date) called nearly every day — while the circumstances could easily have devastated our friendship, we are closer than ever because he was so thoroughly THERE for me, and didn’t back off even though I spent hours sobbing into his ear from across the continent.  And other friends were lower-key, but weeks or months later I’d see an email that said “Hey, I just wanted to let you know that I’m thinking of you and I know you might be having a tough time with the holidays. I’m here if you want to talk.”

I mean, seriously, that last one… grief is always awkward to talk about, and it often feels like everyone else moves on faster than you do.  I haven’t been able to move on, since I’ve had so many ongoing complications, so it’s still a very current part of my life… but hardly anyone brings it up anymore, and I feel bad raising the issue because I don’t want to give people TMI.  But any other medical issue that landed me in the hospital twice in two weeks and required corrective surgery months later… people would be talking to me about it, asking how I’m doing… or would they?  Maybe it’s not just because it’s a squicky women’s issue; maybe everybody is this bad about grief and loss.  Maybe I’ve been this bad about it in the past when other people have experienced loss.  One of the ways I’ve been working to mold this into a constructive experience is to think about how I can be more empathetic to others who have experienced loss or other difficult times.