Tag Archives: miscarriage

Back on the Roller Coaster

It has now been two full months, or about 9 weeks, since my (2nd) miscarriage.  I’ve honestly been pretty numb to it all… except the last few days.

It’s a very different experience, having a 1st trimester loss after (1) a previous 2nd trimester loss, and (2) the birth of a living child.  Everyone’s experience of grief is different, and I know that if I hadn’t experienced those two key events in my life, this event would have been much, much harder for me to process.  As it is, I’ve mostly just been able to write it off as bad luck.  This is my 1 in 4 pregnancies that probably had some chromosomal defect that my body rejected.  We’ll move on and try again.  That’s that.

Until the last few days.

I’ve had highly significant ovulation pain every cycle since the birth of my son, so I’ve been able to tell pretty clearly when I’m ovulating.  I knew that I had ovulated about two weeks ago.  But as the days ticked by and my period didn’t arrive, I started feeling that roller coaster of TTC emotions that I remember so well.  It’s like there’s a constant subprocess looping in the back of my brain:

Could I be pregnant?  It’s too early to tell.  I could take a test!  No, that’s a waste of money — if I still don’t have my period by Monday, then I’ll be pretty sure and I can just take the test to confirm.  Let’s google when your period returns after a miscarriage.  Mine sure seems late!  But I think I know when I ovulated, and that was less than two weeks ago.  Let’s google about getting pregnant before you get your period after a miscarriage.  It’s a thing that happens to people!  But it probably won’t happen to me, because we don’t tend to get pregnant easily.  But we did this last time.  But I really shouldn’t get my hopes up.  Chances are I’m not pregnant.  But could I be pregnant?

And repeat, with increasing intensity, for three days.  UGH.

I won’t keep you hanging any longer — I got my period yesterday.  I’m not pregnant.  I didn’t really think I was.  But boy, did I hope!  I was so mad at myself for hoping, too — or really, for caring so much.  It was so nice after my son was born to just not obsess about my cycle endlessly, and I’m annoyed that now I’m back to doing it even though I really don’t want to.  I guess it’s a good thing that I got my period, since it hopefully means my hormones are back to normal (or my body’s best approximation thereof) and now we can really start TTC again in earnest.  But it’s also a reminder of just how much time it’s taken to go through this miscarriage — this is my first period since March.  Four months of lost time, and another lost baby (albeit a very small one).

Well, I knew that getting pregnant again was likely to be a long haul, so it’s good that we started trying early.  And we’re still in the zone of inconvenient timing relative to my tenure clock, so from that perspective it’s OK if this takes another 6 months or so.  Just not much more than that, please.  I’m not sure I can handle the emotional roller coaster for another two years.

Hopefully the approaching onslaught of teaching and advising and committees and meetings will distract me from the TTC roller coaster.  Hopefully I can just turn that subprocess down to a dull roar in the back of my mind while we keep pushing on with our quest for another living child.  Hopefully it won’t eat up too many more years of our lives and hopefully there won’t be too much more disappointment and heartbreak to come.  Hopefully it’ll be a smooth journey and another uneventful pregnancy.  That’s a lot to hope for, but hopefully at least some of my hopes will come to pass.

Talking about Family Planning with Students

Last week the senior faculty member in my department hosted his annual 4th of July barbecue for our department — all the faculty, their families, and all the students who are here doing research for the summer were invited.  It was quite a crew (for a liberal arts college), with 30 or more people hanging out in his backyard, munching hot dogs and (veggie) burgers, and splashing in the pool.  It was a beautiful day with some really great people, and I love that my department is such a welcoming and family-friendly place (this is one of several regular events throughout the year at which partners and children are explicitly encouraged to attend).

I was sitting on the grass with my son on my lap.  He was contemplatively munching on a veggie burger.  We were surrounded by students.  They were commenting on how much he’s grown since the last time they saw him, how long his hair is (it’s in these amazing platinum-blond ringlets right now since we haven’t cut it yet), asking what new things he can do, etc.  Then, one student busted out with “Are you going to have more kids?”

I gave my stock response: “We’ll see!”

Another (perceptive) student said: “It sounds like maybe you say that a lot.”

I laughed and said, “You’re right!  A lot of people are curious.  Almost as much now as when my husband and I first got married and we got lots of questions about when we were going to have kids.”

Another student said, “It’s kind of a personal question, isn’t it?”

I said, “Yes, it’s personal.”

The student who asked in the first place apologized.  I told her I didn’t mind, that I was also very curious about things like that when I was her age.

It was a brief twinge of discomfort in an otherwise lovely day.  I kept turning it over in my head.  I almost wanted to tell them why it was personal — to tell them about the daughter we lost before our son was born, or the fact that I’ve been pregnant three times with only my son to show for it, but I didn’t want to spoil the festive mood.  On the other hand, I feel that we generally do our young people a disservice by being so closed-mouthed about the realities of pregnancy loss and infertility.  I teach my students lots of things, and sometimes they learn from me whether I want them to or not — I know that the students have been keenly interested in my life since I revealed that I was pregnant with S (the students were also keenly interested when I was pregnant with his big sister, although that generation has all graduated by now).  I also know that for all the young women, I am the sole example they have of a female professor in our field, which can feel like a heavy responsibility.  I want them to be encouraged by my example, not daunted.  But I also want to prepare them for challenges they are likely to face.  There were about 8 students sitting with me on the grass during this conversation — odds are that several of them will experience miscarriage sometime in their lives, and probably one of them will experience infertility.  Is it better to prepare them, or to let them find out for themselves?  I made a choice in the moment, a choice that felt right to me at the time, but I could imagine having handled it a different way.

For now, I educated them that asking questions about fertility plans is personal.  I’ll save the conversation about pregnancy loss for another time.

Update

It’s been a few weeks since I posted an update, so I figured I’d put up a brief post.  I think the two main pregnant-physicist-related news items are:

  • I’m still waiting for my period.  It’s been 6 weeks since I stopped bleeding, so I’m starting to get impatient (they say to expect your period 4-6 weeks after a miscarriage).  I’ve got a follow-up appointment with the OBGYN in August, so hopefully it’ll show up before then, but I’m still in limbo otherwise.
  • According to the pediatrician, S is officially a late talker.  He’s a 16+ months now, and we can self-refer to our state early intervention office anytime — the pediatrician recommended waiting until 18 months (even though he’s officially late already), so that’s what I’m planning to do for now.  Lots of people tell me it’s too early to really worry, that boys talk late, etc., etc… but I’ve got to say that unlike some of the other milestones, I really don’t see any signs that talking is even on the horizon.  He’s still missing things that he was supposed to be doing at 12 months — trying to mimic words that we say, babbling with a wide variety of consonants and vowels (if anything, I hear less variety now than I did at 12 months), no mama/dada, etc.  I’m not actually all that worried yet — his comprehension is great (so much so that we’ve had to start spelling certain words), he makes his needs known, including through a couple of signs, and he’s super-social.  If anything, I suspect it’s limited to a production problem rather than a comprehension problem or autism spectrum issue (I filled out the M-CHAT and he scored just fine).  But it’s one of those situations in which you’ve got to strike a tricky balance between being laid-back and letting your kid develop at his own pace while not missing out on opportunities to help out your kid if they need it.  Language seems to be one of those areas where early intervention can really help (and isn’t going to hurt), so I don’t want to wait too long, but I also suspect he’ll be just fine in the long run.

Otherwise, we’re having a nice, busy summer.  I just started parent-baby swimming classes with S at the YMCA last week, and I count it a success since he didn’t cry the whole time. 🙂 I invited a friend whose daughter is in S’s daycare group (she’s a few months younger) to join us, and I think that was a great idea — the kids clearly enjoyed seeing each other in this otherwise scary new situation.  We also took S to the beach when we visited my mom this weekend, and after some initial skepticism, he loved playing in the sand and knocking down the sand castles that we made by filling buckets with sand.  He is SUCH a happy kid these days — really goofy and giggly, still snuggly and velcroed to his mama in new situations but warming up pretty quickly, and I have to say that I am loving these early toddler months.  It is amazing how much he’s learning and doing, his sleeping schedule has settled into long nights and a chunky midday nap, and he’s still got a huge dose of baby sweetness combined with toddler curiosity, a sense of humor and emerging personality — there’s never a dull moment, and it’s so much fun (most of the time).

Well, that’s all I checked in to say… I hope I’ll have more news to post here sometime soon once the miscarriage waiting game is finally over.  Happy summer to all!

Grrrrrraduation

Please permit me to grouse for a moment.  I don’t get to do it much in real life these days since I haven’t told many people about our miscarriage.

Last weekend was our university’s commencement ceremony.  One of my research students just finished his bachelor’s degree and is staying on in my research group to write a masters thesis next year.  So, he graduated this year, but he’ll also graduate next year (assuming all goes well).  He’s a nice kid, came in as a transfer student from a big state school after his sophomore year, switched majors from English to physics at the same time, and then proceeded to complete the entire physics major in two years!  He’s had some hiccups, and his research skills need work (which is why I’m glad he’s staying for a masters), but it’s extremely impressive that he did what he did.  He’s also just a really nice kid, who works really, really hard, and so despite some of my frustrations with his lack of research progress, I very much enjoy working with him.  I was really looking forward to meeting his family this week and telling them how great it’s been to have him in my research group and how glad I am that he’s staying for another year.

But his dad.  OMG.

To set the scene a little: One of my colleagues (who has three kids) traditionally brings his kids to watch commencement from a beautiful grassy hill overlooking the ceremony, right near our building, which makes a convenient meet-up point for our majors to come visit after the ceremony.  This year I decided to bring my son and join him — it allowed me to participate in commencement and congratulate our students without giving up weekend time with my son, and my son had a blast playing with my colleague’s kids on the hill during the ceremony (or mostly watching them in awe and trying to steal their baseball when they weren’t looking).

So, after the ceremony, my student wanders up with his dad.  I get to congratulate my student, beam, and lay it on thick with his family — I really love getting to talk up my students to their parents, especially students that I genuinely enjoy like this one.  It’s a win-win feel-good situation.  Then his dad stayed to chat while I was supervising my son’s shenanigans with the big kids.  The following conversation ensued:

Him: How old is your son now?

Me: 15 months

Him: So, are you going to have another one?

Me (inwardly rolling my eyes): We’ll see!

Him: No, but really, do you WANT more?  Are you planning on it?

Me (through gritted teeth): We’ll see!

He actually seemed like he was going to push the subject(!) so I excused myself and scooped up my son.

How clueless are people?  And why, WHY would you ever think it was OK to interrogate your kid’s professor about her reproductive plans?!  This one of the few times that I felt that bringing up our losses would have been not only socially awkward but… unprofessional.  I mean, there were times when I had to discuss the loss of our daughter with colleagues, since it affected a lot of my professional life as well as my personal life.  But… a student’s parent?  And a week after a miscarriage?  Seriously?  Argh.

Several people have asked me about my reproductive plans since our miscarriage (which was only TWO WEEKS AGO), but this one has just been gnawing at me.  I’m so angry about it.  Oh, I won’t hold it against the student… if people held my dad against me I’d never have gotten anywhere in life.  But I might just try to avoid one-on-one conversations with his dad next spring.  And I also want to vent on my blog.  Check that one off the list!

Anyway.  Things here have settled down a bit.  I did have one freak-out this week… I had some pelvic pressure, pain, and fever, but I also had a terrible respiratory infection of some sort from my son that might have accounted for the fever, so I didn’t know what exactly was going on but I was so afraid that I was getting another pelvic infection.  The doctor was great, saw me right away, did a repeat ultrasound, redrew my HCGs, and assured me that the fever is probably unrelated.  Turns out I have a medium-size ovarian cyst, which she said can be common during pregnancy or after a miscarriage and is most likely responsible for the pelvic pressure and pain.  I had a cyst during my first pregnancy with my daughter as well, so I think it’s just something my body does in (doomed) pregnancies, maybe?  Anyway, I am mostly reassured and only feeling a little sheepish for having another freak-out around this miserable pregnancy.  I think it’s just that with everything I’ve been through I really don’t trust my body anymore.  With my first pregnancy, I was a pretty laid-back pregnant lady, but look where it got me — not only did my daughter die, which was unavoidable but nevertheless made me question every little risk I took in that pregnancy, but when I didn’t push about getting symptoms addressed after I delivered her, I wound up with retained products, hemorrhaging, and an infection that damaged my fallopian tubes.  I am just so done with the laid-back approach and am glad that they are investigating my worries comprehensively.  Hopefully this is really the end of it now!

Slow-Motion Miscarriage

I really wanted medical management of my miscarriage, i.e., to take medication to speed it along.  I wound up not having that option, since my indicators last week were not great, but also not totally inconsistent with a healthy pregnancy.  Since my doctors weren’t sure, they didn’t want to intervene with medication or surgery (a decision I certainly understand and agree with), which meant that I wound up undergoing a slow-motion miscarriage as, over the course of the week, I slowly went from spotting to bleeding to passing tissue and knew that it was over.  An ultrasound this morning confirmed that my body passed the tissue on its own (even though I am still bleeding), so I have officially miscarried.  Gravida 3, para 1.

The strange thing about going through a slow-motion miscarriage is that you can’t just curl up at home with a pint of Ben & Jerry’s and wait for it to pass.  I mean, I guess you could (perks of the flexibility of an academic job?), but mine has gone on for at least a week, and that would require more pints of Ben & Jerry’s than I am really comfortable consuming.  So, as a result, I wound up doing a lot of things that I never imagined I might do while having a miscarriage:

  • Having a miscarriage during research meetings with my students and postdoc
  • Having a miscarriage while talking with my department chair
  • Having a miscarriage while writing an invited major review article on recent advances in my field
  • Having a miscarriage while sitting on the grass and listening to a student folk music concert with my toddler
  • Having a miscarriage at my department’s end-of-year party
  • Having a miscarriage while baking cookies and playing board games with my old college roommate, visiting from New York City
  • Having a miscarriage during an ice cream fundraiser for my son’s daycare

I mean, on the one hand, if you have to have a slow-motion miscarriage, many of these things are quite pleasant ways to pass an otherwise depressing time.  On the other hand, I’ve felt weirdly disconnected from my life this week, and it’s bizarre to be engaged in some other activity and then have the intrusive thought “wow, isn’t it weird that I’m doing this while having a miscarriage?”  It also feels strange, and somehow dishonest, to interact with other people when they have no idea that you’re having a miscarriage during the interaction — but not quite enough that I really felt like telling them about it (I did tell the two close friends who happened to call this week, and my visiting college roommate).

It’s also frustrating because my son seems to be old enough now that people feel comfortable asking me if we’re planning to have another baby.  Twice this week alone, I got the question, and not from people that I’m particularly close to.  I wanted to yell at them that I was having a miscarriage, and they really shouldn’t ask questions about people’s reproductive plans (or at least point them to this amusing flow chart).  Instead, I just gave my stock answer of “we’ll see!”

One thing I found both disturbing and reassuring this week was a recent study on 2nd and 3rd trimester loss that was published in 2016.  I wasn’t aware of it until this week, since it wasn’t published yet when I was scouring the literature after we lost our daughter in September 2014.  I thought it was such a great study that I emailed the author to thank her for doing the work, particularly since there seems to be so little research on 2nd trimester loss.  You can read the full article here, but these are the two main takeaways for me:

  • Second and third trimester pregnancy losses are strongly correlated, indicating similar etiologies.  Once you have had a 2nd or 3rd trimester loss (including before 20 weeks), you are about an order of magnitude more likely than a typical woman to have another one.  The overall probability is about 4%, with recurrence more likely if the cause of your first loss was placental or maternal, and less likely if the cause was fetal or unexplained.  (This was the disturbing part — my first loss was placental/maternal, which puts me in the higher risk category of ~8% recurrence.  I sort of knew that already, but this was the first time I’d seen the probabilities broken down in that way.)
  • First trimester miscarriage is not correlated with 2nd or 3rd trimester loss, including recurrent 2nd or 3rd trimester loss.  Roughly a quarter of previous pregnancies ended in first-trimester loss for all the women in the study, regardless of the number of previous 2nd or 3rd trimester losses, which is not significantly higher than the general population.  (This was the reassuring part — it makes it more likely that my current miscarriage was just run-of-the-mill bad luck.)

So, anyway, here I am, just waiting again.  Waiting for the bleeding to taper off, waiting for my cycles to reestablish themselves, waiting to see if we can get pregnant on our own again.  The OBGYN had me make a follow-up appointment for August, mostly as a chance to check in and come up with a plan if necessary.  She half-suggested that I could go for an infertility evaluation at the local big state hospital system if I wanted, but since I’m already being followed by an RE at the other major hospital system in the state I figured it wasn’t necessary, at least not yet.  As I discussed with her, while it’s great that we spontaneously conceived (and so quickly!), it does make it hard to know how long to wait before going back to the RE again.  I did put in a note through the electronic messaging system to my RE to update her about this pregnancy and ask if she had any suggestions moving forward, and her one suggestion was: stop breastfeeding.  I’m not quite ready to do that yet, and it seems pointless to go back to her before I am.  So I guess the plan is to wait a few months, see what my cycles are up to, and then reevaluate.  I think I’m OK with that plan for now.

Because Nothing is Ever Simple

So, apparently my HCG levels are still rising.  They went from 1600-something on Monday to 2300-something on Wednesday.  Much lower than they should be at this stage, and not doubling particularly quickly, but still within the “normal” range for the 4w3d ultrasound measurement from Monday.  Argh.  So now they want me to go back for another ultrasound on Monday, just to make absolutely sure there’s nothing in there before giving me the misoprostol to end the pregnancy.

Oh, and to add insult to injury, when I got my blood drawn for the 2nd HCG test yesterday, by the time I got to my office (a 5-minute drive from the hospital lab) my arm had swelled up to the size of a tangerine at the site of the needle stick.  I freaked out and called my doctor’s office, and they said to come in, all so that the doctor could hand me an ice pack and tell me that it happens sometimes (supposedly when they drive the needle out the back of your vein so that it bleeds into the surrounding tissue).  As a bonus, I do have a large and colorful bruise on my arm today!

The doctor called last night with the HCG results, and was awkwardly trying to be reassuring while not giving me false hope — she is a really funny and weird old lady with whom I’ve had awkward conversations before (like the random 3rd-trimester checkup during my pregnancy with S where she said to me, “So, just to make sure, you NEVER, EVER use your cell phone, right?”  My husband and I were looking at each other confusedly, so she repeated herself… and I said, “Um, yes, I do, is that a problem?” and she said, “Oh, I mean, while driving!”)  So on the phone yesterday she kept saying, “Now, I don’t want you to feel like I’m being too optimistic.  But I don’t want you to feel like I’m being too pessimistic either.  I mean, we’ve seen it all.  But that doesn’t mean it’s going to work out this time.  But it might.”  And she kept going until I was like, “It’s fine, I’m glad you’re being thorough so that you can be completely sure before taking any action,” and she seemed content with that.  I like her because she always says exactly what’s on her mind and is very decisive and action-oriented — she’s like a little tornado of doctor every time she comes into a room, even if her verbal communication skills could use some work.  After the bad ultrasound on Monday she walked into the room and two minutes later whipped out a phlebotomy kit and drew my blood then and there for the HCG test — I’ve never seen a doctor do that before!  So I’m actually kind of glad she’s been the one managing this (likely) miscarriage even though I usually prefer the younger, kinder doctor (married to one of the other faculty members at my university) who made me feel so reassured after our daughter died.  I actually just want frank talk and decisive action rather than reassurance right now.

So now I’m just waiting… again.  I’ve been spotting for the past few days and even had some bright red blood this morning, so maybe this will all just end on its own soon.  But otherwise I’m in limbo until Monday.

Too Good to be True

We went for an early ultrasound today, when I should have been 6w1d or 6w2d according to my ovulation date (or 7w based on the date of my last period).  The only thing there was an empty gestational sac measuring 4w3d.

The ultrasound tech and doctor were bending over backwards trying to reassure me that it’s very common to get dates wrong in early pregnancy, but I’m quite certain of the dates (I mean, I had a positive home pregnancy test two weeks ago — it’s basically impossible that I’m only 4w now!).  There’s just no way this pregnancy is viable.  I also had an inkling, since yesterday (Mother’s Day in the US, no less) I had just a bit of mucus tinged with dark brown flecks that looked ominous.  That quick conception was just too good to be true.

I’ve got a lot of mixed feelings swirling around in my head right now.  I’m sad, obviously.  This was a much-wanted pregnancy.  It was a little quicker than we were expecting, but we were delighted that we were able to conceive so easily and looking forward to the prospect of a little sibling for S.  Honestly, I also felt like I might have dodged a bullet — if everything had gone smoothly, it might well have been the end of my reproductive phase of life, which it now looks like is going to drag on even longer with a bit more heartbreak.  I am so done with this phase of life… except that I’m not, because we really want another baby.

On the other hand, there are some silver linings.  The timing of this pregnancy was messing with my tenure clock, and now the odds are that I’ll be able to stick to my original clock, which would be nice.  Also, two under two was a little bit daunting, and now we’ll have a little more time to enjoy our amazing little guy on his own, and he’ll be a little bit bigger and more independent before (hopefully) a future sibling disrupts his universe.  I know these things.  They are not really all that comforting, though. I wanted that baby.  A lot.

The big question now is, what next?  Given how undeveloped the pregnancy is, why is my body still holding onto it?  The doctor drew some blood to check my HCG levels and told me to come back in a week, so there are no immediate plans to intervene (although she did say she’d call later today to discuss the outcome of the blood test).  I hate the waiting game more than anything.  I think that if nothing happens in the next week, I’ll start to ask for medical management with misoprostol.  I just don’t want this to drag on forever — I want it to be over with so that we can move on with our lives, and hopefully with another healthy pregnancy.

In a way, I’m also kind of uneasy about what it means that we conceived so quickly.  Does it mean that the RE won’t want to move forward with the plan we developed before I got pregnant this time?  Possibly not, since I’ve still been having irregular periods since my son was born, and I still have the abnormal HSG — those two things have not changed, although at least now we do have the good indication that my right fallopian tube is still functional after the birth of my son.  I can’t help but be certain that the quick conception was a fluke, and that we’re in for a long haul with conceiving another viable pregnancy.

I guess the other silver lining is that I’m handling this a whole heck of a lot better (at least so far, about three hours after getting the news) than I handled the news of our daughter’s loss at 18 weeks.  For one thing, it’s a lot less unexpected — having no heartbeat on an otherwise totally uneventful pregnancy at 18 weeks was like getting hit by a truck.  At least this time around we knew the probability of bad news was significant.  With early miscarriage rates around 20%, and this being my third pregnancy… well, it was not exactly an improbable outcome.

For another thing… we’ve been in worse places before.  Once you’ve handled second trimester loss, first trimester loss seems somehow more bearable.  That’s not to say that first trimester loss isn’t devastating for many families — of course, it is.  My heart breaks for the stories I read here about first trimester loss — multiple losses, no living children… it’s devastating.  You can’t measure or weigh grief.  Our grief this time is just a little more muted, by two things: the loss of our out daughter “broke us in,” in a way — I just don’t expect good news when I’m pregnant anymore, so this bad news was a little easier to take because of our experience with bad news in the past.  And, the other half of the muted grief is that we have a beautiful, wonderful, amazing little boy at home who means the world to me and whose snuggles take the edge off of the loss of his nebulous, but no less longed-for, sibling.  Plus, he gives me hope that I might someday be able to carry another pregnancy to term.  This time, the statistics make sense.  If we have another early loss in the future, I actually suspect it’ll be a whole lot harder to handle.  Right now we’re at one full-term baby for three pregnancies.  If it becomes one full-term baby for four pregnancies, I’ll start to wonder again what more might be wrong with me that makes my uterus a place where babies go to die.  I also hope we’re not playing “collect them all” with pregnancy outcomes — so far, we’ve had one first trimester loss (still in progress), one second trimester loss, and one full-term healthy baby.  The other outcomes don’t look particularly appealing, so I hope we’ll be able to take a pass on those!

Well, anyway, wish me luck that this doesn’t drag out too long and that we’re able to move on and conceive again soon.