The M Word

In November 2012 I had a miscarriage. It feels as though I’m using the word loosely, even though technically that’s what it was. There was no drama, no blood loss, no bending over in pain. No complications of any sort. It was just one of those things – one moment it was there, and the next it was gone.

I knew things weren’t quite right from the outset. I’d already given birth to a healthy girl almost two years before and the Doc and I were thinking about a second. It had been around seven weeks since my last period, but I knew with utmost certainty that conception could only have occurred within the last two weeks (look yes, it was that infrequent). So when I finally did a pregnancy test, it was with some doubt and mild confusion. I managed to cack up the first sample but the second one read positive, albeit faintly. The whole thing felt slightly odd and I certainly wasn’t getting the sense of elation/fear that accompanied my first pregnancy.

On going to the doctor, I was immediately checked in for the standard antenatal treatment. Though my GP was kind, she didn’t really seem to be listening a great deal to some of my misgivings; having a positive test result seemed to be absolute and not up for questioning. When she finally cottoned-on to my obvious doubt, she referred me to the Early Pregnancy Unit. It was a drop-in service, she informed me, “so be prepared to wait.”

Two hours I waited the next day before I was told by a nurse that I wasn’t going to be seen as my issue wasn’t an emergency. Placating my visible frustration, the nurse took me aside for a verbal consultation. She had that no-nonsense approach that I love in a medical professional and when I explained how some of the conditions of my pregnancy didn’t seem to add up, she asked: have you done a pregnancy test? Yes. Was it positive? Yes, but not definitively as far as I was concerned. She then made a few gags, said some reassuring things and declared I was most definitely pregnant. I was then instructed to stop worrying and book myself in for my twelve week scan. I left the consultation feeling a sort of forced happiness.

A few weeks later and I returned to the hospital for my nucal exam. I was told I would have blood taken first – part of a new practice for Down’s checks. I explained that I was pretty certain there was an issue with my pregnancy and could we do the scan first as I didn’t want blood taken unnecessarily. (An embarrassing though intermittent needle phobia leads me to avoid injections whenever possible.) No, was more or less the response. So bloods were taken and then it was pants down and warm gel time.

As I suspected, my womb didn’t show what it should for a pregnancy at eleven/twelve weeks. I couldn’t help but feel a bit emotional as three different sonagraphers mumbled and fussed over images of what was basically nothing. I could see a sack with a dot in it, but no heartbeat or anything that suggested a healthy pregnancy. When I asked questions, the staff were completely evasive. I was then told to leave it for a week and then go back to the Early Pregnancy Unit. I asked if it would be possible to make an appointment this time, given my previous experience with the drop-in service. No.

I left feeling furious, aggrieved and, on account of the blood test, sick.

The following week was horrendous. I knew I wasn’t carrying a baby; it was there on the screen for all to see. But because no one would tell me so categorically, I couldn’t help but do what was instructed in the faint hope that things would miraculously be otherwise. I decided to leave it more than a week to return – emotionally draining as it was – in order to make the results more definitive. If it was a viable pregnancy, then two weeks should at least show some considerable changes in foetal growth.

Once again at the Early Pregnancy Unit, I waited another two hours or so before I was finally called for an internal exam. I explained to the two sonographers that that morning, I had begun to spot. There was much gentle talking, nodding and once again I was on my back, my pants down and a horrible, cold, electronic penis device (sheathed in a condom no less) was pushed into my lady bits. Despite being emotionally preoccupied, the physical indignity of the situation wasn’t lost on me. What I saw on the screen showed no change; a sad little shrivelled gestational sack with a benign little dot in it. That poor little dot I thought, and my mind began to wander off into mental visions of chicken eggs and the bloody specks one occasionally find within the yolks.

Yet still, no one would call it. Another consultant was summoned. Another no-nonsense woman who, under normal circumstances I would have liked, but in this instance her approach felt brutal. She gave me another internal exam and then said “This is a miscarriage. Enough’s enough now.”

Enough’s enough now? I completely broke down, with my skirt hitched up and my vagina on display in front of three people. Fuck you, I thought. I felt upset by the news – of course – but I had already reconciled that fact days ago. It was the inference that I was some pregnancy-obsessed woman who was unable to accept the fact that her womb was empty, that I was demanding more scans and attention than was my fair share. I had never wanted to be there in the first place! I had no desire to have this process drawn out, but it kept being drawn out for me because I either wasn’t deemed important enough to examine at the outset, or because no one – until this consultant – was prepared to tell it how it was.

As if on cue, when I returned home that day, I began to bleed in earnest.

While I thought the consultant’s words were poorly selected, I ultimately appreciated her candour. I also appreciate the fact that frontline staff working in early pregnancy have to deal with these sorts of issues daily and complications far more serious than mine which, understandably, must take precedence. Even so, it would’ve been nice to avoid being jerked around and then basically told you’re being a nuisance.

Treatment and bedside manner aside, what has been most perplexing for me since this whole experience are the amount of women I know who have also miscarried. Whenever I mention mine, I’m invariably met with ‘Oh yeah, I had that’ or ‘So-and-so had that after their first baby’ – all of whom have gone on to have healthy second babies. So if the occurrence is so widespread, why aren’t we talking about it? This, to me, suggests something unusual about the way we view miscarriage.

On the one hand, we are socially and psychologically geared to view miscarriage as a tragedy. A loss of life, a lost opportunity, even a failure on our part as women to successfully conceive or to adequately care for our foetus. I’m not suggesting it isn’t tragic by the way – for many it is a private, disappointing and most definitely tragic occurrence, particularly if conception is challenging. What concerns me is that early miscarriage tends to be couched in such a way that it almost becomes too shameful to mention, whether because it impinges on our capabilities as women or because it makes for uncomfortable conversation with others. When I mention it in passing (I don’t mean to be flippant about it, but nor do I think it a topic that needs avoiding), I am often met with people thinking they need to provide sympathetic words or some sort of meaningful commiseration for my mourning. I had one day of tearfulness and subsequently, my attitude has been pretty phlegmatic.

Yet on the other hand, early miscarriage is treated phlegmatically by the medical profession. As my consultant said to me (after smacking me in the face with ‘enough’s enough’), ‘we produce a lot of eggs, not all of them are viable’. No point crying over something that is medically speaking, pretty commonplace.

So there appears a considerable disjunction here between the medical realities of early pregnancy and the social attitudes surrounding it. To me, it seems more could be done from both ends to redress this imbalance. What that entails exactly I’m not sure. More could be done in the form of frontline care to determine early pregnancy results effectively and efficiently and to make available to people additional services, such as counselling, in order to manage loss. Conversely, while people shouldn’t be forced to discuss issues they consider private or upsetting, perhaps more broadly, as social creatures, we could do more to debunk the perception of miscarriage being a taboo subject.

Just a thought.

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