Be prepared: the final installment of my three-part series is also the most graphic and disturbing. Some might even call it disgusting– I know how grossed out I was at the time. This post will not be for the faint of heart or weak of stomach, so if you can’t handle the truth (a la Jack Nicholson), please come back in a few days (or possibly only one day) for the return of regular blog programming (aka unicorns and puppies).
It had been nearly a week and a half since I was told I was going to miscarry, and nothing had happened yet. No bleeding, no spotting, no cramping, no nothing. Despite being reassured that these things (i.e. miscarriages) normally happen within 48 hours or so after finding no fetal heartbeat, many days had passed and I was still no closer to ‘passing any tissue’, as the nurses liked to call it. Ahem. (Inside voice: Gross!)
Being scared in general about miscarrying and worried more specifically that something was wrong with the hormones and other chemical messengers in my body, I phoned my doctor after 5 days had gone by. ‘Why doesn’t my body know the pregnancy isn’t viable yet?’, I asked, trying to toss in as many neutral-sounding medical words as I could. ‘Are my hormones all screwed up or are they just taking their sweet time delivering this all-too-important message to my uterus?’
Being the gentle, reassuring soul my doctor normally is, he warned me that this process seemed to be taking too long and that the decaying tissue inside my uterus, at this point, was putting me at risk for septic shock and/or death. (!!!!) In a nutshell, he told me that the inside of my uterus was rotting and that something needed to be done– quickly– to get that rot right the hell out. Fantastic.
It would be a bit of an understatement to say that I was panicked. Maybe my miscarriage messengers weren’t quite up to speed in my body, but my fight-or-flight hormones were definitely in tact. With a vengeance. I quickly whipped myself into a foamy lather of fright and impending doom. ‘I’m going to die!’, I screamed to Marty, who (poor soul) must have been pretty impressed with my doctor’s tact and discretion right at that moment.
‘You’re not going to die’, he reassured me (tossing steely eye daggers in the general direction of my doctor’s office). ‘Think of how many women got pregnant and had miscarriages naturally and unexpectedly before ultrasounds were invented. You’re only afraid right now because your body isn’t living up to the unrealistic statistical experience that the ultrasound predicted you should have. But everybody’s different, and your body will know when it’s time for you to miscarry. Naturally!’.
He had a point. Had I not seen that ultrasound with no fetal heartbeat, and had I not been told by my doctor’s substitute that these things ‘normally’ are over and done with in 48 hours, the alarm bells would not be ringing so loudly in my mind. However… I also wanted to remind Marty that, in addition to all of the spontaneous (and safe) miscarriages that many ultrasound-less pioneer women had experienced before me, many other women at that time got pregnant and died in childbirth or from septic infections before there were ultrasounds around to warn them that something was amiss. In my mind, there was still just cause to be concerned. After all, septic shock and/or death are not usually issues to be taken lightly or dismissed outright.
My doctor booked me into the Early Pregnancy Loss Clinic in Calgary right away so I could discuss my options. The hustle and bustle of it all was quite stressful and did nothing to ease any concerns I had about festering tissues and the like. When I arrived at my appointment (about an hour after I talked to my doctor on the phone), I was told by a very warm and supportive nurse that my options at this stage were as follows:
1. I could ‘wait and see’ what might happen for just a little bit longer– I could let my body take its time and miscarry naturally and on its own.
2. I could induce a miscarriage chemically, by having medicinal tablets inserted to stimulate uterine contractions. I would have the tablets put in at the clinic one morning, miscarry that day at home, and then go back to the clinic the following morning for a check-up and more follow-up if needed.
3. I could schedule a procedure to have the pregnancy tissue surgically removed. This would require the use of a general anesthetic and a lot more recovery time. (This option scared the crap out of me and was always my last resort; the ‘only-if-I-had-to’ route. Besides, I learned that the surgeon on duty for my scheduled day, if I chose to go that route, was this ultra-sketchy doctor who made his millions (or hundreds of thousands) of dollars performing vaginal and labial cosmetic surgery and/or cosmetic endometrial ablations to rid young, professional women of the ‘inconvenience’ and ‘mess’ of their periods. Yes, I have a deep-seated bone with this doctor, and there was NO WAY I would let him anywhere near my uterus!! So Choice #3 was not really a choice at all for me.)
In spite of Marty’s continual reassurance that everything was OK in the hormonal wonderlands of my body and uterus, I was afraid that I was too far down on the scale of chemical normality to emerge from this experience without contracting septic shock and/or dying. Hence, I tentatively opted to induce a miscarriage chemically, even though the idea of PILLS inside my PRIVATE PARTS was terrifying to me. (I have a hard enough time with Advil… in my MOUTH… if that is any indication.)
Alas, because my first appointment at the Early Pregnancy Loss Clinic was on a Friday morning and because the chemical miscarriage required follow-up the next morning, I could not actually have the suppositories inserted until Monday morning, because the clinic (of course) was closed on weekends. I penciled my name in for Monday morning and started putting my winter jacket back on. ‘I can do this’, I thought to myself through gritted teeth. ‘Don’t be a scaredy cat. Don’t be a loser. Everything will be fine.’ (I don’t even need to mention at this point that my entire soul was screaming “OMG!!!!!!!!!!!!!!!!!!!!!!!!!!!!!” Of course I was still afraid.)
Before we left the clinic, the nurse felt it prudent to discuss with us what should be done in the event that my body didn’t wait until Monday morning to be induced into miscarriage. She gave me a very large brown paper bag that was filled with all sorts of oddities and sat me down again to explain what everything inside the bag was for. (Warning: things start getting really gross right about now, at least to me, though for reference, I can barely watch CSI without covering my eyes and/or feeling queasy. You can judge for yourselves.)
The nurse pulled out a white plastic tray that instantly reminded me of a bedpan. “This tray is meant to sit over your toilet seat. If you start cramping and feel an urgent need to use the washroom, please make sure this tray is on your toilet seat before you go, so you can catch any tissue that passes before it lands in the toilet bowl.”
I was mildly horrified at the thought of this but had no idea just how bad the instructions would get so soon in comparison…
She gestured next to a large plastic jar with a bright orange lid (about 4 or 5 times the size of a jar used to give a urine sample). “This jar is to be used to collect anything that might be pregnancy tissue for clinical examination.” (Memories of being laughed at for my last collection of possible pregnancy tissue flashed before me.) “If you do miscarry over the weekend, we need you to bring everything back in this jar so we can examine the tissues and make sure that you have expelled all of them.”
OK… was I hearing this correctly? This nurse wanted me to catch all of my waste in a tray and then transfer it into a jar to bring back into the clinic? Was she insane??!
Finally, the nurse pulled out a handful of disposable plastic gloves. “These gloves are for you to use when you sort through everything that has been caught in your tray. We don’t need you to collect any blood or urine in the jar– just pick out anything bigger that might be a tissue of some sort.”
I. Was. MORTIFIED.
She couldn’t be serious, right? I wasn’t actually expected to sift through my own waste and to pick out anything that might be pregnancy tissue?!! And to collect it in a jar?!! And then to show it all to somebody for clinical examination??!
I might have thrown up in my mouth a little bit just then. Seriously, that was disgusting. And archaic. And frightening! And honestly, was this experience not emotional and traumatic enough, without having to do everything she was describing? Did they not have any other way to confirm at the clinic that I had miscarried (if I miscarried before Monday)? Would my solemn word and descriptive language not be enough?
For somebody who was secretly hoping to be able to miscarry without feeling and/or seeing anything (especially without seeing anything), this whole ‘collecting and sorting’ business didn’t seem like it would be possible. And for somebody who has as weak a stomach as I do, I couldn’t fathom having to do anything that even remotely resembled what she was describing to me. Thanks, but no thanks. I told the nurse that I would just wait until Monday and have everything come out magically and painlessly on that day after the tablets had been inserted…
She gave me a look of full-on sympathy that I normally reserve for puppies at the SPCA. I was gently told that, unless I opted to have the tissue surgically removed (by evil Dr. Vaginal Tightening, no less), I was going to have to see everything myself and I was going to have to collect all of the tissues, regardless of whether the miscarriage happened naturally or was induced by suppositories. There was no other reliable way for the doctors to confirm that everything was out afterwards… and if everything hadn’t passed on its own (judging from the tissues in my collection) then there would really be a risk of septic shock and/or death by then.
So basically… a) I could have surgery from Dr. Your Labia Are A Little Lopsided, Let Me Fix Those For You, or b) I could suck it up and collect whatever came out of my body in my little plastic jar, regardless of whether those things came out on their own or because of chemical tablets.
Incredibly, I thanked her for the brown paper bag of supplies, tucked it under my arm, and went home to wait some more. (This goes to show how deeply my fear of surgery and my distrust of that particular doctor ran. I couldn’t believe I was agreeing to collect my own waste in a jar. And then to show it to somebody.)
Friday afternoon was nondescript. We ran some errands and changed some artwork around at various cafes and coffee shops. Then, walking back to our van after one of the stops, my uterus suddenly felt like an anvil that was being pulled out of my body with all of the forces of gravity. Nothing hurt, but I did feel an incredible urge to either close my legs, practice superhuman-strength Kegel exercies, or lie down. Or all three. It really felt like my uterus would slip out of my body if I gave gravity even the slightest chance to tug at it. So I lied down in our van and tried to think happy thoughts. Puppies, unicorns, rainbows, and lipstick! Puppies, unicorns, rainbows, and lipstick!
We sped back ‘home’ (confession time: we were staying at the place of some friends while they were in Europe) and that’s when the cramping started. Very suddenly. I couldn’t even sit up, the cramping was so intense. Unfortunately, the bathroom and all of my brown bag supplies were upstairs, 2 whole stories higher than the front door. Determined to do things by the book (i.e., The Book of Traumatic Grossness), I dragged myself to the upstairs washroom on my elbows, like a solider whose legs had been shot off. I passed our friends’ cat on my way upstairs. She shot me a look that was clearly the feline version of ‘WTF?’.
‘Don’t ask’, I mumbled back to her, evidently delirious with pain.
Once upstairs and in the master bathroom, I took an Advil (a necessary evil!!) to help numb the intense pain that was radiating throughout my body. (Advil was the strongest drug we had on hand, as we never got around to filling our prescription for codeine beforehand.) I had been told that the cramping would feel like a heavy period. This felt more like what I imagined giving birth would be like– so. tremendously. intense.
I was crying at this point, partly because of the pain, but mostly because I was afraid. I knew what was happening, and I knew what needed to be done, but I just wanted to fast forward a little bit and have it all be over and done with. Puppies, unicorns, rainbows, and lipstick! Everything was scary to me, and I wasn’t entirely confident in my ability to make it through this experience in tact and alright.
Without going into too much of the details now (I know– how gracious of me!), I bled a lot over the next few hours and passed many pieces of tissue, too. I was surprised to feel an overwhelming wave of relief with each bit of tissue that came out. I had expected there to be more pain, but it actually felt really good every time my body got rid of something that no longer belonged inside. (Don’t get me wrong– everything was still incredibly painful, not to mention GROSS, but the pain was broken up every now and then with a little wave of relief.)
It was nauseating to put on my disposable gloves after every trip to the toilet. Some other part of me– a side I never even knew existed– numbly would sift through the tray on the toilet seat and pull out anything that wasn’t liquid to put in my jar. Just to reiterate: this is something I would not be able to do under normal circumstances, but I was so overwhelmed with pain and emotion and whatever hormones were raging through my body at that time that I just did it. I couldn’t believe it, but I did it. My collection of unmentionables grew throughout the night…
I continued to pass tissue throughout the night and the next day (Saturday), too. Our friends were coming back from Europe on Sunday (i.e. the very next day), so Saturday was spent vacuuming and packing up in between my trips to the washroom. How surreal…
When our friends came back on Sunday, we never told them what had transpired in their very bathroom just hours before their return. (How do you weave that into conversation, exactly?)
I also never told my extended family or most of my friends that I had ever been pregnant or that I had miscarried. I just couldn’t imagine how to bring it up naturally… (e.g. “So, how have you been lately?” Me: “Well…. great! Cough.”)
It was only after I knew for certain that I was ‘officially’ miscarrying that I mustered up enough courage to phone my family and tell them that I had even been pregnant in the first place. We all cried together. Marty phoned his parents and tried to explain with his Grade 3-level Czech what was going on. “Dana is not pregnant”, he managed in broken and vague Czech. (He knew no Czech equivalent for medical words like ‘Dana has just passed the pregnancy tissue through her cervix.’) My in-laws, who have never kept their desires for grandchildren secret, were devastated of course. The sadness was overwhelming and confusing to me.
On Monday morning, when I was scheduled to have the chemical suppositories inserted into my body to induce miscarriage, I dutifully brought my jar of tissue instead to the nurse at the Early Pregnancy Loss Clinic. She emptied the jar’s contents onto a light table (right in front of me!) and soon after confirmed that I had, indeed, expelled all of the tissue during my harrowed weekend. Thank goodness. We were free to leave.
With that experience behind us and with the nurse’s confirmation in mind, Marty and I wanted nothing more than to just disappear and escape. Hence, on Tuesday morning, with me still spotting but no longer at risk for septic shock and/or death, we packed up our van and weathered terrible highway conditions to make it to our new home: Victoria. Just like that, it seemed, we had a new home, new friends, new jobs– new identities. And we could forget about everything that had happened until a much later date…
It has taken me this long (2 years) to be able to talk more openly about my experience and to admit that it even happened. I’m not exactly sure why I had such a hard time telling people I was pregnant or that I had miscarried at the time… perhaps it was because so few people seemed to understand why a young, quasi-fertile, married couple like Marty and I would take issue with being pregnant in the first place. There was an overriding assumption that love + marriage + babies in baby carriages = so what’s your problem…? It was a time of feeling extremely out of sorts and out of place, and despite any evidence to the contrary on this blog, I wasn’t usually one to broadcast my abnormalities or oddities to strangers. So I just kept silent.
I know that my experience is just one example out of hundreds of thousands of miscarriages. (Current stats estimate that one in five pregnancies end in miscarriage.) Not everyone who miscarries will have the same, or even a similar, experience to mine. Not everyone will share my feelings, fears, or beliefs. Some women won’t be paraded around in flimsy hospital gowns from ultrasound machine to ultrasound machine before they miscarry– they might not even know they were pregnant until they miscarry. Most importantly: many of the women who miscarry will start from a completely different vantage point than mine– one of wanting to be pregnant. Nevertheless, I think it’s important to share my story and to fill my own particulars in the gaping blanks that were left whenever I tried to ask questions of my doctors and the uber-helpful and caring nurses at the ER in my local hospital.
If anybody feels they would like to talk about their own experiences with me privately (or publicly in the comments– whatever works), please feel free to e-mail me. Personally, I have found it very helpful to connect with other women who have experienced pregnancy loss, so I would be happy to pay that support forward to anyone who feels they could benefit from it.
If you have made it this far: Thank you for listening. You have no idea how much that means to me. xoxoxo