Miscarriage: what mine was like, physically

When I was looking for information about what to expect, what the physical side would be like, and so forth, I didn't find much.

There were a lot of posts and writings on the 'Net from women who (quite understandably) were terrified about what was going on in their bodies, prior to getting confirmation of their own miscarriages. Also quite understandably, there weren't many follow-up posts that told the greater audience what had happened afterward.

I also found plenty of rather high-level articles and posts from medical or sorta-medical sources. You know the type: they purport to be informative, and some succeed to a degree, but they don't actually reveal much. (This might be a factor of the "hot potato" theory I posted about a few weeks back. It also might be a factor of the cautious Web-driven economy: information that's available for free isn't very lucrative, is it?)

So... I'll share my details. I'll try not to be all squicky about it, but I do want to be realistic.

...

My problems began with a few spots -- the proverbial "not with a bang, but a whimper." The blood was light and rusty brown, which fell (as I thought/hoped) within the realm of "normal." A lot of women bleed during gestation, and according to my CNM (certified nurse-midwife), half of the women who do report bleeding go on to have normal and successful pregnancies.

This was on a Tuesday evening, in my comfortable-but-dull hotel room. The blood wasn't copious, but there was enough spotting to startle me. And I'd been away on business for over a week, helping prepare a client to go live on new software. Needless to say, I was getting sick of being so far from home, especially right before Xmas.

I fretted a bit about this, but tried to maintain a positive outlook, and hoped that it would go away. And I didn't want the Mister to worry -- I'm a superhero, don't you know? I'm invincible, and so is my tadpole! Since I am key to his happiness, why, I should maintain it by keeping his happy-bubble fully intact! -- but of course, he is as deeply invested in our reproduction as I am, so it seemed ridiculous not to tell him. (Besides, although I'd probably never admit it, I didn't really want to worry alone.)

I didn't sleep much that night, partially because of the worry, and partially because I was due to go home the next evening (finally!). The next morning, no blood. This cheered me up considerably; I happily let the Mister know that things were fine.

And then, late the next morning (Wednesday), it started again. Still dark and rusty, still spotty, but definitely there.

At some point (I don't remember when), I realized that my breasts weren't tender anymore. This freaked me out most of all. If you've read my initial post, you might remember that before the pregnancy was confirmed, the increased sensitivity was one of the main reasons I knew something was Different. And now they were just normal, boring, everyday boobs again. I kept hoping that I'd just gotten used to them being wide awake, but it just seemed wrong.

I phoned my clinic, and they were cautious about claiming that it was or wasn't okay, but reassured me that sometimes bleeding does occur, and that if it turned bright red and started coming out a lot more heavily, I should really start worrying. I was on the schedule for an ultrasound that Friday, but they moved my appointment up to the nearest available slot, which was on Thursday.

I changed my flight and flew home a few hours earlier, which bewildered my coworkers. I hadn't told them about the pregnancy. Things were happening fast, and there was nowhere at the client site to have a private conversation, so out it came: "I'm pregnant, something is wrong, and I'm going home." They offered tentative, very surprised congratulations; I came as close as I've ever come to actually losing composure at work, choked up a bit, and advised them, "You might want to hold off on those."

So, yes -- home I came. The bleeding didn't increase, but continued at a steady spot.

When I got home, I got a call from the clinic: due to an administrative error, they couldn't see me on Thursday after all, so I'd have to wait until Friday. Fantastic.

The wait was unremarkable, but hellish. I slunk around the house in pajamas, relieved to be away from the client, happy to be home, but worried about the kid. I kept having thoughts like, Our baby might be dead, and there's not a damned thing I can do about it. The spotting continued, but increased a little, and turned a brighter red (which, as I'd been advised, was a Bad Sign). I also started having cramps, which were physically no worse than those of a low-level menstrual period, but the mental anguish amplified their effects.

On Thursday night I dreamed of a two-headed kitten, and of realizing that I would have to let it go, since there's no way it could survive. (I'll write about that in another post.)

On Friday, which was Winter Solstice (how poetic!), I started to find livery-looking blood clots in my discharge. The sadness grew. It didn't seem like there was much hope at this point. The Mister tried to stay positive, and I think he succeeded more than I did; I think he tried to treat it like a normal day on which we'd get some good news, and perhaps get to see our baby squirming on a monitor. On the other hand, I was pretty sure it was over for this little one. And yet I still clung to a little spark of light in my mind, the idea that maybe I was just a "bleeder," and that I might just be worn out from the trip.

The time finally came for the ultrasound. Now, I absolutely love my clinic; I've been going there for many years for the usual well-woman oil change and inspection, and have consistently been impressed with their supportive and compassionate care. Unfortunately, the new assistant who took my initial info proved to be rather insensitive.

After I reminded her that I was bleeding and fairly sure that I was miscarrying, she said, "Well, we'll get your ultrasound going in a few. Just in case everything is okay, here's a new-parent folder for you!" She proudly leafed through the contents for me; it contained a bunch of photocopied info about pregnancy care, a copy of a magazine about babies, timelines about the kid's growth in the womb, that sort of thing.

Great.

Before I gathered the presence of mind to punch her, she was done, and she left. She might or might not have sensed my frustration; I'd love to believe that obvious fury contributed to her hasty exit, but I'm not sure. I've been told that I am rather telegraphic when I'm pissed, but I had other things on my mind at the time, so who knows how well it came through?

Anyway...

The ultrasound confirmed the miscarriage. That's all there is to say about it, really. The vaginal probe hurt like hell, of course; things were sore in there. I remember asking the CNM if there was any chance this pregnancy could have been ectopic, so she checked things out pretty carefully and found no reason to suspect it.

Our nurse-midwife was amazing, completely supportive, and straightforward about what to expect in the days to come. It seemed as though things were already starting to (and I hate this term, although it's so truthful about the process) expel, so it was just a matter of waiting for nature to take its course. If it didn't, we'd schedule a D&C. (I'll talk a little more on that topic in a later post, too.)

She ordered a series of blood tests over the next week. The intent was to monitor my rapidly falling HCG levels. HCG is "the pregnancy hormone," human chorionic gonadotropin, produced at first by the embryo and later by the placenta. It's present in the urine of a pregnant woman, and it's what a pregnancy test looks for when you pee on the little stick. Those tests just tell you "yes" or "no," though, and the blood tests, in contrast, can monitor the actual levels of hormone present in the body.

If the tissue and placenta are expelled (or removed) as they should be, the HCG count, numerically represented in the test output, should drop to zero. And, true to form, my numbers went from 11,000 to 2,000 to under 600 in a matter of a few days. Pregnant, not so pregnant... kablooey. In a couple of weeks, I'll get tested again to make sure the count has actually reached zero. If not, it means that there's still placental tissue in the uterus, which will prevent me from getting pregnant again. (If unused placental cells stick around for long, they can also become precancerous -- another reason to be vigilant.)

So -- yes -- miscarriage has resulted in a number of blood tests. My inner elbows are bruised all to hell; I look like a junkie. If I tell anyone, while wearing short sleeves, that I've recently had a miscarriage, they might glance snootily downward as if to say, "Well, no wonder."

The expulsion hasn't been fun, either. Most women have experienced bad menstrual cramps, so that's a fitting starting point for the description. This has felt like three horrible periods put together. Imagine, if you will, someone cheerfully kicking you in the gut while wearing platform boots. (And imagine dealing with that while surrounded by family members at Xmas, trying to put on a brave face and have fun exchanging presents!)

When I asked about how much bleeding to expect (more specifically, "At what point should I haul my butt to a hospital if it gets really bad?"), the CNM said this: "If you're completely soaking more than three or four pads in an hour, you'll definitely want to call us." In my case, fortunately, it never did reach that degree.

There were a lot of blood clots, which are nothing new in the land of menstruation, but are unnerving in this context and amount. I wasn't mentally prepared for the bits of greyish, gristley tissue that also began to show up. I could actually feel them emerging, and couldn't bear to look at them more closely.

I never did actually see the remains of our kid, and didn't want to.

That's the sum of it. I'd love to end with some kind of reassuring, uplifting statement, but I don't really have one. Even though I am thankful for my amazing partner (who has been completely wonderful through all of this, and has been grieving right along with me) and for my health, there is no way to make this sound any better than it was. It completely, truly, and royally sucked.

One bit of satisfaction: my CNM (who happens to be the director of the clinic) completely reamed that medical assistant about the stupid new-parent folder. And called to let me know, and to apologise again for the assistant's insensitivity.