Shortly after my miscarriage, Truman and I were meeting with the pastor. We had told him about our second miscarriage. He asked if he could anoint me with oil and pray over us, as it talks about in the book of James in the Bible. I agreed. I was continuing charting my cycles, and after that I was struck to see that my cycles became completely normal---my charts looked textbook. This in spite of the considerable stress of preparing to move soon!
I did get a recommendation from a couple of people for an OB in the city where Truman works. I scheduled for a consult with this man, a Dr. Mackenzie. He was nice, almost too nice. He had a sugary-sweet voice, and I could see how some women would just love his bedside manner. But he completely downplayed my concerns about miscarriage. He said there was nothing to test for. I asked about progesterone---he said he doesn’t “believe in progesterone testing.” He maintained that 60% of all conceptions end in miscarriage---so it was just a “normal clinical occurrence.” He totally ignored my feelings as a woman and a mother---these were my BABIES, not some clinical occurrence!
He was intrigued about my history of preterm labor, and my loss of Ezra. He wanted to test me for a type of bacteria that some women carry, and it’s mostly harmless except during pregnancy---it can cause things like preterm labor. I went back at a later date for that. He was very gentle in his technique to get the swab for culture. The results were normal. He said to get pregnant whenever I wanted, and he was sure I would be fine. He would not do anything to prevent another miscarriage. He still insisted that miscarriage was normal and there was nothing to worry about. His answer for two miscarriages in a row? Flip a coin, and it can land tails several times in a row. I wanted to flip out at him!
We got moved in May, but things happened with the town immediately, so we were rather stressed for a while. I was also sick with a terrible cold, sore throat, earache, the works. My next cycle was very long and crazy. With the next cycle though, we were trying seriously. My cycles settled back into a pattern, but we still didn’t conceive. Then my luteal phase got shorter---too short to support a pregnancy, even if conception occurred. I decided to see a Reproductive Endocrinologist. The only one I could find was in a hospital clinic almost 2 hours drive away. But when I called to make the appointment, the secretary assured me that they do test progesterone among other things. I felt we were making the right decision to see this RE. But my test results all came back normal, and we were perplexed as to why my luteal phase was so short, if it was not progesterone deficiency. The RE said it might just be stress. She advised us to give it another 6 months, and if I still wasn’t pregnant, to come back and see her. Six more months??? We’d been trying for almost that already! Well, my cycles are shorter than a month, so it was almost that many cycles. And it was over a year since our first miscarriage, and nine months since my second miscarriage.
I wanted a baby so badly! Especially after all we’d been through in the past year with two miscarriages, I needed to know that my body could function properly and carry a pregnancy. We had figured that since the town was not letting us build our addition this year, we might as well have a baby, then build next year. Infants don’t take that much space, and we could manage. But at this rate, we weren’t going to have a baby either. I was getting so discouraged. I was on the verge of saying forget it. Maybe it just wasn’t meant to be for us to have another baby. I didn’t know why it was taking so long, when I had previously conceived 4 pregnancies very easily!
Also, Eric had been begging me all summer for another baby. In fact, he specifically asked me for a baby girl! Not knowing what else to do---I did not want to promise something I could not deliver---I told him we could pray for a baby girl. At night when we said our prayers, he would “ask God for baby girl”---it was so sweet. I hoped that maybe God would see and reward his faith.
The end of the next cycle, I was pleased to note that my period did not show early like it had been doing. I figured what day it was due for a “normal” cycle. I decided that I did not want to wonder all day if AF was showing up or not. So I took a test that morning. I figured I was wasting a test, because from previous experience, I usually have to be late to get a positive test, even using First Response which is about the most sensitive test you can buy. I can’t afford to buy a lot of tests, so I try not to waste them. But I took the test anyway that morning, October 31, 2003. I was shocked to see the TWO LINES show immediately!
OMG, I was pregnant! I was too awake to sleep anymore, so I got up even though Truman wasn’t yet home from work. He was surprised to see me up---I am usually still sleeping when he gets home. He was even more surprised to see the positive pregnancy test! We didn’t want to tell too many people yet, but I emailed a few of my closest friends to tell them I was finally pregnant again. I also called the RE’s office to let her know I was actually pregnant. Her nurse called me back later---she wanted to test my HCG and progesterone levels, starting Saturday. Their office would follow me to 10 wks pg, then refer me to a regular OB of my choosing in the local hospital.
My HCG numbers were good and continued to rise at a good rate. My progesterone was at the low end of what is considered ok, so she put me on progesterone suppositories to give me a safety net. After 8 days of testing every other day, my HCG levels were over 2500, and they scheduled an u/s for the following week. I had passed the point of my previous miscarriages, and we felt quite positive about keeping this baby. We told my parents, but waited to tell Truman’s parents, since they don’t handle this kind of thing well. We also told a lot more friends, as well as we told Eric. I don’t think Eric fully understands the concept of how long it takes for the baby to grow before it arrives, but it was something he was really looking forward too, and he would talk about the “baby coming.” We still prayed for the new baby when he said his prayers.
My first u/s was Nov. 18. They said things looked good, the baby sac was nice and round, but it was just too early to see the heartbeat. I was over 6 wks, but they said at that point, a couple days could make the difference between detecting the heartbeat or not. They wanted to recheck in 7 to 10 days. The only time I had had an u/s this early in a previous pg was with Ezra, and everything about that pg was different, so I felt I could not compare to this one. I prayed that all was well with our baby, and I rescheduled for Nov 28.
I was mostly feeling great. I had pregnancy symptoms---sore breasts, minor low-backache, gas and constipation, and a bloated feeling that I always got early on with my other pgs. But I wasn’t really sick other than a few occasional bouts of the queasies. I was taking Vitamin B6 and magnesium, along with other vitamins, but those two are known to help reduce nausea. Also, I found that when I did feel icky, eating something always seemed to help---which makes sense when you consider that many times, “morning sickness” is due to low blood sugar. I know with Jamie, I got into a vicious cycle of feeling ill, not eating, feeling worse, then really don’t want to eat, get sick, can’t eat, feel really really bad, get sicker, and so on. I had researched this, and wanted to avoid getting into that cycle again. So when I woke up feeling bad, I would eat even a few bites of toast, then as I felt a little better, have a bit more, until I felt ok, and could eat a decent breakfast. Eating frequent small meals or snacks throughout the day helped. I particularly liked things like eggs, cheese, toast with jam, potatoes, yogurt, and fruit. At night I especially made a point to eat a protein snack, which seemed to get me through the night better. I often woke up early like 5 or 6 am, and wanted a snack, before sleeping a couple hours more (our schedule is late to bed and sleep late).
We went for our next u/s the day after Thanksgiving. It was obvious that the baby sac had grown, and you could see the cute little bean shaped embryo---with a beating heart! We were SO happy. But the tech said it was beating a little bit slow at 86 bpm. She said that often that is a sign that the heart just started beating. I was 8 wks by my dates, so they wanted to adjust my dates to 6 wks, which would be more in keeping with the newly beating heart. They wanted to recheck in 7 to 10 days. I was a little bit worried, because I chart and I knew my dates were pretty accurate. I could not be only 6 wks, because if so I would have been ovulating the day I got a positive pg test---which simply can’t be!
With Eric and Jamie, I had been further along at my first u/s so I could not compare. But for my sanity’s sake, I had to think positive, so I focused on the good things about my pregnancy. I had not spotted one single drop, and that in itself was very reassuring. Plus, my baby had a heartbeat---that meant it was alive! Also, I still prayed very much for my baby to be ok, as I had ever since finding out that I was pregnant.
I was feeling stressed about the slow heartbeat, and I prayed for confidence. We went to church on Sunday, and before the service I was telling the pastor's wife about what they had said about the heartbeat being too slow for 8 wks and they thought I must only be 6 wks, which I know cannot be true. And she commented that doctors don't know everything, and maybe there is a wider range of "normal" than they think. She also was very excited about the fact we saw the heartbeat---that is the thing that kept me going---my baby has a heartbeat! Then during the service, the pastor was saying something about praying for a person who had cancer and the doctors did not think the person would live---but Pastor said how we serve a God of miracles, and the doctors don't know everything, even if they do have much medical knowledge. Both what the pastor said, and what his wife had said, both comments really calmed my heart. I believe in God, and I know that God gave my baby a heartbeat, and He can keep it beating, even if the doctors thought that it's too slow for gestational age. This belief got me through the week. My baby is truly in God's hands, though I prayed that I would get to deliver and raise this precious baby.
I had scheduled the recheck u/s for Monday, Dec 8th, at 9:30 am. I got up early, feeling really nauseous. I made some tea to sip, and ate a tiny bit of yogurt to take some B6 with---which usually helps. I almost threw it back up, but managed to keep it down. Then the cat barfed, and Truman refused to clean it up so I had to clean it up (with my eyes mostly shut so I didn’t puke too). I got the kids dressed and we hurried off to the hospital 1.5 hrs away. I was so stressed, I forgot to lock the house door, but remembered 2 miles down the road, so we came back to lock it.
We got to the hospital a few minutes before my appointment. But they made us wait until 10 am before they took us in. This is the second time they have made us wait really late, and I was stressing because if they made us too late, we wouldn't get home in time and we would miss Eric's school bus. Eric was coughing, he's had a cold last week which he's mostly over so he can go to school, but I was trying to get him to keep his mouth covered when he coughed, especially since they have signs everywhere about what to do to not spread colds, flu, etc.
So they finally took us into the back, but I had to wait for another 5 minutes to use the bathroom, then they took me into a room. It was a different technician, and she made a big deal about Eric's cough. Then the Nurse Practitioner arrived---and asked me how I was. I was telling her what a bad day I was having, and I said I was just very stressed, and I wanted them to refer me to the local hospital, so I don't have to make anymore trips up to this hospital. Then they started the u/s. Almost right away, we could see the amniotic sack which looked larger than before---but it was EMPTY this time.
The NP said, "Abby, I have bad news for you." And I started bawling. They said they think the baby died at least a week before. I guess that explained the slow heartbeat last time.
We don't know why. No one knows why. All they can say is, it happens. The embryo that we saw 10 days ago had disappeared, so they are doubtful that there is tissue enough to culture for chromosomes. I don't know if I want to bother with testing anymore anyway. I've had too many tests in the last 6 mos, and I just don't think I want anymore---they haven't given us any answers anyway.
The NP gave me our options:
1) stop my progesterone, and allow my body to miscarry naturally (could take 7-10 days to start bleeding);
2) have a D&C with general anesthesia (so I don't remember it); they might be able to culture chromosomes from the fetal material to look for abnormalities---but she thought the embryo had disintegrated too much already.
3) have a D&C with local anesthesia and Truman can be in there with me.
She said we could think about it today and call them tomorrow if we want the D&C.
There is always the chance that going natural, I could still end up with a d&c if everything doesn't come clean. Besides, I didn't know if I could wait 10 days, knowing my baby was dead inside me. This was about the most horrible decision I've ever had to make.
I put in a call to my RE's office, and she called me back that night. I asked her questions about the risks involved with d&c. I told her that I did not want to do anything that might risk my fertility in future. Right then I felt emotionally that I couldn't even imagine having another baby, at least not for a VERY long time, having lost 4 babies already. But in my heart I knew I still wanted a baby very much---and I didn't want to close that door. My RE explained more about the risks of D&C. She looked over my u/s results, and the size of the baby sac was about 6-7 wks development (should be 9.5 wks). She felt that physically, my body could handle this on it's own. She said that if the fetus was much bigger (say 10-13 wks), she would recommend the D&C. She also said that some women just need to "get it over with" and opt for the d&c, so if I chose, she would do it. Or if a lot of time passed, and my body didn't do it on it's own, she could do a d&c for me. She also mentioned that there is a prescription drug (I didn't get the name of it yet) that could be taken to encourage my body to do it naturally.
Truman and I talked this over extensively. I emailed and asked many of my friends to share their personal experiences, and I read over those. I also talked to a very good friend of mine who has bt,dt many times. We decided that we wanted to see if anything happened naturally in the next few days. If nothing, I might try the drug (I wanted to get more info on it meanwhile). If all else failed and time went on, we might end up with the d&c (general anesthesia, as I can't imagine being awake for it).
I was still scared. I didn’t know what to expect, other than I knew that this would be different from my other 2 miscarriages which were both so early, that they were little more than a late period. They weren’t even crampy or physically painful, they just hurt emotionally. This time, I had made it 5 weeks farther along, and I knew there would be much more pregnancy tissue to deal with. My biggest fear was that it would hurt a lot. I had heard that some women experience true labor during a miscarriage, and I could imagine that would be tough.
Tuesday I did call and get the name of the drug the doctor had mentioned. It’s actually two drugs taken together, Mifeprex and Misoprostol (sometimes known as “abortion drugs”). Of course there are potential risks and side effects. After reading about them on the web, I wasn’t sure how I felt about taking them. I hoped it would not come to that.
I was also scared that it would take a week or more to start to miscarry naturally, and I began to freak out. I did not think I could take this uncertainty for very long---it was making me crazy. I cried a lot, feeling very scared and unsure of everything.
Wednesday morning, I woke up from a nightmare. I dreamed I was in labor because "they" used drugs to induce me to expel the pregnancy material. Anyway, in my dream, I was in extreme pain, and I was trying to relax in a hot tub to help deal with it. And my best friend was there, almost like my labor coach?? Not sure really. I don't know where my husband was, maybe at work, not sure. It was all very weird, and didn't make a lot of sense. I almost think the dream was my subconscious trying to work through my fears. But I woke up with terrible back pain that morning.
As the day wore on, the back pain worsened, and I called the RE’s nurse. She offered me a prescription for the pain. She said my body was probably getting ready to miscarry, and I might feel back pain like that for several days. Oh, great (not!) I said I would like the prescription, so she got the doctor’s ok to call it in for me. I also began to spot a little bit that same afternoon. The pain meds took the edge off my labor pains---that is truly what they were---and I felt a little calmer.
By Thursday morning, the spotting had increased to a period-like flow. The pains were also in both my back and my abdomen. I was relying on the pain medication to help me get through the day. We had a few things to do, so I kept busy, hoping to take my mind off what was happening. In the afternoon, I took 2 pain pills and laid down to rest, as the pain was bad and I was feeling exhausted. But I could not sleep more than snatches at a time, because my kids were being noisy and screeching at each other every time I started to doze.
I called the dr’s office to let them know I was bleeding “full-flow”, which they had requested. They would schedule a blood HCG for a week from now, to make sure my levels dropped. I told the nurse how I was in a lot of pain which felt like labor. She said it could likely be another day before the pains let up. That didn't sound so good to me. :(
Towards evening, the pains were so bad, I had to breathe through the cramping. I really did feel like I was in labor. The meds didn't seem to help anymore either. I decided to put the kids to bed early, so I could go lie down for a while. I got Jamie in bed, but I could tell my pad was full, so I changed it. Then I got Eric to bed, but I had to change my pad again---barely a half-hour had passed. I felt like a river was coming out of me. It scared me, because I have never bled this hard in my life---not even after giving birth. I started physically shaking, and the cramps were so bad, I was moaning. I was trying to breathe and stay on top of things, but I felt very out of control. I had been instructed to call the dr's office "on-call"service if I was bleeding more than a pad an hour, or if I was feverish. I called, and I was crying when I was on the phone with the on-call nurse. She told me to go to the ER at our local hospital (this was about 7:30).
I woke Truman (who was sleeping because he works 3rd shift). I made him call work and tell them he would not be in (his company has been excellent about all this, and already told him there was no problem if he had to take care of me and could not make work, but just to let them know). I called our neighbor and asked her if she could sit here so an adult was in the house with our kids---she came right over in a few minutes.
While waiting for our neighbor to arrive, I was in the kitchen putting an empty water glass in the sink. I was overcome with a very bad contraction, and suddenly I passed this huge glob of material. I was kind of shocked---it happened so fast. And it felt so weird. I had Truman grab a clean baggie, so we could take it to the ER. I was still bleeding very heavy and cramping horribly. Truman drove me to the ER, but I was so weak, I made him go inside and get a nurse and a wheelchair.
The nurse took me to a room, and got me into bed, then hooked up an IV and notified the dr on call. They thought I might need an emergency d&c. They were glad we had brought the "glob" so they could send it to the lab. They said it was mostly placenta, but it would be checked for fetal tissue. We waited for a quite a while before the dr came. I was in a lot of pain and asked for some medication. They did finally give me some, and as soon as it took effect, I felt so much better.
We must have been there a couple hours, and the ER dr finally came and did an exam. My bleeding was slowing down by then, so they said it wasn't necessary to do a D&C at this point. He said my cervix was still open, and he removed some tissue that was still in there. He said I might still pass pieces of tissue or blood clots for a while yet. The nurse cleaned me up, which I thought was very nice, I was quite a mess from all the bleeding. They gave me discharge instructions (no sex---obviously, no douching, no tampons, etc), and told me to call tomorrow for a follow-up appointment. I decided I would call my RE, to tell her what happened today, but I would probably see an OB locally---I was originally scheduled to see one here once I reached 10 weeks---but now I will have to see them for different reasons.
By late Thursday night, I felt better than I did earlier. At one point I was near panic, and starting to hyperventilate. Now I was much calmer, and the strong pain med they gave me made me feel almost good. I still felt some cramping pain, but not as bad. I hoped the worst was over. Earlier I was beginning to wish I had opted for a D&C in the first place. But I think it's good that we have avoided anything that invasive so far.
I was supposed to rest as much as I could and take it easy for a few days. When we came home, our neighbor exclaimed at how pale I was (I looked in the mirror, and I was pretty white). Truman stayed home with me that night, and he did not have work Friday night, so we got through the weekend ok. Friday I stayed in my pj’s all day. When I called the OB’s office, the nurse said I sounded like I was doing ok, so I could stay home and come in on Monday. I was still cramping, but my bleeding had slowed way down, and was like a medium period flow.
Saturday, I felt better, and we did a few errands. For the most part, the cramps were gone, but I had taken some Tylenol 3 just in case I needed it. At one point, I passed another chunk of placenta tissue. But my bleeding was no more than a medium-light flow.
By Monday, I was only spotting brownish for most of the day. I had to cancel my OB appointment due to stormy weather and icy roads. But late evening, I began to bleed red again, and the flow increased, along with some bits of tissue. I had hoped everything had come clean, but it seemed that there were still some pieces left.
Emotionally, my initial shock was wearing off. Monday I spent the day in tears. My heart hurts SO badly. I am no stranger to grief, but this seems like the hardest thing I've ever had to deal with. It seems so senseless---why did I have to lose yet another baby??? Three in a row, and there is no known reason for it. I know my babies are in Heaven with Jesus, but I no longer find comfort in that. I wanted the chance to raise my children before I had to give them back to God. There is a beautiful song, sung by country singer Sherrie Austin, called “Streets of Heaven”. Part of it says “It must be kinda crowded on the streets of Heaven, So tell me, What do you need her for? Don't you know one day, she'll be your little girl forever, But right now, I need her so much more? .....Lord, don't you know, She's my angel, you've got plenty of your own; And I know you hold a place for her, But she's already got a home......” To hear this song, visit "http://www.sherrieaustin.com"
Truman’s company offers a program where employees and family members can get counseling help. We decided to take advantage of it--God knows we need all the help we can get. I called, and they helped me set up an appointment, but we had to postpone our first session due to the bad weather.
I did get to go see my RE about a week after starting to miscarry. We had a long talk about our options. We had done most of the recommended testing already, and results had come back normal.
The only thing we had not done was genetic testing on me. Truman has had genetic testing done when the boys were tested last year, and he’s perfect. We decided not to do genetic testing on me at this point. It’s really just a numbers thing---they try to compute the chances that we might have a genetically impaired conception. The fact is that we are already at high-risk for miscarriage, just because of my having miscarried 3 times in a row. Genetic testing will not improve my chances for a better outcome, nor prevent future miscarriage.
I am generally in excellent health, so the doctor said there was no medical reason not to try again if we wished to. She said we could start ttc whenever we felt ready. It would really depend how we felt emotionally, knowing that we are at risk to possibly lose another baby to miscarriage. She gave me instructions for using progesterone supplements during my luteal phase to give extra hormone support for a possible conception. Once pregnancy is achieved and confirmed, I am to continue the supplements for at least 6 wks as I did this last pregnancy.
I bled and spotted for 12 days. After that we began ttc. We feel we want a baby badly enough, we will try despite the risks. We can’t give up---I feel that would be admitting defeat.
The first one I took at 12 dpo.
The second one was taken 4 days later. You can tell my HCG levels were increasing.
The embryo was definitely bigger, and they did not have to zoom in as close to get this shot.
