I was pregnant once: Infertility and Loss
Sharing out of the silence on the heartbreak that so many experience
I was pregnant once. 4 weeks ago exactly, actually. But I’m not anymore. And I don’t know if or how I ever will be again.
I spent my teens and twenties thinking that getting pregnant was easy (those “sex ed” classes at school made it sound like if you looked at a boy you’d get pregnant!). That whenever you wanted to (and sometimes even when you didn’t want to), you’d be able to. I know that for many lucky people, that is true. But for many of us — more of us than you know — that isn’t the case.
Some people know in advance that they’ll likely have a hard time. Others start with the same naïve optimism I used to have, only to realize later that their path won’t be an easy one. No matter how and when you realize it, it hurts — deeply — to find out that your path to having a baby may be a long, uncertain and often incredibly expensive one. Especially when your Facebook and Instagram feeds make it look like everyone but you can have babies easily.
I guess I was “lucky” in that I found out I have PCOS, a hormonal issue that is the leading cause of infertility in women, a few years ago. At least that meant that I could find the right doctor (a reproductive endocrinologist) in advance, and I could try to mentally prepare myself for a long journey to motherhood.
But it’s one thing when it’s theoretical — when you’re happily dating the guy you hope you’ll marry (and eventually do marry!) but aren’t ready to have a baby — and it’s altogether another thing when it becomes real. When you and your husband are ready — more than ready, actually, after having to delay for seven months because your wedding was in Zika territory and then you find out the reason you’ve been really sick for the last year is a case of undiagnosed Lyme Disease that needs hardcore, not-baby-friendly medical treatment — it is different. Each day feels like a week, each week like a month, and each month like a year. You see-saw between hope and fear, and with each month that passes you get more and more worried that it won’t happen for you.
We started the pills, the shots, the “deposits” from my husband in a weird room at the doctor’s office with posters of Marilyn Monroe on the walls, the intrauterine insemination (IUI), the 7 am doctor’s appointments every few days for bloodwork and ultrasounds. We started the delicate tango of being hopeful and excited, but not too hopeful or excited lest another month of treatment fail. We started a monthly routine: I spend all month telling myself that I know it didn’t work, and then when the doctor calls at the end of the month and says those words to me, I realize that deep down I did think it worked and tears spring up immediately, and my husband comes home from work with my favorite flowers and a sweet treat. And then we dust ourselves off for another month. But each time the dusting off is harder and takes longer, and feels like it’s taking little pieces of your heart with it.
We were lucky in that we weren’t in this alone. We made the decision to talk openly about our fertility issues with our friends, family and colleagues. Many people don’t do that, and I respect the many reasons why, but for us there was no other way. We cherish our relationships with the important people in our lives and we knew that we would be missing a chance to deepen those relationships and to live authentically if we didn’t talk about what we were going through. It made us feel less alone, it made us feel more loved, and it opened up deep channels of connection with people in our lives. Our relationships became deeper and truer, and for that I’ll always be thankful.
Seven months into fertility treatments, and another call from the doctor saying that the treatment hadn’t worked. Another Friday afternoon spent in tears, another evening on the couch with the peonies and pastries that my husband brought home. A weekend of deep conversation. Should we now start IVF which is not covered by our insurance and costs $25,000-$30,000 per cycle (month)? How would the cost of IVF affect our lives, our plans? How would I make the intense and invasive IVF treatments (with the daily doctor’s appointments and twice-daily self-administered injections) work with an intense job based in another city? How far were we willing to go before looking at other options? How would we make sure our relationship stayed strong, and hopefully even got stronger, as we continued to endure heartache, hormones and the hole in our lives where a baby should be?
A week after the doctor’s call and a week after the evening of peonies and pastries, I realized my period hadn’t started. When you have PCOS that isn’t that weird, but I was normally off by 2–3 days, not 7. A thought popped into my mind which I tried to squash instantly because my bruised heart couldn’t bear another disappointment — what if I was pregnant?
I pushed the thought away for 24 hours, and then on a sunny summer day I secretly took a home pregnancy test. As I did it, I was mad at myself for even entertaining the thought. So I made myself wait 20 minutes to look at it — to prove to myself that I didn’t really care — and then I saw it — POSITIVE. I screamed, a guttural, gleeful noise that caused my husband to sprint into our room. He saw his wife standing in the middle of the room, waving a pee-covered stick, with what I must imagine was the biggest smile he’d ever seen on my face.
Even with that instantaneous joy, my brain (and my mouth) were already saying “This can’t be right, I failed the pregnancy blood test at the doctor’s last week.” But in my gut, I knew the test was right. Three more pregnancy tests — each of a different brand diligently selected by my husband to remove any room for error — and confirmation from my doctor and we finally joyfully said the words I had feared we were never going to be able to say: “We’re going to have a baby.” In that instant I felt changed.
We agreed not to tell our families right away. I was between five and six weeks pregnant and we’d be able to hear the heartbeat in the next week or so. And we were seeing both sets of parents the following week for an early Father’s Day celebration which seemed the perfect time to tell our dads they were going to be grandpas. And we knew the stats — so many early pregnancies end in miscarriage. We were trying to protect our hearts.
I carried our baby, and our happy secret, around. It kept me company over a gorgeous Memorial Day weekend, and then overnight on Memorial Day something went wrong. I didn’t know it at the time. At the time, all I knew was that some pretty strong abdominal pain woke me up out of my sleep. I went over to our guest room to let my husband sleep since he was leaving the next day for a business trip to Europe, and in between episodes of The Good Wife I googled “abdominal pain and early pregnancy” and everything I got back was from women saying that they’d had terrible gas pain and indigestion during their early pregnancy. “Ugh,” I thought, “so I’m not going to get to be one of those annoyingly cute pregnant people. I’m going to be a ball of gas for the next 7 1/2 months.”
I took the day off work and spent the morning in bed, and said bye to my husband who laughed with me as he left for the airport about just how gassy you have to be to be awoken from your sleep. I planned to take the rest of the day off, get a good night of sleep, and work in the morning. No thoughts of calling or seeing a doctor despite the continued abdominal pain and the increased bloating.
But then, by a stroke of luck I will never understand, my phone calendar dinged to remind me that my annual obgyn check-up was that afternoon. I had made the appointment two months earlier, when not pregnant, with a new doctor I had really been wanting to start seeing. In that moment I almost canceled the appointment because I knew that many obgyns don’t see women until they are 8 weeks pregnant. I didn’t want to waste her time.
At the last minute I decided to go, and that is what everything that followed hinged on. I’ll skip through the play-by-play, but essentially a phenomenal doctor, herself pregnant, took my off-hand comment at the end of my appointment about “some” abdominal pain and pulled strings for me to get an ultrasound. The doctor and I had spent the appointment excitedly talking about my “miracle” fertility-treatment baby and all the exciting milestones the next months would bring, so I really didn’t think much of the ultrasound. What I didn’t know is that the ultrasound showed a lot of free fluid in my abdomen, mostly on the right side where the pain had woken me up the night before. Without telling me my obgyn called my fertility doctor, and then called me in to the room to talk about my choices. My husband was at the airport boarding his flight to Copenhagen, so at first I was alone with our terrible choice:
Go home and hope it’s not what the doctor fears it is and risk losing consciousness alone at home if it is what she fears it is or walk next door to the hospital and check myself in for surgery that would require general anesthesia and would jeopardize our pregnancy if it turned out the doctor’s fears were wrong and it was a normal pregnancy.
Risk dying, or risk our baby dying.
It was shocking. Mind-numbing in the truest sense. And my first test as a mom.
I chose to bear the risk, to protect the baby we wanted so badly. I started to go home. But after a few frantic calls with my husband (surely losing his mind at the gate for his flight) and both of my doctors, I acquiesced and agreed to be checked into the hospital in preparation for a surgery I was sure I would end up not needing. I was sure something would happen that would prove to the doctors that our baby was just fine and that the fluid in my abdomen was some weird anomaly.
But then things started to move fast, but in a weird slow-mo way through the haze of my shock, and frantic phone calls were made to our parents. They had no idea that they were going to be grandparents and they were now hearing that they might lose the grandchild they hadn’t known about. My husband hopped off his plane and began a two-hour rush-hour pilgrimage to the hospital. I stalled the surgery, despite two clearly-worried surgeons, two nurses and an anesthesiologist shouting directions through my phone to my husband, just long enough for my husband to race in, kiss me, and tell the doctors not to mess up as they gave me the anesthesia.
I woke up three hours later to my wonderful obgyn holding my hand, telling me that I had lost the baby and the fallopian tube that the baby had gotten stuck in and ruptured. That I had had over half a liter of blood pumped out of my abdominal cavity. That I was lucky I hadn’t delayed any longer. That I couldn’t work, or do anything, for two weeks. That the pictures she was showing me were of my ruptured tube and of our baby who was now gone. Gone.
I was really out of it from the anesthesia, but I remember screaming. The emotional pain felt like more than I could bear. Our baby — our miraculous, much-loved fertility-treatment baby — was gone. And my right tube — the one on the side with my only functional ovary — was gone too. I felt like we’d climbed a fertility mountain, found ourselves nearing the tippy-top, and then got side-swiped by an avalanche that sent us all the way back to the bottom and buried us under 20 feet of snow. I felt like I’d never be able to dig myself out of the snow and climb the mountain again — not emotionally and not physically without my right tube.
It is 4 weeks later — exactly — and I’m much better. Physically at least. Two weeks of medical leave from work both crawled by and flew by in a haze of pain, tears, beautiful conversations with my husband about life and love, Netflix binge-watching and feverish nightmares about the baby we lost. My husband, our families and the friends we told surrounded me with love and care that I never could have imagined. They did everything they could to ease my (significant) physical pain and to create the space for me to feel the (overwhelming) emotional pain.
I share this story only because I know how many women, and families, suffer in silence through fertility issues and/or loss. I respect those who choose to keep it private. But by sharing our story with people as I’ve seen them over the past four weeks, I’ve felt myself start to heal, little by little. I’ve learned about the heartbreak that others have been through, and how they picked themselves back up and eventually got the family they so desperately wanted.
And I want something good to come out of this heart-breaking experience. I want to help make it easier for even one woman to talk about her fertility issues or her pregnancy loss. I want even one woman who experiences abdominal pain in early pregnancy to make sure her doctor considers an ectopic pregnancy in time to save her tube and her life.
Infertility affects 6–12% of all women[i]. Ectopic pregnancies affect 1–2% of all pregnancies, with only a very small number of them resulting in a ruptured tube and emergency surgery like mine[ii]. Most are caught before the tube ruptures, and the tube, and thus future fertility, can be saved. Ectopic pregnancies are the leading cause of maternal death in the first trimester of pregnancy[iii]. I’m an unlucky member of the infertile, ectopic and tube-loss clubs. But so many other women are too, and I want them to know that as sad as I am for all of us, I’m also honored by all they’ve been through and all they share. And I want women to know that ectopic pregnancies do happen, and not always with the most clear-cut symptoms. If you feel pain or experience bleeding (which I didn’t until only moments before being rushed into surgery) before you’ve seen your baby safely located in your uterus on an ultrasound, please don’t write it off. Call a doctor. Your life may depend on it.
I know I’m lucky. I’m lucky to be alive after a ruptured tube with significant internal bleeding, especially when I only saw a doctor because I had a randomly scheduled appointment that day and otherwise would have been home alone that night. I’m lucky to have amazing doctors who treated me with incredible care. I’m lucky that I married my soulmate who knew exactly how to care for me physically and emotionally. I’m lucky that we have the most incredible families, friends and co-workers who showered us in love (and food! and flowers!). I’m lucky that I still have my right ovary and with it the chance to be a mom again, somehow, one day.
But still I’m sad. The kind of sad that sneaks up on you, surprises you at weird times, and takes your breath away. Each day that passes since my surgery takes us one day further away from the baby we already loved so much. I grieve the life that could’ve been. A life we wanted so badly. A life that I found myself imagining and dreaming about in those blissful days while I was pregnant.
And I’m scared. I had fertility issues before this and we struggled to get pregnant before this. It feels like it will be even harder now. I worry that it just might not happen for us. Or that, even if it does, we’ll lose a baby again. I worry that I’m not strong enough to dig out and climb back up the mountain.
But then I remind myself of the incredible rainbow I saw out the window just last week after a massive thunderstorm, surrounded by some close girlfriends as I prepared to tell them this story. After the biggest storms come the brightest rainbows.
[i] Source: CDC
[ii] Source: Human Reproduction Update Journal, Volume 20
[iii] American Family Physician Journal