Thou wast a spirit too delicate…
The last time I wrote here I was pregnant again, for the second time in twelve months. Now it’s well over a month since I lost that pregnancy too.
When it happens once, it feels like bad luck. Horrible, bloody, painful, grief-striking, but nevertheless, bad luck. Twice and it feels personal. Like my body is just incapable; old, flabby, useless. As though I am irresponsible, almost, for even trying.
And here is something else I have discovered. My “que sera sera” attitude to the second pregnancy was no help in the loss and grieving of it. If anything, the first pregnancy — with all its hope — was easier to grieve. With the second, my — almost — denial of the pregnancy in the first place made it difficult for me to make a space to grieve it. How to grieve for something that never existed in the first place? I thought it wouldn’t matter, that because I’d given it so little consideration, I wouldn’t feel the weight of bereavement. That I’d perhaps just saunter on with my life, forgetting the short time for which I had a heightened sense of smell and had to drink a bit less milk in my tea.
But it didn’t work. I felt numb, but had nothing to hang that numbness on. In fact, I felt guilt at seeing the world as so colourless when — what did I have to be depressed about? It wasn’t as if I’d lost a baby — barely even an embryo even — just a thick soup of possibility.
Part of that feeling was my doing — I hadn’t known it wouldn’t help; I acted out of the best of motives, to protect my own heart — but because I’d not allowed myself to feel hopeful about the pregnancy, I felt I wasn’t allowed to feel grief about its ending.
But another part, a big part, was the treatment I received in hospital, in comparison to the first miscarriage. In as much as one can have a “good miscarriage” — and people talk about having a “good birth” all the time; just because the end result of a miscarriage is terribly sad, we shouldn’t be denied the same level of care and thoughtfulness that’s essential for a good birth just because of the outcome — my first miscarriage was a “good” miscarriage. The staff were terribly kind and sympathetic; the actual procedure (the pregnancy sac had become stuck in my cervix, causing much pain and bleeding, and needed removing) was over quickly, and I had something that I could bury, too.
My second experience in hospital was totally different.
It just felt so messy, so undefined as an experience. In the first miscarriage, I found out at my scan and received counselling there and then. The second miscarriage started with an early bleed; I tried to telephone to make an emergency appointment but as bleeding in early pregnancy is common, I was offered a reassurance scan in a day’s time. I continued to bleed lightly, but whilst in work the morning of the scan, the bleeding became suddenly heavier. A wonderful colleague, who herself had suffered a miscarriage around the same time as my first one, helped me out of school without the children noticing. I called my husband, then I called the hospital to ask if I could bring the scan forward as I was bleeding heavily. They said I couldn’t. I asked if I should come in anyway. They said if the bleeding was heavy enough that I was changing my sanitary pads more than every half hour, I ought to come in. I wasn’t. But I didn’t want to wait around until my scan appointment at three either. I knew my pregnancy was ending, but I was terrified of the thought of an ectopic pregnancy, and as most of the pain, although mild, was on one side — I took the decision to go in to hospital.
When I got there, I had to explain my story again to the receptionist, and then there was another long wait. A woman who looked to be about my age started to talk to me about how she was pregnant, but when she woke up that morning she didn’t feel as pregnant any more and that’s why she’d come in. I felt unreasonably cross with her. Here I was losing another pregnancy, needing reassurance that it wasn’t a (potentially life-threatening) ectopic pregnancy, and here she was, in front of me in the queue because of a vague feeling. I realised I was being unfair, but it didn’t stop me having to work very hard not to roll my eyes and ignore her.
A stressed-looking young couple came in with a very noisy toddler who kept running around the waiting room. People were giving them and the child some genuinely horrible looks. I asked if they thought he’d appreciate some paper and a pencil to draw with. They said yes and I rummaged in my bag for the materials. The child quietened down for a moment and then the couple were called through anyway.
The woman who’d come in because she didn’t feel as pregnant any more said, “when you see kids like that it makes you wonder if you’re doing the right thing by having a baby at all.” I hoped she was joking, but nevertheless I felt less guilty about ignoring her after that.
Eventually it was my turn. My husband and I went into one of the treatment rooms where we sat waiting for a while. A woman came in and asked if we minded if some student doctors asked some questions first. I said “no, of course not”, but it was the last thing I wanted.
In came the students. They looked so, so young. Even typing that I realise it’s a huge cliché but nonetheless it’s true. I realised they must be 18 or over to be at university but they looked to me about 14 or 15 and it made me feel very, very old. And the questions seemed to go on forever; at times, it felt like they weren’t sure what they were asking. They also asked me quite a few questions I’d already been asked on the telephone and by the receptionist; I wondered — why did I have to go through this again? When they asked if this was my first pregnancy I said no, I had a nine-year-old child and I’d had a miscarriage last year, making this my third. And then it hit me; these students were closer in age to my child than to me. Suddenly and briefly I felt almost maternal towards them; then, almost as quickly as it came, I realised that was a patronising way of looking at them; they were medical students, the doctors of the future, how dare I see them as children? But that just made me feel cross; if they were going to be professionals one day, why put me through this?
Off went the students, then there was a wait, then back in came the students, and with them, the doctor. I felt such relief when she walked in; maybe, finally, something could get done. She started out by asking me some of the same questions the students had already asked. It occurred to me then; why not cut down on all this mess by getting the students to ask me questions whilst the doctor sat in? Or why not just look through my file first? Did I even have a file?
But eventually, questions asked, the doctor got me up onto the bed, knees akimbo, feet together, and checked my cervix. It was closed. She said that was maybe a good sign, and that the scan, later, would show “what’s happening to baby”.
I’d not even thought of it as being a baby. Because to me, it wasn’t; if anything, it was an embryo at this stage. And this time around, it didn’t even feel like that; it felt like a soup of possibilities. Atom decay. Wave or particle. Experiment.
I knew the doctor was wrong, that the pregnancy was failing. But I also knew — I could see it in his face — that my husband right there and then was grabbing on to that bit of hope like a piece of flotsam amidst a wreck.
More waiting. On the television in the waiting room we watched a programme on collectibles that made the Antiques Roadshow look like Ways of Seeing, then another one where a supposed judge meted out decisions on debt repayments, a Mancunian Judge Judy watered down to the point of homeopathy.
Then the scan. Again, repeating the story, opening my knees. At this stage, the only scan that can see anything is transvaginal, which means a probe up one’s fanjo. And this is where it became especially unkind.
When one has something being pressed into one’s vagina by a stranger, it’s a particularly vulnerable time. Unless it’s for sexy reasons (and even then, the stranger’s choice of language ought perhaps to be discussed in advance of the vaginal probing) the stranger really ought to realise how vulnerable the person in possession of the vagina is, and speak softly. A miscarriage is also a vulnerable time. So multiplying the two leads to a high vulnerability quotient, and a huge need to be spoken to kindly, sympathetically, with a huge dollop of understanding.
“How far along do you think you are again?”
“About six weeks.”
“Well, that’s not a six week pregnancy.”
“But — I mean — ”
“Look at the screen if you want. You’re not six weeks pregnant. There’s practically nothing there. Just a thickened womb lining, but nothing else.”
“But — well — what’s going on then?”
“Don’t know. Could be ectopic, but doubtful, I didn’t see anything near your ovaries, and I looked especially on the side you said you had pain, it could be that you’ve already passed the pregnancy, could be any number of reasons really.”
“But — I mean — ectopic?!”
“I’ll give you a leaflet. They’ll do a blood test today and in 48 hours and check your levels — ”
“Yeah I know how it works, I had the same for my last miscarriage. But is there no way to know NOW if it’s ectopic?”
“It probably isn’t. You said you weren’t feeling any pain — ”
“No! I said I WAS feeling pain, I mean, that’s the side you looked!”
“Mild pain you said. Anyway I’ll give you a leaflet. You’ll have to go back to the waiting room and they’ll do your first blood test. I’ll give you a minute to get your clothes back on now.”
She pulled out the probe at some point during this exchange. I got dressed when she’d gone, and looked astounded at my husband. I had questions, so many questions, but mainly around worrying that the pregnancy was ectopic. How could I already have lost the pregnancy if the cervix was closed? Wasn’t it more likely that the pregnancy was somewhere up in the fallopian tube, undetectable by the probe? My husband also had questions, but his seemed to focus more on the possibility that the pregnancy was maybe viable, and just much less far along than we’d originally thought. “That’s not a six week pregnancy” was ringing in both our sets of ears, but for different reasons.
I had the first blood test. We went back home. Two days later, the second blood test confirmed this was a failing pregnancy, not an ectopic. I felt relief. I think my husband just felt terribly sad.
Between the first and second blood test I scoured the internet for answers but none were forthcoming. The leaflet the woman had given me was useless. In fact, I still don’t have an answer for what happened, not really; I wonder if perhaps the egg was fertilised, but never implanted properly. The womb lining thickened as it does during pregnancy, and pregnancy hormones pulsated through my senses, and my body, old and confused, took two weeks to catch on before delivering what was essentially, a very, very heavy period. But really, I’ve no explanation.
However, the woman’s face — her manner — her tone of voice, as she said to me “that’s not a six-week pregnancy” in the voice one might also say, “you silly little girl” stayed with me, and impacted on my inability to grieve. Between her, and my own downplaying of the pregnancy, I felt numb, like — what do YOU have to grieve for, silly little girl?
Events take over though, and recognising the symptoms of depression (I’ve had it before) in time, I knew I had to do something. The grief for the loss was trapped inside me and presenting as depression, as numbness, as a lack of joy.
When I recognised this, I managed to cry, properly, for the first time.
I spoke to my husband and we gave the pregnancy a name again, like we did last time, too. Whilst I was pregnant, he and I were reading The Tempest to each other during the evenings, and went to see a performance of the play in Liverpool, with a woman playing a steampunk Ariel. And Ariel, that too-delicate, airy spirit, seemed the perfect name for something slightly confusing that was never really there, but also was.
Having had two miscarriages now, I’m hardly an expert but I do have some ideas about what constitutes a ‘good’ miscarriage and what makes a ‘bad’ one. For me, at least, anyway. Not getting hopes up at all during pregnancy does nothing to help in the long run, although I do think it’s important to have in the back of the head that the pregnancy will not necessarily become a baby. People speaking kindly and softly and taking the time to listen and answer questions help so, so much; people being dismissive and hurried makes everything worse. Having to repeat myself over and over again made me feel so utterly fed up; people taking the time to read the information already there would have helped much more. A miscarriage is not a joyful experience for a wanted pregnancy but it can be a “good” one (on a side note, I wish there was more written by advocates for a good birth, on miscarriage. I read so much on ‘natural’ childbirth when pregnant with my first miscarriage, as I wanted to avoid the traumatic hospital birth of my son. When I turned to the same resources to look up miscarriages — it felt like all those writers had turned their backs on me. I contacted someone from AIMS who — in the nicest possible way — told me they didn’t really have much in the way of miscarriage resources, and pointed me in the direction of the miscarriage association, of which I already knew. She was very lovely and apologetic but it did make me wonder, if one in four pregnancies to people my age end in miscarriage — where are all the resources from birth advocates?)
Ariel’s little life was rounded with a sleep — and I am hopeful that in realising that, my own depression will start to lift, and that we can plan for the future.