October is Pregnancy and Infant Loss Awareness Month! The purpose of this is to raise awareness of the prominence of pregnancy loss and infant death, and to offer support to bereaved families that have lost children during pregnancy or shortly after birth. In honor of this, I just wanted to share some information with you and debunk some common myths and misconceptions regarding this sensitive topic. So, let’s jump right in!
MYTH #1 Miscarriages are rare.
Unfortunately, loss happens in 1 out of 4 pregnancies! This is not rare, this is actually very common. If you yourself have not had a miscarriage, I can guarantee that you know someone who has. Pregnancy loss just seems rare because no one really talks about it, which in turn makes it a very isolating and lonely experience. After I began talking about my first miscarriage, I was surprised to be opened up to a whole secret society of women who came forward and expressed that they had lost a baby, too.
MYTH #2 Pregnancy loss happens because you did/didn’t _____(insert any reason people come up with here).
Many people incorrectly believe that stress causes a miscarriage/stillbirth. Or intense exercise. Or past abortions. Heavy lifting. Not taking prenatal vitamins. Getting in an argument. Using birth control pills for too long. You name it, I’m sure you’ve heard any number of these things!
The truth is that most miscarriages are unavoidable genetic accidents, and have nothing to do with anything the mother did or did not do. Another large portion of losses (especially stillbirths) occur because there is some other underlying medical condition, like a blood disease, reproductive tract malformation or placental abnormality. Finally, a smaller number of losses happen because of physical trauma, infection, or exposure to teratogens (things like tobacco, alcohol, and drugs) that harm the developing baby.
MYTH #3 You are not experiencing infertility if you’ve gotten pregnant before.
I was telling a close friend about my personal struggle with loss, infertility and starting a family, and she kind of laughed at my use of the word “infertility”, thinking it was a bit extreme to say that. She told me “You don’t have infertility silly, you’re just having some trouble getting pregnant right now. It’s not like you have a hostile uterus or anything. You’ve been able to get pregnant before”. Her intent was to try and remind me that hope was not completely lost, and I appreciated that. But what she said also made me realize how misinformed so many people are when it comes to this stuff.
Clinically speaking, infertility and sterility are NOT the same thing. Being sterile is a state of being physically unable to reproduce offspring. This can be caused by radiation, surgical procedures (tubes tied, vasectomy, hysterectomy, etc), menopause, genetic defects, and other things, and is usually permanent.
However, a couple is experiencing infertility when they have been having unprotected and appropriately timed sex for longer than 1 year without conceiving or carrying a child to live birth. This means that someone can have previous pregnancies, and still be experiencing infertility if none of those pregnancies resulted in a live birth. This also means that someone can even have other living children, and still be currently experiencing infertility (this is called secondary infertility).
MYTH #4 Your friend who has lost a baby or experienced trouble conceiving does not want to talk about it.
Okay so obviously I can’t speak for everyone, but it is generally not a good idea to assume this about any one individual.
Speaking for myself, most times I do want to talk about my experiences and I wish that I had more people around me who could be a listening ear. Most [well-meaning] people just don’t understand, and that’s what makes me not want to talk about it. They get uncomfortable and change the subject, they make judgement calls on how you should feel, and they don’t know how to listen without offering advice and silver linings (“well at least…”). And you know what? It’s okay. I really don’t fault them, infertility and loss bring about a very unique type of pain that not everyone is equipped to understand.
The best thing you can do is ask your friend if they would be willing to share their experience with you. And when [if] they do share their experiences, try your best to listen intently and offer words of acknowledgement and empathy, realizing that your friend is extremely vulnerable in that moment of sharing. If you think asking your friend about how they’re doing concerning their loss will remind them of it, let me let you off the hook: they don’t need a reminder. Trust me, they have not forgotten their circumstances and you bringing it up will not remind them of their pain. If anything, it will remind them that you remember, and that you care. Again, the best thing you can do is ask someone how they want to be addressed concerning this! You have to be sensitive and mindful, at the same time without walking on eggshells or showing pity. True empathy really is an art! Ask questions. Listen. Acknowledge.
MYTH #5 Your friend who has lost a baby or experienced trouble conceiving does not want to hear about your new pregnancy/baby.
Again, I can’t speak for everyone here. Now, do I want to hear you constantly complain about how horrible your pregnancy is? No. Do I need a play by play on every twinge and flutter that comes from within your belly? Not really. Nor do I want you to joke about how I can have your trouble-making kids for a weekend because you’re sure I’ll change my mind about wanting my own. Save these things for your mommy friends!
However, I do want to celebrate your pregnancy with you! I do want to hear about all the milestones your little one hits, and the silly & amazing things that they do. I do want to be invited to your baby shower (if I am up for it, I will make the choice to attend), and I do want to be included in your little one’s life. I do not want to be left out, that will only intensify negative feelings; as my circumstances already have me feeling isolated and forgotten.
Now that’s just me; but I recognize that everyone is different. As a general rule of thumb:
- DO NOT: Surprise her by telling her in front of other people. No one likes being caught off guard.
- DO: Tell her about your pregnancy via email, card, or even a heartfelt text message before you make the big announcement. This gives her time and space to process the news by herself.
- DO NOT: Ignore her situation. Acknowledge that you understand how difficult this might be for her in light of her recent loss or struggles conceiving.
- DO: Ask her how much she wants to hear about what is going on with you, don’t assume! Respect whatever she says and accept that she may need time and space to feel differently. Follow her lead.
Sure, at the end of the day it will probably be hard for her no matter how you flip it, I won’t lie to you. There’s really no easy way to go about this. But if she loves you, I can almost guarantee that she is not hurting because you are experiencing the excitement of motherhood, she’s hurting because she is not. There’s a difference! Your joy is not her sorrow, her sorrow is her sorrow. And though it may be difficult for her to express it while she’s hurting, know that she is (likely) absolutely thrilled for you.
MYTH #6 The earlier a loss happens during the pregnancy, the better.
Not true, not true, not true. I remember talking to someone after my first loss, and though she had not experienced loss herself, she offered great comfort by sharing with me stories of other women who had. She told me about her friend who had just lost a baby and said: “but hers wasn’t just a miscarriage, she actually had to give birth to hers”.
Just a miscarriage?
This is the equivalent of saying to a victim of sexual abuse *trigger warning* “Well, at least it was only molestation, it could’ve been rape”! Silly, right? There is no better or worse here, only pain. And pain cannot be quantified by anyone except the person experiencing it.
I am not taking anything away from what I’m sure is a very traumatic experience of birthing a stillborn. Both of my losses have been before the 20 week mark (which is the clinical distinction between miscarriage and stillbirth), and both of my unborn babies were removed surgically, and so I cannot comment on anything other than my experiences. However, I can say this: The mother who went into the operating room 11 weeks pregnant and woke up in recovery with an empty womb, hurts. The mother who gave birth to her baby at 28 weeks in a hospital bed, hurts. The mother who gave birth to her tiny baby at home in the bathroom toilet at 8.5 weeks, she hurts too. Losing an unborn child can be incredibly painful and life altering, and I am sure that this is the case for most who have experienced some form of this, no matter when the loss occurred.
Which brings me to my next point.
MYTH #7 An early pregnancy is just a clump of cells.
I think this is one of the most damaging misconceptions out there. And that’s because, for the most part (according to yunno…actual medicine and science) this just isn’t true. A quick embryology lesson: at the time of conception, momma’s egg and daddy’s sperm meet to form a zygote, which is the earliest stage of human life. It is at this stage, at the very moment of conception, that the entire genetic makeup of this new life is determined…hair color, eye color, whether they will be athletic or musical, boy or girl, tall or short, the shape of their nose, the dimples in their cheeks – literally everything – all contained within this single cell.
During that first week or so, the cell divides a bunch of times and eventually forms a blastocyst, which at this point actually is just a clump of cells (albeit, a highly specialized and rapidly dividing clump of cells, but a clump of cells nonetheless). The blastocyst travels to the uterus and implants into the uterine wall, marking the official start of pregnancy, though the mother will not realize she is pregnant for another week or so.
By the time she is able to test positive on a home urine test, usually during the 4th-5th week of pregnancy, the human blastocyst has graduated to become an embryo. And guess what? By the end of the 5th week of pregnancy, that embryo has a heart, and that heart is beating as it pumps blood through the tiny human body. Granted, it doesn’t really look like a human body yet, I’ll give you that. It looks more like a tadpole at that point. But the fact is that it is human, with a beating heart and developing brain to boot. At 5 weeks gestation!! (so in awe of God right now, excuse me)!! By week 7, the face begins to develop and by week 8, the human embryo can move it’s body and limbs. At the end of the 10th week of pregnancy, the embryo has arms and legs complete with tiny fingers and tiny toes. The face is recognizable with a little nose, two ears, and a mouth; and it has tiny boy parts or girl parts (though still too small to tell the difference).
At this point you might be bored out of your mind. Please forgive me, I could go on and on about this kind of stuff. The bottom line is this – around the time that a woman discovers her pregnancy, she already has a living being with a beating heart and its own genetic makeup growing inside of her. Far from just a clump of cells; it is a tiny, developing human being. Life functions on a continuum, and as human life grows and develops, we call it different names. Embryo, fetus, infant, toddler, child, teenager, adult, elder…the difference here is a matter of time.
These are straight facts from my med school textbook, by no means is this an opinion based on my political affiliation or my belief in God as the Creator of human life. The fact is that we’ve been done a huge disservice by being told the “clump of cells” lie. Do your research and know the truth for yourself! And remember this when someone tells you that they’ve suffered a miscarriage. They didn’t lose a clump of cells. They’ve lost a life, the life of their child, in it’s earliest form.
I hope I was able to shed some light on some things you didn’t know, or maybe even reinforce some things you already did. Please like, comment, and share for the purpose of raising awareness!
Today, all over the country people are celebrating the women who gave them life. And rightfully so, I mean my mother is everything to me.
She is the best listener and friend.
Her strength is unmatched.
My mom is quite literally the wisest and most beautiful woman I know. What’s most important – she introduced me to Jesus and lives a life that I can look to as a Godly example of a wife, mother, and woman.
And my grandmother…she has to be the sweetest lady on the entire planet. She is a giver, she always sacrifices for her family – even when it hurts her. She prays with me, she teaches me how to cook, and we have a very special bond.
I was also very close with my grandmother, Lois, who is no longer with me. She was the epitome of grace, class, and thoughtfulness. I miss her dearly. Today I honor my mother and both grandmothers. If your mom is living, make sure you give her a call today. Go see her. Hug her and tell her you love her!
I think it is so important to have an entire day set aside to celebrate motherhood! Women do it all and surely deserve the recognition. I also recognize that this day may not be as celebratory for some.
While a lot of us have our mothers here with us, some of us have experienced loss. Make sure to reach out to the person in your life who has lost their mother or grandmother. Their heart will be a little heavy today and it would be nice to hear from you.
Don’t forget those you know whose mother may be living, but are not a part of their life. I’m thinking of people I know who have incarcerated mothers or otherwise estranged mothers. Reach out to them today.
There are also mothers out there who are estranged from their children. Maybe their children are in jail, caught up in addiction, or not speaking to them. These mothers can feel like a failure. Make time to acknowledge them today, too.
Some of us are longing to be mothers but are struggling with infertility. I’m not going to sugarcoat anything here – infertility just flat out sucks. It is extremely difficult to try and fail month after month after month to start a family. For these women, Mother’s Day can be a painful reminder of their unrealized and much longed for dreams. Find a way to reach out to her today.
Then there are those mothers who have experienced loss. Some of us have carried babies in the womb but our unborn children never made it home. This day is hard for them. Some mothers have even had to bury their once living children after losing them to illness, violence, or accidents. Their hearts will be heavy today. A grieving mother is still a mother, and though you may not physically see her children she should be recognized for the sacrifices she made and the love she gave while her children were here with her; no matter how long that was.
If nothing else, please take this with you: Motherhood is an amazing honor and great privilege! Moms make the world go ’round. Remember the sheer magnitude of this today and reflect on how blessed it is to be able to call or be called “Mommy”. I love you all and Happy Mother’s Day!
My husband and I recently experienced our second *pregnancy loss.
We’ve made 2 babies, but we have no children.
And if we’re being honest – even right now, typing that sentence and seeing it in black & white really just tripped me out.
A little background: My first pregnancy ended over 2 years ago after having a D&C at 11 weeks due to a missed miscarriage. Everything was developing fine with the pregnancy, we heard the little nugget’s heartbeat and had ultrasounds showing normal growth. Then, the baby died. After that it took us almost 2 years to conceive again. I was on my 4th round of fertility drugs when we finally fell pregnant this past December, but sadly that pregnancy ended as a ruptured ectopic in mid-January. The little life and my left Fallopian tube were removed during surgery.
“We’ve made 2 babies, but we have no children”
It never actually occurred to me that I’d find myself here. I’ve always wanted to have kids, and I truly thought once I was married it would just – happen. Growing up I was the girl who had the names of my future, hypothetical children scribbled down in my school notebooks. I had these grand expectations of how motherhood was supposed to go and let me tell you, it sure as hell didn’t look like this.
But..life happens. The reality is that most times life is good, but other times life is really, really shitty. All things considered, nothing has caused me more pain, sadness, and trauma than losing my unborn babies. That may seem like a dramatic statement to you, but it’s my reality. It has been one of those defining life moments for me, and I am a totally different person because of it. I feel distant. Roughened. A little cold and a little icy. I guess life will do that to a person.
For those of you who do not know the pain of pregnancy loss, I hope this blog gives you some insight into the emotions that someone you love may be feeling. Not so that you can feel bad for or pity them, but so that you can begin to understand their experience and try to put yourself in their shoes as best as you can. It’s always easier to be there for a person if you understand a little about what they’re going through.
If you’ve experienced pregnancy loss, unfortunately you know all too well what I’m talking about. Losing a baby during pregnancy can be devastating. I have honestly found so much comfort in reading or listening to complete strangers on the internet talk about their losses. And for those women, I am thankful. It helps me to know that others who have gone through this share in the roller coaster ride of emotions I’m experiencing. It helps me feel a little less crazy, you know? My only goal here is to be that reassuring voice for someone else. To validate your feelings and let you know that girl, I get it.
I get what it’s like to feel more sadness and grief than you ever thought possible. You just lost a baby. Your baby. A tiny, developing human life. Your son. Your daughter. You talked to them, sang to them. Prayed for them. You fantasized about them and picked names for them. You bought things, made plans, and created space in your home for them. You created space in your heart for them. And then suddenly you lose what was and what was yet to come, all at once.
For the first week after my ectopic, I was completely shocked. I was also physically drained and more focused on healing physically, so the grief didn’t come right away for me. Then, the floodgates opened and for about 6 weeks after our loss, I cried constantly. In the shower. In the car. On my way to sleep. When I woke up. Multiple times a day, almost every day, I cried. Whenever I tried to open my mouth and have a decent conversation with someone, I cried. My first miscarriage brought an even stronger reaction – I teetered the line of normal grief and depression while I recovered physically and emotionally. There were days when I wouldn’t even leave my bed. But then one day something amazing happened – I looked up and realized that I hadn’t cried in a little while. Then when I was able to string together a couple happy days in a row, I really thought I was doing something. And juuuust when you start to think “I‘m finally moving forward“, a wave of grief hits you square in the nose and knocks you back a just a little bit.
I grieved both of my pregnancy losses intensely. I get it.
I get what it’s like to feel an overwhelming sense of pressure – from yourself and from others – to move on.
No one else feels this sad for this long, you’re being so dramatic.
You need to get back to business as usual.
It’s time to pull yourself up and move on from this.
I really hate that term anyway…move on. To me, “move on” is appropriate after breaking up with a jerk guy who was no good for you. After losing a baby? Not so much. I don’t think you ever move on from something as life altering as that. You get stronger, God gives peace, you find a new normal, you move forward, but you don’t move on. Moving on implies an event, while moving forward implies a process. I remember freaking out after talking to a doctor-friend who said a woman should be over a pregnancy loss after 6 weeks. I was so discouraged because there I was at week 5, barely being held together by scotch tape and bubble gum…thinking I had just one more week to get myself together.
At this point it’s been 8 weeks since our second loss and honestly I’m just now beginning to feel like I’m finding a new normal. And after our first loss? It took me months to even be able to talk to people. Some women may sort through their loss in 8 days, while others may need 8 months to heal. Whatever is right for you…is just right. Give yourself some time.
I get what it’s like to be unbelievably angry. Just mad at everything. I’m so grouchy these days that at times, I don’t even want to be around me!
I get what it’s like to feel defective. To feel physically flawed, tarnished and blemished, like something is wrong with your body. I get it. It wasn’t until after my second loss that I began to take things personally. Like okay, two babies have died inside of my body, what the heck is wrong with me? It’s embarrassing.
It doesn’t stop there though. I had to have my entire tube removed after the ectopic, and that really does make me feel damaged. It feels so weird to know that a body part is missing, especially one so vital to my future fertility. Gone. Forever. The loss of my tube is just another thing on a long list of obstacles working against me on this journey to mommy-hood.
And then there’s the post-surgical bloating and bruising. That eventually goes away, but the scars on your tummy will be there for the rest of your life. These aren’t battle wounds you wear with pride, but rather permanent reminders of defeat. You feel…damaged. I get it.
“I get what it’s like to feel defective”
I get what’s it like to feel jealous. Jealous of your pregnant friends. Jealous of your friends who have babies. I know it’s hard because you really are in fact happy for them, you’re just sad for you. So you show up to baby showers. You send meals when the new baby arrives. You help care for your friends baby when she needs a break. And you do it all with a smile hoping your feelings will catch up eventually. I get it.
I get what it’s like to feel guilty for feeling jealous, too. Because these are your friends, after all. Guilt can be a heavy burden to bear. Some of you may even feel guilty after losing your baby because you think you are the cause. You think this happened because of something you did, or didn’t do. And no matter how many times someone says it’s not your fault, the guilt remains. But girl I still have to tell you…
It’s really not your fault.
I get what it’s like to be nervous about checking the mail because you know the hospital bills are coming. Not everyone has to have surgery or be hospitalized after pregnancy loss, but for those women that do, it can be costly. Like – congratulations on losing your baby, here’s a bill for $1700. There’s the ER doctor fee, the surgeon fee, the facility fee, the cost of ultrasound, blood work, and IV medications, the fee for the anesthesiologist and the CRNA, the copays for follow up appointments… and it all hits you at once.
Yes, even with insurance, pregnancy loss could potentially cost you in more ways than one. Without insurance? You could easily be looking at $15,000. Because added financial stress while grieving is nice.
I get what it’s like to feel isolated. The thruth is that your loved ones just don’t want to hurt you any more than you already are, so they avoid talking about the loss of your little one. They may even avoid talking to you altogether. They tip toe around you and never ask about how you’re feeling or how you’re coping, not realizing that saying nothing to acknowledge what has happened actually hurts more than saying the “wrong thing”.
You try to avoid people because you know you reek of sadness, and you don’t want them to absorb your negative energy. Some days you may even find yourself avoiding people because you’re actually happy at that moment, but you don’t want others to develop expectations of you to remain that way. Because when I say it’s an emotional roller coaster – I truly mean it. It’s constant ups and downs.
You refrain from catching up with your friends and family because you don’t want to make things awkward when they ask “so how have you been”?! [because talking about these types of things really makes people uncomfortable]. So you lie and put on a face and push down your crap and say “I’ve been okay! What about you”? But ultimately that discourages you from interacting with people altogether because pretending to be okay all the time…is exhausting…and sometimes you just don’t have the mental energy to pretend. All of this, is isolating. I get it.
I get what it’s like to feel like an ugly, crampy, balding, bloated, pimply, hot flashing, bloody mess for weeks on end.
I get how it is to feel uncertain about your future. “When we have kids” turns to “If we have kids” because…you just don’t know anymore. You used to plan for three, but now you’re holding out hope for just one.
“When we have kids” turns to “If we have kids” because…you just don’t know anymore
I get what’s it’s like to feel ashamed and embarrassed. So many women make pregnancy seem like a walk in the park, to the point where you feel incompetent when it doesn’t come as easy for you.
All he has to do is look at me and I get knocked up.
I wasn’t even trying to get pregnant, this was a total accident.
Y’all ain’t got no babies running around here yet?! What’s the hold up?
The sense of failure can be overwhelming. Even the word ‘miscarriage’ paints that picture – as if you are in the wrong. Like you made a mistake or had a small mishap that caused you to mishandle something and then whoops – you dropped the baby. Oh how I detest that word, as it implicitly puts the blame on the mother. It almost (kind of, on a much smaller scale obviously) feels like dropping a baton during a relay race. Hubby does his job to make the successful handoff and you start running full steam ahead – you just have to bring it home. Then suddenly, the baton slips right between your fingers and hits the ground, and you’re disqualified from the race. So now you just watch as the other relay teams keep going around the track, making successful handoffs and crossing the finish line to victory. And you stand there feeling like you’ve failed the team.
You look at your partner and it seems like you’re letting him down…you know how badly he wants to be a dad. Some friends of ours asked Marcus to godparent their beautiful baby boy, and so fortunately I do get to watch him enjoy that from the sidelines. It is a little bittersweet for me because for whatever reason, they thought it best not to include me. But ultimately I know it brings him joy and so yea – even though it adds to my feelings of embarrassment and incompetence, I’ll watch from the sidelines and get in where I fit in. Fortunately we both were asked to godparent our amazingly beautiful goddaughter, and she brings so much sunshine to our lives. It has been great watching my husband in a fatherly role with his godchildren. But that nagging sense of shame and embarrassment is still in the back of my mind…because for now, I haven’t been able to give him that.
Even though you know it’s not your fault, pregnancy loss can truly make you feel like you are failing as a woman. Trust me, I totally get it.
The word ‘miscarriage’ paints that picture – as if I am in the wrong. Like I made a mistake or had a small mishap that caused me to mishandle something and then whoops – I dropped the baby.
I get what it’s like to feel completely out of control. To look up and see that your body has autonomously decided to do whatever the hell it felt like doing that day. It is incredibly humbling and heartbreaking at the same time, to know that you couldn’t keep your little one safe inside of your own body. You did all the right things: took your prenatal vitamins, stayed away from alcohol and cigarettes, avoided sushi like the plague. I even cancelled a medical volunteer trip abroad to protect that little life from Zika.
But despite your best efforts…you couldn’t control everything.
Your body seemingly swats the ball down from the rim and wags it’s finger in your face. Not in my house.
Seriously? The nerve.
And I can’t even begin to describe the frustration of waiting for your pregnancy hormones to pipe down after a loss, which can take weeks. The entire time you still feel all the pregnancy feels. You think you’re going a little crazy because your hormones are raging out of control, which undoubtedly adds to the grief experience. Your body is running the show and you’re just a passenger. You resent it, but you can do absolutely nothing about it…so you buckle up and brace yourself for the wild ride.
I get what it’s like to feel silly and confused for being so sad about it. Most people aren’t able to understand the wide range of emotions couples go through in the aftermath of losing a baby during pregnancy, especially if that loss occurred early on. People expect intense emotional reactions to the loss of a once living spouse, child, parent, friend, or otherwise tangible person. Most people can even understand the pain of someone who experiences stillbirth – because at least that was a real baby. But you? That was “just” a miscarriage; you were barely pregnant. Let’s not get too dramatic here since it wasn’t actually a baby yet.
It was just a glob of cells.
At least you didn’t get too attached, it could be worse.
Just try again.
Oh – the things people say. You start to internalize those things and you really begin to feel stupid for being so distressed. I know I do, especially as a med student – where less than pretty terms like ‘fetal demise’ and ‘spontaneous abortion’ are thrown around callously in the clinical setting.
Maybe I am making a big deal out of nothing.
Maybe I’ve gone a little mad.
You start to doubt yourself, and you don’t feel entitled to grieve because well, your friends sister has a friend who actually had to carry her baby for 9 whole months before it died in a car accident. And you only carried yours for 2. So you should be grateful.
I honestly don’t know what it is about humans that makes us downplay the absolute miracle of life inside the womb. We all have to start somewhere, right? And if we’re being literal about it, developing humans stop being just a “clump of cells” at about week 4…right around the time a woman finds out she is pregnant. By the end of week 5, there’s a tiny heart pumping actual blood through the little one’s body. Week 6? That “glob of cells” spontaneously moves and has the ability to show reflex responses to touch. So can we retire that phrase, please?
The validity of unborn life is severely downplayed, and I think that’s one of the reasons why the emotional impact after a pregnancy loss is so underestimated and misunderstood. To others, your loss is just a blip in time. To you, it is everything. It is a confusing place to be. I get it.
I get what it’s like to feel traumatized after a loss. Because you think you may have just flushed your baby. Because there’s enough blood to stage a crime scene. Because this is the sixth time this has happened to you and you aren’t sure how much more you can take. Because you held your baby’s lifeless body in your hands. Because you never got to hold your baby’s lifeless body in your hands. Because you were pushed to the edge of your physical pain threshold and then forced over the cliff. Because you just spent $15,000 on IVF.
I didn’t realize how traumatic my ectopic pregnancy was for me until I began having nightmares. I had never been so close to death before. Even now, nearly 2 months later there are times when I look in the mirror and let that reality sink in – I literally could have died that day. It’s wild to me, to have confronted mortality.
I get what it’s like to feel frustrated that you’ve had to explain to the receptionist, the nurse, the medical assistant, the other nurse, and the doctor that you’ve lost a baby. Like seriously, did you even read my chart?! Please don’t make me say it again. Please.
I get what’s it like to have to deal with the stress of normal life after losing a baby. To have to return to work or school and face the world again, it’s tough. Going back to med school was so stressful for me [as if medical school isn’t stressful enough on it’s own already]. I took only a week off after the surgery, and then I had to put my game face on because it was back to “business as usual”. In those first two weeks back we talked about ectopic pregnancy multiple times. By the time we got the the cardiology unit, we were learning about ectopic heart beats. Then I get to my exam and there were two questions about miscarriage and one about ectopic pregnancy. Totally wasn’t expecting that so it took me a second to regain focus. The following week I saw a pregnant patient and used a fetal heart monitor on her. Throughout the curriculum we discuss embryology and fetal development repeatedly, because that’s what med students do. Then there’s the pregnant MA I worked with at my clinic, she always wanted me to touch her belly and feel her baby kicking.
I could hardly form a scab before it was picked at repeatedly while doing my normal, back to reality, every day things. It makes it hard to heal. And I’m sure you have daily reminders of your hurt in your every day life, too. Sometimes it seems like life will never get back to where it was before all of this happened. I get it.
If you ever need someone to talk to, you can definitely talk to me. I know I’m a stranger to you but I am no stranger to this experience. These emotions we are dealing with are real and raw and sometimes it’s just plain hard to sort it all out. Honestly, one of the main things that has helped me through this process is talking to other women out there who can relate. Other women who just…get it.
*When I say ‘pregnancy loss’ I am using a general term to refer to several different types of losses. Loss of a life during pregnancy can occur due to complete or missed miscarriage, stillbirth, ectopic pregnancy, molar pregnancy, or chemical pregnancy.
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If you find yourself reading this blog post, it’s probably for one of the following two reasons:
- You’re my friend or follower and you usually read my blog (Hello again, thanks for reading!)
- You found me on Google or some other forum because you fear that you (or your partner) may be experiencing an ectopic pregnancy. If this is you, I first want to say that I am deeply sorry. I hope that the information I share in this blog post can provide some clarity on what is happening to you right now.
Ectopic pregnancy (called EP for short) is a potentially dangerous condition that occurs when the baby is growing outside of the womb. If the ectopic pregnancy ruptures, it is a serious, life-threatening medical emergency that must be surgically treated right away.
I think every woman who is considering becoming pregnant needs to know about the [albeit rare] possibility of having an ectopic. Only 1-2% of pregnancies are ectopic, so statistically speaking, it’s probably not something you’ll ever have to worry about! To put it in perspective, you actually have a better chance of conceiving twins than you do having an EP. The overwhelming majority (98-99%) of pregnancies are NOT ectopic. However, there is still that small subset of women who will experience an EP. And although it feels like it could never happen to you, always remember that it could happen to you. So, you should be equipped, informed, and empowered. That’s why I’m writing this blog.
Having just gone through my own ectopic pregnancy experience, I hope that the things I learned can help you.
What is an Ectopic Pregnancy?
The word ectopic is Latin for “out of place”. So in the most basic terms, an ectopic pregnancy is simply a pregnancy that does not occur in the right place. The only place that a baby can grow and survive before birth is in the mother’s womb. Normally, the egg and sperm meet in the Fallopian Tube and then the fertilized egg travels down the tube to implant in the uterus. In an EP, the fertilized egg gets “stuck” in the tube (or otherwise finds itself in a place it does not belong) and begins to grow. It’s an unbelievably unfortunate accident that almost always results the death of the baby because it can’t get all the nutritional support it needs to survive.
The vast majority of EPs happen in the Fallopian Tube, you may have heard it referred to as a ‘tubal pregnancy’. EPs can also happen in the ovary, cervix, and even in the abdomen, but this is far less common.
About 80% of EPs are discovered before the tube ruptures. Some doctors choose to do what is called ‘watchful waiting’ or ‘expectant management’, in which they just let the body do it’s thing and wait for the EP to resolve itself. Sadly, most babies will die on their own and the mother will miscarry because the embryo can’t get the nourishment it needs. Ectopics can also be treated with an injectable drug called methotrexate which terminates the pregnancy and causes her to miscarry.
Unfortunately, medical science has not yet found a way to transfer an EP safely into the mother’s womb where it belongs.
In about 20% of cases, an EP is not detected before the tube ruptures. The mother may be unaware that the pregnancy is non-viable, and the baby keeps growing until it stretches the tube to a maximal point, at which the tube begins to tear and eventually burst. This can cause massive internal bleeding, which is why ectopic pregnancies are no joke. A ruptured ectopic pregnancy can. kill. you. if you don’t get help. With the advent of medical technology and blood transfusions though, expectant mothers with a ruptured EP generally have a good prognosis after treatment.
What puts you at risk for developing an Ectopic Pregnancy?
Anyone can have an EP, but there are certain things that put you at greater risk:
- Fertility Treatments – taking fertility medications and/or using assisted reproductive technology like IVF or IUI
- Advanced Maternal Age
- History of Pelvic Inflammatory Disease
- History of Abdominal/Pelvic Surgery
- Previous Ectopic Pregnancy
I had several of these risk factors under my belt already, and now that I’ve experienced an EP my risk for another one has gone up even higher. You should know what the risk factors are and talk to your doctor about what this means for you. If you fall pregnant and have several risk factors for ectopic pregnancy, make an appointment with your doctor for an early scan and ask them for serial Hcg levels (repeated every 48 hours). You should be closely monitored until it is confirmed that the pregnancy is not an ectopic.
What are the signs of Ectopic Pregnancy?
Let me start by stating the obvious, everyone is different. Just because you have these symptoms does NOT mean that you for sure have an ectopic pregnancy. Also, you may have an EP and not experience any of the symptoms I’ve listed below. The key is knowing your body and discerning what’s normal or abnormal for you. For the most part, my EP was pretty textbook. I broke each of my symptoms down a little just to give more insight into my experience. The signs and symptoms I had before my tube ruptured were:
- Vaginal Bleeding – I had bleeding the whole time that I was pregnant. People kept telling me “bleeding in early pregnancy can be normal”, and I know that this is true for some. But in my case, with this pregnancy, the bleeding was not normal. It was a warning. Most days it was just spotting..mostly brown, sometimes pink, definitely controlled with a liner. For about a day or two the flow was moderate and bright red – more than spotting, but not as heavy as a normal period. Then it turned back to light spotting and eventually tapered off. Anytime you have bleeding during pregnancy it’s safe to just go get it checked out!
- Lower Back Cramps – This started happening about 3 or 4 days before my tube ruptured. I was using a heating pad and trying to avoid medications to protect the pregnancy, but eventually used Tylenol to help with the pain. At the time it was hard for me to tell whether this was an early pregnancy symptom or not.
- Low Progesterone – Progesterone is a hormone that helps regulate your cycle and maintain pregnancy. Medical science seems to be ambiguous as far as the causal relationship between progesterone and ectopic pregnancy. Some sources say that low progesterone may be a cause of an ectopic (or otherwise non-viable) pregnancy, while other sources say that low progesterone is a sign of an ectopic pregnancy. Basically, it’s unclear as to what comes first: is your progesterone low because you have an EP? Or do you have an EP because your progesterone is low? Either way, there is a definite correlation between serum progesterone levels and ectopic pregnancy. Progesterone is not a routine prenatal lab so you’ll probably have to ask for it to be done if you suspect reason for it. I had my progesterone drawn in the ER about a week or so before finding out I had an EP and it was extremely low.
- Low Hcg – Okay so my Hcg levels were doubling every 48 hours initially, right on target. As time went on though, they kept going up but weren’t rising as fast as they were supposed to. This is called ‘slow-rising Hcg’. It was concerning and I really should’ve been more closely monitored by my gynecologist because of it, especially considering that my ultrasounds showed no evidence of an intrauterine pregnancy at a point where something should’ve been visible. Unfortunately, early pregnancy is tricky that way because not everyone follows the “textbook” pattern, making it difficult to diagnose when something is wrong as opposed to just a deviation from “the norm”.
The morning that my Fallopian Tube ruptured I experienced:
- Severe, Localized Abdominal Pain – It started off as a sharp pain in my right lower tummy, and over time the pain gradually spread throughout my abdomen and pelvis. It happened very suddenly; I was sitting in bed doing nothing and then BOOM, I was doubled over in pain. I would describe the pain as severe, I felt like I couldn’t move. It was quite literally the worst pain I’ve ever felt. I have ruptured several ovarian cysts, endometriosis causes me pretty bad menstrual pain, I have like 6 tattoos..but this pain was borderline unbearable. Also, it was waxing and waning, meaning that it randomly got worse and then a little better..and then worse again and then a little better. But the underlying pain was always there.
- Shoulder Pain – I told the paramedics that I had burning shoulder pain, and one of them told me that it was probably because of anxiety and that I should just calm down. In reality, shoulder pain can be a sign of internal bleeding caused by blood in your abdomen irritating the nerves that control your diaphragm.
- Syncopal or Near Syncopal Episode – Syncope means “passing out” or fainting. I’ve never passed out before so these symptoms really freaked me out. My hands were shaking and I was super dizzy. I started grabbing at everything around me because I could barely hold myself up. Then suddenly my vision was blurred, I became extremely nauseous, hot, and sweaty, and then cold and clammy. My poor husband was so scared and helpless, all he could do was hold me up and try to keep me awake while we waited for the ambulance.
- Symptoms of Shock – Once I arrived to the ER, things went from bad to worse. My heart rate went up to 130, my blood pressure dropped as low as 90/50, I felt really weak, sweaty, and mentally I was completely out of it. My body was going into shock from the blood loss and I knew I was extremely ill. At this point they were still running tests and stuff trying to figure out what was going on but I seriously thought I was dying. I had my husband make calls to our family to inform them of what was happening.
Why am I going through all of these lengthy details?
Ectopic Pregnancies can be tricky to diagnose. In the weeks leading up to my hospitalization, I went to my gynecologist twice and had even made a trip to the ER because of the symptoms I was having. I had several ultrasounds and my blood work was done each time.
All three times I was sent home.
The paramedics didn’t take me seriously either, and it’s literally their job to recognize life-threatening emergencies. After I explained my symptoms to them and told them that I was 7 weeks pregnant, one of them (a woman) said to me “I had cramping and bleeding with my son. He’s 6 years old now and perfectly healthy; so there’s probably nothing wrong with you”.
I could smell the stench of arrogance from across the room. She was so condescending and I wanted so badly for her to stop talking, but she wouldn’t shut up.
“It’s just a little cramping honey, you should really just calm down. Your shoulder pain is most likely due to anxiety”.
I’m pretty sure she could see the steam coming from my head at that point.
She went on to say that the ambulance could “give me a ride” to the ER if I felt like I really needed to go, but that I shouldn’t expect immediate answers because I was so early in my pregnancy. I even told her that I was concerned about the pregnancy being ectopic and she was still completely dismissive. She literally tried to convince me that it was all in my head.
And to be honest, she almost did.
First of all I never in a million years thought that this would happen to me. Even with me having several risk factors, I just didn’t think it would happen. Not to mention, I really didn’t think I’d loose two babies in a row. That was out of the question.
Also, I think as women we tend to try and be tough when it comes to pain. Speaking for myself, I think it may stem from a fear of coming across as melodramatic. I don’t want to appear weak, I want to look strong. I want to be strong. Plus I didn’t want to feel stupid if it turned out that nothing was even wrong with me. But in that moment I had to realize this truth: it takes both strength and wisdom to admit when you might be in trouble.
So, I politely told the paramedic that I would like to be taken to the ER by ambulance because I think that something is wrong. I then went on to explain that I am in medical school and have several years of clinical experience, mostly in emergency medicine. I’m not stupid. It’s not all in my head. And I know what I’m talking about. She was a little less condescending at that point but I could tell she was still skeptical.
Right before I went into surgery my gynecologist looked me square in the eyes and told me that it was a good thing that I came to the Emergency Room when I did. Had I listened to the paramedic and ignored my body, it’s possible I wouldn’t be here to tell you about it today. My husband really looked out for me and pushed me to get help when I didn’t want it. It was his decision to take me to the ER, and his decision to call the ambulance when I wasn’t thinking straight for myself. I lost a baby and I lost a Fallopian tube, but I didn’t loose my life because we acted quickly and got the help I needed!
So, that’s my story. If it’s one thing I want you to take away from all of this, it’s that you have to speak up for yourself.
You must be your own advocate.
Ask for those extra tests. Bring your questions and concerns to someone’s attention. Don’t take ‘no’ for an answer and don’t be scared to be wrong. Most doctors are very great at what they do but they are humans too, and they can make mistakes. I can’t help but think how different this all could have been had my early concerns been investigated more thoroughly.
My incisions are healing up, the bruising on my tummy is starting to go away…but the hole in my heart is still very fresh. Part of me feels like I haven’t fully processed what has happened, it all still feels so surreal. I know that this pregnancy was never truly viable, but to us, it is a devastating loss. We will always remember our unborn child and the joy we shared for the 7 weeks that he or she was with us. And now, 12 days after surgery, the real healing process begins.
It’s exactly 8:04 am right now as I type this, on January 14, 2018. I’m in a hospital bed, my husband asleep in a recliner to my immediate left. As I take in my current surroundings it’s hard to believe that just a short 24 hours ago we were at home, sitting up in bed together, talking about normal things. Doing normal life and going about our normal business. I had just taken my prenatal vitamin and gotten off the phone with my dad. We talked a lot about my pregnancy; it had been a complicated one so far but it was the end of my 7th week and things were, slowly but surely, moving along. I touched my belly and prayed for the baby like I had done every morning for the past few weeks. It started off as a normal day.
***I’m just going to drop a trigger warning right here before I move forward. I assume you’ve read the title of this post so you should have an idea of how this story ends. I’m telling you right now, it’s not a happy ending. That said, this may be an emotional trigger for you, especially if you’ve suffered a similar loss. And if you think talking about bodily fluids is TMI…then you might want to leave this page, too.***
Wow – it’s been over 4 months since my latest post. I haven’t blogged since before Christmas! So far this year life has been pretty hectic for us and I haven’t really had much time to write. First, let me say hello to all of my new followers and readers!
Last year, I shared with you the experience my husband and I had with our miscarriage. Long story short, we had a surprise pregnancy that ended devastatingly when I was nearly 3 months along; I detailed that story here. A whole 15 months have passed since then and so far, most of my blog posts have been centered around this loss. I remember feeling like I was never going to make it through that time of my life! But here we are over a year later and we’re making it through. God has kept us. We’re not over it, I don’t think you ever “get over” something like that. However, we’ve adjusted and we’re okay now. I am okay.
What I haven’t talked much about though is what’s been going on since then. Marcus and I are coming up on 2 years of marriage. With that, people are getting really antsy and for whatever reason feel comfortable enough to ask about our family planning.
“Where are the babies?”
“You must be waiting until you finish medical school. Smart girl!”
“Are y’all thinking of having kids any time soon?”
If you’ve been married longer than 15 minutes I’m sure you’ve heard it all before, too! Usually I just force a smile and say some vague, canned response like “Whenever the time is right I guess”. I can’t really get mad; most of these questions come from well-meaning friends and family who are genuinely interested in my life. But very few people know that Marcus and I are currently trying to get pregnant again, and have been trying again since last March when we were cleared after the miscarriage. I think now is an appropriate time for me to share.
It’s been 14 months of trying. 14 months of failing. 14 months of unwanted periods and negative pregnancy tests. 14 months of wondering what’s wrong with me. 14 months of Facebook pregnancy announcements and baby shower invitations (don’t worry, I’m happy for you. Just sad for me). 14 months of praying and crying out to God.
It’s also been 14 months of amazing baby-making with my husband – so it ain’t all bad. #heyboo
Point is we’ve been trying again for over a year and nothing is happening. And as discouraging and frustrating as that is for us, there are so many other couples out there who have it far worse and have been silently struggling to start a family for years. Making a baby may be natural, but that doesn’t make it simple. A lot of people have long and very complicated journeys to parenthood.
1 in 8 couples struggle with infertility
Even though it is common, infertility is just one of those things that people don’t openly discuss…especially within the African American community. It’s often presumed that women of color don’t have issues getting pregnant. Period. It’s a stereotype that has historical origin and is still perpetuated in our community today. I could honestly write a paper on this topic but we’ll save that for another blog post.
Anyway, we assume infertility only happens to wealthy, “workaholic” white women who decide to have a baby a little too late in life. But the truth is, black couples are more likely to experience infertility than their white counterparts; and are less likely to seek medical treatment for it. I think there are several factors that play into this, including access to healthcare, affordability of infertility treatment, lack of reproductive health awareness, and religion. For example, we say things like “God must not want you to be pregnant right now, just keep praying. He will make a way”. Now don’t get me wrong – I am a believer in Jesus Christ and I have no doubts about the power of prayer. However, what doesn’t occur to most is that sometimes “a way” is made through help from others. If you’ve been trying to get pregnant for a year or longer and haven’t been able to, that’s infertility; and you should see your doctor.
Many people don’t know that infertility is defined as not being able to conceive or carry a pregnancy to term within 12 months of actively trying
Another reason why I think African Americans are less likely to seek help for infertility is because of the shame and embarrassment they feel. There is an undeniable stigma that comes with having trouble achieving or sustaining a pregnancy. If you don’t believe me, then think about why we use negative terms like “dried up” when referring to an infertile woman; or “shooting blanks” when a man can’t impregnate his wife. An important step in overcoming that stigma is to have open and honest conversations about it.
I guarantee that someone you know is currently experiencing the heartbreak of infertility, whether they are open about it or not. This week (April 23-29, 2017) is National Infertility Awareness Week and I wanted to share my story because I know how it is to feel alone on this journey. Thankfully I have a wonderful husband to fight with me, but as a unit we often feel isolated. I get it. The lost babies, unsuccessful treatments, hospital stays, constant poking for blood work, constant probing for ultrasounds, the bills, the waiting, the uncertainty – it’s hard.
We are currently seeing a specialist at an infertility clinic and received a diagnosis last week. I won’t go into detail in this particular blog post, but the news was bleek. Basically our doctor said he has no idea how we even got pregnant the first time, and it’s going to take a serious miracle for us to conceive again.
Thank God, He specializes in miracles.
If you’d like to follow our story, I will be blogging more about our real-life experiences with infertility as it happens. Usually people share their battle with starting a family after they successfully have babies. Testimonies are great and very encouraging! However I do think there aren’t enough couples voicing their struggles as they go through them. These blogs will naturally be a little more personal and because of that I don’t plan to post every single one on social media, so make sure to click the “Follow” button to receive updates in your email.
Infertility In The Media