Ectopic Pregnancy Signs and Symptoms

If you find yourself reading this blog post, it’s probably for one of the following two reasons:

  1. You’re my friend or follower and you usually read my blog (Hello again, thanks for reading!)
  2. 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:

  • Endometriosis
  • Fertility Treatments – taking fertility medications and/or using assisted reproductive technology like IVF or IUI
  • Advanced Maternal Age
  • Smoking
  • 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:

  1. 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!
  2. 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.
  3. 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.
  4. 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:

  1. 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.
  2. 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.
  3. 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.
  4. 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.

 

When the Birds and the Bees Aren’t Enough

 

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

hey boo

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.

 

NIAW


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 Resources
https://infertilityawareness.org/
http://www.ihr.com/infertility/
http://resolve.org/
Scriptures For Infertility & Pregnancy Loss
Infertility In The Media
Fox 2 Infertility Awareness Week
Michigan Center for Fertility & Women’s Health on Live in the D
Local 4 Shares One Couples Story
Chrissy Teigen & Tyra Banks Talk Infertility

 

 

 

 

 

Rainstorms & Rainbows

“My Little Angel Baby” is changing to “Rainstorms & Rainbows”. The content will be the same, but I felt inspired to change the name of my blog for a couple reasons.

First, I really do believe that one day God will give me and my husband a healthy child. “My Little Angel Baby” only focuses on the one unborn child I lost; and while I will never forget my sweet August, losing that baby is not the end of my story. Battling infertility is only for this season. There’s a rainbow coming; and when that happens, I want to continue using this blog to document those pregnancies, births, and our journey together as parents.

My hope is in Jesus and He promises to work all things together for my good. That means He can turn my lemons to lemonade, my mourning into dancing, and my rainstorm into a rainbow. And I’m waiting with expectation for that promise.

 And we know that for those who love God all things work together for good, for those who are called according to his purpose. Romans 8:28

 

Lastly, I don’t believe that my baby, who was once a tiny human growing inside of me, is now an angel. I do believe that the souls of babies and other loved ones who die in the Lord go to be with him in heaven, but not as angels. I think a lot of people use that imagery as a form of comfort when they lose someone, which is okay, but it is not to be taken literal. So, I changed my blog name. Splitting hairs, I know. I’m a deep thinker 🙂

Oh yea, I also added something new to the site! Inspired by Pregnancy & Infant Loss Awareness month, I wanted to create a wall of remembrance where you can submit a form to have your baby added. Check it out!

 

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Love always,

Nikkie

What’s In A Name?: Why We Named Our Miscarried Baby

One of the first things hubby and I decided to do after we lost our little one was to give him/her a name. I’m not going to lie, it felt weird at first…naming someone who never lived a day on this Earth. Nobody ever said this but I feel to most other people who knew we were expecting, our baby was still hypothetical. Something that was supposed to happen, but never did. Somewhat of a theory or abstract concept maybe, but not a real being to be named. Furthermore, we never found out what sex our baby was. The appointment that was originally scheduled for blood work to determine sex ended up being the follow up appointment after we found out we were miscarrying. We never knew if we were having a boy or a girl. So yes, initially I felt weird naming our angel baby.

But the fact is, my baby was real, and though we will never know with certainty what the sex was, hubby & I believe it was a boy.  I heard his beating heart. Saw his little nose. He had fingers, toes, arms and legs. He had a brain that controlled his developing lungs, muscles, and other organs. And above all of this, he had a soul; a soul that is unique to him and him only. He was a person. A little person, but a real person nonetheless.

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We picked the name August. I was due to give birth in the month of August so it felt like a cool way to commemorate that. We also felt it was gender neutral, in case we were wrong about him being a boy 🙂

To us, naming August after the miscarriage was important because

  • It was a way for us to honor and commemorate his short life, though it was lived entirely inside my womb. Giving him a name felt like we were giving him an identity other than “the baby I lost to miscarriage”. It helped provide a small sense of closure and also helped us to connect with our little one. Granted, I would never hold him, nurse him, or watch him grow; but what I could do was name him. Giving August our last name really connected our family and it is one of the only ways I could mother this child.
  • Almost immediately after finding out we were expecting we started picking names. We had a few boy and girl names that we were really committed to, but when we lost the baby it felt like we’d also lost all of those names. It felt like those names were off-limits for any baby we could potentially have in the future because they belonged to this baby. However, after picking a different name for August, it kinda freed up those names for us to still be able to use in the future should God decide to bless us with another child.

Naming your baby after miscarriage or still birth is a personal choice! Please do not feel pressured to name your baby if you are not comfortable with it, there are other ways for you to acknowledge and honor your child. However, this is something that worked for our family and helps tremendously as we cope with the loss.

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I made a bracelet with his name that I wear all the time. It helps to see his name and have something physical to remind me of his sweet little soul.

Did you name your baby after loss? If so, what name did you choose and how is it significant to you? Feel free to leave comments below and follow me on Instagram @_mylittleangelbaby

 

xoxo,

-N

 

 

 

 

 

First Blog Post – Finding Out I Was Pregnant

I started writing about a month or so ago. It is really therapy for me, as my husband and I are going through a miscarriage. After allowing him to read what I had wrote he says “wow, babe you should really do something with this. Let someone else read it, write a book, something”! While flattering, I don’t think what I have to say is exactly book worthy, so today I decided to start this blog. Feel free to visit the “about” section if you haven’t already for a brief introduction; because I am going to skip all of that here and get right to it!

As a warning, this first post is rather long. I don’t plan on all of my blog posts being this long but due to the way this story ends I really just wanted to savor every moment and recount this day as clearly and thoroughly as I can. This is one of those things that I have to do for me and my healing process. You’re welcome to skip and find another post, or you can read along and relive this day with me.

Continue reading First Blog Post – Finding Out I Was Pregnant