As a female growing up, it is drilled into you that you must always use contraception and never roll the dice as you can fall pregnant so easily… it just takes one time! Whilst this fundamentally true, what I didn’t realise was that you spend your teenage and young woman days trying desperately NOT to get pregnant, only to realise when you are ready to have children that it is not in actual fact that easy. There are so many windows that must align in order for conception to occur, and even when you fall pregnant, no-one really tells you in your younger years that it is also not that straightforward to keep a pregnancy. Approximately 25%, thats one quarter of all pregnancies will miscarry. These statistics are a little skewed, as many occur in the first trimester, some of these before the woman even knows she is pregnant.
You may be thinking, yes I am aware of all of that, but for me, I was not aware until I reached my late twenties and my husband and I decided it was time to start a family. At this point, I had been on the pill for over a decade and had not really given the whole conception thing a second thought. I just assumed that when you decided you wanted to have babies, you stopped using contraception and voila – you’re pregnant! I have friends who have been fortunate in this space and have fallen pregnant literally the month that they start ‘trying’. But I know far more women who have had to go to incredible lengths, putting stress on their bodies and relationships, whilst investing time, energy and money into conceiving a baby. I have supported many friends on the painful fertility journey. It is a terribly hard thing to watch someone go through, especially when you know what an amazing parent/mum they will be.
My hubby and I were relatively fortunate in that we have been able to naturally conceive and carry three beautiful children whom we cherish deeply. However, I have also carried two other pregnancies, both of which ended in early miscarriages (within the first 12 weeks of pregnancy). After our first baby was born, when trying for our second child, I experienced my first miscarriage. As far as miscarriages go, it was relatively ‘straight forward’. I had a positive pregnancy test at around 6 weeks pregnant, but when I had my blood tests the numbers were very low which indicated that the pregnancy was ending. A few days later I commenced the miscarriage process naturally. Whilst I understood the rationale at the time; people would comfort me with comments like ‘your body wasn’t ready’ or ‘there was something wrong with the pregnancy and nature took care of it for you’, I couldn’t shake the feeling of loss and grief. The doctors and sonographers were sympathetic to an extent, but there was almost an air of, well thats lucky you weren’t further along or, it was only early days so thats good. Somehow, it felt as though this reduces the emotional impact it has on us as a woman. I sincerely believe this is something only another woman who has miscarried can understand. It doesn’t matter what point of the pregnancy you lose a baby, you are entitled to feel that loss and grieve for the child that could have been. For me, miscarriage is something I saw as a failure of my body to do what it is supposed to do. By not being able to carry the pregnancy, I am letting the team down. This is my burden, and my burden alone to share.
Some months following this, we conceived our second baby. We then waited some time to decide whether to ‘go again’. I talk more about this is my blog ‘My Journey to Becoming a Mum of Three’. Once we made the decision, a number of months of ‘trying’ followed before we fell pregnant again. This time, I felt a strong sense of being pregnant, sore boobs, exhaustion, nausea. I had a positive pregnancy test then waited til 8 weeks to get my dating scan. I knew something was not right when I lay on the table and the sonographer did their first sweep over my belly. Their brow furrowed and they clicked the buttons and moved the dial a few times without addressing me. Up until this point I was expecting a non eventful confirmation of the pregnancy, with an estimated due date and approximate gestation. The sonographer took a few moments before addressing me, advising that the heart rate of the embryo was very slow and it was much smaller than should be expected of an eight week embryo. He reflected that this could for two reasons; it could be an indication that the pregnancy was a lot earlier than I had calculated and therefore the heart had only just started to beat, or it could be that the pregnancy could be finishing (i.e. miscarrying). I remember feeling so scared in this moment, my husband had not attended the scan as I believed it was a ‘tick the box’ before the more exciting scans later in the pregnancy. The sonographer advised me to seek an additional blood test to see what my hormone levels looked like. My GP ordered the blood test and had it done immediately, I needed to know what was going on. I waited a few excruitating days, and finally got a call from the GP. My blood test results were deemed inconclusive, I had what they described as slow to rise HcG levels. Basically, my levels were increasing but not doubling every 48 hours as it should do at this point in the pregnancy. The GP asked me to wait another week then book another scan. I remember this being a time of high anxiety, I googled everything under the sun, viability, was I miscarrying, what do slow to rise HcG levels mean. It was a lonely and exhausting time for me. As a general rule, I don’t share with people about my pregnancy until I’ve reached the 12 week mark and had the all ok through the GP and scan, so there were very few people I could talk to at this time. When I turned up for the second scan, this time with hubby in tow, I was incredibly nervous. The sonographer took a quick look and shook her head. Whilst the gestational sac remained, there was no heartbeat. The embryo was gone. I remember crying quietly and feeling so alone. So back to the GP who advised me to seek advice from my obstetrician.
I recall walking into the obstetrician’s office, feeling really surreal. The last time I had seen him, he had just delivered our second child and all my visits to his office prior to this day had been to check on the pregnancy and monitor my progress. I looked around the waiting room and all I could see were babies and big bellies, it was a really emotional moment for me. Naively, up until that point, I had just assumed everyone visiting an obstetrician was there because they were carrying a pregnancy. I now understand, that there are many women who are desperately trying to conceive with the assistance of an obstetrician, or like me, they are in the process of or have just miscarried. The obstetrician was kind but matter of fact. At this stage, I was still showing symptoms of being pregnant, I had not miscarried naturally. My ob advised that I could wait two weeks to see if my body would naturally miscarry (the preferred option) and after that point, I would need to attend hospital for a D&C. I waited the two long weeks, without any signs of miscarrying. The term the medical community refer to here is a missed miscarriage. Basically, although I was no longer pregnant, my body has continued to produce pregnancy hormones and was carrying effectively a ‘phantom’ pregnancy. At some point, my body may have worked it out itself, but by this stage, I was about three weeks into this tortuous journey and just wanted to wipe the slate clean so we could move on. The day of the procedure, I was feeling quietly optimistic. This was our opportunity for a fresh start and I felt I had grieved the loss and was ready to start again. It wasn’t until I was in the hospital gown getting ready to go in that, I had to repeat multiple hospital staff the reason I was having the procedure and what it was called, that I started to feel the hollow ache again. When the pastoral worker visited from the Church (I was in a Catholic hospital so the pregnancy, event at 10 or 11 weeks is considered a loss of life), I really broke down again. It took me some weeks after the procedure to feel like myself again, the sadness stayed with me and affected me more than I had ever anticipated.
I believe this, is at least in part due to the fact that early miscarriage is often concealed, misunderstood and not openly communicated about. There is a general ‘down playing’ of the seriousness of them, because of the earliness and because there’s this idea that you’re ‘barely pregnant’. I am not trying to take away from miscarriages at later stages of pregnancy, they would come with their own grief and emotional journey, but as a general rule, these are more out in the open and shared amongst friends and family. Early miscarriages are often only shared between the husband and wife and maybe some of the family and a few friends. Sometimes, it is literally just the woman who knows. That to me, is why it can be such an isolating and lonely time. It is a time of loss and grief, but I did not always feel that society allowed me to really feel that grief. I also believe that because many women like myself feel a sense of shame at miscarrying, they are reluctant to share their ‘failure’ broadly. I am hoping that by being open and sharing my journey, that it will encourage other women and partners to feel like it is ok to talk about their losses and grief too.
Love Tash xx
Bianca Keat
I have always wondered where and why the 12 week ‘rule’ began. At which point in the history of mankind and did it evolve to be something it wasn’t originally intended? This 12 week mark, the balance point between ‘nothing is happening here people’ and getting in before the rest of society starts talking! More often in the past, extended families lived together or close by and perhaps, while announcements to the world weren’t officially being made, women still did have a small, firm network of support behind closed doors?? As society moved away from this way of living, surely much of the support needed during our more intimate and personal struggles was lost. I personally felt it made sense to tell those closest to me the moment I was pregnant. The people I would look toward and rely on, who I knew would be there for me if anything were to go wrong. It seemed a very huge burden to carry alone and I was thankful that I had those same friends and family when we did experience the losses we did. It is a personal choice but important for all to know we are allowed to question and choose the path forward that is right for us.
Tash Hanham
Hi Bianca, the 12 week mark is such an interesting concept. I understand that this is the point when the risk of miscarriage reduces significantly, but why up to this point do we hide the fact that we are pregnant? I believe this contributes to the feeling of guilt and shame when some of the early pregnancies do not continue. There is an idea that somehow as the woman that perhaps we did something to cause the miscarriage? I agree, we need our support network around us more than ever when an event like this occurs, and having to hide it or not talk about it feels deeply wrong to me. Again though, this does come to personal choice, but I wonder if more women felt it was acceptable to talk about it, then perhaps more women would be comfortable in sharing.