I barely slept the night I found out I was pregnant, having read that my baby was somewhere between the size of a lentil and the size of a blueberry and already forming a face. I was blown away by the insane miracle that human life happens, that microscopic cells divide and grow and become a person, that chromosomes meet up and have the coding to know what to do. Turns out the chromosomes of my lil’ babe didn’t totally know what to do, or maybe its coding didn’t quite line up. Either way, it didn’t make it. Only three out of four really do.
I had a miscarriage at just shy of seven weeks. I was elated about the pregnancy. The loss was sad for sure (though I count myself very, very lucky that it happened so early), but what hit the hardest during the miscarriage itself was the extent to which I did not know what was going on with my body. In that sad and confusing time, the wisdom of real life ladies proved far more helpful to me than my doctor’s advice. I am lucky to have friends who will get all gross and nitty gritty about these things, and I am lucky to have friends and family who helped me firm up my shaky decision to follow my gut over my doctor’s advice (not something I’m advocating, but it was the right choice for me that day). Everyone should be so lucky.
What’s weird to me is how little people tend to talk about miscarriage. I’d heard very few miscarriage stories from friends and family prior to my own. Once I brought it up, so many more materialized – if not friends’ own stories, then their aunts’, mothers’, cousins’. It’s crazy to me that there’s any kind of stigma around talking about something so common. At least a QUARTER of pregnancies end in miscarriage. It happens all the time. I don’t say that to scare newly pregnant mamas-to-be. On the contrary, I think there’s a way in which silence provides cover under which fears can hide and grow, and talking about this stuff feels to me like dragging those deep fears out into daylight, letting them air out and fade in the sun.
Sometimes the hush is understandable and necessary. Not every woman wants to talk about her miscarriage. It can feel quiet and private, too painful to broadcast. But I am doing OK, and as such, it seems worthwhile to raise my hand, to say that this is something that I experienced, that I am fine, and that it doesn’t have to be quite so scary and weird to talk about. I’m writing because the silence about miscarriage felt so heavy to me when I was having one, and I want to lighten it up a little. This is absolutely not intended to replace or override medical advice – it is simply a collection of things I learned. I’m sharing in hopes that it will reach a woman out there who’s as confused as I was, new to pregnancy and bleeding, not sure which end is up. Imaginary woman, you are part of a long line of women who have been through this. You are not alone. I hope you have friends who will talk to you about even the ickiest parts. But even if you don’t, or even if they’re all asleep right now, you’re not alone.
Are You Actually Having a Miscarriage? What I Learned About Bleeding
I’ve yet to hear of a woman experiencing miscarriage the way it frequently happens in the movies and on TV – a sharp pain that triggers the woman to reach into her pants with her bare hand and bring it out covered in blood, immediate confirmation that things have gone awry. In real life, there is a lot of gray area, symptoms that could be OK or could not. Plus, most women don’t reach blindly into their undies when things don’t feel right.
It turns out lots of women have spotting during pregnancy. It could be something minor going on with your cervix. It could be implantation bleeding. It could be miscarriage. My sources on the interwebs concur that spotting that is pink or brown is less likely to indicate a problem with pregnancy. Bleeding that is bright red or heavy, or bleeding with clots is more likely bad. Pain is also a bad sign. If you are experiencing any kind of spotting or bleeding during pregnancy and are reading this online, odds are the internet has already told you all of this.
But what is spotting? And what is heavy bleeding? What constitutes a clot? This is where I felt most in the dark and where the internet really let me down. There seems to be an expectation that we are all on the same page and inherently know the difference between spotting and bleeding and can easily fit our symptoms into neat little boxes. But here’s the thing: If you have any blood coming out of your vagina during pregnancy, it’s probably going to be alarming. There’s a good chance that any blood at all will seem like a lot of blood. Mine was bright red, a red flag if you will. Because I was looking at one bad sign, it seemed like I was seriously bleeding. When I called the nurse line provided by my insurance, she asked me a slew of rather clinical questions that I found myself unable to answer until I pushed her for definitions. This struck me as completely backwards. We should get the definitions before the questions, or the questions should be open-ended with room for descriptors. Questions with yes/no checkboxes that have not been explained were not particularly useful to me. I thought I was bleeding heavily, but when I finally got the phone nurse to define spotting, it turned out that fit the bill for me (no need to change a panty liner within 4 hours).
And then there’s the issue of clots. I could not, for the life of me, get a good definition of what constitutes a clot. If anyone has one, please post it here. There was stuff in the blood, but there’s always stuff in the blood when I have my period. The knee-jerk response seemed to be that anything other than pure liquid meant that I should go to the ER immediately, but I was not convinced that the stuff in my blood signaled danger. I had some pretty comprehensive sex education growing up, but I found myself wishing it had been even more graphic. I found this handy video about different sized clots in menstrual blood (spoiler alert – if you regularly have golf-ball-sized clots with your period, you should get checked out), but nothing about lumps in pregnancy spotting. A friend told me she always thought she’d had clots in her period, but that her miscarriage was different – she had a slight fever, and the clots were way bigger, even though she was very early on. That gave me some comfort for a little while since my lumpy stuff was all pretty small, but there was enough of it that I grew pretty sure over the course of day one that my pregnancy was ending (p.s., unlike in the movies, miscarriage is not usually a one-time gush, but something that sticks around for a little while). In the end, I never had anything major – no huge chunks, no heavy bleeding. It was almost exactly like a light period. It’s different for everyone.
Hospital or No Hospital?
I started spotting at 6am, too early to talk to my mom or my friends, also too early to call the midwife’s office I’d identified via Yelp as a potential good fit. And so I turned to the internet. One of the first things I’d read, when I’d moved on from Googling “spotting in first trimester” to straight up reading about miscarriage, was a story about how it’s possible to be OK after miscarriage. The things that the author found comforting were the very things I’d included in early morning text messages to my mom, the reasons I’d given myself to be OK if I was indeed miscarrying. Buried within one of many comments on the post was this:
“I wish at the time when I’d been scouring the internet in a late night haze that I’d come across something that had said, MISCARRIAGES ARE VERY COMMON AND UNLESS YOU’RE GOING THROUGH MORE THAN 2 PADS IN AN HOUR, YOU CAN WAIT IT OUT AT HOME.”
Once again, I am not dispensing medical advice. There are some really good reasons to go to the hospital during miscarriage. If you’re in major pain or hemorrhaging, it could signal a serious problem and could indicate that your health is at risk, not just your pregnancy. If your symptoms are more tame, but the anxiety of not knowing what’s going on makes you feel like you’re going to jump out of your skin, go and get yourself some answers!
My morning was a whirl of trying unsuccessfully to find medical care that was not the ER. My gynecologist had moved, leaving me between lady doctors. I called a potential new OB/GYN office and explained my symptoms and asked if I could come in. I was told to go to the ER. I called the nurse line offered by my insurance. She did not specify ER, but said that I needed to see a doctor “within the hour” (something that has never once happened in my history of emergency room visits). I went to see my GP, whose office is around the corner from my house and who takes walk-ins. I explained that I knew he couldn’t do anything for me, but that I hoped he could call up an OB/GYN and get me in fairly quickly. He called up his gynecologist buddy and described my symptoms. The buddy told me to go to the ER. Well, not exactly the ER, but the OB on call at the ER, which is pretty much the same thing. My doctor gave me a note to try and speed me through the waiting process at the hospital.
Here’s the thing: I had mild cramping, sometimes waves of pain, but it felt like period pain, nothing worse. The insurance nurse had helped me understand that I was spotting – nowhere near hemorrhaging. The reason I was told repeatedly that I needed immediate care was that I had some tissue in the blood. But wouldn’t any miscarriage involve the release of tissue? And hadn’t women had miscarriages for thousands of years without the aid of the ER? My gut sense was that I was OK – that I would be in more pain or have a fever or even more alarming symptoms if I was in any danger. It was the first hot day of the year and happened to be the day that my local botanic gardens offer free admission. Wouldn’t it be better to take my sadness there, to get some sun and stare at flowers, than to sit alone in a hospital, most likely for hours, waiting for an ultrasound to tell me whether or not there was a fetal heartbeat? This early in pregnancy, it would likely be a transvaginal ultrasound. A cold piece of machinery in a rather invasive spot did not sound like it would be a comfort to me.
Finally, I spoke to a doula friend who gave me the number of a midwife. The midwife said, “I’m so sorry” when I said I thought I was having a miscarriage. She listened to all of my symptoms and said she could see me on Friday. I mumbled my speculations regarding the advice to go to the ER: “All they’ll do there is give me an ultrasound to confirm whether or not it’s miscarriage, but I’ll most likely know in a few days on my own, right?” She said most likely, “And if there was a concern about ectopic pregnancy, I’d have a lot more pain, or pain on one side, or a fever or something, don’t you think?” Again, she said most likely. I was hoping for a solid “yes,” but there are liability issues when giving medical advice, and this was the closest confirmation I was going to get that I was probably OK.
My husband and my mom both supported my decision not to go to the ER. Friends who’d had miscarriages said I might not even be having one (a short-lived comfort, but a lasting bit of perspective on how not terrifying my symptoms sounded to others). I took my doctor’s note in case anything changed for the worse and went to the botanic gardens. A dear friend was able to join me and hug me and stand quietly beside blooming magnolias – soft, pink ones that look like frizzled fireworks, luxuriously creamy saucer ones set off by dark branches and a bright blue sky – to lament that the cherry blossoms weren’t out yet, to watch the turtles swim lazily and lie out on rocks, basking in the glory of that first hot day. I cried behind my sunglasses. I stood in the sun. I laid out in Prospect Park and talked on the phone when my friend had to leave. It felt better than being inside.
I continued spotting for a few days and kept my appointment with the midwife later that week. She gave me a prescription for a sonogram in case my blood work was inconclusive, but, when the results came back the next day, she was able to confirm that I was no longer pregnant (my hCG level was far too low).
If you don’t know what’s going on, talk to someone who knows more than you. Talk to a mother or an aunt, a friend who’s had a miscarriage. Talk to your OB/GYN or your GP. Use Yelp to find a midwife who answers her own calls and can listen to you describe your symptoms. But listen to your body, too. If you feel OK, you are probably OK.
Some Things That Helped
Hands down, the thing that surprised me most was how calm I was during my miscarriage. I tend toward anxiety (honestly, who doesn’t?), and I was surprised during my brief pregnancy by how fearless I felt. Granted, I didn’t have a ton of time for my mind to go to dark places, but I really didn’t consider the possibility of things going wrong. When things did go wrong, I was confused and upset, but I was surprised to find, somewhere at my core, this belief that things were unfolding as they were meant to, that I was going to be OK.
I’m not a particularly religious person. I love me some yoga. I believe in spirit. I don’t think much about fate or what’s “meant to be,” but I had this feeling in my gut that if I was indeed having a miscarriage, it was because the pregnancy wasn’t meant to be. This little dose of spiritual wisdom came from a most unlikely source: WebMD. It was there that I first read that “most miscarriages that occur in the first trimester are caused by chromosomal abnormalities in the baby.” I probably hadn’t done anything to harm my baby. Most likely, there never was a healthy, fully functional little embryo at all, but one that never had the necessary equipment to become a full human being. I’d been astonished by my ability to love something so small, sight unseen. It turns out it was something different than I thought it was, something too flawed to make it. Odds are, it was never going to be a baby. I was grieving a dream. Somehow, believing that was helpful.
I’d been trying to get pregnant for quite a while. For women under 35, the recommendation is to try for a year before seeking medical advice. It could take a month, it could take 11. I fell well within normal range, but it had been long enough that I was starting to wonder if I could get pregnant. Even though my pregnancy was short, learning I could get pregnant was a positive thing. Miscarriage is incredibly common and does not in any way indicate that something is wrong with you. The lesson learned, that I’m releasing eggs, that my husband’s sperm know where to go, that they can meet up, is a really great lesson that still holds true, as does the conviction that came in a new and solid way with pregnancy that being parents is something my husband and I both want.
Somehow, the fact that miscarriage is so common and that most women who have a miscarriage go on to have a perfectly fine baby made it all seem like a step on a path, a page in some future book about being a parent. I felt this way even before I received the most perfect email in the world from a friend who’d been downright jubilant when I told her I was pregnant. If you are having problems with your pregnancy and fear miscarriage, plug your name right in there in place of mine. My friend would want it that way.
Sweet Megan
Your baby – the one that has or will make their nest within you – now knows the delight with which you will receive her/him.
Any doubt has been washed away.
Yes for sure there is a soul throwing a party.
This is part of conception – a tender, hard, heartbreaking part, but part of your pregnancy journey, and it is still really really exciting that you are on this path.
I wish I could hug you right now but I am sure you are being hugged.
Magnolias was a brilliant choice.
I wish you flowers and the comfort of friends, grief in whatever way serves you, and a million babies if you want them.
A Working Draft 