Monday, September 21, 2020

Bloody Hell

The bleeding started when I was six weeks pregnant. At first, it was just a mucusy little string of red on toilet paper. Then the cramps came on. My heart sunk. Since I’d miscarried three times in the past, I knew what this meant: the beginning of the end.

I silently berated myself for the things I’d done that could have caused a miscarriage: they ranged from the obvious (too much exercise) to the absurd (a face cream that contained willow bark). This was all my fault somehow; of that, I was sure.

I was also convinced that once you start miscarrying, nothing you do makes a damn difference anyway, so I went to the gym. While slogging away on the Elliptical, I thought about how unfair it was that I only got to enjoy being pregnant for a week-and-a-half. I wanted more time with my little one. “Please, God, let this baby live,” I prayed over and over.

When I called Dr. Baby-Maker’s office to report the bleeding, the nurse told me to come in right away for another beta hCG and an ultrasound. Suzy, the upbeat sonographer who’d told me I had a “miracle lining” just a few weeks before, now guided the ultrasound probe inside me and said, “I’m going to be looking for a sac.”

I held my breath and tried to decipher the grainy black-and-white images on the screen. I couldn’t see anything.

Finally, she spoke: “I don’t just have a sac; I have a baby, too!”

She pointed out a flashing line – the heartbeat. Praise Jesus.

“Baby looks as perfect as you could hope for,” she said. “And I don’t see any internal bleeding. You can breathe a sigh of relief now.”

Did I ever.

“The cramps are likely just a result of your uterus growing,” she said. “But just in case, you’re on pelvic rest. That means no sex and no aerobics until your next ultrasound.”

She sent me home with pictures labeled “YS” (for yolk sac, which nourishes the baby before the placenta develops) and “BABY.” Later, a nurse called to say my beta hCG was a whopping 5,811. Hallelujah. Everything was OK.

My relief lasted three days. Then, at 4:30 a.m., the bleeding started again – a brownish red, enough to necessitate a panty liner, similar to how my periods usually start. Unable to sleep, and with nothing to do until the clinic opened at 8 a.m., I sat at the kitchen table and prayed.

Then I did what I swore I would never do: opened What to Expect When You’re Expecting and flipped to the chapter on miscarriage. Though I’d been through this three times, it didn’t make the experience any less terrifying. Reading about miscarriage was like it was like going into a haunted house I’d visited before; it was familiar but still scary. The information wasn’t even that helpful, and might have been a little too hopeful.

Assuming the worst, I not only went for my usual morning walk, but I also elongated it, detouring through the woods in the dark and the fog. It took me almost an hour, and that whole time I prayed and thought and hoped and wondered.

When I returned home, I checked my panty liner again. The bleeding hadn’t increased with the exercise. I felt strangely calm, like I was being held, that I would be OK no matter what.

I called the clinic at 8 a.m. on the dot. They told me to come in right away. When I arrived at the medical building, I shared an elevator with a very pregnant woman. She pressed the button for the third floor, which I thought was odd, because all pregnant women go to the fourth floor, where I was going. The elevator opened, Preggo got off, realized she was on the wrong floor, and got back on again. She did this motion with her head, as if to say “Where is my brain?!” and I wanted to say something nice to her, like, “Hey, I’m in the same boat,” but I couldn’t. My embaby might have already jumped ship.

Sonographer Suzy wasn’t in that day. (Where was Suzy? I wanted Suzy!) I had a serious sonographer, who did nothing to assuage my anxiety. She inserted the dildo-like ultrasound probe, all business.

I said another silent prayer: “Dear God, whatever happens, please just be with me.”

Then the picture came up on the screen and…there was the baby! She was even a little bigger than last time. But I couldn’t see the heartbeat, so I got scared. The sonographer found it and showed me – all 116 beats-per-minute (BPM) of it.

“Bleeding with IVF babies is perfectly normal as long as it stays brown,” the sonographer said. She removed the probe; it was covered with brown sludge. “If this is all it is, you’re fine.”

And it was fine…until the brown bleeding turned red two days later. A gush between my thighs woke me up at 3:30 a.m. When I got to the bathroom, my panties were soaked through, stained scarlet. There was a blood clot on the toilet paper. I debated for almost an hour over whether or not to bother the on-call OB because 1) I was too Minnesota Nice and didn’t want to wake them up and 2) I didn’t see what they would say that would change the situation anyway.

Finally, I called the answering service and a man who sounded very awake for 4:30 a.m. took my information. Shortly thereafter, an OB from Dr. Baby-Maker’s practice called me back. We’ll call her Dr. Cranky because she was the least compassionate female OB I’d ever spoken to (and would have to speak to again in a postpartum emergency; story for a future post). Her voice was so hoarse and scratchy it was obvious that I’d woken her up.

“If you soak through a pad in an hour, go to the ER,” she said. “Otherwise, call at 8 a.m. for another scan.”

I was sick of scans. I wanted an actual doctor to do an internal exam and tell me if my cervix had opened, because that’s what it felt like was happening.

“I want to say ‘fuck everything’ and go for a run,” I told my husband after hanging up the phone.

“Do you want to bleed out?” he asked.

No, I didn’t. But I also didn’t want to sit all Zen-like on the bed and wait for the inevitable to happen.

I made some tea and my husband and I went on a walk. As we neared the turn-off toward our home, a fox ran right across the path in front of us. It stopped and stared at us, totally calm as if it knew us, then continued on its way.

"I think that fox was our baby's spirit," I said.

“I was thinking the same thing,” my husband. He squeezed my hand.

When I called the clinic, they scheduled an ultrasound – and a nurse practitioner visit. I knew that couldn’t be good.

A nurse called me back as soon as I arrived and took my blood pressure and weighed me.

“I just did this on Friday,” I told her.

“I know,” she said. “I saw you. We have to do this every time.” (“As part of a prenatal visit,” is what she didn’t say.)

While she did the blood pressure, I stared at a chart featuring all the different kinds of birth control. It read: “Without protection, you have an 85 percent chance of getting pregnant in a year.”

“Ha! I wish!” I thought. Even with IVF, I doubted my chances were anywhere near 85 percent in a year. I thought about how much I hated the birth control pushers and all the bullshit sex ed women are subjected to, the way educators make it seem like you could get pregnant at any point in your cycle with just one solitary drop of sperm, when in fact getting knocked up after age 35 was harder than we ever could have imagined.

When the serious sonographer came into the ultrasound room, I felt like I was going to cry. (“Where is Suzy?!” I wanted to say. “I want my miracle friend, Suzy!”)

“How are you doing?” she asked.

“Not too good,” I said, fighting back tears.

The ultrasound machine wasn’t on, so we had to sit there for a minute waiting for it to warm up. The screen saver featured a cheerful pregnant woman with her doctor. Cue slew of expletive-laden thoughts here.

The sonographer seemed extra cautious, like she was preparing to deliver bad news. She pulled up the image of the baby and then…a heartbeat! 118 BPM! Measurements showed she was still growing and was now two days ahead of schedule.

I didn’t know how to react. I had been really sure this time that it was all over. I wasn’t happy; I was shell-shocked.

“I’m sorry for freaking out,” I said. “But I’ve had miscarriages before and that blood clot was really scary.”

“I understand,” she said.

I wasn’t sure that she did.

“At some point will the doctor examine me and check if my cervix is closed?” I asked.

“I can see it on here,” she said. “It’s closed.”


“You’ll go see the nurse next. Just tell her everything.”

In the exam room, there was a flip chart about women’s reproductive health on the windowsill. It was open to the section on menopause. The ovaries looked all dried out and shriveled.

When the nurse came in, I told her “everything.”

“This is very common,” she said. “Pregnant women are in here every day bleeding.” (That did not make me feel better.)

“You have what’s called a subchorionic hematoma,” she continued. “It’s the most common cause of first-trimester bleeding.”

(I would later Google this, of course, and learn that only 1 percent of pregnant women have subchorionic hematomas. While they tend to go away on their own, they are also related to miscarriage, placental abruption, and preterm labor.) 

“Is there some way to stop it?” I asked.

“I’m sorry, no.”

The bleeding-freakout-ultrasound cycle continued every few days. In addition to measuring the baby (who continued to grow ahead of schedule), the sonographer also calculated the size of my “bleed” every time I had a scan. 

After every appointment, I’d send off the images of the healthy, growing baby to my teens and my husband. They’d all express relief, but I couldn’t join in. I desperately wanted the baby to be OK, but I was simultaneously preparing myself for bad news. The emotional tumult was taking its toll on me. If pregnancy was going to be this fraught, if every morning I would wake up wondering if I would miscarry, I wasn’t sure I could handle it. Miscarriage almost seemed preferable to living in a constant state of dread (and I say that as someone who wouldn’t wish pregnancy loss on their worst enemy). If I did miscarry, I was confident that I would never, ever, try to get pregnant again. This was it for me. It was too hard.

My thoughts became darker and more frightening. I couldn’t even share them with my husband. But there was one place I could unload them – with my therapist, Shania…

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