Please be aware that this blog post includes an honest and detailed account of my early pregnancy loss. If you are squeamish, or if reading about loss is something that you do not wish to do, stop reading now.
Because I chart my signs of fertility, I was pretty sure I was pregnant, even one week after conception, so missing my period was not a surprise. Even then I wondered if I would miscarry because I have never had a viable pregnancy without at least one of my post ovulation temps reaching 98.8° and none of my temps got quite that high. Still, though I knew so soon that I was probably pregnant, I felt very scared about being pregnant, because of almost losing my youngest living child in a traumatic home birth just two+ years ago. It took me a week and half after my missed period before I even took a pregnancy test. It was no surprise that it was positive. Both Chris and I were frightened to consider another home birth, so I visited a free standing birth center and had the delight to talk with one of the midwives for a consult. She made me feel hope for the first time that, even with my history, I could still hope for a normal pregnancy and birth. Still, I wasn't quite sure I wanted to birth at the birthing center and wanted to consider some more options. I visited a nearby hospital, but it didn't feel like the right fit for me. I felt stuck--part of me just didn't feel like this was a decision I needed to make. I just didn't feel like any course was right for me. So the weeks zoomed by and all of a sudden I was 11 weeks pregnant and feeling like I'd better Just Pick Something Already because of course I had had no prenatal care that whole time. (Although I was taking good care of myself and checking my own blood pressure.) A dear friend who knows my whole story coached me through my options. I was strongly and happily leaning toward getting prenatal care from a midwife and birthing in a hospital, and had a consult scheduled with a midwife who seemed like she would be a really good fit for me and I was also going to meet with a doctor and tour a different hospital about which I have been hearing good reports.
| The day after I made these decisions was this past Sunday. As I was sitting out on my deck, a beautiful yellow butterfly came out of the sky and flew the whole length of the deck, and I had this eerie feeling that it was trying to get me to notice it. I wondered if seeing this butterfly meant Theo (my last miscarried baby) was coming by to say hi again, or if it meant something else... |  |
The very next day (Monday) I was startled after all those weeks to find that I was spotting, and yet, in my heart of hearts, I wasn't at all surprised. A dear midwife friend said she could help us listen for the heartbeat with her doppler, and of course there wasn't one. So she advised us to have an ultrasound the next day. In case we had missed the baby, she gave us a tincture to calm the uterus and I started to take it and the spotting stopped.
Tuesday's ultrasound showed that our baby had died quite early in the pregnancy. It was not a surprise, in fact, I had been worried all through the pregnancy that I couldn't "feel" the baby's presence / spirit as I had during my pregnancies with my living children. And of course the ultrasound confirmed not finding the heartbeat so there was now no doubt in my mind that our baby was gone. I stopped taking the tincture and began to prepare for what I thought would be a loss at home. Spotting resumed on Wednesday as the effects of the tincture wore off. As a way of honoring the life of our baby, and bringing some kind of good out of this sorrowful time, I hoped to have a gentle birth at home, and set up everything I needed in the birth room where my son was born, in another building on our farm (not our house).
When the loss began at 9 am on Thursday, it came on hard and fast and I was not able to leave the bathroom in our house. I had expected contractions, like one of my earlier miscarriages which also happened at 11 weeks, but I never had contractions, just waves of cramping that were followed by the expulsion of blood and tissue. I really didn't have many clots, just passed lots of tissue because the placenta seems to have come apart in pieces. I passed so much blood. About an hour later, I got in the tub, knowing that the hot water could increase bleeding but I wanted to clean myself and figured it would be OK. I was wrong. I lost a lot of blood in the water, and it was rapidly turning the water in our jacuzzi rust colored and then a deep reddish-orange. My husband, Chris, was there with me most of the time up to this, but when I got in the tub he had left to settle the kids out of the house. I knew I was bleeding too much and when he returned, I asked him to go and get some herbal infusions I had measured out but not finished (because I wasn't sure when the loss would begin and figured I would have enough warning time to boil water!). When he was waiting for instructions, I remember saying, "Go get me..." and I leaned my head against the bathroom wall, too tired to finish my sentence. "Get what?" he asked, and I think I heard concern in his voice. "...orange juice," I answered sleepily. So he was gone at a very crucial moment. I felt everything dimming and sort of like time was slowing. I knew I was very close to passing out and that I didn't want that to happen in the tub, which I had started to drain but was still half full. I turned onto hands and knees and was aware that it was like everything was closing in on me, and my space of awareness was limited to just the space right around my body. (I was still passing blood and tissue in that position.) I knew this was Not. Good. I shouted "HELP!" but Chris couldn't hear me. I knew that I had to fight losing consciousness and I told myself to drink some of the water I had there and get out of the tub and lie on my side. (I hoped lying on my side would slow the bleeding.) Within moments of lying down on the floor, time resumed its normal pace, my consciousness was restored and I felt blood rushing back into my tingling hands. My hands tingled intensely at first, and continued with lessening intensity for what felt like maybe 10 minutes after I laid down.
Chris delivered the herbs I had partly prepared (which I never ended up taking) and I told him that I needed him to go get my tincture of shepherd's purse and that I needed it NOW. (Which of course was in the other building in our birth room.) He took one look at me and said he was calling 911. (He was right. That just didn't occur to me; I was focused on needing to slow the bleeding.) He made the call and maybe 10-15 minutes later the paramedics arrived. They checked my vital signs and prepared me for transport. They also brought along the tissue that I had collected as it passed, for inspection at the hospital. They took me by ambulance, and on the way, they started an IV and chatted with me and by now, I felt like myself again. They also put some "stickers" on me to keep track of what my heart was doing. They were very professional and caring. On the way, we even realized that one of "my" paramedics had responded to the call for our son's near stillbirth, and it was great for her to hear that he is doing just fine now and get closure on that case.
I was checked out by a couple of nurses, and then was left alone. I had not had time to even think about the sadness I felt at the loss of our baby, and the poor woman who came to collect vials of my blood was subjected to my cries of sorrow and inability to speak to even answer her questions. Soon after, my husband was allowed to come back, and I felt much better being with him. While I loved the care from the paramedics, I received rather poor care in the emergency room. No one checked how much blood was soaking into the chux pads nor how much blood and tissue I was passing in the toilet at the hospital. I even had to change my own chux pads! The paramedics brought the postpartum pads I had saturated in the first hour of the loss but no one knew or thought to ask how much had come out in the tub. Furthermore, I was using my own cloth maternity pads that I use for postpartum (because I did not anticipate bleeding so much and that was all I had on hand that could absorb enough blood). But each of my pads was stuffed with a thick "doubler" and I don't think the nurse who checked them was aware of that. She opened the bag and just kind of glanced through it. So if she was going by how much blood was on the top of the pads, that was just a fraction of the blood in each of the pads. A hemorrhaging woman can seem very aware and alert despite having lost a substantial amount of blood. (We're women--we're used to rising above it!!) No one was documenting my urine output either which was very minimal. In retrospect, I feel like I was kind of forgotten about because I 'seemed' fine. The ER doc did a pelvic exam and saw that no tissue was stuck in the os. He noted that I had minimal bleeding. The problem was that I was slowly but constantly bleeding that whole time and it added up to a lot of blood. I had an ultrasound and the tech said my uterus was clear. He was pressing down on my uterus harder than any ultrasound I have ever had in my life. It was painful!!!! When that was over, I went to the bathroom and passed a lot more tissue; I suspect that it had pooled in my vagina and that's why it didn't show up on the ultrasound. (I did pass one more large piece of tissue at home. It was 3 inches long and an inch wide. I still don't know why that didn't show up on the ultrasound!)
The ER doc came in and said I could go home. The nurse who discharged me warned me that my blood pressure was "soft." (My last blood pressure check before discharge was 90 over 58.) The way she said it sounded like she was concerned about me, but she wasn't the one who was in charge. My dear doula and midwife friends had arrived while we waited for discharge, and at about 2:15, when we left the hospital, they accompanied us to our car.
We were five minutes out from the hospital when I had a seizure. To me, I remember feeling like the car was insufferably hot and asking Chris to turn on the air. Then I felt a wave of cramping and simultaneously got faint. I told Chris I was getting faint, and then right away, that I WAS fainting. He said to put down the back of my chair. I reached for the handle, couldn't find it, and that's the last I remember.
From my perspective, I was dreaming...and for what seemed like a long time. I don't remember the dream except that I was having a good conversation with someone in a very peaceful place. I remember the blue sky and clouds. Then it was like I had double vision of Chris, was saying something to him, and my vision fully returned and I found myself looking directly at his face. From Chris's perspective, I lost consciousness and had a seizure during that time for about 30 seconds with my eyes open. (I have always wondered if a seizure is scary, but for me, it was entirely peaceful.) I asked him what I had said to him, and he said I didn't say anything, so I guess that was the tail end of my dream. By now I found the handle, lowered the back of the seat and put my feet up on the dashboard. I heard buzzing in my head and everything was way too bright as Chris drove around a restaurant and parked. Chris made me look in the mirror and said my lips had turned completely white. He called the hospital and asked if we should turn right around and go back. His call was passed to a couple different people. Meanwhile, I was feeling terrified that I had lost consciousness so quickly and had had a seizure. The last person he spoke with said if I was feeling OK, we could continue on home! In retrospect, I think that they discharged me too soon and did not fully understand how much blood I had lost. On the plus side, the nurse allowed us to take home the remains of our baby that I had passed, which sadly is not typical of an emergency room loss (except for the tissue which I lost at the hospital--I just couldn't bring myself to reach into the hospital toilet).
When we got home, Chris helped me upstairs and I got in bed to rest. I was very weak. As soon as I passed the final larger piece of tissue, my bleeding slowed considerably to a very light flow. Out of my window, I saw the yellow butterfly from Sunday fly past me two times. I think the butterfly was a sign from Anaïs that the worst was over and that everything is going to be OK.
Sadly, my experience illustrates the dreadful state of care for women experiencing early pregnancy loss in America. I am frightened for mothers experiencing early pregnancy loss in America. We are left on our own for the most part to "get through it." While some women might have their husband or partner present--and let's face it, most of these men do not have the training to adequately help a woman if something goes wrong--many women are completely alone during an event which can quickly turn dangerous and even lethal. I believe that I experienced at least two life-threatening episodes during my loss when my blood pressure was dangerously low. I lost a considerable amount of my total blood volume and still feel incredibly weak. We need to do better. We need specially trained midwives, trained in the care of women experiencing loss who can accompany women during loss at home. I feel certain God and my little one were watching over me, along with her five other brothers and sisters in heaven. But my experience would have been much safer and much less scary if a trained midwife had been present both early in the loss when I was losing so much blood, and later, in the car, when I had the seizure. Such a midwife could act as liaison with medical personnel at the hospital and communicate in their terms an estimated amount of blood loss, or the actual status of the mother, facts that are difficult for a mother or father, in the midst of losing their child, to adequately assess and express. Feel free to share your loss-birth stories and reply in the comments if you think America needs specially trained midwives to care for women experiencing early pregnancy losses at home.
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