My pregnancy was diagnosed as “non-viable” on a grey Valentine’s Day morning, but that’s where the certainties and answers stopped. The consultant couldn’t tell me when my miscarriage might happen and she couldn’t, despite her expertise, explain why. It was, she said, a common occurrence; a painful case of wait and see.
Why now, why me? Did I somehow sabotage this with anxiety? Too much caffeine? And when would my body finally realise – and do its job? A calm, professional voice pre-empted the immediate self-recriminations that washed over me like waves. “There’s nothing you could’ve done differently,” she said. The next four words, a mantra for every woman who’s ever questioned herself in those hospital stirrups: “It’s not your fault.”
My story isn’t unique. According to Tommy’s, an organisation that funds research into stillbirth, premature birth and miscarriage, one in four pregnancies (that we know of) ends in miscarriage. And, yet, I’m stumped as to why so few of our voices are being heard. Do the realities concerning a woman’s uterus really make us feel that uncomfortable? Is the language we use ill-equipped to push the conversation forward? And why, as I sit down to write mine and share it with you, am I filled with a conflicting mixture of conviction and crippling self-doubt?
As my ankles rattled in the hospital stirrups earlier this year, I clenched my husband’s hand and stared numbly at the empty, black ellipse on the screen. It took a minute for the ultrasound wand to confirm what the gynaecology clinic had cautiously predicted a fortnight earlier: my pregnancy was anembryonic (or, to call it by another outdated term – a “blighted ovum”). At eight weeks, my husband and I should have been looking at our baby, with tiny arms and legs, a mouth and nostrils. The nurse was prepped; our expectations were, too. In theory, we’d finally be able hear a strong foetal heartbeat. In reality, all we could see was an ever-growing 16mm gestational sac. There was nothing inside. Our baby had stopped developing in the early stages of pregnancy and yet my body had kept going, regardless. The wand was still moving around inside me, like a desperate flashlight in the dark, when the doctor finally delivered the diagnosis. She was very sorry, she really was, but this was likely to be an early embryonic demise.
Like a lot of women out there, my miscarriage took weeks to diagnose and it didn’t resolve itself quickly or easily
When I googled that word “anembryonic" after my initial diagnosis, I was shocked to discover that it’s the leading cause of early pregnancy failure, causing half of all miscarriages in the first trimester. And yet, until my own experience, I’d never even heard of it. When I finally sat down to really analyse why my understanding of miscarriage was so limited, I realised it’s because our collective conversation is, too. As is so often the case with reproductive and maternal health (quite frankly, anything involving a woman’s body), too few of us are being heard.
If you had asked me last year what I knew about miscarriage, my answer would’ve been based on approximately two or three features I’ve read in women’s magazines over the last 10 years. So, my knowledge was incredibly narrow: a woman suddenly feels pain out of nowhere, bleeds heavily before immediately miscarrying – right? Yes, in some cases – but, for so many women out there, this narrative isn’t theirs. So few accounts couldn’t ever encapsulate such a multi-varied experience.
How could I, a woman who writes regularly about women’s health, be so ignorant of the complexities of such a common occurrence? When I spoke about this with Ruth Bender Atik, national director of the Miscarriage Association, we discussed the role of language and the impact it can have on our understanding. For instance, why hadn’t I heard of a “blighted ovum” – and the cruel, lengthy process that can occur – before it eventually happened to me? “I wonder if it’s a combination of the language,” she answered, “and the fact that it’s easier to use the word ‘miscarriage’, which people understand.
“Blighted ovum” is a pretty unpleasant term – “blight” sounds like a disease. “Anembryonic” is both hard to say and understand – and it’s not entirely accurate. The pregnancy did have an embryo – it’s just no longer visible at the time of the scan because it has gradually disintegrated.”
I’m pretty ashamed to admit that it took my own miscarriage to wake me up to the reality around me, and the limitations of the language we use. When it comes to talking about this – really talking about it, without the everyday filters we unconsciously employ – whole chunks of dialogue are missing. As a consequence, many women can be left feeling dislocated and isolated in their grief. I’m pretty sure I’m not the only one who feels like I’ve been sleepwalking through the brambles of an extremely confusing, traumatic experience with little understanding or guidance. And I’m fairly certain I’m not the only one who has found the path – the path that leads back to myself – a lonely one.
Like a lot of women out there, my miscarriage took weeks to diagnose and it didn’t resolve itself quickly or easily. Instead, it was punctuated by numerous transvaginal scans and excruciating ellipses: “Let’s wait and see…”; “Come back in three days…”; “It’s too soon to call it…”. At the same time that my brain was gradually coming to terms with the fact that our embryo had probably died, my body had other ideas. If it wasn’t for some very light pregnancy spotting, I’m fairly sure I would’ve got to my 12-week scan with no clue as to what was really occurring inside. Ruth Bender Atik tells me this happens in many miscarriage cases.
On the outside, I had all the right pregnancy symptoms at all the right times – a common phenomenon due to the fact that HCG (the pregnancy hormone) can continue to rise because of a growing placenta and gestational sac, despite a missing embryo. Headaches and dizziness; fatigue and mood swings; nausea, vomiting, food aversions and a heightened sense of smell – it was all there…and yet our baby wasn’t. I can’t even begin to explain what a monumental head-fuck these two opposing realities created in the days that followed our diagnosis. Nothing made sense. The more my pregnancy continued, the more I channelled my upset and anger on to my self, my body. It had tricked me. I felt humiliated.
Niggling anxieties reared their head. Was I over-sharing with those around me? Should I just shut up and deal with it quietly, instead?
On top of this, although my husband and I decided to share what was happening with our family and close friends, niggling anxieties reared their head in spite of my better judgement. Was I over-sharing with those around me? Should I just shut up and deal with it quietly, instead? Lena Dunham, who has been open and honest about her struggle with endometriosis, blames this kind of self-censorship on the TMI brigade and recently said she finds the term “too much information” a sexist one. “I think when men share their experiences, it’s bravery, and when women share their experiences…people are like, ‘TMI,’” she said. I’m not too sure how much this fed into my own anxieties about speaking up during my pregnancy, but I suspect that the three-month secrecy rule did – albeit subliminally. Over the last few months, I’ve been regularly reminded of a sentence I read in Chris Kraus’ cult feminist opus, I Love Dick: “Who gets to speak and why is the only question.”
Who gets to speak and why? The 12-week rule can protect many women who wish to keep their private life private, but it can also act as a double-edged sword for the equal numbers of women whose natural instinct is to talk about what’s happening to them, and to seek support during a very nerve-racking and vulnerable time. It assumes that if something does go wrong within those tricky three months, a woman shouldn’t share it. As such, it strikes me as an outdated social code that can make a lot of women feel like they’re waiting for permission to speak about something that’s off-limits. And, when we’re finally flashed that green light, we must still edit ourselves in order to smooth over the messy bits that others aren’t quite comfortable hearing.
Which is why I’m sharing my own experience now, as honestly as I can – just like I did when I went through IVF two years ago. Speaking the truth about my body, especially my uterus, shouldn’t feel like a radical act. As long as it does, I’ll continue to write about it – not because I find it easy (I don’t), but because it puts one more woman’s voice out there for another woman to find. Perhaps, when she does, she won’t feel quite so alone.
A week after my anembryonic diagnosis – during my sixth ultrasound scan, and with all the conviction I could muster – I finally asked the doctors to intervene. I numbly read over the paperwork as clinical words jumped out at me such as “evacuation”, “surgical management”, “non-viable” and “pregnancy tissue”. I was told that the surgeon would dilate my cervix before my gestational sac and placenta (now referred to as “retained products of conception”) would be surgically removed. I was informed these “products” would be sent to a lab for testing. I gave permission for them to be, later, cremated. I circled the “YES” for a blood transfusion in case of excessive bleeding and I signed on the dotted line.
A day later, I was wheeled into day-surgery while my husband waited nervously in a nearby cafe. I went to sleep nine-weeks pregnant; I woke up in recovery with mild cramps, a sanitary pad between my legs and a cup of sweet tea alongside a packet of biscuits on my bedside table. The feeling – that feeling – was gone.
How can you grieve for something that was never really there? That’s something we’re both still trying to figure out. Every day is different. I am certain of one thing, though: what cannot be seen can still be felt – and it still counts. As I wait for my period this week, my thoughts are consumed with what ifs. Sometimes, there aren't any answers to explain the losses you feel.
It was the flicker of something. A flutter. My body, our chance. A transient, fleeting glimpse of what could have been.