Is it better to know why I miscarried?
A few weeks ago I shared that I was expecting for the sixth time, and that I had three miscarriages in the past. Unfortunately, in the meantime, I lost this most recent baby, too. That makes four total miscarriages for me. As horribly sad as that is, I have learned something very important though, through it all. What I’ve learned is that it is sometimes better to NOT know why the loss happened. At least for me.
When I thought miscarriages didn’t happen to people like me.
I first was pregnant in 2007, and it all came so easily. We got pregnant quickly, and started making plans to do a completely natural pregnancy. My wish to do things as conservatively as possible led us to a wonderful midwife and birthing center in Florida where we were living at the time. She was so supportive and was always very patient to answer all of my first time mommy questions and help allay my fears. We had our first visit with her when I was eight weeks and I remember her trying to find the baby’s heartbeat using her Doppler, and when she couldn’t find anything, at first I felt very nervous, but then she assured me that it was really early to find a heartbeat that way. She promised we try again at 12 weeks and so I went home, full of promise and believing all was going well.
Twelve weeks came around, things were still looking good, and we tried the Doppler again, with no results. But again, our midwife didn’t show any visible signs of being concerned, but she did offer to get us an ultrasound to make sure that all was ok. Still living in a place of hopeful innocence, and believing that “things like that” (aka bad things) didn’t happen to “people like us” (yeah, not sure what that meant) we declined and figured that our sixteen week appointment would come and we’d hear a perfect heartbeat, with no trouble.
We never made it to the appointment, because on a date for our wedding anniversary, I began to spot in the middle of dinner. It wasn’t much though, so after calling the midwife, we took her advice and headed to the emergency room to get things checked out “just in case.” I truthfully had no clue that there would be anything other than a healthy baby when I saw that ultrasound screen. Even when the ultrasound tech wouldn’t let us see the screen, and then reluctantly showed it to us, I didn’t realize that the baby was DRAMATICALLY too small to be 16 weeks, I still was holding out hope that we were just having a little spotting and I’d have to take it easy. So when the doctor came in and told me that my baby had died eight weeks before, I was thunderstruck. I could not figure out how, or why. Why had my body kept pretending that things were ok?
The hospital sent me home and said to contact my midwife. In stunned disbelief we went home, and in the morning spoke with the midwife who told us that we could wait it out or see if my former OB/GYN would do a d&c. When I called to find out my options from the OB/GYN he told me that he would not see me until after my miscarriage ended and that my midwife “needed to finish what she had started.”
I couldn’t believe how calloused that he was. It was one of the more painful moments of that experience. We decided to wait it out, but after two more weeks of nothing happening, and another trip to the ER in a neighboring city with the on call doctor sending me home after telling me not to waste their time, I couldn’t emotionally take it anymore.
So under my midwife’s guidance, we undertook an herbal protocol to induce the eventual miscarriage and I finished the miscarriage at our local hospital once it was finally underway. The local hospital was very kind and I was thankful that they were there with me, because I was so scared, and I needed someone to tell me I would be ok.
Since it was my first miscarriage, I wasn’t offered any testing and went home with the reassurance that it was “normal” and I would likely have a normal pregnancy next time. Even though they weren’t sure if I had delivered the placenta or not, they sent me home, and told me to come back in if things didn’t seem to resolve.
They did resolve, two weeks later, when I delivered the placenta in the bathroom at work. Yeah. At work.
When I started to wonder if I was just really drastically unlucky.
In the months after the loss, I sought out a doctor’s practice that also included midwives, and found that I really loved the practice, and the doctor was willing to work with me and check things more closely to reassure me. When I became pregnant again a few months later, we had an ultrasound at 6 weeks, and again, no heartbeat, but they saw a yolk sac, so we scheduled another ultrasound at 8 weeks and tried again.
Eight weeks came and went, no heartbeat, and an empty sac. Just to be sure, we had another ultrasound at 10 weeks, and as we had hoped not to see, there was still no baby. Something had gone wrong, and the baby had not developed. Remembering the long, painful drama of the last experience we elected to have a d&c so that we could move on. At my followup appointment I asked my OB whether we should do some testing since I had now had two consecutive miscarriages. He said that he didn’t recommend testing until a woman had experienced THREE consecutive losses.
I’ve since found out that many doctors do perform testing now after two losses, but at the time, we waited six months and then became pregnant again, ultimately successfully with our wonderful son who is now five. That experience, while I was nervous the entire pregnancy, went a long way to helping me feel like the previous two losses had just been a really bad roll of the dice, just being a statistical anomaly. After all, someone has to occasionally have those sorts of experiences, just because of the so-called 1 in 5 chance of miscarriage in every pregnancy.
Two and half years later, our daughter joined our family, and further pushed the doubts about miscarriage deeper into the back of my mind. Since those first two losses we had made huge strides to become more healthy as a family: cooking from scratch, eating whole foods, limiting our exposure to chemicals in our home environment, avoiding unnecessary over the counter medications. We were all more healthy that we had ever been.
When I was sure that two healthy pregnancies was my insurance policy for future success.
When I became pregnant again, I didn’t seriously think that miscarriage was a likelihood. We sailed through the eight week appointment–good ultrasound with heartbeat. We had another appointment at 13 weeks–great Doppler with steady heartbeat. When a brief spotting incident led to an ER visit at 14 weeks, we were relieved to see a live and active baby on the emergency ultrasound. But at the 17 week checkup, no heartbeat again, and an emergency ultrasound revealed that baby had died within days of the emergency ultrasound several weeks earlier.
Because the baby was much older, we opted for induction, and you can read more about that experience in my last article, but after the loss, we made preparations for lot of testing. After that late of a loss, we felt that if there were answers to be had, we wanted to have them.
Now I get to be even more transparent with you.
I wanted answers because I wanted confirmation that I was broken. I wanted some sort of official proof to confirm my inner dialogue that tormented me with thoughts that I was to blame. Of course I had tried to do my best, but maybe my body had betrayed us all. Maybe by some unfortunate “twist of fate” I had some medical issue that would be overcome with intervention in the future, but mostly, I felt I was to blame. I couldn’t reasonably punish anyone else, so I wanted to punish myself. After all, why else would I feel like such a miserable failure?
What I don’t think I wanted to hear then was that many times, testing uncovers NOTHING. Do you know that the majority of miscarriages are considered a complete mystery? Just random bad luck. It is actually pretty unusual for something helpful to be found by testing. Even women, like myself, with multiple losses can go through the full gamut of testing and still find no helpful information.
So, I consulted a reproductive specialist, I consulted with doctors, genetic specialists, had an autopsy and genetic testing performed on the baby, and the information we found out, well, it left us hurting, and with no better direction. I couldn’t even blame myself. I couldn’t blame anyone.
I had no idea how much I desperately wanted to blame someone or something until I couldn’t blame anyone.
It left me realizing, that sometimes it is harder to go looking for answers, and finding problems that don’t give you a direction to pursue.
What we found out was that, at least on the third miscarriage, our son was profoundly disabled, and if he had somehow managed to live past 24 weeks, he probably wouldn’t have survived birth. Since we didn’t find any sign of it being an inherited defect, we were left with the possibility that it could have just been a fluke.
But since we had two other losses, it makes it harder to believe that it was just a fluke. But then you consider that I have two perfectly healthy children, it makes it even more confusing.
What is our normal? The miscarriages or the healthy children? I don’t know. And that is a horrible thing to ever think about.
Seriously, who thinks like that? I guess I do. And unfortunately, some inconsiderate people do too.
So, where did that leave us? Exactly where we were before. If there is a genetic component, we don’t get a choice in that. The genetic die is cast from the moment of conception. We don’t get to choose which egg and which sperm combine, and while we can try to be as healthy as we can, ultimately, there is no guarantee. Which we already knew.
Is it better that I know that my child was profoundly disabled? No. I would have loved that child no matter what. I don’t feel relieved that I avoided that situation. I feel grieved that I lost the opportunity to mother a much wanted child. Do I feel that knowing that it could happen again helps me? No. We knew we want more children, we also know that we have no control over their genetic “destiny” and truthfully, we wouldn’t want to. So we are right back at the same set of imponderable horrible possibilities. Not helpful.
The hard lesson I learned, I have more questions than answers, there is nothing that I could possibly have done to keep any of this from happening, and ultimately it just gives me more things that I can potentially worry about. Things that worrying can never change.
So here I am, now having experienced a fourth miscarriage. And strangely, I am at peace. Not because I know why, not because I have a clear path for the future. Because I have chosen to see the beauty where life lets me see it. I love all my children. All of them are beautiful and none of them were mistakes.