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Diary Of A Lost Pregnancy, Part 1: No Fetal Heartbeat

On September 17, 2014, I went for a routine 8-week prenatal check-up. It was the only routine thing I would do for more than two months.

During this time, I e-mailed a small group of people. Some were aware of the pregnancy, some had plans with me that would need to be broken, and still others simply asked after my health on the wrong day. This is the first of 11 such messages. They have been edited to remove identifying information and inside references, but otherwise remain largely unchanged.

September 23, 2014
Dear Friends,

Apologies to those of you who are hearing about this for the first time. I have been living in two worlds for the past few days.

As some of you know, I went in for my 8-week prenatal checkup last Wednesday. When the midwife performed the ultrasound, there was no fetal heartbeat and little evidence of embryonic development. An ultrasound technician was brought in to confirm that there was a gestational sac, but she also could not find evidence of development inside the sac. The midwife ordered a series of blood tests to confirm the diagnosis of a non-viable pregnancy; she felt there was a possibility that fertilization happened later than would have been suggested by the date of my last menstrual period. I did not hold out much hope. In order for that to be possible, I would need to ovulate almost three weeks late - a considerable variation from an otherwise regular cycle. However, I agreed to treat the pregnancy as viable until the testing was complete.

Testing involved two blood draws, on Wednesday and Friday. The object was to compare levels of hCG, a key pregnancy hormone. In early pregnancy, hCG should roughly double each day. My tests showed almost no change in 48 hours. Therefore, the diagnosis of non-viable pregnancy is confirmed.

There are three possibilities for how the pregnancy ultimately will end. First, my uterus could shed its contents naturally. Second, I could take medication to induce contractions. Third, I could undergo a surgical procedure known as a D&C - dilation and curettage. There are pros and cons to each alternative, and believe me, I have been running them in my mind more or less constantly for the past five days. My preference at the moment is to let me body handle the situation naturally. However, there is no way to estimate how long that may take. The midwife is consulting with one of the practice's physicians to see how long is too long in terms of my health and safety. [UPDATE: the doctor has recommended a second ultrasound to better evaluate embryonic development. This may help clarify how long the process will take.] However, I am keenly aware that there are limits to my own endurance.

While this pregnancy continues, there is no way to evaluate my future reproductive options. My menstrual cycle will not resume until the pregnancy is complete. I find I cannot even determine if I want to try again because my body is still trying. It is like a plug in the bathtub, with more and more concern and doubt building up on top of it. I can't say whether it will overwhelm me in a week or a month or more, but it will overwhelm me eventually. I need to balance my faith in natural processes with my very real need to move on from an experience that, objectively speaking, sucks donkey balls.

There is not much in this situation that I can call positive. However, it has allowed me to appreciate the family that I have all the more. I can't say enough about the steadfast support and comfort I have received from my husband. My daughter has also been a wonder. She has been aware of the pregnancy all along and understood that not all pregnancies lead to babies. We told her a few weeks ago that there was an embryo in my tummy, and that some embryos grow into babies and some do not. My husband told her on the way back from school Wednesday that the embryo was sick and might not be able to turn into a baby. She was definitely disappointed, but seemed to accept the news. She told me on Thursday that she felt very sad and mad. She was worried that I would die and angry because, in her words, "this was my first baby and I've waited so long for my first baby." So we had a little shared cry and both felt better. When I told her today that there wouldn't be a baby she said it was OK, she knew that might happen.

I should also say that simply being a parent is helpful. We went to the circus yesterday and my daughter got her face painted. It's really hard to be depressed when your four-year-old looks like Wonder Woman and is grinning ear-to-ear.

Love,
nj

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Tomorrow: A choice of tortures.

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Comments welcome.



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Posted on January 19, 2015


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