On the lonely pain of miscarriage.

It was my second pregnancy. I already had an 18-month-old toddler. We’d gone through anguish to have her. My daughter’s coming to being had started with a health hiccup that became an alarming question mark. The question had changed. It was no longer the casual, Do we want children someday? (I’d always assumed we’d get to it . Soon, maybe – I’d just turned 30.) Now the question was pressing, urgent, Could I have a baby?

The ballpark changed. I’d always been healthy – and still was – but, inexplicably, after having periods like clockwork since I was 11, they had been absent for several months. I say inexplicable, because although doctors probed and tested and hypothesised, they never discovered the cause. They thought, at first, it was a side effect of coming off the pill, then stress, then low body fat. But as its absence dragged on, it became two years of doctor’s offices, tests, arms covered in long sleeves to hide tiny plasters, vials filled with blood, procedures, alternative women’s health practitioners, rooms with canned flute music, low lighting and plump furnishings, acupuncture, osteopathy, and the constant terrifying knowledge that my body was failing me.

And then I got pregnant. 

Luckily for me they didn’t need to know the “why”, the doctors figured out the hormone imbalance and fixed it. 

I was pregnant. And she stuck. Three years after I started on the road, I gave birth to a healthy baby girl. It’s everyone who’s gone through fertility treatment’s dream. I knew I was one of the lucky ones. Lucky to have a healthy baby, lucky to have any baby at all. So I didn’t dare to hope for more.

Then, when my toddler was 18 months old, my oldest friend announced she was pregnant. She talked about how tired she was. Suddenly I thought, I’m freaking tired too. We were at a café with our mothers and toddlers eating cheese scones slathered with butter. I became acutely aware of a particular kind of queasy. I put it down to the scones, to sympathy sickness, but the question was sharp in my mind.

Back home, I dug around in the back of the bathroom cabinet and found an old pregnancy test. It failed. As in, the test malfunctioned, the lines swirling around all over the place. But I knew.

It was almost dinner time, but I chucked my protesting toddler in the stroller and strode, furtively, to the local chemist and purchased two different brands of tests. The positive lines  on both were immediate.

When my husband came home from work I met him at the door, tests behind my back. “I know why I’ve been so tired,” I practically yelled.

His work face was worn. “Have you been to the doctor today? What’s wrong?”

I thrust the pregnancy tests at him and let the slow smile of recognition dawn. 

The next morning I was dry retching while breastfeeding our toddler. My husband stroked my hair, held my hand and the bucket. He was ecstatic. We both were.

I worked out my dates – I was almost seven weeks. The first time I was pregnant, I found out at four weeks. I remembered how torturously slow time had been, inching to the first scan at seven weeks, then 21 more days to the “safe” 12-week mark. This time round I felt so lucky to have skipped three weeks of excruciating waiting time.

I texted my friend. “It’s bloody catching.” 

She rang, screaming with excitement. 

Two weeks passed. I did my first anti-natal bloods. I planned. I mapped out my life over the next seven months, did the maths around how old my toddler would be. I fretted about names. I told close family and friends I was pregnant. I was in shock. It all seemed too good to be true. Too easy. 

And it was.

Despite being sure of my dates, I asked for a dating scan. It was scheduled for just over the nine-week mark. The night before I asked my husband to come. He was busy with work. “I’ll come next time,” he said, brushing me off. I couldn’t help remembering how much he cherished attending the first scan – at seven weeks – with our daughter. This time it just seemed routine to him. 

The waiting room was full. It was close to five, the witching hour, my daughter’s dinnertime. She wasn’t interested in the small selection of plastic toys. She wanted to run through the automatic doors to the very busy road beyond. I was short with her. I’d been jittery all day. I was planning on telling more people after this scan. It’s about to get real, I told myself. 

Finally, 20 minutes late, the radiographer came out, preceded by an extended family clustering around a young mum-to-be, her skinny spotty partner pale but grinning, clutching his prize – the printed out black-and-white scan of the baby – while the family whooped with excitement.

The radiographer led me into the darkened room. She slid the sheet over my legs. My toddler stood on the blue plastic chair next to me, peering close at the greenish gel being squired on my bare stomach. 

The Radiographer was silent. The probe roamed over my body. 

“Are you sure of your dates?” she asked, circling around in the cold gel. 

My reply was mumbled, unsure. “Yes?”

“It’s not as big as I expected…” her voice trailed off. She concentrated. Finally she spoke again, brisk. “Go to the bathroom and come back,” she said. “I need to go internal. I need a better look.”

Legs shaking, I hastily peed, then jumped back on the bed, sliding my now naked bum under the white starched hospital sheet.  My heart was knocking. “It’s early,” I told myself. 

She slid the cool probe inside me. The foetus appeared, a curled up little bud, the head and shoulders just beginning to show. A string of pearls for a spine. I gazed at it. I’d seen so many scans with my first, and yet, still I didn’t get it. 

The radiographer tapped a button. The image froze. She slipped the probe out.

“Honey,” she said, her eyes meeting mine in the blue glow of the screen. “There’s no heartbeat.” She gently tapped the still heart point on the screen. “That’s where the heartbeat would be.” 

She began to press tissues into my stomach to mop up the congealed gel, “Has something happened?” she was saying. “Did you know?”

I shook my head. Tears coming, I stared at the screen – the tiny, curled, distinctive baby shape. I wanted to wrench my eyes away, but instinct told me it would be the only time I’d ever see my baby. I would not be leaving this place with a printed-out image. I wanted to hold on to it before it was gone forever. 

My toddler was on me, in the gelly mess, her sticky hands hot in my hair, her face bunting into my neck. 

“Mummy needs a hug,” the radiographer was saying to her. “Mummy needs a cuddle”.

The rest is a jumble of snatches. They got me dressed, led me to a small room with a narrow single bed. A cup of tea, strong and sweet, appeared. A box of tissues. Someone shut the door and I slid down to the floor. The next thing I remember is an unfamiliar person opening the door. She was wearing the centre’s uniform. I blinked away the blur and saw the room filled with shredded tissues, laid out on the hospital bed like empty ghosts. My daughter’s work. I had forgotten she was there. The woman in the uniform told me gently they were closing. She helped me stand. I looked into my toddler’s worried face. She must have been hungry, but she was quiet. How long had we been here, me crying, her quiet, shredding tissues? What kind of mother was I? I splashed water on my face from the small sink. I registered the time on my watch, an hour past my daughter’s dinnertime. I walked out of the clinic conscious of my one empty hand, the other clutching my living child’s arm. My daughter was still unnaturally quiet. On autopilot I bucked her into her car seat. I rang my husband. “Come home?” I managed to say. “Can you?”

I took a breath. I started the car. 

My husband met me at the door and pulled me close. My legs were hollowed out, my body a long way from me.

Somehow, the next few days flickered past. I told my family. I sobbed in a ball. I curled, unsleeping, in my bed. I called in sick. I smiled at strangers. I scraped marmite across toast and cut it into triangles for my toddler. I drank too many cups of tea.

I had what is called a missed miscarriage. My body was still clutching tight to the little budding foetus. I’d had none of the pain that often precedes a miscarriage and I hadn’t started bleeding. I had had no warning. 

My midwife told me to call the early women’s pregnancy unit at the hospital. They were sorry, they said, but the next appointment wasn’t for five days.

“I can’t carry this dead baby around inside me for five days!” I sobbed into the phone.

“I know,” the nurse soothed. “I know. But we’re very busy. You might start bleeding and expelling the pregnancy tissue in the next day or two.”

“How can you expect me to do this?” I asked, crying. “I can’t.” 

My body was a tomb.

“Go to the hospital if you start bleeding naturally,” the nurse said. “Otherwise, trust me, you’ll survive.”

I survived. I survived, every single moment conscious I was carrying this little dead being inside of me. 

That week was supposed to be one of the highlights of my professional life. I was launching my first book. A week earlier, at the first book launch with the publisher in Wellington, I’d just found out I was pregnant. At the Auckland event two weeks later, I’d just found out that I wasn’t. I had to get through it – the smiles and congratulations and joy – all while conscious of every internal twinge, wondering if this was the moment my body was going to let my secret, this failed pregnancy tissue go.

Because by now, in the medical professionals’ eyes, “my baby” had become “pregnancy tissue”. Not just that, but “failed pregnancy tissue”. 

Failed. 

Miscarriage/miss/mistake the words carrying in themselves the signal of my wrongness. And because I had had a missed miscarriage I hadn’t miscarried naturally. Turns out I couldn’t even do a miscarriage right.

The process I went through was grisly. Despite desperately wanting to opt for a general anaesthetic and have the terrifyingly named “evacuation” – i.e. the baby surgically removed from my uterus –it carried the sliver of a risk that my uterus could be damaged, could make it harder to get pregnant again. So, I chose the misoprostol pills which would bring on uterine cramps and the body would expel the tissue as naturally as possible. Because by this point I was absolutely sure – I wanted another baby.

It was more difficult, painful and scary than I imagined. I ended up in hospital; I was unlucky, it doesn’t happen to everyone, but in A&E with the pottles of canned peaches, the kind nurse and the disposable underwear, I liked the reprieve. I didn’t have to be a mum to my toddler here. I didn’t have to tell my worried husband I was fine when I went to the toilet and spent too long crying when I was supposed to just be changing the pad. I didn’t have to pretend I could go to work, even though no one could tell me, exactly, how long the miscarrying process might last. When I might be again struck by another rogue wracking, cramping pain. 

In hospital I could turn my face to the grey pockmarked wall and let the tears leak out. But still there was pain – the moment when a new nurse came on duty, looked me in the eye and asked sternly if I’d consider contraception now. At my falling face, the second nurse asked gently, “Was the baby wanted?” They thought I’d had an abortion. As if that justified her attempt at humiliation. 

That’s when I learned the process of early abortions and missed miscarriages is the same. I was 34 years old, must have had several friends who had miscarriages, and possibly abortions too, and yet, I didn’t know these processes. Why not? 

In New Zealand miscarriages happen to around 25% of early pregnancies under 12 weeks. That’s a staggeringly large amount. You will know someone who’s miscarried early, but probably – especially if you’re a man and it hasn’t happened to your partner – won’t know it. And even if you do know, you most likely won’t know the process. Because all of this is knowledge you usually receive after a miscarriage. In secret. Even the way to the Early Pregnancy Unit at the hospital is signposted by a scrappy, tiny sign, not like the other hospital signs. It’s as if even the sign is designed to make you feel as if what happens there is something covert, something you shouldn’t dare discuss. 

It is so common. Yet when it happens your first thought will be, What did I do? You were too stressed, or you had that glass of wine before you knew, or you took too many neurofen for your headache, or ate the freshly-opened-hummus or looked sideways at sushi. 

In my case, it was a minor car accident. A few days earlier another car grazed my wing mirror, frightening me – could that small shock have done it? This, along with all the other things you invent to blame yourself is very, very unlikely to be true. This won’t stop these thoughts from being the most pressing, loud and immediate. Desperately you will try and find some way to heap blame on yourself. 

They told me the most likely scenario is that the under-12-week-old foetus spontaneously aborted because of a genetic abnormality. Most likely there was nothing I could have done differently, nothing to say I wouldn’t get pregnant again, or carry a healthy baby to full term. But this didn’t stop the guilt.  

The grief of my body failing is almost indescribable – a thing I once trusted turning its back on me. But it’s the silence that was truly damaging. Lost unborn babies are not treated like other grief. It’s shadowy, the taboo of even daring to discuss being pregnant before the 12-week mark all colludes to make the loss something that the woman experiencing is supposed to bear alone. It’s as if, because the pregnancy isn’t allowed to even be acknowledged before 12 weeks, the grief isn’t allowed to be as deep. It’s a secret that magnifies because it’s hidden. And perhaps it magnifies the sense of failure too, and underneath that failure, the most insidious of secret and damaging emotions: shame. Shame that your body failed to give life, and shame that the grief is so great. 

I’m not very good at being emotionally vulnerable, but I couldn’t, literally couldn’t, physically bear it alone. Like any of life’s other deep and shocking griefs – a relationship ending, a loved one dying – I couldn’t hold the weight of it in my body. I had to talk to those closest to me. And still, kindhearted as they were, people didn’t necessarily know how to talk about it. 

“At least you know you can get pregnant again,” more than one person said. And it was true. Of course. And of course it didn’t help. However, for the longest time even I believed that it would help me recover.

We started trying again straight away. Three months passed. No baby. My life became pegged on the future. When I was pregnant again I would be OK.

And then, at the four-month mark, my husband left. The ending of my marriage is another story, but suffice to say that’s when the grief hit me full throttle. I could no longer wait until I had another baby to properly let go of the lost one. Now I had to face it without a narrative to tidy it away. I had already imagined the way I’d tell this story in the future. I wanted to be able to say over coffee, Oh yes I miscarried and then I had my second baby and it was all wonderful. It made me really decide to have number two.

But I couldn’t make reality turn out the way I wanted.

The reality was I’d lost a tiny, unformed, eight-to nine-week-old foetus. Nothing more than a fragile clutch of cells the size of a raspberry that, more than likely, was genetically flawed, unable to grow. On one level, nothing. 

But I’d also lost the promise of a future. And I had to grieve it. I had to face that specific grief, for that specific lost child’s lost future. And it wasn’t until I faced it, and understood that my loss was real and deep, that I could process it. 

There’s one more thing. I think I did know. The day before my scan I was lying on the couch. I usually played with my toddler after daycare, but all that day I’d felt worn out, sick. And when I got up off the couch to drag myself to the kitchen to make dinner, I felt this little flip inside. That’s the baby saying, hello. But in my mind an image had appeared, a goldfish going belly up. Quickly I dismissed both the image and the flip. Thinking, It’s very early and probably just wind. 

“Hello baby,” I whispered, anyway. It was the only time I spoke to the baby. I assumed there would be so much more time. 

That was years ago, and I have travelled lifetimes since, but I still think about that moment. For whatever reason, that baby wasn’t able to come into being, to stay with me, but I think it was signalling. Just like that grainy image on the scan, the one they never printed, it was proving it existed. It existed and it was mine.