bittersweet

peonies

I love Christmas. I love the Christmas carols, and the warm, cozy feeling the season is meant to invoke. I love Christmas trees and wrapping presents and fireplaces and family. But this year the season is bittersweet. I feel sadness as a I continue to grapple the loss of our second pregnancy. And I feel sad that I feel sad during this time of year.

I remember sitting on a bench in the middle of the Santa Monica promenade, my husband and I taking a break from Christmas shopping to enjoy our favorite treat, self-serve frozen yogurt. I had smushed together a combination of peppermint bark, cake batter, and cookies and cream and was delightfully taking in the mashup of flavors, occasionally sampling my husband’s double chocolate and snicker doodle treat. From our bench we could see a handful of street performers, a soulful singer delivering jazzy renditions of Christmas songs, a trio of guys with an impressive popping and locking dance routine. As the California sun beat down on us, I turned to my husband with tears in my eyes. “How can things be so wonderful, and so terrible at the same time?” I asked him. It was a dramatic overstatement, but in that moment I felt a tangled paradox of emotions. Life was so beautiful, but my heart was still so broken.

We were spending Christmas with my in-laws this year, in their big, beautiful home, with my husband’s loving and hilarious siblings. When I first learned that I was pregnant I had smiled to myself, thinking of how Christmas would feel so special this year. Christmas day would mark our entry into the 2nd trimester, a club I was desperate to get into. But we had lost our baby two weeks prior. We were still picking ourselves up, still figuring out how to remain optimistic, positive, and hopeful. I had spent the few days before our departure to Boston relatively happy, feeling the lift that comes from surviving a trauma and realizing you could still figure out how to smile. But when we arrived at LAX the morning of December 22nd I burst into tears. Our Christmas holiday was starting, and we didn’t have our baby to be.

This feeling amplified because of the juxtaposed position my brother and sister-in-law were in. She was days away from hitting 12 weeks in her pregnancy, and she and my brother were on their way to her childhood home in Ohio to make their big announcement. They were debuting their wedding video for her family and wanted to include a surprise message at the end. WE’RE PREGNANT! I wanted nothing less for them, and it warmed my heart. But it made our loss that much more raw.

Bittersweet. I remember learning the meaning of that word while studying Romeo and Juliet in 9th grade English, as we discussed what was meant by “sweet sorrow”. But now I had lived the meaning of the word. It was the paradox. The wonderful with the terrible. The happiness for others with the pain for yourself. The warmth of the sun with the tears in your eyes.

The joy of the season with the wound in your heart.

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my d&c

The morning of my D&C I was scared. I had never been under general anesthesia before, and felt scared to be completely put out. On top of the jitters I had anticipating an unknown medical procedure, I was also suffering from the emotional aspect of it all. Three days prior I was pregnant with what I thought was going to be our future child. Today, I was waking up at 5:30am to go the surgical center to have the contents of my uterus expelled. I blinked back tears all morning, as I got dressed and while my husband drove me to the surgical center; as I filled out forms, and sat in the waiting room to be called in; as I laid in my hospital gown as the nurse inserted the IV needle into my arm. My husband stayed by my side, held my hand, giving me tentative smiles. I was happy when the anesthesiologist arrived, asked me a bunch of questions, then said “this is going to help relax you.” It took 30 seconds before the horrid knot in my stomach melted, untied, and I finally felt ok. I looked at my husband and giggled, self-conscious that I was completely high. He giggled back, and we shared a few moments of laughing at each other for no reason. Momentary relief. I could almost forget what was happening.

Soon they wheeled me off to the surgical center. I said goodbye to my husband and as reality hit, a tear slid down my face. Twenty minutes later I was no longer pregnant. The first face I saw when I woke up was my husband’s, smiling, peering at me. I became vaguely aware of the doctor telling me everything went well, my uterus looked great. I was woozy, dizzy, tired. I had no pain except for a sore throat and felt extremely parched. What felt like just a few minutes later (my husband tells me in actuality it was about 30 minutes) the nurse helped me get dressed, and put me in a wheelchair to help me get to the car to go home. The entire process took less than three hours.

Once home, I cozied up on the couch and spent the day watching comfort TV. I was grateful to have no cramping or pain, which they had warned me of. I took naps off and on all day. Emotionally I felt ok, I wasn’t sure if it was lingering effects of the anesthesia, or that I had gotten through something that I was so scared of. The D&C had such a finality to it, it didn’t drag on for a week like my first miscarriage. It felt like it was time to rest, heal, and begin to move on. The day before I had anxiously and emotionally debated the best method of undergoing the miscarriage – wait to see if it occurred naturally, take pills to induce the miscarriage, or the D&C. I had heard that the pills could be harsh on your body, painful, and may not expel everything, leaving you needing a D&C anyway. And although I had started spotting, I couldn’t predict what my body would do – how long it would take to fully miscarry. Emotionally, I needed to move through this as soon as possible, and dreaded a long, drawn out situation. And although I worried about something going wrong and wanted to avoid a surgical procedure, I decided the D&C was the best choice for me. Overall the experience was quick, and physically painless. I bled lightly for about a week and my period returned exactly 4 weeks to the day of the D&C.

losing my baby, again

After our first miscarriage, I felt like the only thing that would take the pain away would be to get pregnant again. My body, hormonal and raw after losing the first baby, was craving it, needing it. My husband, motivated by some kind of biological urge to impregnate his wife as quickly as possible, agreed. It took us three months of trying, a short amount of time in hindsight, but to us felt like an eternity. Every period that arrived after we started trying again reopened the wound. When I would see the drop in my temp and the faint smear of blood, I would cry. The loss would feel so fresh, like it happened yesterday. The blood caused visceral feelings of pain, reminding me of the moment I realized I was miscarrying and losing our baby. After a few days, my resilience would come knocking, and I’d prepare myself for another hopeful month of trying.

I already knew I was pregnant again before taking the pregnancy test. I knew what the familiar flutter in my lower abdomin meant. The slight bloating and the fatigue had already kicked in. I had just gone through the first few weeks of pregnancy less than 6 months prior, and the symptoms were very familiar. Even still, my heart was pounding when I took the test, and then was flooded with mixed emotions when the word ‘Pregnant’ stared back at us. My husband and I just looked at each other. We weren’t sure how to feel. I was happy and relieved, but I knew how this could end.

I called my doctor and she said to come in for some early bloodwork to test my hcg, progesterone and thyroid levels. I made an appointment for an early 5-½ week scan. At the scan, we saw an empty gestational sac, when we should have seen a fetal pole and yolk sac as well.  A flood of dread washed over me combined with crushing disappointment. I can’t go through this again, I said over and over in my head. My doctor said it could just be too early, and this happens sometimes. Even still, I went home and cried, reliving the grief of my past miscarriage, anticipating the grief of my next one.

I googled “empty gestational sac at 5-½ weeks” over and over, and kept finding happy stories of women that had seen no embryo, only to return a week or two later and see their little bean with a healthy, beating heart. It was so common, and slowly I started gaining hope. My feelings that I was just counting down to seeing the dreaded spotting and subsequent blood dissipated, and I started to feel optimistic.

I didn’t think I was capable of enduring a second miscarriage. I thought I’d break down and lose it, unable to go on, unable to function. When we finally received the bad news at our next scan, I was numb. I was afraid to look at my husband. I remained as hard as I could, even though tears started to stream down my face as I put my clothes back on. When we walked past the waiting room to my doctor’s office, I thought I heard a collective sympathetic “ohhhhhh….” as the tears hugging my face gave it all away. I still don’t know if it was real or imagined, but I rushed by the waiting room of pregnant bellies as fast as I could, head down.

My doctor told us that the fact that this miscarriage was a different situation that the first one was good news. It was less an indicator that there may be a problem, and more of an indicator that we may just be the victims of bad luck twice. Our first miscarriage, the heart had stopped beating at 9 weeks, this one, a blighted ovum. She said we could start with doing a blood karyotype on both my husband and me, to see if either of us carry an extra chromosome that we may be unknowingly passing on, and perform a blood clot test on me. She gave us my options for terminating the pregnancy.

I tried to go numb. I already knew what this would feel like. To truly grieve for a lost baby, a child I would never know, a little person I was hoping to hold in 7 months. I wanted to swallow the disappointment, move on, not acknowledge the aching heart. But it consumed me. I couldn’t run. Those same feelings came after me again. But this time, I was scared. Something wasn’t right.

my miscarriages

When I was young I remember distinctly a scene from a movie of a women being rushed through the halls of a hospital on a gurney, covered in blood, and wailing in pain. She was having a miscarriage, I learned. I don’t remember the name of the movie, or why I was watching that gory scene, but the image has stayed with me since. Miscarriage looked horribly traumatic and painful; the worst thing to happen to a pregnant women. Like many tragedies, I assumed it only happened to the unfortunate few, and clung to the unconscious assumption that it would never be my reality.

I just suffered my second miscarriage. Not only am I still coming to terms with the idea that this is part of my reproductive reality, I’m also struggling with the idea that I’m now categorized as a woman with “recurrent pregnancy loss”. While my first miscarriage was marked with piercing grief and disappointment, this second loss is a battle against fear. Will we ever be able to have children? Why did this happen twice? What is in store for us – will we have further losses or be thrown into IVF, and suffer continued devastating disappointments? Or are we the less than 4% of couples that have two losses in a row, and just plagued with two cases of bad luck? How much more sadness will we have to endure?

Our first miscarriage happened in early July this year. It was our third cycle trying when we first saw the word ‘pregnant’ on our Clearblue digital pregnancy test. My husband and I held hands as we walked together, with our eyes partially closed, smiling and nervous, to the bathroom to see the results. Pregnant. Seeing that word was an incredible moment, the feeling emblazoned in my memory forever. A simultaneous experience of disbelief, awe of the unknown, excitement, and relief it had actually happened. One of the rare moments when tears and laughter happen at the same time, I jumped up and down giggling, crying, as my husband laughed at my outburst.

We loved our baby instantly. We came up with a nickname and ascribed a persona that amused us endlessly, imagining our baby already with so much personality, busy in the womb, doing hilarious things. I felt the bond immediately, even before I knew for sure I was pregnant. Three weeks after the positive pregnancy test we were in the ultrasound room, seeing it for the first time, a blur of grey, with a rapidly thumping heartbeat. Seeing the ultrasound made my husband nervous. “It seems so delicate!” he marveled. I felt reassured. My body’s doing what it’s supposed to do.

“It’s measuring small,” the technician told us. At eight weeks along, it measured six weeks five days. Our doctor did not seem alarmed, only that we needed to come back for a second scan in a few weeks, to make sure it continued to develop. Dates can be off, she told us. We left the office, happy, excited, ready to share the news with our family. I ignored the nagging question, why is it small?

Three days later, I saw what makes every pregnant woman’s heart stop. Spotting. The blood was so faint I thought I might have imagined it. I called my doctor who told me to rest for the remainder of the day and call back if it turned heavy and red. I hung up and followed orders, teary and hormonal, but relying on my positive nature to cling to the hope it would be ok. The next night it was official. I let out a pained shriek when I went to the bathroom and saw the gush of red blood, the symbol of pregnancy loss, the death of our child to be. My husband rushed me to the emergency room, where they admitted me immediately. “Do you have any pain?” I was asked, and shook my head no, refusing to acknowledge my throbbing lower back, or the cramps that had plagued me the day before. If I don’t admit to them, maybe this won’t be real.

The four hours in the emergency room were hard. A doctor with a poor bedside manner, the endless moments of silence and waiting. I remember trying to read the ultrasound in the reflection of the window, as our technician’s poker face gave us no answers. Under some miracle, is our baby still in there? Ultimately we were given the news we already knew, and were sent home. I took a shower and lied awake for the rest of the night, empty, not wanting to go to sleep and have to wake up and remember that we were no longer expecting a baby.

Four months later we were pregnant again. Tentative, cautiously optimistic, the pain from the first lost finally starting to lessen. I felt constant anxiety, on some days feeling like it was just a countdown until I miscarried again, other days feeling like just maybe there will be a baby at the end of this. I was afraid to bond with what was inside of me, afraid to acknowledge it, so busy worrying about whether I would keep the pregnancy that I didn’t even dare to begin processing the idea of becoming a mom. I constantly tried to “read my gut”, as if my gut could predict the future. Is this it? Is this the one? Or will our pregnancy be taken from us once again?

At the ultrasound we should have seen an 8 week embryo with a clearly beating heart. All we saw was an empty gestational sac. I could immediately see on the ultrasound that there was nothing there. There is no baby, I said in my head, numb, not reacting. “This is not good” the technician said. She didn’t need to say it. Technically termed a blighted ovum, an embryo had failed to develop. I had three choices as my body had not yet recognized that this was not a viable pregnancy: wait to miscarry naturally on my own, take pills to cause my uterus to contract and pass the pregnancy tissue at home, or visit the surgical center for a D&C to remove the remnants of the pregnancy. After an emotional day of agonizing over which method would be the most painless and least psychologically debilitating, I chose the D&C. “You go to sleep with the problem and wake up without it,” as one doctor put it. The next day at 6am, I was in a hospital gown, attached to an IV, a tear sliding down my face moments before the general anesthesia took effect wondering, how did I get here?

As anyone who’s grieved before knows, time is the only healer, only it’s not a linear process. You become comfortable with the ebbs and flows of your feelings, being able to laugh and find joy again makes you feel like you’re being strong, but you know it might be short lived. The searing pain can come unexpectedly, the slightest reminder can be your worst enemy. I became so sensitive around pregnancy that even seeing a man with a sizable pot belly sent a quick volt of pain through my body, even though I knew that was ridiculous. The belly envy I felt was enough to make me feel sick, aggravating the ever-present pit in my stomach, and plunging me into a level of jealousy I had never known before.

Through the pain of these losses, I took comfort in still being able to see so clearly all the other ways I am so fortunate in my life. They cut through the bleariness of the days following my miscarriages and felt like a warm blanket. My husband and I grew closer than I thought possible and our love for each other intensified in such a visceral and tangible way I thought I might explode. We physically were not capable of leaving each other’s sides for even a moment in those days following our losses. We both cried on the other’s shoulder, taking turns in the support role. My beautiful home helped me feel safe, the sun that we can always rely on in our Los Angeles neighborhood never stopped shining. My family stayed by my side, often my mom laid on one side of me, my husband on the other, while my dog napped curled in the nooks of my body. I started receiving cards in the mail, flowers and cupcakes at my door, and even received a painting a friend had done herself, painted from a photo from our wedding. I cherished every gesture of love and thoughtfulness and used every bit of it to regain strength.

I still don’t know at what point of the journey we are in. I sit and wonder, is this just the beginning? It can take some couples years to finally conceive their healthy babies. How much more will our endurance, optimism and resilience be tested? How much more of our heart will be broken? Or have we gotten through the toughest part, with the odds on our side that our next pregnancy will actually result in finally meeting our baby? I’m having to learn to live with uncertainty, to take it day by day, and remain present in the moment. To become comfortable with living with a pain in my heart, a yearning for something I can’t have just yet. To understand that every dark place I visit during this time adds texture and depth to my life and the person I’ve become. This is just part of my story.