A Long Story for a Short-Lived Pregnancy
Miscarriage is a weird thing to talk about, let alone blog about and publish for the public masses to see. I know that, and I have still felt pretty strongly about sharing my story anyway. So, here goes: I think that the easiest way to go about telling this story is to skip forward to April 19th 2016, sitting in the OB/GYN office. It had been over 12 months of actively trying to get pregnant at that point, which basically means that the doctors finally cared what I was saying about suspecting that something was wrong with my body. They hadn't taken me close to seriously before this moment. I had had a history of abnormal periods, suspected hormone imbalances, and a handful of excruciatingly painful cyst-rupturing events by now, not to mention over two years off birth control and I had never felt farther away from attaining pregnancy. I was frustrated with being told that I just needed to "relax" and it would happen when I least expected it and I desperately needed more concrete answers. Now that my mandatory 12-month waiting period had passed, I guess I was finally deemed "worthy" of a better picture of my fertility.
After a series of blood tests and a vaginal ultrasound, I was quickly diagnosed with PCOS (Polycystic Ovary Syndrome), which basically means that my ovaries are filled with cysts and my hormones are incredibly screwed up. They hadn't suspected it previously, because PCOS presents itself more commonly in overweight women, although it is a genetic disease and being overweight is not a requirement for diagnosis. Other PCOS symptoms include irregular periods, insulin resistance, mood swings, hair growth and loss, acne, fatigue, and even infertility. Check. Check. Check. Check. Check?
I know that I probably should have felt worried or upset at my diagnosis, given that PCOS is a chronic disease that doctors don't know too much about treating, but I was actually incredibly relieved and felt overwhelmingly validated, because I had known that something was wrong for years, I just never thought that I would actually be able to put a name to it or prove it to anyone. To be able to learn about PCOS and try to manage this thing the best that I could would be a great blessing compared to the past months I've spent with all of my unanswered questions, anxiety, and pressure to "relax."
I was told that it was very likely that I hadn't been ovulating for the majority of my past menstrual cycles and sent home with a prescription for Clomid, a drug to help induce ovulation and I thought that all of my problems were solved. That prescription paper was gold to me. I could see the light at the end of the tunnel. It's funny how past pains are so quickly forgotten at the sight of the finish line. It's all relative.
I was instructed to wait for my next period and then to take Clomid on days 5-9 of my cycle. I was given three months worth and told that if I was not pregnant by the end of that time period I would be referred to a fertility specialist, because after multiple rounds of Clomid I would be at a higher risk of ovarian cancer. I was hopeful that I would not need all three rounds of Clomid so long as I stuck to what my newfound PCOS research had taught me and prayed extra hard.
I waited. And waited. And waited. Finally, on May 10, I counted 35 days since my last period and was at my wit's end. It was always such a toss up how long I would have to wait for a period and I didn't want to wait any longer to get the good drugs in my system. I woke up with the thought that maybe I should take a pregnancy test just in case. Luckily, I had one on hand. It was positive.
I couldn't believe my eyes when that second line showed up bright and clear. In fact, I was in such shock that my first reaction was anger at myself for jumping the gun and even thinking that I could be pregnant in the first place! I convinced myself that it was a false positive and immediately started reading the instruction pamphlet for some indication that I might have messed up the results. I couldn't find any explanation of anything that I could have done wrong and the shock was just starting to wear off when a last glance at the box showed that the pregnancy text was expired. At this point, I knew it was a false positive. I was absolutely crushed. I felt that I had just played such a stupid game with my own emotions and didn't want to ride this emotional roller coaster any longer... I had already convinced myself that it couldn't be true, but of course I had to know for sure, so I drove to Target and bought two more pregnancy tests.
I finally started to believe the miracle in front of me as I stood in my bathroom staring at not one, but three positive pregnancy tests, all different brands too. I was pregnant all on my own, even without the Clomid! I was thrilled, but it felt so surreal I couldn't cry or really do much of anything besides sit and wait for Ben to get home to tell him the great news.
Ben cried when I told him and hour by hour, day by day, it started to feel real. We were glowing, living a fairytale life of excitement and relief. I spent hours everyday scrolling through my pregnancy apps, reading What to Expect When Expecting, researching PCOS and pregnancy online... I even started a baby registry on Amazon and changed the name of my Pinterest board from "preggers stuff one day" to just "preggers".
At four weeks, I showed back up to the OB/GYN office that I had been originally diagnosed with PCOS at (only to conceive days later) for my first OB appointment. I was called back up to the front desk shortly after signing in. Bad news before I even made it back into a doctor's office. My insurance wouldn't cover prenatal care.
I was reeling at this information. How in the world could my insurance not cover prenatal care when it had covered everything else at this same office up until now?! I thought that it was illegal not to cover pregnant women. Turns out, since I am only 23 and had never needed to transition off of my dad's family insurance plan previously, there was a loophole in the policy that I would not be covered for OB, only GYN. I felt misled and cheated by an insurance company that covered "infertility" appointments weeks ago and wanted to dump the full cost of a baby onto me weeks later. I asked how much it would be to pay out of pocket. They said $400+ just for this one appointment and that a full term pregnancy would end up costing over 10K! No exceptions. No less paying cash. The office became foggy and so did my brain. I was advised to apply for Medicare, that I would (most likely) be approved within days and could reschedule my initial appointment within a week. Hanging on to hope that that was a legitimate option I cried in frustration home to start the process.
I was denied Medicare coverage within minutes of submitting my application, due to our combined household income being over the limit... of course. I also learned that any pay-out-of-pocket clinics in the valley were billed on a sliding scale according to income and wouldn't save me much money for lesser quality care and that I would not be able to join Ben's insurance coverage until January 2017. I was due January 10th. That meant that even if I could get on Ben's insurance, the baby absolutely could not be premature and that we would end up bearing 90% of costs anyway. I sat in our little home office bawling my eyes out, thinking that it couldn't get any worse than this and that our only option would be to fork out over $10,000 and start our lives with a baby in debt. I wouldn't sacrifice care for cost and anyway, I had known people spent this kind of money on IVF and the like for a baby and the most important thing was that I was pregnant in the first place.
After hours filled with tears and prayers, I started to seriously consider going the midwifery route. The idea seemingly came from out of nowhere, but I feel that I had been prepared for that moment as I had heard bits and pieces of stories regarding natural birth that now came to the forefront of my mind. I did extensive research on midwives in Las Vegas and the quality of care that they could offer. I read tons of reviews and articles listing the pros and cons of a doctor vs a midwife. I eventually discovered Kim Trower of Mother to Mother Midwifery and felt impressed to reach out to her. I let her know my predicament, that I hadn't previously considered midwifery, but that I was in a tough spot with insurance and I was curious what her rates would be. She was incredibly sympathetic to my situation and assured me that she was able to take great care of me for as long, or as short, as I would like. Her rates ranged from $150 per appointment to $4000 for an entire pregnancy and home delivery. I was beyond grateful for an option that seemed to appear "out of nowhere" and was still better than anything else I had planned thus far.
Walking into Kim's office was heavenly. I had never considered myself granola by any means and never before even considered having a natural birth, but all of the sudden it felt very, very right. Kim was professional, organized, therapeutic, understanding, friendly, and well-educated. I trusted her care more than I did a doctor's at this point. She was a great listener and counselor to me. Once again, the trials of my recent past were forgotten and excitement replaced anxiety very quickly.
When she asked if I wanted to take a shot at finding the heartbeat on a Doppler, I was caught totally off guard. I didn't know that was a possibility! Kim told me that at seven weeks, there should be a heartbeat, but not to get my hopes up, because sometimes it was very hard to find without an ultrasound. She gave it her best shot, prodding all over my lower abdomen with the Doppler sounds amplified on a speaker in her cozy office, but no luck. She reassured me that we could try again in a couple of weeks and not to worry, but also asked me how I felt at that point and if I was interested in getting an ultrasound so that I could see the heartbeat sooner. I most definitely was interested, I think that Kim could sense my worry. Even though I hadn't expected it, I felt like my life now revolved around getting to hear this baby's heartbeat, so I made an appointment for a heartbeat check as soon as I could.
I waited almost three weeks for that appointment and it seemed like an eternity. Finally, at ten weeks I was able to get in for an ultrasound I had bought through Groupon previously. (Thankfully, given the whole ongoing insurance nightmare.) I remember vividly waiting in the front lobby for my turn to come. It was a small office, very homey with pictures of babies and pregnant women and ultrasounds sprinkled everywhere. Ben was with me, playing on his iPad while I just stared motionlessly forward, consumed with anxiety. We were both very excited for this moment, but for some reason I now felt very uncomfortable and unsure of myself. I felt like I was flung backwards in time to first staring at the positive pregnancy test, again thinking that it was too good to be true. Ben held my hand while we waited for our turn to come.
A glowing couple finally exited the ultrasound room and we were welcomed in. The technician was very friendly, making small talk as she rubbed my belly with cold gel. She eventually turned the monitor towards us, turned on the speaker, and started probing around. She asked me to move around a bit, asking a couple of questions about how far along I was and what doctor I had seen, before eventually zooming in on what she called the "pregnancy". Not the "baby", the "pregnancy". Ben later told me that he could see her face visibly change in an instant, dread. Static whooshing filled the speaker. There was no heartbeat. I knew it before she even said it. I felt like I was going to throw up. Ben refused to believe it. She showed us the flow of blood in my uterus with red and blue blurs on the screen, explaining that the fetus wasn't receiving any blood supply and something had gone wrong. She said she was very sorry, but that there wasn't really a question, she was sure there was no heartbeat. She gave us a print out picture of the "pregnancy" that I could not bring myself to look at and I rushed out, breaking down before I made it to the car.
People always tell you to wait at least twelve weeks before announcing your pregnancy to anyone, in case of miscarriage. That had made logical sense to me, so I hadn't told a soul outside of Ben (even though we had already planned extensively how to break the news to our families on Father's Day). I never expected to regret that decision. In the moments after finding out that I was going to miscarry though, I immediately felt that Ben and I were alone and no one would ever understand what we were going through. Now, I don't think there is anything wrong with telling close family or friends you are pregnant, because even if you do miscarry, you will desperately want a loving support system to help you through it. I wished more than anything that I could tell my mom I had miscarried that day and let her comfort me without having to awkwardly tell her that I was pregnant first.
Ben and I left the ultrasound appointment and climbed into his truck and he just held my hand as I cried for a long time. Not knowing what to do next, I decided to call Kim (my midwife) and tell her the bad news first. Kim was more loving and sympathetic than I would have ever expected. She expressed her deep regrets and guided me through my emotional state. She also prepared me for what was going to happen physically in great detail so that I wouldn't feel as surprised or scared when the actual miscarriage started. Kim assured me that most miscarriages are normal and not something to worry about, especially just after one, and that I would likely have a successful pregnancy in the future. I remember her saying that it would not make me feel better to know how common miscarriages are, but that maybe down the road it will allow me to heal more quickly. I learned that almost one in four known/unknown pregnancies will end in miscarriage and this helped me to feel a little less like my body was a failure. Even so, I couldn't help but tear myself up thinking that maybe I shouldn't have drank those two cokes, taken any baths, continued working outside, or not gone to the doctor when I had an overnight flu... Deep down I doubted that I could have done anything to prevent this miscarriage and resolved that it was most likely a chromosomal defect and maybe somehow a blessing in disguise, that the body wasn't good enough for our future child. I was still obsessed with trying to think back on anything that I could have done wrong anyway.
Because of our lacking insurance situation, I was not able to have a D&C and would have to miscarry naturally. Kim told me that this could happen within hours or weeks... Unfortunately, it took weeks. Kim called me every couple of days to check on me, I was very thankful for her. I was also able to tell our families and close friends what had happened and allow them to comfort me. My mom was an angel. During the time between finding out that I was going to miscarry and actually miscarrying I felt like a prisoner to my own body, stuck in an intolerable in-between. I still felt very pregnant, with symptoms like fatigue, nausea, and frequent headaches. Previously, I endured these happily, believing that a baby was worth all the trouble, but now I just felt cheated. I was disgusted with the idea that I was carrying a little dead baby around inside of me and had to continually remind myself that it was nothing more than a bunch of badly formed cells. This helped me continue life as normally as possible, taking only one day off of work and usually getting to sleep at night.
I started bleeding heavily right around the twelve week mark, but didn't actually miscarry until over one week later, on July 3rd. Miscarrying was unlike anything that I had experienced before. It did not hurt as badly as when I had ruptured cysts in the past, but it was still very painful and felt a lot like what I would imagine labor to feel like. I started having something like bad cramps and contractions in the late afternoon that increased in strength and frequency as the night wore on. I spent half my time in the bathroom waiting and half clinging to my life-saving electric heating pad. I was eventually laying in my bed, extremely frustrated, when I actually felt my water break... something that was totally unexpected and really weird for me. I went straight into the bathroom and less than half an hour later I knew that the "pregnancy" was finally outside of me. I worked a twelve hour shift the next day and tried my best to move on as quickly and efficiently as possible.
Ben and I had really struggled with all of this. I turned envious of pregnant women everywhere and became hypercritical of many mothers. Ben tried to cheer me up, but I could tell that he was just as disappointed as I was. I frequently found myself asking "Why me?"... While reading the beautiful autobiography of a young neurosurgeon diagnosed with a deadly cancer, When Breath Becomes Air, I learned that the answer to the question "Why me?" was "Why not me?". (Food for thought.) I was positively impacted as I gained strength in hearing that so many of my friends and family members had endured the same miscarriage trial that I had and gone on to have healthy babies shortly after. I was grateful for my knowledge of the gospel and my understanding that there was opposition in all things, that without sadness there would be no joy, and I believe that my testimony and relationship with Ben grew stronger from enduring this trial. Almost three months later, I am now finishing my second round of Clomid (for real) with high hopes. I have accepted that I may never fully understand God's will, but that I could now understand the pain of loss more acutely and sympathize with others who had had similar experiences. I have learned to be thankful in the meantime for the miracle that I was able to get pregnant in the first place, to count my blessings and remind myself daily that It could be so much worse. I know now that I am fertile, cysts and all, and that time is the most precious thing in the world.