Story of a Miscarriage

‘Story of a Miscarriage’ was originally posted on a blog that’s no longer in existence, so I’m reposting it now to remember and honour what happened. It may be a triggering read, so please do exercise caution. I wrote on 3rd February, 2015 as part of coming to terms with what happened; the scan was on 27th January, the hospital visit on 29th January. I’m writing dates here as memory is a fickle beast. I’ve also included an addendum, the ‘what happened after’ — when I wrote this, I had no idea there’d be another few months of medical visits and coming to terms with the physical, emotional and psychological impact…

This is the story of what happened to me last week. It’s not everyone’s experience, but with miscarriage being so common but so un-talked about, I wanted to share my tale in case it helps someone else. I think it would have helped me. It’s not an easy read but…

“I’m really sorry, there’s no heartbeat.” The sonographer quietly left us as she went to get a colleague to do a double check. Only a second before, I’d dared to take my hands of my eyes and look at the screen. I never really saw my baby, just the flat line of a graph underneath. My husband sat there gripping my hand, himself tumbling from the peak of elation at seeing his baby on screen to knowing there was no baby.

Another sonographer arrived, and very delicately picked up the scanner and tried to find a sign of life. My hands were back over my eyes and I desperately tried to stay still and not let the big sobs escape. Any previous discomforts of having an overfull bladder for the scan were gone, and we were left with the shock of having all our hopes shattered in those few moments.

They left us for a few minutes to find an empty consultation room and to give us a few moments to ourselves. I went into a more pragmatic mode, devastated for my husband more than for me, and trying to console him. It’s rare I see him cry, but that moment nearly broke my heart. We were led to a quiet room and told that a midwife would be with us shortly.

I noticed she had black patent shoes when she arrived. They struck me as being a bit fancy for work; little details suddenly mattered. She told us that between 1 in 4 and 1 in 5 pregnancies end in miscarriage. In my case it was termed a ‘missed miscarriage’. Apparently, it just happens and there’s no known reason, which was consolation and no consolation at the same time. I thought my chronic fatigue might have meant my immune system had missed there was a problem, but was told there was no evidence for it.

We were given options of what to do next. We could either go down a ‘conservative management’ route (leaving nature to run its course, but that could take several weeks), ‘medical management’ or surgical. At the time, I’d been suffering abdominal pains for a couple of days, but as there were no other symptoms whatsoever, there was no suggestion of miscarriage. Despite being told we didn’t have to make a decision then and there, we both felt that medical management, where I’d be given drugs to speed up the course of nature, would be best. I’d have to go to the gynaecology ward as a day patient and be overseen whilst it happened. It was Tuesday and we were asked to come back on Thursday morning as they’d have a bed for me.

The staff that day were brilliant, sensitive and let us take our time. We walked out of the unit in a state of shock, going home via my Mum’s to let her know. She wasn’t in, so we went home and curled up on the sofa, letting people that knew I was pregnant, know that now I wasn’t. Both my mum and my sister came round, and we got hold of my mother in law. We drowned ourselves in tea and took the dog for a walk. Everything was surreal and numb. We ended up going to a DIY store to buy a bit to mend the upstairs toilet cistern with, it was something to do that didn’t need thinking about or require an emotional response.

Later that evening, the abdominal pains got worse. Paracetamol hadn’t worked so I moved onto co-codamol the next time I was able to take something, and that took the pain away. I saw a bit of spotting, and knew that my body had started to miscarry without medical help to start it off. Still, it didn’t sink in. On Wednesday, I tried to do a few bits but couldn’t focus. The pain was still there, and thankfully my husband was able to work from home in the next room, so I wasn’t alone in the house. Later on, my mother in law came to pick the dog up to take her for a ‘holiday’ for a couple of days, practical considerations taking over once more.

Thursday morning arrived. I’d been advised to take an overnight bag, ‘just in case’ and some heavyweight sanitary towels. I phoned the hospital at 7am, to check they had a bed, as I’d been advised that I might be bumped on a day if they had any emergency cases. I was asked to ring again at 8am when they had a better idea of discharges, so I sat drinking tea, with my TENS machine strapped on in lieu of any painkillers, in limbo.

At 8am they apologised that they couldn’t yet let me know, and said they’d ring mid-morning. It was a strange wait. I couldn’t take any drugs, in case it interfered with my treatment later, and could feel the constant flutter of the TENS, over-riding most of the abdominal pain. I couldn’t read, couldn’t listen to music, couldn’t move very far. They rang, and asked that we could be on the ward for between 11.30am and 12pm.

Arriving on the ward, we were shown to my bed and offered a cup of tea. The room only had one other bed in, and it felt more like a hotel than a hospital. My husband was allowed to stay with me the whole time, and we didn’t have long before a staff nurse came and asked me to come to a treatment room to go through paperwork, and be able to ask any questions, in a more confidential environment.

She explained that I would be given misoprostol vaginally, one antibiotic pessary rectally and another antibiotic orally. This had been explained by the midwife on the Tuesday, but the details had passed me by in a blur. Misoprostol is a synthetic prostaglandin which causes contractions of the uterus, and thins the cervix, and the antibiotics were precautionary. I was asked that every time I went to the toilet, I used a ‘liner’, a compressed cardboard bowl that fitted over and into the toilet seat so they could monitor what I was passing. She advised that the whole procedure normally took about six hours at which time I’d be able to go home. Because things were already happening, it could be quicker than that.

I asked to see the sonographer report, it said that I had been nine weeks pregnant exactly. Before going for the scan I thought my expected due date would have been changed to a couple of weeks later, so I’d been right. It also said ‘early foetal death’ and I was then asked if wanted to sign a form for ‘sensitive treatment’ of my foetus and placenta. It meant that instead of going in the medical waste, it would be taken to the hospital chaplain, and would have a joint cremation and a few words spoken before the ashes were scattered. It seemed fitting, so I signed the form. That was all about 12.30pm. I was also given paracetamol and codeine for the pain.

The lunch trolley came, and I felt fine so had a really nice tuna salad and yogurt. Once all the patients had been fed, my husband was offered food too and had pasta bake and wedges, followed by sponge pudding. It was far better than either of us were expecting, considering I’d never had a hospital stay before, and the seemingly undeserved reputation of hospital food.

By 1.30pm, my abdominal pains were a lot worse and I had another dose of codeine. I got a bit giggly on the codeine, and obsessed with the corner of a pillow, but it took the pain away for a short while. However, twenty minutes later the pain was nauseating. I didn’t know whether to sit, stand, curl up or just die. The presence of someone else in the room, behind the curtain in their bay, helped. I really wanted to scream out and swear, but they were a moderating presence, which gave my brain something to cling on to and bizarrely I knew that if I could control it even to such a little extent, that it might somewhere down the line be okay. My husband let me cling on to him, using him for emotional and physical support. Without him, I would have gone to pieces.

I needed more painkillers and diclofenac helped a lot, but even then, it only lasted a short while. The nurse was fantastic, and let me know she knew that what I was going through was horrible, but not unexpected. It was a little comfort to know that this wasn’t just me. She brought me tramadol, and I really didn’t want to take it, and whilst dithering, things changed.

She had explained the pain growing in my abdomen was pressure building on my cervix, and that once things started moving, the pain would ease. The best way to describe it would be like a ‘pop’, or trapped wind that had been released. The pain wasn’t gone, but I could suddenly stand. I needed the toilet, and partway down the corridor, could feel that I was leaking. Thankfully, I’d been using night-time sanitary pads since I’d started spotting, so knew that I wasn’t going to be leaving a trail behind me. It felt like a huge amount.
I grabbed a liner and pulling my jeans and knickers down, sat on the toilet. I wasn’t prepared for the amount of blood and tissue and just lost it. I howled my eyes out. There somewhere in all the mess could have been my baby. And the blood just kept on coming. I filled the liner, and couldn’t focus because of the pain and was sweating, feeling lightheaded and just got overwhelmed. I pulled the alarm cord next to the toilet, and waited for someone to arrive to alleviate me from the hell I was in.

The same nurse as before came, and treating me with a huge amount of dignity, gave me the help I needed. She helped me change the liner, and waiting until I was okay, took the previous one away and went to let my husband know I was doing alright (at my request) and to fetch me some water. When she came back, she let me know that I had passed the foetus, and some of the placenta, but there was more placenta to come. They were looking for a particularly fibrous bit of tissue which came out last, and she also knew that the amount I’d passed so far wasn’t enough.

The bleeding calmed to a more manageable level, and she helped me clean up and put on some disposable pants, complete with layers of sanitary towels. Because I was dizzy and still in pain, I was wheeled back to my bed, complete with hospital gowns for modesty. I thought the pain would start subsiding, but it continued along with the bleeding. To be honest, the pain and blood was horrifying and it just wouldn’t stop.

I think we naively thought that it would be a quick, relatively clean thing and we’d be able to go home and wrap our heads around the fact that all of a sudden, we had no baby on the way. The reality was different and all I could focus on was the pain. It seared through my body in a way that I’d never felt and it just wouldn’t subside.

The nurse came back and said because of the amount of blood, things weren’t moving quite as they should. My body was trying to bleed the rest of the placenta out and that was causing the pain and blood loss. She wanted to give me an injection of syntometrine, a mixture of ergometrine and oxytocin to help move things along. Ergometrine, and oxytocin which is a hormone present in labour, cause contraction of the uterus to help expel the placenta. With a warning of transient vomiting as a side-effect, I let her inject it in the top of my bottom, and took the tramadol from earlier.

The room seemed really hot, and I stripped down to my bra, trying to hide the appearance of the loose-weave disposable pants from my husband – he’d seen enough already and my brain told me in the midst of the fog that they really weren’t sexy and he shouldn’t have to view them too. I just couldn’t get comfortable temperature wise, and ended up fanning myself with whatever came to hand.

Twenty minutes later, I vomited twice, filling the sick bowls and vowed never to have tuna in hospital again. I don’t know whether the tramadol had taken effect or not, but it really felt that it hadn’t, the pain was still horrific. I’d been back to the toilet several times, and no more lumps of tissue had come out, and the bleeding hadn’t slowed. The nurses helped clean me up several times, cutting off the disposable pants, and padding me out with folded incontinence pads as these were the only thing big enough to cope with the blood. Normal sanitary pads just weren’t enough.

By this time, I was knackered, emotionally and physically drained and I hit my low point. I just sobbed in my husband’s arms as he held me, and apologised that this had happened to us. I knew it wasn’t my fault, but I was still sorry. Now, a week on that I’m writing this, it’s remembering that feeling, that still makes me cry.

Not long after, the lady in the bed next to me was discharged and I remember the relief although I’d probably disturbed her, rather than the other way round. She’d had a visitor all afternoon and their chattering had been difficult to bear. I work at home, and with the chronic fatigue, tend to not play too much music or have background noise on. The constant bright lights and noise were overwhelming, and contributed to how badly I was feeling.

I needed the toilet again, but on the way started feeling light headed and went back to the room. I managed to grasp on to the bed, before kind of collapsing on it, telling my husband to get a nurse. My blood pressure had plummeted to something over 44, partly due to the drugs I’d had and partly due to fluid loss through the bleeding and vomiting.

I laid on the bed and realised that I still needed the toilet. They offered to bring a commode and I felt so ill, that my normal tendency towards privacy went totally out of the window. It was just me and the nurse and another liner in a commode. I did lose a lot more tissue, which was a relief psychologically that something had moved, but I still had the pain.

They decided to do a physical examination to see whether they could see anything awry, and again, all I wanted for it all to be over, so I readily agreed. Back in the treatment room, I laid on the bed and it was raised up so the surgical registrar could see. I had to lie in the same position as when you have a smear test, but ended up having to prop bum on my hands so I was at the right angle. Again, it was the little things that caught my attention; the bright light that half shone in my face, the nurse’s gloved hand resting on my calf as reassurance, the absolute kindness these strangers were showing me, far above and beyond what their job entailed.

I had some placenta stuck in my cervix and this was removed with forceps, and carefully put aside to be examined. It occurred to me much later, that these pieces would also be disposed of according to the form I signed. As the last piece was removed, and they really weren’t big pieces, I felt the pain shift. It was like a switch had been turned off. All of a sudden I felt so much better, and hungry.

I remember the registrar having a word with us, but can’t now for the life of me remember what he said. I think it was confirmation that everything I needed to pass was out of my system. We got back to the room and I sat up, talking, and paying attention to other things and the bleeding had significantly slowed. The nurse came through and said that I’d need a couple of hours observation but should be okay to go home after that. She also offered us food, and again, treating us like we were in a hotel, brought through a tray with a plastic jug, in lieu of a teapot, full of tea, toast, Nutella, jam, butter and some yoghurts.

There was a staff shift change and I was really concerned that the new nurses and assistants wouldn’t be as lovely as the previous ones. It was an irrational concern, but I think it had been such a traumatic day that all my thought patterns were out of whack. The night staff were just as good. My blood pressure was taken at intervals and had stabilised, but they wanted to keep me in overnight. They allowed my husband to stay over, giving him pillows and a duvet, and he had a recliner chair to sleep in. At about 11pm, I realised that I couldn’t sleep. I was uncomfortable, and every time I closed my eyes, I’d start crying. All I wanted to do was go home.

A nurse came and spoke to us, and explained that I’d had a complicated miscarriage with a lot of blood loss. She told us they don’t normally give the syntometrine injection to women with earlier miscarriages like mine, so really wanted to keep an eye on me in case of haemorrhage, and that it was against their advice to leave. What she said made sense and as she left she closed the door to block out a lot of light and noise, so instead of trying to break out, I fell asleep.

The next morning, I was woken at 6.10am by a cheery doctor wanting to take a blood sample to test for iron levels. I must have been feeling better as I told him that tea and toast would have been a better wakeup call! My results were back within the hour and it suggested only very mild anaemia. I’d passed no more tissue in the night, was feeling sensitive but not in pain and my bleeding was down a more manageable level, like a heavy period. I was offered painkillers to take home, but I refused, knowing that if I did need to take anything, co-codamol or paracetamol would be enough.

They discharged me fairly quickly and by 9am I was in bed at home, shaking under the duvet with what had happened, and my husband wrapped around me, holding me close.
Today is Tuesday that I’m writing this. And I’m nearly back on my feet. There has been bleeding and pain since I got home, the two things generally correlated, and I have had a couple of doses of painkillers as well as used the TENS machine. My blood pressure took a dip on Friday evening, but we rang the ward and they weren’t overly concerned, telling me it was the effect of the drugs but to keep monitoring and have plenty of rest and fluids.
The dog came home yesterday and seems to have forgiven us for sending her away, and I did manage a 20 minute walk with her earlier, although it was tiring. I’m not sure I’ve fully got my head around what has happened yet; these things take time.

We’ve seen how wonderful and supportive our friends and family are – we’ve been brought food, had meals cooked and sent, and had amazing emotional support and we will try for another baby, when we’re ready.

ADDENDUM
Unfortunately, I hadn’t passed all the tissue. I ended up with infections, my then-GP telling me I needed emergency surgery else I risked death, after she saw scan results. The hospital looked at me gone out when I turned up — more tests, a point blank refusal to operate for risk of perforated womb. I never did lodge a formal complaint about my GP making unqualified suggestions, or when over the phone to me, she said ‘abortion’ and not miscarriage.

At one stage, I passed a huge amount of tissue, nearly passing out with the blood and tissue loss and the emotional pain… this was several weeks on and I wanted to move on, but my body held me back. One set of antibiotics made me feel empty and almost suicidal within a couple of days. I was prescribed a different one and within a day, my mental health was back where it had been.

Eventually, we went on holiday. At the end of March, we stayed in a cottage on the side of a Scottish loch; it was isolated and beautiful and I started to heal emotionally. Until I passed one last piece of tissue and my husband found me rocking on the bathroom floor. I came so close to breaking at that point and he brought me back from that edge, holding me so tight I could barely breath, until I at last calmed down, hours later.

I was never offered psychological support, never signposted to anywhere and I do feel angry that I was neglected in this way. Too late, when I’d found my own way through, I found forums and resources. I wish someone had told me about them sooner.

I would have had the baby at the beginning of September 2015, the 3rd, if she’d been on time. I don’t actually know and never will, but I’m sure she was a girl and I had a name ready for years… Olivia Grace. In the end, we decided not to try again — our shared and individual experiences had been too much to handle, it taking its toll emotionally and physically on us both, and neither of us could imagine risking going through that again.

If you need support for miscarriage, the Miscarriage Association may be a good place to start.

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