Ready to try again

How one woman learned to move on after a miscarriage

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I have no trouble remembering the date: February 29, 2008. Before leaving for work in the morning, I stop to use the washroom. The colour crimson catches my eye in the toilet bowl. Big blotches, each the size of an egg yolk, are dripping from my body.

“Shawn!” I scream. “Shawn!” I’m in panic mode, on the verge of hysterics, but my partner has already left for work. I know something is wrong. You aren’t supposed to bleed when you’re pregnant. I hail a cab on the street and tell the driver to take me to the nearest emergency department.

“I’m nine weeks pregnant and I’m bleeding,” I tell the triage nurse when I arrive moments later. I’m trying to act calm, but my legs are shaking.

“Right this way,” she says, and guides me to a bed in the back. The waiting room is full, but somehow I jump the queue. I take her urgency as a bad sign. I’m in a daze as I put on a backless blue hospital gown.

The first doctor who sees me is hopeful. “Lots of women experience first-trimester bleeding,” he says calmly, as he begins to perform a series of tests. I see blood on his metal instruments as he removes them from my body. Then he snaps off his bloodied surgical gloves. “I’m going to send you up for an ultrasound, and we’ll see what’s going on.”
It takes an hour for the results to come in. A different doctor pulls up a chair next to my hospital bed, looks me in the eye and apologizes softly. “I’m really sorry, but there is no heartbeat.” I stare at her in silence. “There was an embryo, but according to the date of your last period, you should be nine weeks along. It looks like the baby stopped growing three weeks ago.”

I can’t absorb what’s being said. I can’t understand the doctor when she tells me about the options for getting the remaining tissue out of my body. There is a procedure called a D & C that I can schedule in hospital next week, or a drug called misoprostol I can start taking at home that afternoon. I’m so confused.

The only thing I can hear in my head is the song I’d been singing over and over again since a pregnancy test revealed I was finally pregnant: You’re just too good to be true/Can’t take my eyes off of you. I was going to sing it to my baby, Lauryn Hill–style, in the mornings and in the middle of the night. It was going to be our anthem. Suddenly, in the hospital, the song is making me sick. All I know now is that I want something done and I want it done now. I want to start fresh, to try again.

I decide to go with the drug, a set of pills I need to insert vaginally; they’ll cause my uterus to cramp and expel all the remaining tissue that had been accumulating in my body these last nine weeks. I am warned that the drug may cause nausea and headaches, but decide these are better options for me than undergoing the D & C. (See Miscarriage: the facts for more on the procedure.) The doctor says I can try to get pregnant again in three months, once my body has had a chance to recover. Three months seem like a lifetime away.

Over the next several days, I camp out on my parents’ couch and am surrounded by Shawn and my family. I cramp and I cry. Even after all the tissue has left my system, more than two weeks later, I can’t contain my tears. I wake up crying into my pillow in the middle of the night. I cry in the morning. I can’t go to the grocery store where, inevitably, I see moms shopping with their babies. I can’t even bring myself to talk to my pregnant friends. I’m too angry and too jealous to face them. Shawn holds me tight every time I cry, but it’s pointless. There’s nothing anyone can say to make the pain go away.

I had told my family and close friends about the pregnancy, and now I confide in them about my miscarriage. They are all sympathetic, but most don’t seem able to grasp the extent of my grief. In my heart, I was pregnant with my first child, not just an embryo the size of a poppy seed. I had names picked out, visions of what the baby would look like, and thoughts about how we would raise him or her.

When I talk about my miscarriage, a handful of people open up to me about miscarriages they, too, have suffered. They all assure me that things will go well the next time. But what if they’re wrong? What if I can’t get pregnant? What if I have another miscarriage? Or I never have a baby? I feel hopeless and scared. I feel like everything is out of control, including my negative thoughts.

Somehow, through the thickness of my depression, I recognize I need help. I call the obstetrician I was supposed to see at my 12-week appointment. By now, it’s a month after my miscarriage. “You shouldn’t still be crying,” my almost-obstetrician tells me. Though his words sting, I thank him for referring me to a mental health professional at Mount Sinai Hospital in Toronto, one who specializes in perinatal issues. I am relieved to have someone to speak to about my loss — someone who doesn’t know me or hasn’t already heard me cry for days on end. Over the next few weeks, I spend several hours on a couch in the therapist’s office — just like on TV. She encourages me to grieve for my loss as long as I need to. “You’ll know when you’re ready to try again,” she says. “You’ll know when you’re ready to stop crying.”

This is one of the most comforting things anyone has said so far. My therapist also advises me to speak to other women as part of my recovery. We continue to see each other once every two weeks, then once every four weeks, for four months, so she can monitor my progress.

In some faith traditions, you light a memorial candle to commemorate the loss of a loved one. As part of my recovery, I light a candle for my baby — the baby I wanted desperately, but never got to hold or sing to. I watch the flame flicker and peter out a day later. Now I’m ready to talk about my miscarriage to a wider circle than my family and closest friends. A woman named Jen, whom I’d recently met through my job on the communications and fundraising team at a non-profit organization, tells me about her two miscarriages — and also about how she went on to have two healthy children.

“After my second miscarriage, my doctor told me he just knew that a year from now I’d be a mom,” she confides. “You know, Erin, I think that a year from now, you will be a mom too. The only thing that will truly get you through your loss is getting pregnant again. And you will soon.”

It is this prediction — that I will be a mom within a year — which helps me over the final hump in my mental recovery. I hang on to Jen’s words like a security blanket. Finally, I stop crying.

It is now September 29, 2010. My four-month-old son, Joshua, is calling for me. It’s 4 a.m. I have just enough time to feed him in the dark and put him back to bed before his 19-month-old brother, Ari, is up too. I am tired beyond belief, but it’s part of the reality I’d dreamed about — finally becoming a mom — and that makes it all worthwhile.

When I nuzzle with Joshua at night, or get a warm bear hug from Ari in the morning, I can’t help but hum the song that’s been playing in my house a lot lately: You’re just too good to be true / Can’t take my eyes off of you.

As it turns out, this song was meant for their ears all along.

How to help

From my own experience, I’ve learned there are some things to keep in mind when you’re trying to comfort a woman, and her partner, following a miscarriage:

DO understand that a miscarriage is a loss.

DON’T tell her to get over it and move on.

DO encourage her to talk about it when she’s ready or get help when she needs it.

DON’T tell her when she should stop crying.

DON’T tell her stories about people who’ve suffered many miscarriages; this is not a time for more bad news. Focus on positive or encouraging stories.

Miscarriage: The facts

Paul Bernstein, an obstetrics and gynaecology specialist at Mount Sinai Hospital in Toronto, has delivered countless babies — and also lots of bad news to hopeful parents. This is the information that he provides to patients to help them understand the facts about miscarriage:

• Of all pregnancies, 10 to 15 percent result in miscarriage.

• There are many reasons a woman may miscarry.

• Before the 12-week mark in a pregnancy, it happens because the fetus isn’t developing properly.

• When it happens later in pregnancy, or a woman suffers multiple miscarriages, there may be underlying medical problems. Blood tests and ultrasounds may be ordered.

• There are three approaches taken to remove tissue left behind after miscarriage:

Do nothing. The tissue will leave the body on its own over two to six weeks.

Take misoprostol. This anti-inflammatory drug causes the uterus to contract and expel the pregnancy tissue.

Have a D & C. In the dilation and curettage procedure, the tissue is scraped or vacuumed out.

• “Most of the time,” says Bernstein, “there is nothing you could have done differently to prevent a miscarriage.”

While some people move on after a few months, others take more than a year to recover psychologically. According to one American study that followed women after miscarriage, 55 percent were experiencing significant psychological stress immediately after; 18 percent at the six-month mark; and 11 percent still at one year.

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