Trigger warning. This blog is a whole blog of triggeration: While I always attempt to keep in close touch with humor, this blog maybe will be different. If you hate when people share their feelings on the internet, X it out. Right meow. I'm going to write about a topic that I was
unfamiliar with until just recently, and if it makes you eye roll that I'm sharing this about my life on my free blog - that's okay, you aren't required to care.
Just please come back for the next one!!
Full disclosure I feel judged even as I begin to write this blog. #vulnerability
"Death is not the biggest fear we have; our biggest fear is taking the risk to be alive - the risk to be alive and express what we really are. Just being ourselves is the biggest fear of humans." Don Miguel Ruiz, The Four Agreements, page 17
Let's do good news/bad news. Bad news first, get it out the way.
Here are some statistics about the topic in this blog. References saved for the end, because I'm not gonna help y'all cheat...
Most of the time, we won't know why it happens to a person. Although, there are a lot of reasons why it happens.
Estimates are that it happens to at least 10-15% of people affected, for sure, but likely up to 50% of people affected overall.
Physical recovery and return to normal physiology (a normal body state) can take 4-8 weeks.
Mental and emotional recovery - a return to normal emotional state can take weeks or months for some people.
Affected people may experience clinical (diagnosable) grief.
Can often be very physically painful and cause large amounts of bleeding.
Can require surgery in some cases.
Can happen with or without warning. Most of the time it can't be predicted.
Can happen to the same person more than once.
Happens to healthy people and unhealthy people.
There are risk factors for it, but you can have zero risk factors and still experience it.
Yep. Warned y'all. This blog isn't going to be quite as upbeat as the others.
Myself and my husband are now in the statistics. Many of you are as well.
Deeeefinitely not putting those pictures on the refrigerator.
Let me be clear: This blog is not being written for "thoughts and prayers", for sympathy, for attention, as a therapy session (I do pay a professional for that), or any of the many reasons that people hate when other people write about these types of things on the internet.
This blog is being written because I was blindsided.
It was not even on my radar that this could (and would) happen to me.
And, although I do hate to be a parrot, it's been said a million times - I was blindsided and unprepared for this outcome because people. don't. talk. about it.
So, no need to fear, my next blog will be funnier, more in keeping with the theme of the rest, and about a medical problem y'all equally hate to talk about - constipation! Everybody poops. And guess what, a lot of y'all have hemorrhoids because y'all don't tell anybody you can't poo until you come see me in Urgent Care and you got a big ole' hemorrhoid hanging out your butt.
Miscarriage is not going to be my hemorrhoid.
I am a transparent, no filter, say-how-I-feel, never-leave-you-confused type of human, to a fault. I can talk to almost anybody about almost anything.
I am not afraid to be vulnerable, yet I am deeply afraid to be judged.
It's a weird, seemingly hypocritical existence for somebody with a mouth like I got.
If you're ever wondering how your life is going, ask yourself, "how many plants did people send me in the previous 2 weeks?" And listen, we needed some greenery in this house, buuut I'm not sure this is how I envisioned fitting it in......
Also, if you're ever wondering if you have successfully surrounded yourself with high quality people and a job that cares, ask yourself, "how many plants did people send me in the previous 2 weeks?"
If the answer is 1 ...or 7 plants, you've likely just walked through a valley in life...
I was particularly blindsided when they told me our baby had no heartbeat, first and foremost because I was "dated" 3 weeks behind what I thought I was going to be. For anyone unfamiliar, 3 weeks in pregnancy feels like 3 centuries. But, also because nobody really talks about the rate of miscarriage, and how common it is, especially in first pregnancies. It's like this unspoken semi-common knowledge I guess. We see a lot of "rainbow baby" posts on social media when there is a new actual baby to pair with it, and there's a sprinkle here and there of pregnancy loss awareness. But overall, I find it's all very vague, passive, and still somewhat reserved for a highlight reel.
In no way am I insinuating that we need to post our real-time, play-by-play grieving and bleeding on the internet or post selfies with tears and snot. That is most definitely TMI and inappropriate. But what I am saying, is that I was shocked at how many people in my personal life experienced miscarriage, and I never knew it until I reached out for support. This probably contributed to my radar being devoid of any preparation for the pregnancy not working out. When I started reading for this blog I was surprised to see how low the actual, known miscarriage number was (10-15%, 25% in one study), and expected it to be the assumed percentage of closer to 50%. (1)
As a healthcare provider - I talk to people about risks/benefits/possible side effects of taking medications or doing tests or opting out of things. We give "ER precautions" when someone is sick with a condition that could get worse.... "things to watch out for".
Listen, I have a wonderful, excellent, caring, super smart doctor/group, this is not a dig at them. Most of the time, pregnancy is a happy thing! Nobody wants to talk about or think about what can go wrong, and what patient wants a debbie-downer-doctor that says "just know there's a 15% probability you'll miscarry this baby because it's your first"?!
Zero people I'm sure?!
So there might be a few gentle questions about "any cramping or spotting?", but there are no discussions happening on the front end.
Maybe that's just my personal experience? I don't know. Many of you reading this are much wiser and more experienced than me with this, unfortunately. Maybe I sound naive. I also have considered that some people may not care too much if they miscarry. It doesn't affect us all the same way, and some women may not grieve or be upset. I 100% thought I would be that person. Thought I would just know that it's a "thing" that happens and bee bop along.
w r o n g!
I waited to write this until I was out of the valley! I'm generally on the uphill, still thinking about it often and trying to figure out how I feel. But, I'm definitely writing from a place of enlightenment, experience, and humility.
Every time we told somebody we were pregnant, the very next thing I said was "I'm breaking rule #1 telling people so early."
Thaaaat one came back to bite me, it's almost like I was subconsciously preparing myself for a bad outcome? As I do, I'm one of those people... but I wouldn't take it back. I needed to be able to talk to people about it to understand it and to not completely lose my mind.
If you are a person who will be pregnant one day, or you will be a partner to someone who will be pregnant one day, you may be as "educated" as I am (about nursing and primary healthcare of all things), and still not know much about pregnancy, and how often it goes sour early on. Pregnancy was just never my jam. I enjoy emergencies.
I use the term "rollercoaster" a lot, but this experience was a damn rollercoaster and a half and I even puked on it once.
Some of the facts:
...the terms miscarriage, spontaneous abortion (yes, you read that right, abortion doesn't only mean what politicians and Catholics say it means), and early pregnancy loss (EPL) are used interchangeably... (3)
ACOG (The American College of Obstetricians and Gynecologists) say, "Early pregnancy loss is common, occurring in 10% of all clinically recognized pregnancies (translation: you had a positive pregnancy test and a confirmed fetus). Approximately 80% of all cases of pregnancy loss occur within the first trimester." (3) This is the most conservative number I've found in my reading. Most sources say 15%-25% of all known pregnancies end in miscarriage in the first trimester.
If you're like me, you see 10% and think... mmm that doesn't sound too common, that's a pretty small number. Until you look up how many pregnancies were estimated to occur in the US in 1 year. The most recent data available is from 2009, and was released in 2013. "The estimated number of pregnancies dropped to 6,369,000 (4,131,000 live births, 1,152,000 induced abortions, and 1,087,000 fetal losses". (6) A million times a year, this happens to people.
Approximately 50% of all cases of early pregnancy loss are due to fetal chromosomal abnormalities. (3) Saying this to myself and to you: this is an act of nature. or biology. or God. This is no one's fault. And it's the cause over HALF of the time.
The most common risk factors identified among women who have experienced early pregnancy loss are advanced maternal age and a prior early pregnancy loss. (3) What is "advanced maternal age" (aka geriatric pregnancy)? Pregnancy after the age of 35. I am 33 at this time, and have no prior pregnancies.
There are 4 ways to have a miscarriage: spontaneously, expectantly, medically, and surgically. A spontaneous miscarriage happens naturally on its own, and is likely what happens to most women in the first trimester, and probably is mistaken for a regular period. It's also the reason why it is estimated that actually up to 50% of pregnancies end in miscarriage. Expectant management "allows spontaneous passage of retained products of conception" - meaning, you know you are pregnant, you know the baby is not viable or has died/stopped growing, and you allow the miscarriage to happen naturally. (4) "Medical management uses drugs to aid expulsion of retained products." (4) This entails taking 1 of 2 prescription medications that induce (cause) the abortion (miscarriage). And of course there's surgical management. Depending on how far along the pregnancy is the options are "dilation and suction" or "dilation and evacuation". This involves opening the cervix and removing the "products of conception" with suction or with forceps. (5) Which option is used is first based on whether or not there are signs of emergency for the mother (clotting, bleeding, ectopic (tube pregnancy, not in the uterus is another story) and so on), how far along the pregnancy is, and the patient + doctor preference.
Most miscarriages happen in the first trimester before the 12th week of pregnancy. Miscarriage in the second trimester (between 13 and 19 weeks) happens in 1 to 5 in 100 (1 to 5 percent) pregnancies. (2)
The most common causes of early miscarriage are: Genetics, Infections, Anatomic Problems, and lifestyle factors. Genetics: Multiple possibilities, but as mentioned previously, "about half of all miscarriages are caused when an embryo (fertilized egg) gets the wrong number of chromosomes. This usually happens by chance and not from a problem passed from parent to child through genes."(2) Another reason for genetic miscarriages is "Intrauterine fetal demise. This is when an embryo stops developing and dies." (2) This seems to be what happened with us. Infections: mainly sexually transmitted diseases. Anatomic Problems: the woman's uterus isn't formed normally (there are specific conditions that cause problems), she has uterine fibroids or she has problems with her cervix (the opening to the uterus that dilates to allow a baby to come out during labor). Lifestyle factors: smoking, drinking, drugs, obesity, maybe even caffeine intake. (2)
That's about enough of all that. This discussion could go on and on and on... there are mountains of information about pregnancy and miscarriage. A whole mountain range.
What's the GOOD news?
1% of women will have repeat miscarriages.
I repeat: "About 1 in 100 women (1 percent) have repeat miscarriages." (2)
That's still a lot of people. And it's gut wrenching for those people who have to experience it, I am absolutely not minimizing how terrible it is for those who have been through or will go through "repeat miscarriages". But if you're a silver lining person, or a hopeful person, there's only a ONE percent chance this could happen to you more than once.
Be nice to each other. Like I said, some of the people I'm closest to in my life.. I never knew this happened to them. And each one of them could write and articulate how I felt and validate my roller coaster of emotions and thoughts - and I never even knew they went through it too.