You are a Strong Ass Woman: Loving yourself through recurrent miscarriage

My body and mind are numb as we drive to the hospital. Holding my husbands’ hand, we walk into the hospital, check-in, and are guided back to our room for the day. On the gurney lies blue hospital socks with little gripper bottoms and a light green gown. The nurse greets us, we sign the paperwork, and within the next thirty minutes, an IV is started, anesthesiology and the surgeon stopped by for pre-procedure reviews. Full of anxiety, despite medication to help me relax, my husband kisses me goodbye and I am wheeled down the hall and into a large, white, cold operating room. This has been my reality of recurrent miscarriage.

This exact situation happened not just once but four times within a two-and-a-half-year timeframe to us. I felt so ashamed and just utterly destroyed, each time we went through this. It took me a long time to feel worthy and loved again. Every day I miss being able to experience the late-night feedings and little league games that could have been with those four babies. This is the reality of recurrent miscarriage.

If you have been in this situation, let me remind you that you are not alone. There are, unfortunately, so many of us out there to support you. Miscarriage is not something that many post about on Facebook, rather it’s in those touching individual conversations when you realize “you’ve been through this too”. Once you open up yourself to share, others will feel comfortable too. You are not broken; the other women are not broken, we just have scars. We are strong ass women.

Our Story: Recurrent Miscarriage

I met my perfect match a little later in life and we married in April 2018. We had spent the past few years traveling the world while working through our infertility journey and we’re so excited to start our family. Our first miscarriage occurred a week before our honeymoon in Greece (August 2018)and the third occurred days before our trip to Israel and Turkey (January 2019). I was thrilled about a positive pregnancy test in August 2018. I kept the news to myself and put together a “you’re going to be a daddy” gift for my husband. It was such a special day and I was grateful that our journey to parenthood had finally started.

Too good to be true

Once you get that positive pregnancy test, my OB is the first call, to confirm the amazing news. They will typically check your HCG levels, progesterone, and some additional baseline blood tests are captured. My HCG levels were on track initially, but fast-forward to week seven, instead of going up by thousands, they were only increasing by 300 every three days. Everyone has their own HCG baseline and your doctor will tell you if you are on track or there is any cause for concern. In our case, there was a cause for concern.

An ultrasound took place the following day and my worst fear turned reality, no fetal pole. It was clear something was wrong when the ultrasound tech quickly wrapped up and told me I could get dressed. The next step included a quick walk over to the doctor’s office where he shared the news. There was a gestational sac and fetus but no heartbeat. We left the building in silence and I cried for what seemed like days. I was so ashamed that my body let our baby down, I felt completely responsible. It had to be something I did.

Preparing yourself for the miscarriage process

Miscarriage is painful, both physically and mentally. Many women silently suffer. According to the March of Dimes, it could be as much as 50% of all pregnancies end in miscarriage but only 10-15% diagnosed due to the woman even knowing she was pregnant. I had a D&C each time, mainly to capture the chromosomal information to better advise our next protocol. It is difficult to go to the hospital, knowing what is happening, and undergoing anesthesia. The process itself, however, is a day versus multiple days if you were to miscarry naturally at home. To learn more about a D&C versus natural miscarriage, please check out my recent post. Each hospital or procedure location has a different process.

A D&C Procedure

Three days later my husband took me to the hospital for a D&C procedure. Thankfully, a nurse called me in advance and walked me through what would happen. She warned me about two particular questions they would ask, “what would you like to do with the remains” and “would you like a chaplain present”? She walked me through common options for both scenarios. I was so grateful for the opportunity to prepare for those difficult questions.

I held back the tears until I was wheeled back to the operating room. In my mind I was screaming, “This can’t be happening. We just need to double-check”. With tears streaming down my face, the last thing I remember was a nurse holding my hand and telling me that I’ll be ok. Thank god for nurses. I needed someone else to be strong for me at that moment.

The D&C procedure timeline: What to Expect.

1. Fast (no food or drink) for 12 hours prior to the procedure.
2. Arrive at the hospital 90 minutes prior to the procedure time.
3. Once in your room, you will change into a hospital gown and will be visited by a variety of people. An IV line is started and the Anesthesiologist and surgeon will stop by to review the final questions.
4. You will be rolled back on the gurney to the operating room.
5. The nurses will get you situated in the operating room and the anesthesiologist will start medications.
6. The procedure times will vary. From room to room; estimate 90 minutes.
7. Once you come out of anesthesia, you may feel cramping or an extreme urge to use the washroom.
8. The observation will last an hour. A snack is provided during recovery.
9. At home, plan on resting for the remainder of the day. You will be able to resume relatively normal activity the next day, but make sure you minimize long walks or running until your doctor gives the ok. Cramping, the uterus contracting to transition back to size, can be painful. Tylenol will help.

It will be a rough day, you might be angry and sad. Recurrent miscarriage is difficult, painful, and stressful. You will get through the day and you will pick yourself back up because you are a Strong Ass Woman!

Off to the Infertility Doctor

Due to my age, my OB referred me to an Infertility specialist at our local hospital. I know that God had a plan for my husband and me. It is just so incredibly hard to keep faith in the plan. After the August 2018 miscarriage, I had another in January 2019, the third in July 2019, and the fourth in March 2020. Each miscarriage took a piece of me, however, having regular appointments with an action plan provided relief.

Specialist after Specialist

Over the next two years, we tried various treatment protocols and I saw multiple doctors. I became a human pin cushion and truly had every infertility test imaginable. I transitioned to another specialist after my first infertility doctor retired. The doctor was very knowledgeable, however, the support team did not meet my expectations. My expectations are; return phone calls, answer insurance questions, and communicate timing with adequate notice. After wasting six months trying to corral the nurses, I opened up to someone I barely knew at the time. It turned out her journey wasn’t the easiest either. She is a huge support for me. I am grateful for her referral to yet another doctor. Many times, when you feel things crumbling, reach out. There are other women who have been there and are willing to help. Recurrent miscarriage or other reasons for infertility should not take control of you. Thank god for strong ass women always picking each other up.

Light at the end of the tunnel

This new doctor was direct and was determined to get this process moving for us. One positive thing in our scenario is that we are able to get pregnant ourselves, the problem is staying pregnant. After additional tests, we finally had a possible cause for recurrent miscarriage; I have a blood clotting autoimmune disorder and thyroid elevations. I felt in control. We finally had an answer and a protocol designed to help. We tried two rounds of the protocol, complete with an increased amount of vitamin supplements, medications, and daily shots to help control my blood clotting disorder. I had a black and blue stomach for about six months. Not taking into consideration black and blue arms from weekly blood testing. Before starting this protocol we had just experienced miscarriage #3 and daily shots and weekly blood didn’t phase me anymore.

The first time trying the protocol resulted in miscarriage, but we decided to try one more round. Our doctor was direct, IVF, although not as effective in our situation but surrogacy should be on our radar. We moved forward with another round of the existing protocol. The protocol worked! I don’t know how this pregnancy will end, but we are already in our third trimester. Surrounding IVF, the only variable this eliminated was chromosomal abnormalities. The benefit allowed the strongest embryo to be selected, although this did not solve the problem of sustaining a pregnancy. This route could easily end with another recurrent miscarriage and significant expense.

Preparing for IVF when not covered by Insurance

The hard truth about IVF is that it is incredibly expensive and hard on the body, but let’s be honest, I’d already been giving myself daily shots and a variety of other medicines. We ended up sustaining a pregnancy and did not have to follow this process, but we were within a week of pulling the trigger. If your insurance does not cover IVF, you have options.

IVF Financial Support options:

• Military service: Do you or your partner have any prior military service? Our provider offered a significant discount for veterans or active military.
• Marketplace: Many people think the insurance marketplace is only for people who do not have insurance or need the support of Medicaid or Medicare. That is not the case. Through Obamacare, we found plans, in the private market that covered a large portion of IVF.
• Grants: There are several resources online that offer financial support for IVF if you meet certain criteria. Fertility Within Reach is a great site that educates on available grants for Infertility and Adoption.
• Experimental trials: Ask your doctor if they are aware of any trials in your area where you might be a candidate.

Thankfully my husband served our country and we were eligible to receive a generous veterans discount. We planned to pair the military discount with a private insurance plan from the marketplace. The marketplace plan we looked at was around $450 a month. It covered a majority of the costs associated with the retrieval and implantation procedures, and about 50% of the $7,000 in medicine per cycle. Be mindful that marketplace plans differ by state, and not all states cover IVF. In Illinois, as of 2020, some plans did.

Loving yourself through it all

Miscarriage and recurrent miscarriage may be one of the most difficult scenarios you will encounter. After the first and second miscarriages, I felt lost. I was letting down my husband and was struggling with the realization we may never have the family we desired. Through the following tactics, I was able to develop trust in my body, control my mind and realize it was not my fault. I am not a psychologist, therapist, or academically trained for this topic, however, I have significant experience.

Recommendations to support you through the process:

• Talk to your partner/spouse. Be open and transparent with how you are feeling. You both experienced the loss. Share with your partner what you need from them to heal and ask what you can do to help them.
• Support at the hospital. Prior to leaving the hospital after a D&C procedure, you can ask to see a support professional. Hospitals will have a person on call who will be able to speak with you then or schedule a time to connect.
• Seek professional counseling or group support. My local hospital offers a support group for miscarriage, recurrent miscarriage, and infant loss. Ask your nurse or OB about groups in your area. What to Expect and Facebook also have groups dedicated to miscarriage.
• Focus on the plan. Find a specialist in your area and book an appointment immediately, if you plan on continuing your journey to motherhood. Your specialist will run tests, review results from “products of conception” if you selected that option, and recommend a plan. Ask questions and advocate for yourself if you feel that either the plan is too aggressive or not aggressive enough. If you do not feel the support or plan is sufficient, get a second opinion.
• Surround yourself with strong women. The first few months after miscarriage it is incredibly difficult to interact with individuals who do not understand. I wholeheartedly understand the frustrated feelings when someone says “enjoy the journey” or “your time will come”. I also understand when your neighbor, friend, and past acquaintances all post-pregnancy announcements on social media right after your miscarriage. Those situations can be very difficult. Whether it is through Facebook groups, or by talking to women who have been there, wrap yourself up in their arms. In time, you will find your way back to being that supportive neighbor and friend and will look forward to celebrating their bundle of joy with them. In the interim, give yourself some grace.

Miscarriage does not define you

Whatever your outcome, I can guarantee that you will feel comfortable knowing you gave it everything you had. I told my husband that five miscarriages were my ending point, and at that time I would feel like I truly gave it everything I possibly could. Through this entire process, I truly realized that I am stronger than I thought possible. You are too. This will always be part of your story, but it does not define you. Why? Because you are a Strong Ass Woman!

Much love!

Emily M