Sometimes, I Get Angry

I am tired of the fertility posts that are either -- hey, look at the bright side, they kept their heads up, blah blah nobabycakes; or, I am so sad and can't believe other people are so rude to be having a baby when I have problems, woe is me. It's like there is no middle ground.

I am human. I am complex. I made choices:

• I want a kiddo. 
• I can be sad or angry for myself, but that should not preclude me from being happy for others, or sympathetic when they are having a tough time parenting. It's not all about me; I chose not to be hypersensitive to every thing to the point of offense (and, yes, I believe this is a choice. Maybe I'm harsh...but oh well; I am a little fatigued of women feeling like no one else in the world should dare speak baby in front of them, or complain about how tough things can get.) 
• That I would be honest and forthcoming, with the good and ugly, so that other women wouldn't feel alone or ashamed that they are feeling "abnormal" 
• That starting a family -- and the challenges to get there -- would not be my main topic of conversation day in and day out.

That said. I am human. The last year has not been easy. Keeping up the "good fight" has not been easy. Maintaining work, life...not easy.

Some days I get sad. I'd be lying if I didn't admit that a lot of the time, I also get angry. A lot of this doesn't seem fair (J's response to this is usually, "Life isn't always fair, it's complicated."), and makes me question every single thing I have done with my reproductive health throughout my life -- should I have stayed on the pill so long? Did the IUD do something? Maybe I shouldn't have gotten the D&C? WHY ME (but really, more, why any of us)?

It's also unfair to J -- this isn't what he planned in his life, either -- but he seems to handle it much better than I.

I see everyone around me with babies, and occasionally I wonder, "why not me?" "When will it be my turn?" I am not a patient person, I am also not a passive person....I am a doer who goes after what she wants. This new process we are in, however, doesn't allow for much active behavior. There's a lot of waiting. And I feel like I can't move forward in other parts of my life while this is in limbo.

I watch shows like Girls, where this season, Hannah Horvath, the main character, gets pregnant accidentally. And I am in awe (and yes, I know this is a TV show)...everyone I know who is trying to get pregnant has to take their temp each morning, log everything in an app, take an ovulation test...but here it's easy (it always is on TV...except for my new spirit animals: Monica & Chandler). I wonder if our child's birth mother might be someone like Hannah -- a twenty-something who suddenly finds herself pregnant. And I wish and hope that this woman who will be our child's birth mother would just find us already.

I am human. I am sad. I am angry. But I am ok. I made choices. And I have found that I am stronger than I thought I was, or could be.

The Next Journey

I am grateful that our battle with infertility* was over quickly. We are lucky that the fertility doctor we saw was not one who tried to milk money out of us, or give us false hope. It hurt, but hearing that our chances of changing what my body could do were slim allowed us to make decisions quickly.

From the early days of our relationship, J & I talked about having a family. We discussed what our various options would be -- I thought that due to my age, getting pregnant may be a problem -- and one of those options was adoption. While we were at the fertility doc, she also brought up options, though she was leaning towards surrogacy. This isn't something we really considered. I am not 100% sure why, but neither of us were that interested in it.

We went through two rounds of fertility treatments -- for me that meant a few rounds of estrogen. At the same time, we realized that this may not be the best avenue for us, so we started exploring other options, specifically, at this point, adoption.

I guess nothing in life is guaranteed, but with adoption, you are likely to end up with a child. Unlike IVF, or surrogacy, where you can spend a lot of time and money and still be left with a hole in your family. I'd seen many of my friends go through some extreme fertility issues --  I saw the stress to them and their relationships -- and while those that ended up with children said it was all worth it, I wondered about those who ended up still childless.

But still we thought we would see one more specialist. Then, my uncle passed away very suddenly. Very shortly thereafter we found the second round of estrogen hadn't worked at all. And I was tired of fighting what seemed like a very uphill battle where we were unlikely to be successful. And I needed success; I needed a win. J & I discussed and then agreed to stop fertility treatments and focus more seriously on adoption.

And this decision was the best we could have made.



*I still struggle with considering myself infertile, but, by definition, I am. I can conceive, but not get pregnant. 

The Small Percentage

20% of known pregnancies become non-viable/end in miscarriage.
2% of known pregnancies end in missed miscarriage (the body does not expel the fetus, even after non-viability)
30% of D&Cs from a missed miscarriage lead to Asherman's Syndrome (uterine scarring)
23.5% of women over 35 diagnosed with Asherman's are able to give birth.

What does this all mean?

My doctor was convinced I would get pregnant very quickly once I got my period. Frankly, I thought I would, too! But when that period never came...we started to get concerned. We waited a bit...just in case my body was taking its time getting back on track. When after over two months came and went, it was time to take things into my own hands and push for further diagnosis. (tip: become your own advocate. Push when you think something is wrong.) 

First I had a sonogram -- luckily we had this scheduled because my doc thought she saw a strange blood vessel and wanted to get it checked. That didn't tell us much, but the sonogram doc recommended that I have a sonohysterograph. Sounds intimidating, no? (tip: take a few ibuprofen and be prepared for some cramping. It is uncomfortable but not painful) The doctor became concerned when she could barely get the fluid in. I became concerned when she said that meant there was some scarring...and the call from my ob-gyn further confirmed this and suggested I see a specialist.

Off I went to a specialist in minimally invasive gynecological surgery. Full of hope, I watched as he looked over my results. I listened as he talked about my uterine scarring, also known as Asherman's syndrome, and went over how he would perform the surgery, an operative hysteroscopy, and the risks involved. And a few days later, there I was in the operating room, and shortly thereafter, in the recovery room. The scarring was extensive, he had gotten most of it, but I needed to have one more to finish it off. In the meantime, I would take estrogen to help build my endometrial lining, and progesterone to help get my body to have a period.

Knowing what I know now...not getting that period would have been a sign that something else was wrong. I didn't know that then, though...what I did know was that I had a short window in which to have this surgery before I, once again, had to travel for work. I adjusted my schedule, and on our first anniversary, 9 May 2016, I went in for my second hysteroscopy.

I will not forget the look on my doctor's face when he told me that while he had gotten all the scarring, my endometrial lining was less than optimal; in fact, it was almost non-existent. After a month of estrogen, it should have been nice and thick...and it wasn't. I cried a lot that day. J felt sad that day. To me, that news was harder than hearing our pregnancy was non-viable. It was harder than the D&C procedure that had likely caused the scarring. The following day when my ob-gyn called to tell me to say she'd never seen anything like this, reminded me she had stopped the D&C so she wouldn't go too deep, and that I would need to consider other options, I cried more.

In a weird way...it felt like the first time I had felt something visceral since my dad passed away. The sorrow was deep, my cried more like bellows...I wonder what the person in the hotel next to me thought. I quickly made an appointment with the fertility specialist, but that day, I started grieving. I had lost my ability to carry a child.

We went to the specialist -- tried a few more rounds of estrogen. We tested my eggs -- there were a lot and they were good. My body was absorbing the estrogen well, but still my lining didn't exist. The cruel irony didn't escape me...I thought it would be my age that would hinder our ability to have kids, but no, I am fertile Myrtle but with no place to put 'em! I listened and cried as two different fertility docs told me to consider surrogacy. I grieved that my body couldn't do what it was supposed to.

And I was angry. Angry that my body couldn't do what it was supposed to. That through no fault of my own, my fertility was taken from me. I was angry that my body felt terrible -- bloated and crampy -- and I got no relief. And I was sad that J's chance for a bio child was taken from him, too. That took a long time to get past.

During this time I also suddenly lost my uncle, which, in a weird way, helped make our next step decision a bit easier.

So what does this all mean?

It means I had a lot of bad luck in the fertility department. How I ended up in this small percentage, I don't know. But I did.

This wasn't where I expected life to take us. I allowed myself to grieve and be sad. This was very important. I tried not to be too hard on myself -- which in itself was tough. Once I allowed for all of that...I was able to focus on our next journey.

When It's Finally Over

When your pregnancy is found to be non-viable, you have a few choices:
1. Wait for it to pass naturally
2. Take medication that causes your body to abort
3. Have a medical procedure
4. Drink (well...that is an adjunct to all of those!)

I had a work trip planned about two weeks after we found out. I didn't have the luxury of time, but also, my body wasn't doing a great job of miscarrying on its own. I decided first to take medication.

This was the only time I slowed down slightly from work. I relaxed, took the medication, and waited for the cramping to come. I waited...and waited...and waited...There was one moment when I thought, yes, this is it. But a small clot passed and a small cramp, and that was it.

This gave me a lot of time to think and get angry.
Why was my body behaving in such a way?!
Could it not do anything right?

This did no good, I could not will my body to pass this mass of tissue that was now tricking my body into thinking it was still pregnant. Until I could let it go, I would remain tired. My boobs would remain swollen. My hormones would remain a bit out of whack.

I remained hopeful throughout the weekend that the medicine would take care of things. Alas, it was not to be. My body -- she is a stubborn one! We had a contingency plan with the doctor should this happen, and that was to get a dilation and curettage (D&C) early in the week. This carried with it some risk, but I was told that it was minor and the best way, at this point, to complete the miscarriage.

I have always been a strong advocate for a woman's right to choose, and for safe access when a woman chooses to end her pregnancy. After going through the procedure myself, this need to safe access resonates even more so. This is not a sophisticated procedure -- you have strong pain medication, and the doctor sticks a suction tube up your lady bits and scrapes around. Without a sterile environment, by a professional who knows what they are doing, there is a huge risk for infection or worse.

At any rate, my doctor and I chit chatted while I tried to stay brave throughout the procedure. I was super grateful for my high pain tolerance...though I did ask them to pump up the drugs at one point. And then, just as quickly as it had all started, it was over.

The procedure. My pregnancy. All officially over.

It was pretty unceremonious, and while they required that someone pick me up, I could have just as easily driven myself home.

Which I should have...because to add insult to injury, I ended up getting a parking ticket after leaving my car parked nearby overnight.

Why We Shared

On this Thanksgiving Day, I am thankful for what I got to experience over this past year. I got to experience a tremendous amount of love, support, and patience (including from myself!) and for that I am grateful.

It's been my experience that many women, and their partners if they have one, choose not to share the news of their pregnancy until they are at least out of the first trimester. The thinking is that you wait until you are in the "safe zone."

But...there really is no 100% safe zone. People experience losses at all stages of pregnancy, and there is one common thread through it all -- we all need support.

Keeping a pregnancy secret is really, really hard. Especially when you find out right at the start of the holiday season...there are a lot of parties, and a lot of people watching every thing you put into your mouth. I was very tired, as well, so trying to stay up late enough to even go to a party was difficult (my apologies to everyone whose party I flaked on). Even without that, you are excited and scared and need to shout it from the roof tops.

J & I discussed quite a bit whether or not we should tell everyone. We knew our families would be together on Christmas, and, after all, the doctor had told us we could. If we shared early, we figured, the worst that could happen was we'd have to go back and tell people it didn't work out.

So we shared.

And it didn't work out.

We were so glad we shared. I will never forget the smile on my mom's face when we told her. I will never forget her tearing up when my nephew walked out in front of the family with a "Big Brother" shirt on Christmas Eve (yup, my brother & sister-in-law were also pregnant, due two weeks or so before we would have been)...and I will really never forget the whoops and tears, so loud my ears were ringing, when we lifted my nephew's shirt to reveal a sign that said "and big cousin." It's now made even more special because I'd not seen a smile that big on my Uncle B's face in a while; he is no longer of this earth, and I carry that smile with me. I will never forget J's mom needing to hand the phone off because she was so happy, the texts we got from his family, and his little sister being so excited when we called her. I wouldn't trade those memories for anything.

But we are mostly glad because when all was said and done, we needed their support. Some people were uncomfortable, some didn't know what to say, but because we'd shared, they were in our corner, they were there to hold us up as we wobbled down this road. And we didn't have to hide or be secretive when we had our bad days. No one questioned when I had to beg out of a party because of a slight emotional breakdown on the way. We could talk about it -- both me with my friends and, equally as important, J with his friends. And many people let us know that they, too, had been through this (but hadn't told anyone).

There is a sense of shame that many of us carry -- especially with women -- when a pregnancy becomes non-viable. Because we don't talk about it, the shame is compounded because we feel abnormal. We need to talk about it, because we are not abnormal, we did nothing wrong, and we are not alone...it is estimated 20-30% of pregnancies become non-viable, that is one out of every three people.

I am not suggesting we introduce ourselves to strangers by leading with, "Hi, I'm Annie, and I have had a non-viable pregnancy." But I am hopeful that we stop hiding. That we stop waiting until another friend experiences the same and then we tell them. And that we stop being uncomfortable when a person talks about their own experience.

It is not an easy thing, but it is not a rare thing. And support can truly make a huge amount of difference.

Ok, let's eat.

A Different Type of Devastation

The toughest thing for me was not that the pregnancy didn't proceed the way we would have liked. For me, it was the incredible loneliness that was associated with it and the ensuing events.

Physically, I was not alone. I have a wonderful husband by my side who was also dealing with his own grief. And, since we had made the choice to tell so many people, we had a lot of support.

But emotionally, I felt stranded. Everyone was treating me like I should be devastated. Tiptoeing around, both wanting to bring it up and not wanting to bring it up at the same time. All of this was out of love for me & J, this I knew. But I wasn't devastated, not by this. Devastated was what I felt when my dad passed away, like the rug had gotten pulled out from under me and beneath it, the floor was missing. With this, though...I was sad, yes, but intellectually I knew this was the way my body was supposed to work. And I was very sad for J.

And the hormones do nothing to help this sense of sadness, the sense of feeling like an oddball, nor do they help make sense of much. (postpartum depression, I learned, can happen even when the pregnancy doesn't proceed)

I spent a few nights googling "not devastated by miscarriage," or "non-viable pregnancy but feel ok." And I found very little. I found pages and pages of women who wrote they could barely function -- was there something wrong with me?

J told me to get off the internet. And it was true -- all it was doing was making me feel worse that I didn't feel that bad. I was shaming myself to feel something I didn't. Which is dumb. And it was just exacerbating that feeling of loneliness.

But here I am writing on the internet, and you are reading on the internet, so let me say this. The truth is, there is no right way to feel. We all have different reactions, and none of them are wrong. For me, I know that if this pregnancy had been right, it would have remained viable. Instead of feeling devastated, I choose to see this as my amazing body doing what it was supposed to do. So I was not devastated by my miscarriage*. Instead, I was confident that next time it would be different. Or, if it wasn't, my body would again to its job. I chose appreciation and awe.

*yes, I hate the word miscarriage...but this is to help other women who may be searching for that particular phrase, like I had

So Wrong it Could not be Righted

I was not that shocked to learn that our pregnancy was not viable. A part of me had felt that it'd all been too easy -- we had "pulled the plug" on my IUD just three months earlier, and had only really been trying for a month (trying = tracking my cycle, taking my temperature, watching when the moons aligned, yadda yadda yadda). This easy barely happens -- especially not to women my age (or so I thought). Then once the doctor started giving us subtle clues that things were less than ideal, I started to prepare myself.

Still, as I prepared to leave work to go to our ten-ish week sonogram, I was optimistic. The waves of nausea, while mostly gone, had happened. My boobs still occasionally hurt. I was still tired all.the.time. So I was caught a bit off guard when I made one last pit stop before the drive, and found I was bleeding.

My heart was racing as I got into my car for the long drive to the doc. I debated calling J -- why worry him if it is nothing? (I called him) Throughout the drive, I waited for the big cramps, for the pain, the gushes of blood that you see/they describe on TV or in the movies. (Never happened)

When we did the sonogram (and, I should note...early in pregnancy, these are mostly trans-vaginal, not like on the belly -- much more invasive!), the doctor confirmed our fears. We could see the little gummy bear, but we could see no flutter, which by then should have been more than a feather. I think J was a bit gobsmacked...me, I immediately wanted to know what was next.

Indulge me for a moment as I step on my soapbox about some common terminology. I do not like the word miscarriage -- it implies that I did something wrong. I did not "lose the baby," I did not misplace it (and in my case, it wasn't quite a baby yet). The word abortion takes on a whole new meaning when you see it on your medical records -- and once you go through the D&C procedure often used when a pregnancy is terminated, you realize the importance of keeping it legal and safe. So much of the terminology feels, when you're going through it, like you are to blame.

Which I was not. I prefer to say our pregnancy was non-viable. Because my body is so amazing it could tell there was something so wrong that it could not be righted, and the safest solution was for it to cease support. The female body is truly incredible.

What We Needed to Hear

If we'd really listened, perhaps we would have heard.

If the doctor had been more direct, perhaps we would have understood.

The moment she realized she "forgot" to print the sonogram picture, perhaps we should have known.

As we walked away with a weird print out of measurements -- measurements that were not what they should have been -- perhaps we would have heard what she wasn't saying.

I don't blame us. There were were, a hopeful, newly-expectant couple. A few weeks earlier, the blood tests showed that the pregnancy was progressing at a normal pace. We arrived at the doctor's office that morning -- two days before Christmas -- excited to see our baby for the first time, to see its heart beat.

And we did. We saw the little blueberry. We saw the small feather of a flutter, the heart seemingly beating away. "It's small," said the doctor,"but sure, go ahead and tell your families, if you want, that there's something there with a heartbeat. Your actual doctor will be able to tell you more at your next appointment."

And while I tried to stay positive, what she said didn't sit well with me. What she didn't say sat even worse.

What she should have said is that due to the size (measuring at about five weeks, when it should have been at least eight weeks), that the pregnancy would not likely be viable. Instead, after much prodding from me in subsequent emails, she eventually said, "Sometimes these things turn out ok. But you'll need to talk to your doctor."

What she should have done was be direct. Rather than talking softly, or putting the onus on our doctor, she should have just told us what she was seeing. While it wouldn't have changed the outcome, it would have saved us a little bit of grief, or allowed us the space to think about if it was really something we were ready to share.

Perhaps if we would have listened harder, we would have heard what she didn't say.