Missed Miscarriage

“I’m so sorry.”

Those are the last words you want to hear exit your sonographer’s mouth.

“There is no heartbeat.”

Today was the day you were going to announce to the world the future arrival of your second baby, due at the end of April. Your family already knew thanks to a cute “Big Sister” glittery onesie your daughter proudly owns. Instead, you get to announce the death of your eight-week-old fetus, even though it’s been eleven weeks. That’s the most shocking part: the heart stopped three weeks ago. You’ve been carrying around a dead fetus for nearly a month. Your body doesn’t know it yet, hasn’t figured it out. That’s why it’s not simply called a miscarriage – like some innocuous collegiate football term for fumbled ball-handling – it’s called a missed miscarriage. You never even knew the term existed.

You spent the small hours of the previous night-into-morning in the Accident and Emergency department of your local hospital, waiting with your fourteen-month-old among much sicker patients. She didn’t sleep a wink for the entire four-hour hurry-up-and-wait process. You only went in because you were spotting (totally normal), but slightly worried about the color (bright red). You hummed and hawed about the futility of anything concrete happening at A&E – you weren’t dying – and you were mostly right. They triaged you (likely last in line), and asked you to pee in the world’s tiniest test tube. You tried your best not to urinate on yourself. Two hours later, a nice foreign-born nurse jabbed a needle into your drug-addict’s-dream median cubital vein. Medical staff have always swooned over your arm veins. You filled four vials. You didn’t know why so many samples were taken. They released you back into the crowd to wait. At one in the morning, a young doctor escorted you to a curtained-off room and asked mundane questions. He seemed perplexed you showed no other warning signs besides bright red spotting, which had subsequently stopped. He tried to worry, but all the tests came back normal. He then sent you home, but said he’d ordered a morning scan for you at the Early Pregnancy Assessment Clinic.

Once home, you put your child down in her crib and stumbled into your husbandless bed, falling asleep immediately.

Your alarm wakes you too soon. Your daughter needs to go to nursery; it’s her one full day there. Normal morning routine ensues: feed the hungry baby, feed the hungry cats, feed the hungry dog. Apply baby’s medication. Brush baby’s teeth. Drive to day care. Afterward, you sleep past eleven. You have an appointment with the EPAC at noon. You are not worried.

The Women’s Hospital is comforting. You’ve been here loads because of your last pregnancy and delivery. The staff is always welcoming and wonderful, despite the depressing 70s-era construction. You head to the Jasmine Ward and the name reminds you of Aladdin. You read a leaflet about the EPAC, curious that you never heard of this place before, but then again, you never had any questions between weeks 6 and 18 before. A nurse sends you down to the ultrasound section. You’re seen within minutes.

You receive the bad news in silence. A second sonographer confirms the diagnosis. The words bounce around your head – no heartbeat, no heartbeat, no heartbeat. You don’t have any questions because you don’t know what to ask. They release you to go back upstairs and wait. You buy a mocha. You text your mother-in-law to please drive down to be with you. She’s been in the loop since last night.

The same nurse as before brings you to her office. She is blunt, but not unkind. She asks you to explain to her what happened downstairs. This is so she knows you know the truth. You tell her. There is a fetus, but no heartbeat. The heart stopped around eight weeks. You are now eleven weeks along. She nods. She explains your next steps, your next options. Two involve waiting out the missed miscarriage, letting your body catch up with your uterus. You wonder how long this might take since your body still hasn’t figured it out, or maybe has just started the messy process. The last option is surgical. Though it involves no cutting, it does require general anesthesia. You’re handed two pamphlets about your options and then sent home. You’ve barely touched your coffee.

You remained stoic in the hospital from instinct, but this armor breaks down three-quarters of the way home. You wipe your face before turning into your driveway. Your neighbors don’t need to know yet.

Your sister calls like she usually does on her way to the gym. She is eight hours behind you. You hesitate, then pick up. You let her chat about her morning, her proposed workout, her form while lifting. When she pauses, you ask if she is ready for some bad news. She says yes. She is the first person you’ve spoken to. You’re surprised you can talk. She starts crying. You start crying. Maybe it’s a twin thing. You end the conversation on a practical note, talking about friends who’ve had miscarriages, stillbirths, pregnancy complications. You know you’re not alone. You know it’s very common. You knew this could happen, and for no reason. The first trimester is the biggest hurdle.

You read through the pamphlets. You research online. You drink your cold coffee. You’re pretty sure you know which option you want. You’re flying out to see your deployed husband in a few weeks and you want no complications on the flight there or back. You’ve already crafted an email in your head to your husband. It is not easy to write. You hit send. You write nearly the same thing to your family. You also email your work contact in Germany, countering the email you sent two days ago announcing your pregnancy. You email the medical section about what paperwork they will need. You wonder if you’ll still have to run a combat fitness test this year for the Reserves.

Your mother-in-law won’t arrive for a couple hours yet and your daughter doesn’t need to be picked up until nearly six. So, you mow the lawn.

An hour later, a call comes through the house phone. The operator asks you to wait while she connects you. Your husband’s soft voice spills over the line from four thousand miles away, “Are you alright?” You know he’s been crying. You tell him you were mowing the lawn. You tell him everything you’ve been through, that you’re not in any physical pain, that his mum is on her way. You tell him you’re pretty sure you could have a procedure as early as tomorrow. There’s no use delaying. He just wants to make sure you’re okay. You worry about him flying. You know it’s killing him not to be home with you. There’s no more to say right now. You both send your love and hang up.

You finish mowing.

Your mother-in-law arrives just as you’re scheduling an appointment for the next day. She wraps you in a bear hug and you let her know her son called. You tell her you’ve opted for the surgical option, that you’ll need to head in tomorrow morning, and she suggests her eldest daughter drive over that night to help with childcare the next day. You call your sister-in-law and she immediately says yes, she’ll be over that night. You always knew this support structure was in place, but you hoped to never need it. You pick your daughter up from nursery, put her to bed, eat dinner, and go upstairs early. You lie in bed, but you don’t sleep. Your heart is thumping ten beats too fast. You hear your sister-in-law arrive just before midnight. You listen as she and her mum talk downstairs, then go to bed. You kick the cats off you as they invade your half of the bed. You get up to pee multiple times.

Your alarm goes off at 5:30 and you hit snooze for fifteen minutes. Then, you head downstairs to make a bagel and pour orange juice. The nurse said you had to stop eating at 0600. You stumble back to bed after your quick meal. Your daughter sleeps in late, nearly past breakfast. You scramble to get her ready for nursery, then rush out with your sister-in-law since she’ll be picking her up later. You take a quick shower, pine after the toast and tea your mother-in-law is having, and drink water instead. Overnight bag packed, you and your mother-in-law get a ride to the hospital with your sister-in-law. The day is severely overcast and raining.

You head upstairs to Jasmine Ward and check in. They’re expecting you. You’re led to a private room, fill out some forms, and settle in for the wait. It’s 10:30 and the earliest you’ll be seen is in three hours. You’re told you’re the first on the emergency list, but that’s barring anything more severe coming through the emergency department this morning. You stop drinking water at eleven. It’s so you won’t choke on your own vomit while under general anesthesia.

A nurse arrives to explain that the fetal remains are handled with dignity and respect and you can choose cremation or burial. You like the idea of cremation and scattering the remains over a beautiful garden up north, but don’t like that the plot is unknown, unvisitable. The burial option is local and there will be a non-religious ceremony at some point in the future with “other little people” in the plot. You think this option is better for closure, not just for you, but for your husband, your in-laws, your parents. You can visit any time. You can even bring Beaner when she’s older. You decide.

Just past 12:30, a nurse says to change into one of those amazing, backless hospital gowns. You’re allowed to keep your socks and underwear on, plus she lets you throw your hoodie on over. The room is drafty. Your mother-in-law sends a long email to all the family explaining what is happening. The procedure is imminent. You’re ready.

An hour later, no one has come to fetch you yet. It’s about that time. A nurse appears in the doorway briefly to let you know there’s been an emergency admitted and the theatre is currently in use. You’re not surprised. Triage happens for a reason. You settle in for another wait.

Two hours later and still no word. You push the call button at your side. You ask the nurse what’s happening, and she explains that there were two more women admitted. One looks to be more severe than you. The other may be as well. She’s not sure if you’ll be seen today at all. She asks if you might want to go home and come back the next morning. You’re flexible, you explain, but would like to be seen today if possible, even if it’s late. You’re hungry and very thirsty. You just want this over. The nurse says she’ll speak to staff and see what’s happening. You’re pretty sure you won’t be seen tonight.

A half-hour later, the nurse returns with good news. Yes, there’s another woman ahead of you, but the theatre will take you next since your procedure will not last long. The emergency they admitted just before one o’clock is still on-going. Longer than expected. You understand. You’ll wait.

At five-thirty, you’re wheeled out of your room and through the maze of corridors stitching the hospital together. Your mother-in-law will finally be able to eat something in the canteen. She didn’t want to eat in front of you since you weren’t allowed. She’ll meet you in your recovery room in the general ward section of the hospital. You joke with the nurses pushing your gurney, answer the same question three times as different nurses and specialists come and go, and find yourself in the anesthesia room. You confirm your date of birth and full name one last time. You wonder if your will is actually up to date. There’s nothing to be done now. The cannular goes in and a chemical cocktail drip starts flowing. You ask what they’ve given you. By the time they answer, you’re already lightheaded.

You sleep.

Someone is saying your name. This reminds you of childhood, when your parents had to gently shake you awake, still groggy with sleep from the sandman. You’re not sure if you’re in your recovery room or somewhere else, but you don’t care. You’re clearly not dead. Your throat hurts, but you expected that. They shoved a large tube down there so you could breathe while under. It feels like the beginning of a cold. You drink the water they provide with a straw, happily sucking down the cool liquid. It’s your first drink in nine hours.

Two hours and four observation checks later, you ask the nurse if you can go home. You feel no physical pain and rejected the paracetamol they brought earlier. You’re looking forward to the spaghetti and brownies your sister-in-law made while you were gone. You don’t care that dinner will be at midnight. You walk out of the hospital in pajamas and red chucks.

As you climb into the sporty little Clio that will take you home, you notice it’s still raining.