Miscarriage and Me

Meghan Markle wrote an op ed piece in the New York Times this week about her miscarriage in January. There has been a lot of perplexing backlash.

I agree with her that miscarriage is often not talked about and carries a stigma of shame and distaste. However, miscarriage is normal and very common, and I think that we should talk about it openly and regularly in those terms.

Disclaimer & trigger warning: The more I wrote about it the more I realised how difficult and upsetting the process of miscarriage can be and how hard it might be to read about.

But women are so often treated like second class citizens, particularly in relation to their own health and reproduction, and sharing these stories is an important step in bringing about change.

This is my own personal story and it will differ from others’ stories. I thank you in advance for reading, and hope that it will make a tiny dent in the demystifying of a secretive phenomenon.

I started writing this post and realised that there is so much that isn’t said about miscarriage – not just its emotional impact, but the bare physical realities. I’d like to talk about some of those realities. I don’t think I can fit everything I want to say into one post so I’m going to write a couple.

This is where I’ll start. With my own story.

It’s important to tell my own story because everyone’s experiences of miscarriage are different. The real human relationship to pain and loss is bundled up in the context of their lives.

My story is just one tiny piece of a big puzzle. Each piece of that puzzle makes up the bigger picture, and without each piece there is a gap. I hope you will read this post and that it will be be part of making that bigger picture clearer, and will provide an insight into one couple’s experiences.

I’m going to jump forward to the third day of my first miscarriage. This was the part I had no idea was coming. I’d been to the hospital – it was Manchester Royal Infirmary – more on this later. And was sent home, advised to watch and wait and to come back if there was any pain. Nobody had said these words: “expect excruciating labour-like contractions that will make you feel like you are made of pain, where you will have no choice but to be on all fours screaming and your boyfriend will be absolutely terrified out of his mind”. Nobody said that. They didn’t even say “it could be very painful, and that’s normal”. Nope. Nobody warned me that this pain could last for 5 hours. And that the time between contractions might be as short as a minute. And that this would continue off and on for five days.

The thing I think that took me by complete surprise is the physical experience of miscarriage. I expected to feel sad. Though to be honest, I didn’t feel that sad at the time because I was so focused on getting through the bodily experience. There was a kind of unreal disconnected quality to it. I did feel really very annoyed that I didn’t know what was going to happen or if it was what should be happening. Afterwards I googled like crazy and I didn’t find much useful information. But at the time it felt like it was probably normal. It made sense to me that my body would need to expel the pregnancy in the same way that it would give birth. And I had no desire to leave the comfort of my home and to go back to the hospital where almost all the staff had been rude and dismissive and uninformative.

So, the hospital. Manchester Royal Infirmary has a shiny new building. It’s light and airy and modern and clean. Until you get into the Emergency Gynaecology Unit. Although the offices and scanning rooms are fine, the waiting area is a tiny, dingy, hot, over-crowded room lined with chairs facing into the centre. And it’s overfull with women (and sometimes their partners) in various stages of distress and discomfort. On both occasions I visited - the first for a scan to confirm that I was having a miscarriage which confirmed that there was no longer a foetal heartbeat, the second to confirm that all the “products of pregnancy” had been expelled and no further action was required, there were a lot of toddlers in the waiting room playing amongst people’s legs.

Not everyone was there because of miscarriage. And a lot of people deemed non-emergency seemed to have been waiting for some time. One young woman in a red coat, her eyes brimming with tears, sat rigid in her chair clutching her partner’s hand ‘til her knuckles were white, and flinching every time a rumbunctious two year old clattered into her.

For some reason, and I can’t remember why, I had a scan in the prenatal centre at the same hospital half-way through the miscarriage. The prenatal centre is entirely different to the emergency gynaecology unit: a big bright waiting room, and a seating configuration that allows for at least some privacy, with a lovely receptionist who offered me a private area to wait in. It felt at the time, and with hindsight, that those women who were successful procreators were treated well and respectfully, while we reproductive failures were shunted into a grubby afterthought of a back room where the receptionist rolled her eyes, and the triage nurse was abrupt and unkind.

In triage I gave an account of events, which were that less than a week before we’d been for a private scan that showed a 9 week foetus with a strong heart-beat. I’d read that if there’s a strong heart beat at 8+ weeks then the chances of successful pregnancy rises from 75-85% to 98%. So I was feeling more relaxed and confident. I had just had my first midwife appointment. It was a warm day, and after the appointment we decided to walk to get lunch. We walked about a mile in the sunshine, and at lunch I started to feel pain in my back. On the way home, I had to stop and sit down a few times because I was breathless and my back was hurting. I felt strangely weak. None of this alarmed me too much though, because the first trimester of pregnancy had floored me. Even though it was fairly early on in the pregnancy, time had seemed to have stretched out, and the experience of pregnancy was intense and consuming. I was constantly exhausted and nauseated, and there were always strange twinges and stretching pains. Walking and breathing had been a bit of a challenge anyway, so I wasn’t too concerned.

But later in the evening after my boyfriend had travelled the 50 miles back to his house I passed a large clot, and I had an unfamiliar palpitating pain. I had no doubt that this was not routine pregnancy pain. He got the train back at 7.30am the next day and we went straight to the hospital.

The miscarriage proper started later that day and continued for 5 days of intense pain. Rather foolishly, I was in the frame of mind (because of the pregnancy) that I couldn’t take painkillers, so I experienced it full force.

It wasn’t like in films where there’s blood everywhere or where someone just goes to the loo and comes out saying “oh, dear, I had a miscarriage”. Mostly I would have intense contractions for several hours and then pass large clots and pieces of tissue. Eventually, on the final day, I saw the pregnancy sack, a kind of semi-opaque grey membrane and the pain stopped soon after. I felt rather proud of my body for being very efficient and doing what it needed to do. That gave me a lot of comfort.

And so to the emotions of miscarriage. I can’t ignore the fact that this happened less than six months after my stepdaughter had died by suicide just a few weeks before her 25th birthday. I had known her and been her step-mother since she was three. It was a role that defined me. So, my emotional experiences of miscarriage have to be taken in the context of the violent and unexpected death of a child that I had known and loved into adulthood. I felt quite pragmatic about the pregnancy loss. I had never conceptualised the foetus as a child, more as the possibility of a life over which I was custodian, grower and caretaker. I was excited, but cautious. And so I didn’t feel that I had lost a baby (many people do feel this way, and it is an entirely valid response – in fact, the emotional responses to miscarriage vary enormously, in much the same way that physical experiences do). But I did feel that I had been through a significantly transformative experience both through pregnancy and miscarriage. I did think that there was something peculiarly traumatising about the experience both in relation to the physical symptoms of pregnancy and miscarriage, and the way that I felt the medical world had responded to what amounted to a significant personal crisis.

For good or ill, I tend towards a holistic view of life events, whatever they may be and I think that with any loss comes gain. So, while my first miscarriage was very testing, I do not regret that it happened. And here’s why. At 41 I had never experienced pregnancy. It is such a unique and consuming experience that I was so glad to have had the opportunity to feel it. Many of the things I thought would make me anxious didn’t – the thought of growing another being was far from the parasitic thing I thought it would be. I really did connect with the idea of the miracle of life. Cells splitting week on week to grow something that would eventually be a person walking, talking, thinking. That in itself was a gift.

The other thing that I learned was about my relationship. In the year after we met we had both experienced significant turmoil. I lost my granddad and less than a month later my stepdaughter was dead. His 31-year-old brother was diagnosed with stage 4 bowel cancer and had had half his liver removed on Christmas eve. And I was still reeling from the grief of my husband leaving me. There had been a lot to deal with so I knew that we had one another’s backs emotionally. But the miscarriage taught me that I could absolutely rely on him to be deeply compassionate and attuned in even the scariest situations. The trust between us feels like it was forged in the fires of hell. And in the midst of pain there is growth.

I don’t think that we should be looking for silver linings in painful situations. There’s something undermining about that. And sometimes all we will feel is sadness and hurt. Luckily for me, in the sadness and hurt there has also been light. However, I was aghast at the casual carelessness of some of the caring profession*. And the way that I couldn’t access basic information about what to expect.

I know that it’s not a comfortable or nice thing to hear about. But miscarriage is very common. One in four women will experience miscarriage in their lifetime. So we must and we should talk about this thing that can be utterly devastating and happens to so many of us.

*I would also point out that when I had my second miscarriage the experience was entirely different and every single one of the people at the (different) hospital were caring, kind, helpful, respectful and compassionate making the experience much less frightening and isolating, and that they actually provided much more comprehensive information.