Yellow Light: Proceed With Caution

4 September 2018

Today is one of those days where the blog title is both a figurative and literal description of events. I am well aware that my openness about this topic will likely raise eyebrows and possibly unleash a load of derision and judgement, however it is also the state of my own mind. A topic which I question even being able to pull apart in my head; whether I am right to give it any attention at all. So here we are, pulling gently into the intersection of ideas and feelings, proceeding with caution.

May it be said at the outset that I am not writing this in the pursuit of sympathy. It is my intention to break down the barriers which prevent people from feeling free to speak about these so-called taboo subjects and leave them suffering with the burden of the “unsaid”.

I have talked in depth about miscarriage in past posts, documenting our painful experience in the aftermath of the initial scan in 2015. Three years since the loss of that pregnancy came and went in June this year, that tugging feeling of absence well and truly in place, despite the health and vigour of our now two-year-old son.

What I did not expect to be doing now was unpacking a subject even more taboo than miscarriage, and that’s the awkwardly named “chemical pregnancy”. I have struggled to talk about this at all, dragging along a barge-load of emotions the last few weeks, until deciding that I should do what I do best. Write about it and get the clutter out of my mind, working through it with words on the page instead of performing the endless mental obstacle course.

Chemical Pregnancy. What is it?

A chemical pregnancy is described as one which results in an early loss, prior to five to six weeks. From six weeks, when a gestational/yolk sac is visible on ultrasound, the official diagnosis of loss becomes early-stage miscarriage.

Despite common misconceptions, a chemical pregnancy is still a true pregnancy. Implantation has taken place: without it, there cannot be a detection of the hCG hormone which provides the result on your home test.

After a painful six months, battling the barricades of the NHS and waiting lists up the wazoo to have a scan-guided removal of my IUS because of the unacknowledged cock-up of a GP with its insertion, I was finally able to embark upon the terrifying journey of whether we could give our son a sibling.

Broadly glossing over the finer details, we conceived with eye-watering speed, something I genuinely had not anticipated, even given the rapid conception of the pregnancy which resulted in our loss, and indeed that which followed and was successful.

I was always incredibly sceptical of women who maintained they knew they were pregnant before taking the test.

I openly consume a crate of Humble Pie.

In the week preceding testing, I began experiencing symptoms. I wholly attribute the comprehension of these to the fact that I have had them with my two prior pregnancies, granted not this early. However it is commonly said that you become acutely more aware of your body’s progression in each pregnancy you experience, so perhaps this was why. I woke nauseated and lack lustre every morning for nine days. Each night, without fail, I fell victim to extremely vivid nightmares of a violent nature, something I struggled with every night with one or two exceptions for my 36 week gestation previously. It was safe to say I suspected something was up, even if I was dumbfounded and taken aback that it was even possible.

Being amenorrheic  with the Mirena in place, I had no clue as to the current calendar structure of my menstrual cycle. As the amenorrhea meant I could live pain free, and carefree on a reproductive level, it wasn’t something I needed to consider, until of course you wish to expand your family. I researched the detection and interpretation of Cervical Mucus in my previous efforts to fall pregnant, wanting to avoid temping and minutely charting, and as such I had a good idea of the fact that I could indeed have fallen pregnant and when to roughly test for it.

And this is where things fell apart.

My faint positive. The growing incredulity of it all. The “take a step back and wait a couple of days to see if things intensify” resolve. My confusion when its opaqueness only reduced, before disappearing entirely.

Now. I was the first to question a faulty test. Or tests.

I was the first to consider a false positive. False positives. I had someone else look at the test, to make sure I hadn’t imagined it.

Then slowly, after a week, things began to fall into place.

My amenorrheic status meant I had insufficient lining for any pregnancy to be successful. It had all just happened so fast.

Immediately I began to blame myself. I tested too frigging early. It was my fault. If I had waited a few more days, I would never have got those faint positives. I rushed too eagerly into it.

It was nothing. A loss without being a loss. Hardly even a pregnancy to consider, because there wasn’t time to sneeze at it.

Subsequently I have realised that I poured upon myself the judgements so many other sufferers of chemical pregnancies have experienced: that the “loss” is trivial and nothing more than a delayed period. That actual miscarriages are inherently more meaningful.

As a miscarriage sufferer, I couldn’t begin to compare our loss with this. And yet, it was still undeniably a loss. Even without the tests, I knew instinctively what was going on. I would always have suspected. The argument raged in my head between allowing myself to feel disappointed and glum, and beating myself violently over the cerebral cortex for being such a dickhead in feeling anything at all. Not to mention blaming myself for my own ridiculous impatience in not waiting longer. It was my fault. I was upset over my poor judgement call.

Upset. As if you can be upset so early on.

But you can. Pregnancy tests are sometimes unbelievably sensitive, upon which we can pin the early loss disappointment of so many women.

Should it be their fault?

In the 1980s, my mother had to miss two periods before the doctor would test for pregnancy. With me, she was told when she was 9 weeks pregnant. In complete contrast, 9 weeks in Scotland is your midwife booking appointment. A lot of us know of conception at 4 weeks, bang on the dot of a missed period.

Are we at fault for our impatience?

The tests are what they are. They are readily available, and in the case of my local Big 4 supermarket, a box of two costs merely £3.55 and have never failed me. When you suspect a pregnancy, or are actively trying for one, and tests are like sliced bread in their accessibility, it is obtuse to expect women to wait.

Yet we now face an increasing percentage of women who are acutely aware of very early and early stage pregnancy loss. With that comes the inevitable emotional load.

Sure, I am glum. I feel weird. I’m still angry with myself. I know what happened, and while I am not fixating upon it, I have to acknowledge that it sucks.

But what about all those other women who are experiencing chemical pregnancies in the quest for their first child? The women and their partners who may be struggling through the emotional journey of IVF and continue to have these so-called chemical pregnancies, where by and large the medical community disregard them because of their timely “insignificance” on a gestational scale…

Before now, I shamefully admit that I didn’t see how it could be the same as being told at 11 weeks that your pregnancy had ended.

I was ignorant and selfish in classifying one as worse than another.

Loss is highly subjective. Any positive test hits the switch on the neon-lit rollercoaster “Land of What If”.

I remain positive that our situation will result in the outcome we would like to see. Of course I do. Or I try to, when I’m not busy remonstrating with my body for being so utterly stupid (even my successful pregnancy was ridiculously complicated and not without emotional turmoil and significant concern). Is my son enough if fate determines it so? Of course. He is my world.

However, not everybody is so fortunate as to have another child to focus his or her attentions on.

Grief is an entity abundantly individualised and unable to be neatly classified.
Nobody can truly know how deeply someone’s circumstances can impact on these very early losses, these “chemical pregnancies”.

Let us hold out our arms to anybody who is suffering loss, for it is wrong to box each other into categories of when it is acceptable to feel sad.

Sadness is as sadness does.
It is there.
Be there whilst it is.
It can only help.

Stay afloat - hands will find you
Photo by Alex Blăjan on Unsplash

Spinning Tires

Monday, 20 March 2017

There's a lot to be said for the cloud which still lingers over mental health, not just here in the UK or back at home in Australia. Sometimes I don't even see it as lingering, but more smothering to the point that a lot of people shun the idea, run away from it, or even bury and hide it. And that's just the people who are suffering...

Media campaigns fight to unshackle the stigma, and get people talking. Posters adorn GP clinic walls. Badges are on bags and lapels. Pamphlets are stuffed into holders.

And yet, here we are. Even with all the info, and a pamphlet in the back of my baby's Red Book, I still remained oblivious to the fact that what I could be driving a hard bargain with every day is another branch of the Black Dog. (Trip Advisor: 2* - mattress is pretty good, but disappointing interiors and a questionable breakfast buffet. Left me mind weary.)

I'm still a bit unconvinced that Postnatal Depression (PND) is definitively my issue, and wonder whether it's not just rough around the edges everyday depression with some generalised anxiety piped on for good measure.

Although in actual fact, I think the reason for thinking that is perhaps one of the reasons why ladies who very much are in the throes of PND don't realise that they are. Every celebrity sufferer video says they struggled to bond with their baby.

I found it a little less natural to start, as he was taken away to the NICU for antibiotics, oxygen therapy and phototherapy for three days, at 8 hours old. So by the time he came back down to me, I'd had only a few short holds because of all the wires and monitors, and only had the initial efforts of breastfeeding colostrum after birth, plus over the first hours where I was lucky if he'd taken 1-2ml total through his exhaustion, and then once on the evening of Day 1 (birth day is Day 0 here - maybe it's everywhere but took me by surprise. God knows why). He had to show he could take a bottle of expressed milk twice before they would discharge him (despite my want to breastfeed) to my ward, and when I'd fallen asleep that night with exhaustion after nearly 4 days of minimal sleep and hadn't had time to express I panicked. I didn't know what to do. He had to feed or they'd take him away from me again. Luckily a lovely breastfeeding specialist was doing his vitals in the humidicrib in my room, and she supported me throughout. But I still felt this poorly little bundle, with all his heel pricks and phototherapy masks, wasn't really mine.

NICU phototherapy - 15 hours old
That didn't mean I didn't love him. I did, passionately and with a protective lioness verve I wasn't expecting. I just wasn't sure that I knew what to do.

So when the predominant vein of identifying PND seems to be lack of baby bond/seeing them and feeling nothing/repulsion, I talked myself out of it. I mean, you get baby blues. I had them, at Day 4. They were hideous. Milk had come in PM Day 2/Day 3 (thank you waters breaking, though medical not supposed to, for kickstarting hormones despite my Caesarean). But on Day 4 I cried at everything. Breathing seemed to induce sniffles. Choosing food off the menu (in fairness, I was so fed up with this menu after over 2 weeks of eating from it before birth anyway) had me welling up with the weight of making a choice. You can imagine how I felt then when they took my little boy away for his bilirubin heel prick, and came back to tell me he needed yet more phototherapy.

I disolved, akin to one of those pathetic Home and Away scenes when the ditzy character collapses to their knees on the beach and wails to the ears of the overtly blue sky. I was convinced I had hurt him through my breastfeeding, as his levels had plummeted to a safe zone at 6am but were sky high again by 4pm. I'm still embarrassed at how much I cried, having thought he was doing so much better. But a ginger walk (looking at you, abdominal surgery) across my (mercifully) private room to look at his wee frame in his regular hospital crib delivered me a bubba with a skin tone more akin to an extras role on TOWIE than a newborn. Serious orange spray tan issues. The guilt was palpable.

My incredible midwife Ann, on the day shift, was initially very worried until she asked how many days post I was. But at the same time, was absolutely the only midwife I had between Tuesday morning of his birth and my discharge on the Sunday night (she stayed late to make sure my paperwork was complete and to see me go, the absolute champion) who took any notice of my mental health history, and my perinatal psych review.

Blaming baby blues and adjustment to motherhood was an easy out. The perinatal review indicated that I was again a high risk of PND because of my mental health history (WOO depression!) and my genetic predication to it (karma for causing it to my mother?). But the lovely psychiatrist also said that my feelings at that time were perfectly reasonable, given the isolation I was feeling without family, my being unable to work and the financial ramifications of such a situation, and the complications and unknown situation of the pregnancy itself, plus emotional baggage from the missed miscarriage. For the most part, I had to battle to get an appointment to even get a Caesarean surgery scheduled - and despite every request, was never ever seen by my assigned obstetrician. Nobody seemed willing to make any decisions, and so I spent a lot of time sitting at home on couch rest, waiting for bleeds, never knowing what the hell would happen next.

By the time we got home, Master C had lost a solid 9% of his birth weight, dropping down to 6lb 9oz from 7lb 4oz. I will, since doing some reading on the Australian Breastfeeding Association website, stoutly argue that a degree of his birthweight was due to my IV lines immediately before his birth, as their research suggests that otherwise healthy babies (granted born to term, but still) whose mothers are subjected to IV lines before birth have the fluid cross the maternal/infant barrier and artificially inflate their birthweight. I would argue this more so, given how quickly after birth he soaked my midwife in wee. 5 minutes post birth is a pretty impressive urine display, when it goes through the towel in which he is wrapped, and right through her scrubs. Mel, I am so sorry.

While his weight was borderline for discharge, and his jaundice was still visible, the first midwife who came to see me the day after we got home wasn't worried. She was super chilled. The next one was so beastly careless about me, at nearly 5pm on a Friday whilst herself pregnant, that she bullied me into submission because he was gaining weight so slowly. She threatened me with being admitted to hospital again if I didn't feed him better and his weight didn't come up.

Jaundice Central - 6 days old
And that was the beginning of the end.

What I otherwise think would have been a natural experience of blues, rough days, guilt, confusion, genuine WTF am I doing moments, and OMG WHAT IF I KILL HIM flashes, instead became one huge guilt trip.

He didn't regain birth weight until 3 weeks old. He was an incredibly slow weight gain baby. I was belittled by a GP at his 6 week check, who said that he was "failure to thrive" despite the NHS no longer using this term to describe a baby who only ticks the box for slow weight gain. She told me that an appropriately breastfed baby would gain an appropriate amount of weight, and he wasn't. It was as close to telling me I was starving him, without committing to it.

His weight was still painfully slow. Some fortnights he chucked on a burgeoning number, for him anyway, and other weeks he was gaining roughly 10-15g in a seven day period.

Every Health Visitor I was seeing at the Baby Clinic for weighing, for about 5 months, told me that I should be topping him up with formula. The fact that I had paid out the cost of a National Childbirth Trust breastfeeding specialist home visit not once, but twice, to check out my feeding (with absolutely no issues found) meant nothing. They dissed me and said he wasn't gaining enough and would be suffering. I was never offered any support. Just told formula, and come back in a week.

I had my home visit HV talk me through a paediatric referral, and she got me into my GP with a degree of speed to be seen. Yet again he was described in the official referral as Failure to Thrive. We were also referred to the Evelina Children's Hospital for a heart check, as a murmur was found.

Mercifully, after 8 weeks of waiting, the heart check showed the murmur to be innocent and no threat to his health and wellbeing, or his weight. The paediatrician couldn't find anything wrong with him, other than slow weight gain, although in his first presentation he gained the largest amount of weight in a short time frame ever. He then reverted to his meandering efforts. Eventually full bloods were ordered, to check all his vital organs, and we were additionally referred to the paediatric dietician.

Bloods came back clear - only ever so slight indications that he might not be getting enough calories, but absolutely no sign of it in his developmental progress. Queries were raised as to whether his own genetics (slim parents and families) and heightened activity level on stuff all daytime sleep could be do to with this. By this time, the dietician said it was possible. But to every question I asked, her answer was high calorie formula. She said I would need to do accelerated weaning. I asked how. She gave me no answer. I said how do I feed a demand fed baby formula when he feeds until he is full? She said, you do.

So really, with all the stress over his weight issues... The constant battle to prove myself worthy as a feeding agent... The intensifying pressure of being a failure because no amount of feeding (or looooong couch and boob/skin-to-skin sessions) were making any difference...

Is what I'm feeling PND?

Let's not delve into the greater darkness of how I feel about myself right now. Let's save that one. This epistle is long enough.

I took myself off to the GP and finally raised the question 20 days ago. She didn't give me the form to fill out to identify whether I was a mess. She offered drugs, I declined. She said she was happy to refer me for counselling, and that it would be 7-10 days for a call. She let me say that I suspected it was PND but never offered an opinion. She then sent me home to wait, without any literature or support suggestions, because I had no suicidal ideations.

Is this what it takes, still? For anyone to offer you any "in the meantime" support, or even a pamphlet, you need to want to off yourself? I thought it was shit enough when I was discharged from my miscarriage surgery without any advice on where to turn for support if I needed it.

Today I received a text message, 20 days after the fact, to say my referral had been received and to call and make an appointment. 7-10 days my fat backside.

I'll go. I should make that next step, if for nothing else than to get an actual diagnosis.

And hopefully, with a few sessions of someone kicking me up the arse about how much I think I'm a worthless sack of crap, and useless as a parent, a scourge on society, a dismal entity that people befriend out of sheer pity, and to blame for everything that went wrong with either of my babies (even though I am well aware that the latter is complete trollop, but you try telling the emotional centre of my brain that), and with some self-evaluation and deeper research into what and why PND is/occurs, I'll be less of an Eeyore. A monochrome Eeyore.

Just a little splash of colour would be a nice start.

Breaking New Territory

Sunday, 12 March 2017

It's been quite the time between writings. Much has happened. Many maps have been traversed, pages turned, dog eared, smeared, pencil markings in the margins, chapters closed, and new ones begun.

Even now, approaching two years on from the miscarriage, there are still days where it hurts. It's fresh again, and weeping around the edges. It traverses each cycle of the moon behind my eyelids, in that darkened space, healing but never forgetting.

In September 2015 we were blessed with a second positive pregnancy test. We didn't dare to hope too hard. After being lulled into a false sense of security by all the symptoms the first time, it was impossible to relax. Every twinge, every tug, every wave of nausea on my morning bus trip, every painful ligament stretch could mean everything or nothing. I obsessively checked for blood, and yet was still afraid to breathe when nothing appeared.

We had gone in for a reassurance scan at 7+6 weeks to make sure everything was on the right track, and saw the little flutter of a heartbeat. On November 9, at 12 weeks, we saw our baby for the very first time, rocking and rolling and pumping along to the beat of its own drum already, refusing to hold still for the technicians. It was healthy, and full of beans, and so Jelly Bean was formally announced to the world!

Of course in typical Amanda fashion, nothing stayed simple. After beginning to bleed at 20 weeks, and being sent home to wait it out, our anomaly scan diagnosed the relatively common condition of placenta praevia. But to complicate things further, the specialist who was brought in to check me out also diagnosed me as having a rare bilobata placenta  - or double placenta. The two lobes were connected with foetal vessels which were also in a dangerously low position, known as vasa praevia. This rarer condition, undiagnosed or with an unexpected rupture, can be fatal to the foetus.

With the greatest of mercies, the anterior placental lobe continued to pull itself higher up the uterus wall and by 28 weeks the foetal vessels were regarded as safe and out of danger. This wasn't before I had already spent a period of time as an inpatient because of repetitive placental bleeds. I became very well acquainted with the Labour and Antenatal Wards of King's College Hospital. I did consider change of address cards.

By Easter 2016, I was admitted for the fourth time. I had bleeds for which I did not present to the doctors, but this was my seventh recorded bleeding episode. Things began to get serious, and I was administered with the steroid injections required to encourage and support Jelly Bean's lung development. We already knew I wouldn't go past 37 weeks, but there was concern it might not get that far. However I couldn't submit to the recommendation to be hospitalised for a further five weeks until my planned delivery, and signed myself out on Easter Sunday, desperate for my own bed and a hot cross bun.

Were we to have been living any further away from the hospital, or had I had another episode of any magnitude, I would have stayed. I had already proved the medical anomaly by possessing this double placenta, and by having the bleeding episodes so early. Nobody had expected them before 28-30 weeks, by which time I had already spent a bit over an accumulative fortnight in hospital under observation. It now appeared that when the bleeding episodes would usually start, mine were coming to a close.

On Anzac Day, four days out from my booked caesarean delivery (there is no option other than a surgical birth for major and complete placenta praevia) and after getting up at 3:30am for the dawn service at Hyde Park Corner, I could be found shifting the dining table, obsessively scrubbing windows, and standing on a dining chair, vacuuming cobwebs only I could see from the cornices of our 9ft high ceilings. The dull ache in my lower back, and upset stomach, I had been feeling for a few days still hadn't passed, and I chalked it up to stress and nerves.

At 5am the following morning, I woke from a dream of avalanches (in fairness I had been watching the Everest documentary before bed, whilst cleaning) and immediately knew I was bleeding. One gets quite good with the instinct of a bleed after a while. I also knew this was different. The bleeding was far more significant than in the past, and it wasn't showing signs of abating. I wasn't prepared for this, having convinced myself that since I had been bleed-free for nearly a month, Jelly Bean was good and safe and waiting for Friday. Jelly Bean was clearly not on the same page of my playbook. Damn it, this was supposed to be my "visit old workplace and gorge on cake whilst waddling like a fat penguin and having people laugh at me" day!

With no hospital bag ready, and baby supplies arriving by Amazon order that day, I followed my registrar's strict instructions and called for an ambulance. With only two hours sleep, I woke my poor zombified husband, threw a phone charger and whatever few bits I could locate into a bag, packed my hospital notes and sat on the floor in shock. My back was still aching, but I assumed this was stress. Still.

The paramedics arrived, called ahead, and bundled me up. After a stretcher ride through A&E and the back entrance into the Jubilee Building, and a run-in with the labour ward reception staff ("Why do you THINK she's here?" -- the paramedic left for his next job, still raging about the idiots in the world), I was pushed into a delivery room to await my fate. Stuck with needles, veins pierced and burst, and cotton wool pads adorning my arm, I was eventually cannulated and hooked up to the foetal monitor. The bleed had stopped, and an apple sized clot (which hurt like a bitch) was removed. The duty registrar told me they would prep me for delivery, just in case, and continue monitoring.

At 7:15am, with the onset of mild contractions, my waters broke. This isn't supposed to happen with placenta praevia. The midwife informed the senior surgeon, who in turn insisted it wasn't supposed to happen. Jelly Bean was well and truly done with being jammed transverse under my ribs. The senior anaesthetist came to visit; the senior surgeon did a preparatory scan and discovered my two placentas; and shit got real. Turns out, lower back pain and an upset stomach was the indication of baby ready to appear.

Senior staff were everywhere. I could have swung a cat and netted enough for an auction. It was the start of the Junior Doctor strike, which we thought we'd miss. I couldn't have had better care. Or more support for the Juniors on the picket lines. Long live the NHS! Down with Jeremy Hunt!

At 8:15am, in the operating theatre with Absolute 80s playing away on the radio and the sun pouring in through the window, I was administered my epidural. I worked out shortly after not to look up whilst on the table, or you can see everything they do reflected in the lights. Shit got realer still and they stuck the catheter in. Epidurals might kill the pain but they also make you feel really weird. And sick. Being numb from the boobs down is not a normal, every day, popping to the supermarket for a pint of milk experience.

At 8:46am, after the pre-emptive warning of even more shit about to be getting super real from my anaesthetist, our son was born. Feet first. Then bum. No mistaking the appendages. A little help from the forceps to remove his (hopefully intelligent) head from where it was stubbornly stuck.

I knew it had been a boy. I just knew. Too many external stimuli of his father's preference had resulted from in-womb responses. Blur. Idlewild. Horse racing. Football. And to make his daddy proud, after he was brought to me by the midwife whilst I was being closed up (another way to feel ill, whilst things are shoved back to where they should be, and you feel motion sick but are genuinely frozen to a table -- thank you anaesthetist for your miracle drugs), he let go an almighty wee. Soaked his towel. Soaked my midwife. A sign of the power of the wee to come.

April 2015 was a moment of mind-numbing excitement when the second line appeared. June 2016 was a rending of all the maybes and a shattering of the possibles. September 2016 brought hope.

April 2016, born nearly 4 weeks early at 36+3 weeks, our little rainbow baby entered the world.

There is much to say since that day. It hasn't been easy. Medical concerns. Guilt. Newly diagnosed PND. Adventures. Wee. So much wee. My god, the wee. And the milestones too.

Mum life is hard. Dad life seems a little less hard sometimes. It's confusing. Conflicting. Distressing. Disturbing. Wet. Mucky. Sleepless. Worrying. Rewarding.

After all the screw ups, I managed to at least get this bit right. I like to think that our angel baby made sure we'd be kept on our toes with this one. And I like to think that we've started the next generation out pretty well.

There will never be a day go by where our angel baby isn't part of our lives. But even in the most difficult times, when you're sitting in a corner rocking back and forth and chewing your hair, wondering how something so small can make so many demands and never be satisfied, I realise I wouldn't go back and change where we've come from. Without our loss, we wouldn't be here. We wouldn't have our Jelly Bean in the flesh.

Troublemaker. Phone stealer. Flirt machine. Heartbreaker.

Master Christopher -- 26 April 2016.

Halfway up the hill, and ten steps backward

Tuesday, 18 August 2015

Every day, at some given point, sometimes multiple times, I react to no longer being pregnant.

I know precisely, without calculating, that my miscarriage began 11 weeks ago this Thursday. I know, exactly, that I would be 22 weeks by now, able to discover our baby's gender if we had elected the option.

I know my womb is empty every time I can order a glass of wine. I know my womb is a barren wasteland every time I don't have to consider the food in front of me.

I know that I hate this. With a passion. A passion unbecoming the person I used to be before.


What I wouldn't give for before.

I rarely talk about my experience, or my grief, any more, not even with my husband.  I know he hurts. I know that he finds some days more testing than others. I know he doesn't want to hurt me by showing his pain. I know he misses our little dot, and can't help but think about what would have been. But I don't want to bring down his efforts to move on, and show him how teetering on the edge of holding it together I really am. I'm all twine and staples inside, buckling and twisting, straining the meagre restraint they have managed to maintain on my emotions.

Mostly though, it's because there are few people who have the interest to stop and listen, and give me the ear I desperately seek. Not every day, just the few days when I'm deep inside the dank, slimy well of heartache and all around you are those slick stones that give you no purchase to haul yourself out.

On those few occasions where I've risked it, the responses are difficult to hear.

"Just relax. It'll happen one day. Stop pressuring yourself."

"You've got age on your side."

"Think yourself lucky you got pregnant the first time so quickly. Others take a year to even get the first go."

"It was early on, so really it was for the best. You didn't have enough time to get that attached."

"If you keep dwelling on it, you'll never get over it. Just let it go."

"But what do you mean, it still hurts? You're over it, surely? You act so normal."

Yes. My online presence is normal. I don't mention it. Just that once, where I stupidly tried watching One Born Every Minute and the little boy was born way premature and didn't make it.

I have to be normal online. Nobody wants to know that you're drowning, unless it happens to be when you're actually drowning initially. Preferably in a ball pit, because hey, there's comic value there.

I have to try to be normal every day, or I won't get out of bed. Or leave the house. I picked up my life and kept on going, as soon as I could stand it, because I have responsibilities.

It in no way makes me normal.

I could explain my response to every comment that I quoted above. If you're reading this, I doubt I need to. I expect my feelings are pretty apparent.

However: Let it go? This isn't a bloody Frozen narrative. What to the scientific and medical communities were categorically just "a bundle of cells" was my heart's desire. My dream. My baby. Our baby. I can't let it go. Just like you can't forget that you once had a limb where now there is a stump.

My body took a new life within it and wanted to nurture it. My body changed, developed, grew. That life just wasn't capable of making it. Or maybe my body wasn't capable of sustaining it.

I had nearly 12 weeks to be attached. Every time I bubbled with nausea, I was attached. Every time I had to talk myself through each step of my morning, to ensure I left the house in shoes and not my pyjamas, I was attached. Every time I rested my hand on my belly, or thought of the day to come, or a name, or a dream for the future, I was bloody attached.

I pretend to be completely fine when the café I'm in fills up with newborns, infants and toddlers.

I pretend I'm coping when suddenly my train carriage fills with pregnant women, prams, and pregnant women with prams.

I pretend that I am full of joy, with no pain, when yet another person in my life (online or in person) announces that they're pregnant. Or gives updates and ultrasounds. Or both.

Why? Because the last thing I need is to be labelled a bitch.

A bitch for not being happy for someone else. A bitch for not just getting over it. A bitch for being in despair that I was pregnant and now I'm not, and all I want is to be a mother and bear a child for my husband, a grandchild for our parents.

Sure, the pain will dull with time. It has, it does, but some days just plain suck. You slip into a puddle, and then before you know it, the bottom has dropped out of the earth, and there you are, huddled on the mossy cobbles at the bottom of that well or perhaps fighting to keep your head out of the stagnant water.

It is impossible to be perfectly normal every day. Christ, it's impossible to be normal every day, let alone perfect.

I am not normal. I am not okay. Not yet. Not yesterday, not today, probably not tomorrow.

My heart carries the weight of loss.

On the day when the universe blesses us with a new pregnancy, it still will. If we get our rainbow baby, it still will.

There will never be a day, for the rest of my life, where our baby didn't make it and it isn't still sad.

I will never be your definition of normal again. I will always have lost our child. But eventually, I won't need to go over it again and again, and feel the rawness of it all.

Until then, for me, and for every other couple suffering the effects of a miscarriage, please stop.

Stop and pause for just a second.

We are not unusual. We are not rare. We are not alone.

There are millions of us. Millions of women whose wombs are empty. Millions of men whose hearts are full of sadness. Millions of couples who sometimes just have to sit together, holding each other, and remember that there is something, someone, missing. It hurts.

It really bloody hurts.

And it should. It does. It will.

There is no "lucky" in the loss of a pregnancy.

I am not crazy. We are not crazy. Not even that couple across the hallway, and down a few doors, is crazy: irrespective of age, race, creed, sexual or political persuasion.

We are probably not "normal" or even "okay", even if we insist we are. Even if we demand that we ought to be. Not just yet.

But we don't have the plague. We cannot pass our misfortune onto other pregnant women, or women trying to get pregnant. We have feelings, and a lot of them. And I, at least, was incredibly attached.

Every day that I get up, I strive to be normal and not remember what was.

Every day, at some given point, sometimes multiple times, I react to no longer being pregnant.

The Crossroad and the Aftermath

Thursday, 18 June 2015

Disclaimer: This blog post may contain description which could be graphic or distressing to readers.

In the last two weeks I feel it's safe to say that my husband and I have encountered a number of crossroads whilst trying to overcome the miscarriage obstacle...

Which direction do you choose to take in conversation?

Which way do you respond at the rescan? Which choice do you make if they ask whether you want to see the ultrasound screen?

Which choice do you make when given the "management" options?

Which face do you pin on? At home? In hospital? In public? To friends? To family?

Even harder, which face, if any face, do you pin on for each other?

At the first sign of bleeding, at 2:50am on Thursday the 4th, I called my midwife service and was recommended to attend the A&E at my local hospital. Unfortunately, all they could do was have me checked over externally by an ED doctor and be referred to the Early Pregnancy Unit, as no internal ultrasound equipment is available outside of their clinic and they are only open Monday to Friday 9-5. Ever grateful for living right by the bus which runs 24 hours, right past the hospital, we were able to get in and back without fuss, and returned to the unit a couple of hours later. A&E can only generate paperwork, despite their claim of making you an "appointment", and so at 14th in line, and still bleeding, we waited 2 hours to be seen by a doctor.

After all the awfulness that came with being told by the gynae doctor, and then the consultant, that there was no heartbeat, and being comforted by the attending nurse as I broke down, we were told that because it was my first pregnancy, I would have to return in seven days time for a rescan in order to confirm that the pregnancy was no longer viable.

We left the clinic with nothing but our shattered selves.

With only a week until our nuchal dating scan had been due, not even the knowledge of the commonality of miscarriage could have prepared us for that moment, or the days which followed.

We had nothing to go on, no literature to refer to from the hospital: just the instruction that if the bleeding intensified to a particular level or I began experiencing high levels of pain, then we should return to A&E. Otherwise, we must wait.

But we couldn't wait. How could we? We knew that with the report stating the embryo was undersized and no heartbeat was detectable, along with the seriousness of all the faces in the room and free flowing sympathy of the attending nurse, our dream had reached, for this journey, the impassable. There was absolutely no error in my dates; even the doctor had said as much to the consultant. Perhaps in the back of my mind was that tiny sliver of hope that I had got something wrong, that the next week we would hear the miracle heartbeat start... but honestly that's probably optimism smeared in broad brushstrokes to reduce the memory of crushing despair. It was over. There was nothing to hope for.

As I called home to my Mum in Australia, on the bus back to our flat, and relayed the news, I felt the air slowly escaping me. With every few yards we covered between the hospital in Denmark Hill and our home in Forest Hill, I became more and more like a discarded balloon: one of those you try in vain to inflate, but the bastard just won't get past a certain point and so you let it deflate and chuck it to the side in arrogant defeat. Our baby was gone. Our baby was gone, and there was nothing I could do.

The next week passed with a quagmire of emotion, of disbelief, distress, disappointment, devastation, depression... Of painful, flowing tears... Of completely raw, stinging, open wounds... Of utter numbness. To call it a roller coaster is a pitiful metaphor, and yet all too appropriate. It's one of those blind ones, where you've heard there are unexpected twists and turns, and inversions, but until you're strapped into it with no chance of getting off until an external force applies the brakes, you are at the mercy of someone else's creation. You cannot script it. You cannot adjust it. You can predict it, but even then you can be upside down and back up before you realise what just happened.

Writing the first post on this new blog helped me extract some of the swirling thoughts from my mind, but instead into the vacancy washed hour after hour of confusion, grief, loss, and agony.

The day before the rescan, while my husband attempted his first day back at work, I looked up the management options available to me to deal with the miscarriage, thanks to the Miscarriage Association, and read some recounts of experiences from other women. I managed to successfully terrify myself. I had been stop/start bleeding for six days, still without any pain, and with no indication that the miscarriage was advancing. Physically I needed it to be over so I could regain control of my body - emotionally, it had to end. I could no longer handle waking from another "sleep" filled with nightmares, only to find my body had ceased bleeding during the night and was again waiting to screw with me in my waking hours.

I had three options: Natural, Medical or Surgical. All come with positives and negatives. The Natural course is exactly that, waiting for the body to naturally pass the tissue or to reabsorb what remains and pass it during the next menstrual cycle. Medical Management involves taking tablets or using pessaries to cause the uterus to contract and push out the tissue, akin to labour. Surgical Management is with local or general anaesthetic and, slightly unlike the D&C procedure, involves a vacuum evacuation of all the tissue. The stories of people electing Medical Management caused my terror, with their contracting pain and large clots, of passing the gestational sac and contents into the world and being able to see their miniature baby. I shut down. I couldn't be alone at home, waiting for this.

Forty-five minutes before the Unit opened for walk-in appointments the next day, we were still 5th in line to be seen. An hour later, with a different doctor, I had to retell my initial problem and the details of the past week. I had tried so hard to hold it together all this time, but now faced with the stirrups and instruments, I felt my composure start to crumple and fall away. I declined her offer to wait until I was "less emotional", and let it start. My husband held my hand, and together we waited for the news we already knew was coming.

...Just keep breathing...

She explained the findings and then, much to my distress, she turned the screen around to show us what she was talking about. In that alien image, supposedly belonging to my insides, sat everything we had lost. In all its smallness. In all its departure. The consultant came to confirm. My feet still in the stirrups, the doctor explained the three management procedures. She said that the Natural option could take up to another six weeks before actually producing results. I was already vehemently against the Medical option. Both had no guarantee of not requiring the surgical option anyway. I elected Surgical - I wanted it over. For both of us. For all of us.

The following day I travelled alone to King's College Hospital for the surgery. Day Surgery doesn't permit companions due to the limited space, and it seemed pointless to drag my husband down to drop me off at reception and then go home and wait to return and collect me. I felt overwhelmed by "irrational" emotions. I knew there was nothing I could do to save the baby - while the doctor could estimate the week it stopped growing, there was no way to tell just how much longer it had held on, or whether it ever had a heartbeat at all. I knew it needed to be removed for the health of my body and mind. But all of a sudden I was fiercely protective: the only thing I had managed to do was hold on to it for as long as possible, for nearly 13 weeks now, and keep it safe. Now I was hours away from it being suctioned from my body and destroyed. I didn't want them to take it away from me. I wanted to keep it safe from harm forever.

In reception, not even Bargain Hunt on the television could save me. Silent tears rolled, much to my shame, and dripped at their own will. A woman on the next block of seats moved to sit beside me. She asked if I would like the company, as she figured we were all waiting for pretty much the same thing. She was called in soon after, but that moment of kindness from a perfect stranger had helped dim the darkness. A little later, I was called forward with another woman. Her friend asked questions about picking her up and how long things would take... I watched the woman start drooping as the seconds passed. First the corners of her eyes, her mouth, then her shoulders slumped and she started quivering. As we were walked through the door to the wing, I heard myself say to her that if we were close to each other on the ward, I would keep her company if she liked. She turned to look at me, and whispered thank you, before her tears started to flow. Strengthened by the kindness shown to me in reception, I reached out and took her hand and she grasped it tightly. My own tears started to fall again but now, in those few moments as we walked towards our fate, neither of us were alone.

The hours on the ward passed in a slurry of the same questions, signing consent forms, vaguely reading the free newspaper, being measured for stockings, and waiting inside my little blue curtain cubicle, cut off from the world. I was walked into theatre, mercifully blind from having no lenses in, and as I lay on the gurney and saw the smears and blurs of the room being assembled, the tears just trickled free. The anaethetist injected a relaxant into my cannula and soon everything slipped away...

The aftermath of surgery was fuss-free, although the cramping whilst still on the ward was unbearable without more pain relief. The surgeon was pleased that all went well without complication. She talked me through trying again soon, so that it would try to stop my depression surging up and paralysing me with the fear of ever trying again, and also so that if I were one who miscarried again, they would be able to see if there was a genetic problem or reason for it, sooner rather than later.

I am now physically through the ordeal, nearly a week later. Some bleeding is still expected, but it is now manageable. Psychologically and emotionally however...

It has been hard to explain the process to people without any experience of it. People have assumed that when you say you've miscarried, everything is over in that moment. Confusion has been painted on faces in trying to comprehend why I had to wait a week for a confirmation, and then my procedure. "But surely it was over when you started the bleeding..?"

I am trying incredibly hard to let it all go, and leave it behind me. I feel compelled to attach a brave face before being around people I know, afraid to cry or express true emotion in case they don't know how to handle it. At home, around my husband, I also try and leave the mask in place... I want to save him from my grief, while he copes with his own. I don't want him to worry - I want him to find his "normal" again and be okay in this world without our baby. I know he wants me to be open and honest and not push him away. I am afraid to take off this mask, for fear of what lies beneath it. I feel as if the holes I have drilled into my face, to hold it on, are slowly tearing and infecting and filling my heart with yet more pain.

But how do you find "normal"? When will it come back? Will you ever be that person you were before?

People haul you up to standing now, brush your dust off, and say that thousands of people are going through this, and the world hasn't got time to stop and wait for you to catch up. Get back on the train of life. Make normal things happen. Keep going. It will get easier. It's common. You're no different to anybody else.

Two weeks ago today, we were shoved onto a crossroad and left to find our way out, with no signposts. No guidelines. No road rules.

Normal may come, but normal is relative. It takes time. It is different for everyone. Grief is not identifiable as one particular colour. It will change with the light, with the weather, with an individual outlook. It takes time to understand, to comprehend, to accept, to assimilate. There is no cookie cutter way of responding. Of recovering. Of learning to let go. Of saying goodbye.

A friend wisely stated that no one is perfect. Except David Bowie and cats.

I think there might be something to that.

The Obstacle (or the Sinkhole of Miscarriage)

Monday, 8 June 2015

I've turned to writing as an emotional outlet many times throughout my life, and it seems apt that I return to it at this life-changing obstacle into which we've hurtled this week.

On April 13, I was overwhelmed with surprise and overjoyed to find that the pregnancy test showed a positive result. Immediately incapable of stringing together a sentence, or breathing regularly, I managed to use a form of eyebrow raising and charades to tell my husband that I was pregnant ... in the thirty seconds we had at 5:49am before he left for the station to catch his train. Appropriately timed to a Blur song, like some of the best moments of our relationship, we shared the briefest exchange of joy.

And now, in the aftermath of Thursday, I reflect on the irony of that brief exchange.

Just like the brief exchange that was our impending excitement at being parents, right up until the moment that the bleeding started without notice, without pain ... Right up until the moment that all hope was shattered when the doctor couldn't find a heartbeat.

Miscarriage is the unspoken Club of Exclusivity, one that you never want an invite to join and, yet, one to which the secret handshake is given as soon as you utter the password, without the need for an application, or the vetting of your personal qualities by even one character reference. The one for which you join the immeasurable register of members with the simple words, "I lost my baby."

I knew that the figures and statistics for miscarriage were high; 1 in 4 women in the UK will suffer one during the first 20 weeks of their pregnancy. I also knew that 80% of those miscarriages occur during the first 12 weeks.

The magical safety barrier of 12 weeks. That time when it's socially acceptable to announce that you are expecting...

But what about all those women who, like me, fall short of those 12 weeks?

I carried our baby for 11.5 weeks. I became a mother at the moment in which the test returned positive. I experienced all the symptoms while our baby transformed from an idea to a growing reality. Our baby developed limbs and all its organs. Our baby was planned, wanted, and most importantly, loved. I talked to it every day, and I dreamed so many dreams of the future.

We made the decision to share our news, in our own time during the course of the opening weeks, with selected family and friends before the 12 week period was up. As an Australian, married to a British man and living in London, I am sorely deprived of geographical access to my family and long-standing support network. I needed to know that, if anything were to go wrong, I would be able to turn to people in England to hold my hand.

In hindsight, I am so glad that we did. I have been blessed to have so many offers of support, to have people checking in just to say that they are thinking of us.

Yet, at the same time, I have never been so ashamed.

The stigma of breaking silence on early pregnancy is thick in our society, as is the topic of miscarriage ... and never more so than when one is combined with the other. In a time when the prevalence of miscarriage is so high and, as a result, medical professionals encourage you to keep your pregnancy secret until the magic 12 weeks, we are actively telling women that we are only interested in celebrating with them if and when their pregnancy reaches the safety zone. If you are in the 25% who don't make it, the secrecy of your pregnancy is now overshadowed by the expectation that your miscarriage should also be a secret, for how can you suddenly announce your suffering when nobody was aware of your joy?

It is wrong. So incredibly wrong. We are painting women into a corner from which they cannot escape. How many will never tell anybody of their pain, of their loss?

Too many times already, people have said in the same sentence as "I'm so sorry" the unbearable "but at least..." and inserted any number of supposed positive spins, or silver linings.

Such as, at least you know you can get pregnant - that's really lucky/fortunate.

Or, at least it didn't happen any later on ... often followed by an example of someone they know who suffered a stillbirth.

Or, that's why they say you shouldn't say anything until the 12 weeks is up.

I cannot, and will not, deny that we are indeed fortunate that we were able to conceive. We are supremely lucky that it was not at 37 weeks.

But who decided that the way to console a person in a time of unbelievable loss and grief is to try and compare their misery with that of someone else? How is trying to minimise my grief by putting the plight of someone else above my own going to make me feel better about losing my baby? About never knowing them? That despite the fact we will move on from this, we will never forget and never stop loving them?

All you are doing is making me feel ashamed: ashamed that I wasn't one of the successful ones, ashamed that I am taking the time to deal with my pain, ashamed that I was so in love with the baby I had yet to meet, ashamed that I said anything at all.

My grief, my misery, is not a competition.

We are hurting. We are devastated. We will never see the face of our adored one or hear their little foetal heartbeat. I will never feel their hiccups or kicks, I will never deliver them into our loving arms and try to help them find a way in this world.

But I am supposed to be relieved because it didn't get any further.

Something needs to change. People need to start talking. The walls of the Exclusive Club need to be broken down.

I am not saying that every woman should shout news of her pregnancy from all possible rooftops, nor am I suggesting that every person should feel comfortable discussing miscarriage and its finer points.

What I am saying is that society's response to antenatal death should not be centred around shaming a woman for not carrying far enough to be classed as a still-birth. It should not consist of "at least" and "there's always next time" or "you've just got to look on the bright side".

It should be the love and support of "I am so sorry for your loss... I know that nothing I can say is going to make you feel any better at the moment, but I am here for you if you need me to get you anything/talk to/hold your hand/for anything at all."

Equally as importantly, it should be about giving men the freedom to also express their grief outside of the house. Just because they don't carry a child, in no way means that they don't also feel the loss of fatherhood and dreams. Perhaps they shelve it and bury it to be strong for their partner, perhaps they feel like they don't have the right to the keen feelings of loss because they had yet to physically experience their child. They have every right to be consoled, they have every right to be recognised.

We all have to die. We all experience loss. Some of us are just unlucky enough to lose our babies before society consider them worthy of an expression of sorrow, without a cut-and-paste silver lining tacked onto the end.

My grief, our grief, is not a competition. Nor is the grief of anybody else who is suffering the effects of a miscarriage.

We have no reason to be ashamed - we should not be made to feel like pariahs.

Somehow, soon, something must change.

To our little poppet: Mummy and Daddy loved you unconditionally from the moment we knew about you. We were prepared to give you the world. You were not ready for us, and we know that this time was just not ours to become a family...but we shall never forget you, and we will hold you close in our hearts always. We can only hope that your great-grandma is looking out for you in that special place, and keeping you safe now that we cannot. Due 21 December, farewelled 4 June 2015.

Powered by Blogger.