Miscarriage #4: time to stop trying?

Finding out about our fourth miscarriage – our third missed miscarriage – felt like reliving a particularly bad dream. I hoped we’d never hear the words ‘I’m sorry, there’s no heartbeat’ again, but there was the sonographer, going through the now-familiar routine of patting my knee while breaking the bad news.

Me and my husband had prepared ourselves for this outcome as well as we could. Neither of us had spoken much about the pregnancy, there were no conversations about reaching the second trimester or bringing home a baby. We hadn’t discussed names, whether we hoped it was a boy or a girl, about how our life would change with a new addition. We were neck-deep in denial, talking of our pregnancy very rarely and only then in the language of ‘if’ and ‘maybe’.

This time, when my pregnancy should have measured 8+6, the scan showed our baby had only made it to 7+2, measuring a little over 11mm from crown to rump. It was dwarfed in its sac, which presumably had continued to grow after the baby’s heart had taken its last beat. The sonographer asked us if we wanted to see the baby up on the large screen. But why? To add another memory of stillness and death to my memory banks? No, all I wanted was a scan photo, something I could look at in my own time.

The usual apologies followed, kind smiles, asking if there was anything they could do, all passed in a blur. We just wanted to leave the clinic, to be alone, to process.

On our way home, as I silently cried tears of hopelessness and resignation, a message was left on my voicemail saying we had to go straight to our hospital for a second scan, and to discuss our options for the miscarriage. No, I thought, not this time. I needed this fourth time to be on our terms.

Speaking to the Emergency Gynaecology Unit the following day, I asked about treatment during Covid19. No surgery, she said – it’s too risky during the pandemic. No medication until you’ve been waiting for several weeks for a miscarriage to start. Conservative management is my ‘option’ – so really, there’s no option at all. Now, we sit and wait and hope my body will soon realise its status as a morgue and begin the miscarriage process naturally.

So I find myself four days into limbo. There is no bleeding yet. I still feel pregnant. I’m tired and hormonal and nauseous, and yet I know there is no positive outcome. Instead of dreading blood on the toilet paper, now I’m disappointed when it comes away clean. When cramps begin, I will them to get stronger, and feel let down when they ease off.

Like we did during our first miscarriage 2 years ago, we have celebrated our wedding anniversary in the days since finding out about our loss. Grateful for each other, but heartbroken that our plans for another year have gone so wrong. It’s my husband’s 40th birthday next week – a day that would already be downplayed due to the pandemic – but now my husband feels there’s little point in celebrating at all.

Early in this pregnancy, I decided that, if it was unsuccessful, I couldn’t go through it all again. I’m 41 years old, so there is more chance of chromosomal abnormalities due to my older eggs. If I did get pregnant again, there are more likely to be errors in the process of meiosis (cell division in early pregnancy) meaning more chance of miscarriage. Add to that the increased risk of miscarrying again after recurrent loss. I have to ask myself if this is something I can willingly put myself through again. And at this stage, I don’t think it is.

The conversations me and my husband are having at this point focus on what our lives might look like without children. How we wish we had met younger to avoid these fertility difficulties. How we feel jealous of the people who find family-building easy. How we wish it could have been us. 

There is so little narrative in society for people who try and try to have a child, and yet ultimately fail. It seems most fertility stories end neatly – ‘We had given up all hope and then – bam – I fell pregnant. And this time it worked!’ What about those of us who don’t have that success, who see decades stretching in front of us, with no prospect of nurturing our child, of watching them grow and flourish? What is our narrative? I guess the only option, if we decide to stop trying, is to write our own. 

Resources:

• This leaflet by The Miscarriage Association may be helpful for women who are considering giving up on trying.
• This video by Tommys showed me that, although it sometimes feels like it, I’m not in this awful place alone.
• And this blog by Wendy Pratt explains some of the many thoughts about being childless not by choice that are currently bouncing around my head.