The first time

My pregnancy with Amelia was not our first. In the fall of 2002, we were happy, but surprised, to discover that I was pregnant. We had planned on "trying" beginning in late fall of that year. I wanted to complete the school year (I was teaching first grade) and secure my permanent teaching certification. But, we were thrilled with the prospect of becoming parents, albeit a couple of months before we had planned. My due date was May 12, 2003. The day after Mother's Day, and the day after my own mother's birthday. A spring baby! I soon found out that my neighbor and friend was pregnant with her second child and due on May 10. I anticipated the fun our little children would have together.
We were sent for an early ultrasound, and the baby measured a couple of weeks smaller than expected. I wasn't the least bit worried. I had never had regular cycles, and that's what due dates are initially based on. More importantly, I had no idea the bleak prognosis for embryos whose measurements are that far behind. I asked for a picture, but the tech wouldn't give me one. Said there wasn't enough of r a picture, we wouldn't be able to make out anything. I figured I'd just get one the next time.
A week or so later, I began bleeding. Spotting, really. The doctor saw me, and did an exam, which showed everything looking the way it should (i.e. cervix closed) ordered two rounds of blood hormone levels done, and I was told to stay off my feet. One round wold likely tell them nothing. What we needed to see was the second number significantly higher than the first. HCG levels need to double every couple of days for the first ten or twelve weeks of pregnancy. My levels on Tuesday were approaching 80,000. On Thursday, my blood was drawn again, and I could call on Friday for the results. I spoke to the nurse of the other doctor in the practice, as my OB generally doesn't have office hours on Fridays. The nurse said my levels were just over 90,000 and everything looked fine. I questioned that, as that was not at all doubling, but she said that the doubling slows down eventually. I was almost 10 weeks...the leveling off usually happens at 12, but I was new to pregnancy and unaware of this, so I accepted her assurances that all was well. My husband and I proceeded on a planned trip to Pittsburgh to visit our oldest niece, a freshman at Pitt. We brought one of her three sisters with us, and, confident all was well, shared our news with our nieces. They would have a new cousin in the spring. We shared the news with the friends we were staying with, as well. We were walking on air.
The following Tuesday, I showed up for a previously scheduled follow-up related to the spotting. My OB looked concerned, and he confirmed this as he discussed the numbers with me. He was not convinced that all was well and scheduled me for an ultrasound for the following day. My husband was to be on a business trip in NYC, and he didn't think he needed to be at the ultrasound, because we were, after all, convinced that everything was fine. Instead, my mother traveled 150 miles to be with me for the ultrasound. I tried to tell her that everything was fine and the trip wasn't necessary, but she insisted; I am still deeply grateful to her for this.
We showed up for the ultrasound on Wednesday afternoon. It was one of the fun ones...the transvaginal ones where they give you a "wand" of sorts, all covered with goop, and have you insert it into your vagina. the tech then moves it around to get a view of things. The tech, in this case, didn't have much to say. A red flag had I known better. She did her thing and left the room. When she returned, she told me that the doctor was on the line for me. I was again speaking to the "other" doctor, not mine. She informed me that the heartbeat, which we had seen two weeks prior, was now gone. The embryo (always "the baby" to me) had already started to disintegrate. In short, our little baby had died. There was nothing to be done. It was over. My mom and I cried for a little while, and then went to call my husband. He was already on the train on his way home. Intuition? A couple of hours later, we met him at the train, and he and I stood in the train station, embracing each other and crying.
I was overwhelmed by the amount of grief I felt. After all, I had never seen this baby, never held it. I had essentially lost something totally intangible. Yet I couldn't recall having ever been in this much pain. I wanted to stay home and never, ever leave my house again. And I hated that first ultrasound tech for refusing me a picture. It would have been my only remembrance. My only picture of my child. Instead I had nothing.
We saw the doctor the next day (MY doctor this time) who informed us of our choices: a natural miscarriage or a D & C. We opted for natural, for two main reasons. First, I feared the scarring that was a risk after a D & C, and could make future conception difficult. The risk was minimal, but I didn't want to take the chance. But more importantly, I couldn't bear the idea of having my baby, however small and unrecognizable as a human being, torn from my body. I couldn't do it. I wanted it to be as gentle and natural as possible. My doctor assured me that generally, the process starts within 2 weeks of a "diagnosis" of miscarriage. Then, it is usually 4-6 weeks until periods return and the journey of conception can resume. So we waited. Two weeks passed. I followed my husband around he house when we were home, almost afraid to be alone. I only really left to go to work. I cried every day and I was tortured by the thought that the demise of my child had somehow hurt him or her. I know now that an embryo cannot feel pain, but then, I was so sure that it could. What was I doing at the exact moment that my baby's heart had stopped? Did he want me to hold him? Did he suffer long?
During this time, a close friend found out she was pregnant. I was alternately numb and agonized. I hope that somewhere I was happy, but at that point, I could not find it. My own grief was so thick and heavy and my vision beyond it was obscured. Two weeks passed. Nothing happened. The doctor sent me for bloodwork each week to check my hormone levels. This HCG, famous for doubling, also has a half life. This half life differs from woman to woman and determines, in conjunction with how high the levels were at the time of "diagnosis", how long one can expect before the physical miscarriage begins. Home pregnancy tests generally detect HCG at a level of 25. By doctor's standards, I would no longer be considered pregnant when my levels were below five. My levels were high, my half-life unbearably long. It was taking forever for my levels to drop. But they were dropping. There is no way to make the HCG levels drop more quickly, except to do a D & C. Remove the pregnancy, kill the hormones.
Just about a month after the "diagnosis", my body finally began to let go. It was November 10, 2002. Coincidentally, another of my friends gave birth to her first child that same day. The bleeding lasted a month. It wasn't heavy enough to warrant concern on a physical level but from an emotional standpoint, I was beginning to wonder how much more I could take. I continued to go to work every day. I continued to get my blood drawn every week. And I continued to grow more and more miserable.