Taking part in a Tommy’s research trial helped my healing process

Katherine Miles from Oxford had 3 miscarriages and a life-threatening ectopic pregnancy before being referred to Tommy’s National Centre for Miscarriage Research in Coventry. After taking part in the SIMPLANT trial, her daughter Sietske was born in 2018.
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Our first daughter Anika was born in Thailand in February 2013. Like any new parents our lives were turned upside down, but we quickly adjusted to our new reality.

In 2014, we moved back to England and later that year I became pregnant again. Innocently, it never occurred to me that I would experience problems with pregnancy after the safe arrival of our first child. The weeks passed by, and things seemed to be progressing nicely; I even had a little bump developing.

Shock and pain  

I was 12 weeks pregnant when the bleeding started. I got straight into the car and headed to the hospital. I remember that journey so vividly. I knew in my heart that something was wrong, but I had no idea about what was yet to come. The doctor in A&E prepared me for the worst and I was booked into the Early Pregnancy Unit the following day. However, I started to miscarry when I arrived home that evening.

The taboo of miscarriage meant I had no expectations of what I was about to experience. Having been through labour before, I recognised the feelings of contractions and I lost a lot of blood. I was in shock. There was no doubt there would be nothing to see in the scan the next day.

Adjusting to life after loss

I felt emotionally drained after our loss. I wasn’t offered follow up care and didn’t even get a chance to speak to a midwife about what I’d been through. Instead I was left with my maternity notes, and some baby clothes I had bought on a recent business trip to India. These served as a painful reminder of the baby that didn’t materialise.

More heartbreak

Almost a year later, in October 2015, I became pregnant again. This time, I was 9 weeks pregnant when I had a miscarriage. The bleeding started when I was on my way home from a work trip in Brazil. Luckily, I was back home with my family when I naturally miscarried. Despite having previous experience, the physical and emotional pain was no less.

My work means that I travel around the world, and I started feel to pressure from those around me to ‘slow down’. Several people implied I’d lost my baby because I’d flown long-haul during pregnancy or had been working too hard.

We found out we were pregnant again in December 2015. This time, things felt different. At 5 weeks, I started to bleed lightly. At an early scan, the doctor suggested I might have miscarried already as the pregnancy could not be located within my womb, but I knew this wasn’t the case.

As the festive season passed, I felt increasingly anxious that my pregnancy was ectopic. I was in and out of the hospital over Christmas having blood tests and scans. I hadn’t experienced the classic shoulder tip pain but I knew that something wasn’t right.

Emergency surgery for an ectopic pregnancy

At 7 weeks, my ectopic pregnancy was finally diagnosed. I’ll never forget that scan. The doctor went silent for a moment before informing me. He said he was shocked that no one had caught it until then. The started preparing me for surgery immediately. It was terrifying. Unfortunately, my fallopian tube had ruptured by the time I was operated on and it and had to be removed. I was lucky to be alive. In other parts of the world with weaker health systems the outcome could have been very different.

In hindsight, I think I suffered with post-traumatic stress after everything we’d been through. I repeatedly went to the doctors about my anxiety and, eventually, I was sent for a few sessions of counselling. It took a while to heal from the shock of it all.

The pain continued

In November 2016, I became pregnant again. Everything felt good this time, and I was delighted to see a little fluttering heartbeat at an early scan, then another miscarriage happened at 11 weeks.

This time I was away on business in South East Asia, as a consultant to one of the UN Agencies. I had just run a series of workshops in the region and was on my final stop in Laos when I realised what was happening. I tearfully travelled to the airport and flew to Bangkok where I had been advised to get myself to in case anything went wrong with the pregnancy.

I arrived late at night and couldn’t go to the hospital until the next morning. The next day, I arrived at hospital with my suitcase as I was due to be getting a connecting flight back to the UK later that day. The doctor scanned me and gave me her condolences. I was immediately taken in for surgical management. I was heartbroken.

Research gave us hope

I didn’t know where to turn next. There was no medical reason for my multiple losses. Over the years, I’d seen women in a Facebook baby loss group I had joined discussing the work of Professor Quenby in Coventry.

I had previously been wary, but when I realised that Tommy’s were involved, I felt it gave the clinic credibility. I asked my GP to refer me to Tommy’s National Centre for Miscarriage Research in Coventry. I then met with Professor Quenby at the beginning of 2017 who recommended I participate in one of her trials. This meeting was the start of the next part of my miscarriage journey.

The SIMPLANT trial

I enrolled onto the SIMPLANT trial in March 2017 and we had to stop trying to conceive for a couple of months as a condition of taking part. The trial looked into the effectiveness of a repurposed diabetes drug called sitagliptin for women with experience of recurrent miscarriage.

Professor Quenby explained that this drug would help my body to develop more stem cells in the lining of my womb. Cells in the womb are renewed often, for example after a woman’s period when the lining of the womb regrows. Stem cells are essential in this process. Without them, body’s tissues age faster – this in turn can cause inflammation that could be harmful to the growing baby, leading to miscarriage.

My healing process

I found the process of participating in the trial very healing. I spent a lot of time driving back and forth to Coventry from our home in Oxford and this time was peaceful and restorative and it gave me time to come to terms with what had happened to me

During the trial, I was cared for by the dedicated Dr Shreeya Tewary under the supervision of Professor Quenby. The team were so kind and understanding. The trial itself involved attending hospital regular appointments, taking the drug at a specific time each day and keeping a diary of any symptoms.

Our victory

A couple of months after the trial had been completed, I became pregnant. Naturally, I felt incredibly anxious during the pregnancy. I felt like I had to explain often in tears what I’d been through to each medical professional I met. I wasn’t offered any specialist care but I enrolled on an antenatal mindfulness course in Oxford which was incredibly helpful. The weeks passed us by and turned into months.

I entered my final month of pregnancy in April 2018. It’s tradition in Oxford, that on the morning of the first day in May, people fill up the streets of the city to hear a boys’ choir sing at dawn from the tower at Magdalen college, part of Oxford University. My family and I had planned to join in with the celebrations but I was already in labour. We opened the roof in our loft-bedroom to see if we could make out the choristers on the top of the tour, and amazingly the beautiful music reached our house on the wind. For a moment, I was relieved of my labour pains.

Our beautiful second daughter arrived later that day. We named her Sietske which, we later discovered means ‘victory’.  Holding her in my arms felt almost surreal as we reflected on the 4 years of pregnancies that ended with empty arms. It was a real victory for us after all we had been through.

After all that pain, I couldn’t believe our new reality.

Giving back to Tommy’s

In March 2019, I took on the challenge of running the London Landmarks Half Marathon to raise money for Tommy's. I attribute the safe arrival of my baby daughter to their medical research on recurrent miscarriage and I will forever be grateful.