It’s hard to know what to say to someone who has had a miscarriage. In my experience, if your response starts with the words “at least” then don’t say it.

by Carol Dineen

June 2016

“There’s no easy way to tell you this. I can’t see a heartbeat.” It is 5th November 2015 and my husband and I are at the 20 week scan for our third child. For the last 4 months we have been on this train journey, chugging gently along towards our planned destination: scheduled arrival time 26th March. But now, with these words, the train we are on takes a sudden unscheduled stop. We are then diverted onto another, much windier track with no way of knowing if we’ll ever reach our desired destination. I lie on the couch and think “I really don’t want to be here”.

The 12 week scan had gone well. The due date given was 26th March which would have been 6 days after my son’s 3rd birthday and 11 days before my daughter’s 5th birthday. This was the age gap we had planned and we’d laughed at how close all their birthdays would be. We announced the pregnancy to friends and family after the scan and told our children about their sibling growing in my tummy. I couldn’t have wished for a better reaction from my daughter. She was so excited and would touch my tummy all the time and ask questions like “what does the baby eat in there?”

Two weeks later I received a letter saying I had low PAPP-A levels and because this is linked to low birth weight I had an extra scan booked in at 30 weeks. There was no extra information in the letter so I turned to Dr Google and sent myself into a spiralling panic reading about how low PAPP-A levels could lead to adverse pregnancy outcomes. 

Reassurance came at my midwife appointment. She told me low PAPP-A is common and nothing to worry about. We listened to the baby’s heartbeat and it was loud and clear, she even commented on it being “good and strong”. I was 16 ½ weeks. I drove home excited and happy, blissfully unaware that the baby would die over the next few days.

In the run up to the 20 week scan I became anxious. I hadn’t felt the baby move whereas I had felt my previous two pregnancies by this stage.

I knew in my heart that something was wrong but I tried to convince myself that all was OK. I had a sizeable bump and was in all my maternity clothes so the baby must be growing, right? Back to the scan room. I lie there and wait for a second opinion. A doctor comes in, looks at the screen and says “I’m so sorry”. We are led to The Room with The Tissues and offered a cup of tea. I love how British this is. For the first time in our lives my husband and I refuse tea. Then, another first – my husband cries and I don’t. I am a highly emotional person and cry easily but this time I have no tears. We are in the room for an hour and I find myself trying to reassure everyone I speak to. I phone my mum and tell her “it’s OK because we don’t have any ‘decision’ to make. This is out of our hands.” To the doctor who tells us how sorry she is for our loss I say “It’s OK because we have 2 children already”. I tell my husband “It’s OK because when we leave this hospital we are still parents. This doesn’t change that”. And yet it isn’t OK. I have no tears but I shake uncontrollably. 

I am given a pill to stop the placenta working and as this takes 48 hours we are booked into the gynaecology ward for 10am on Saturday morning. We go home and start to break the news. My husband collects my daughter from school and on the walk home he tells her what has happened. She cries. I feel guilty as I know how excited she was about being a big sister again. She sits with me on the sofa for hours and provides more comfort than she will ever know.

The hardest part about waiting 2 days is that I still look pregnant. This is my third child and therefore I am showing a lot already. Knowing that my bump contains a dead baby is horrific. I can’t bear to look at it, to touch it. I can’t sleep as I can’t get comfortable. I haven’t been sleeping on my stomach for fear of squashing the baby and even though I know I can’t harm him/her any more I still can’t bring myself to lie that way. I go downstairs and sit on the sofa. The house is eerily silent. My husband comes downstairs to see what I’m doing. He hugs me as I cry.

The next day we go out to get some lunch and I keep my big raincoat on all the whole time to hide my figure. I can’t risk seeing anyone I vaguely know and for them to say “Oh I see you’re pregnant” only for me to have to respond “actually it’s dead”. A friend comes over with flowers and cries with me. This helps so much. 

It is Saturday and we go to the hospital. The staff we encounter are all amazing. They treat us both with respect and empathy turning what could have been the worst day of my life into actually quite a positive experience. The first dose is placed in my cervix and then we just have to wait for it to take effect. Despite everything my husband and I have a nice day. We watch Peep Show dvds on the laptop, we buy a quiz book and do crosswords together, we read the Saturday papers and we laugh. We are in this together and it is incredibly bonding. 

The pains are still only mild so at 6pm I have my second dose and the contractions get stronger. To speed things up we go for a walk around the hospital. The hospital is on a hill overlooking the city and as it is the Saturday after bonfire night there are lots of firework displays taking place. We stand at the edge of the car park and watch the fireworks going off all around us. It is beautiful and unexpectedly romantic.

The contractions get stronger so we head back in. I have been offered a wide range of pain relief but I don’t want to be ‘out of it’, I want to be aware of everything that happens so I opt for the paracetamol with codeine. I have been through labour twice before so my body knows what to do. I am expecting full labour pains but they never come. I sit rocking on the edge of the bed through each contraction and it occurs to me that had this been my first pregnancy this would have been agony but because I’m comparing it to full term labour it is bearable. I start to panic about the baby coming. The nurse pops in to see how I’m doing and I tell her I’m scared the baby will come when we’re on our own. That I’m scared of seeing a dead baby. She understands and says she’ll stay in the room so there’s no risk of us being alone when it happens. The pain ramps up again and she calls for gas and air but as it arrives I feel a pop and my waters go. The pain stops in an instance. She helps me swivel my legs up onto the bed and asks me to “push”. The baby comes out. It is 10:30pm. My husband covers my eyes, knowing I don’t want to see. The nurse cuts the umbilical cord and takes the baby away. I lie on the bed with my legs apart waiting for the placenta to come out. As I lie there I feel totally calm.

I know the tears will come but at this moment I feel hugely relieved like a sense of peace has descended on me after the pain of the last 3 days.

Unfortunately the placenta gets stuck so I end up lying there for over an hour as first the nurse and then a junior doctor try to remove it. We are on our own and I suddenly feel dreadful. My vision goes, all the sound is crackly: I am sinking and spinning. My husband pulls the alarm and in rush the staff. An oxygen mask is put over my face and the registrar obstetrician gets the placenta out. I have lost a lot of blood and my blood pressure has dropped very low so I am put on a drip and I am to be monitored every half hour. It is midnight by now so the nurses drag a mattress into the room for my husband to sleep on. I don’t sleep. The drip is uncomfortable and each time I move it sets off an alarm. Also my bed has been tilted so that my legs are higher than my head. The nurse does obs every half hour and the machine beeps loudly each time because my blood pressure is still low.

The next day I am discharged at 1pm tired and fragile but not broken. As soon as I get home I go to the cupboard and take a folic acid tablet, already planning my next pregnancy.

In the week that follows I cry a lot. Triggers are everywhere: my maternity jeans innocently hanging in the airing cupboard; the BabyCentre website coming up on my browser; my daughter asking me “how did the baby get dead mummy?” 

My mum comes to stay so I’m not alone and this helps a lot. Friends come over with hugs and chocolate. I receive sympathy cards and so many flowers I run out of vases. I am genuinely touched at the support. I am a mess on the outside but deep down in my core I feel positive. 

On the Tuesday my milk comes in. Mother Nature is amazing in so many ways but this feels cruel. I now have porn star tits and a large dose of hormones to contend with.

Life goes on. My son’s nappies still need changing; the floor still needs hoovering; the laundry still needs washing; my daughter still needs taking to and picking up from school. I want to hide away as I’m scared of breaking down in tears if anyone asks about the baby but I know I need to get out there and face the world. The longer I leave it the more I’ll build it up in my mind. So on Thursday I am back doing the school run. I do bump into people who don’t know what has happened and each time I say the words “I’ve lost the baby” I cry. But it doesn’t matter because everyone is lovely. One of the other mums gives me a goody bag of sweets and chocolate. It is such a thoughtful gesture I start to cry again. I have absolutely no control over my emotions.

An unexpected side effect is that I feel everything more intensely and so in the weeks that follow I have some of the happiest moments of my life. I feel so lucky to have my children and my wonderful, supportive husband that I find myself just watching them and treasuring every moment. I take my daughter ice-skating at the Christmas Market determined to make the most of not being pregnant. 

I begin to see that this has been good for me, that I have learned so much from this baby. I’ve always been such a planner and now I’m realising that I can’t plan everything, especially not the exact age gap between my children. This is the first really horrible thing that’s ever happened to me and I’ve survived it which is empowering and I feel more confident as a result. Most importantly though, this baby has taught me the true value of kindness.

Six weeks later I am still bleeding on and off so I am put on antibiotics as the obstetrician thinks I might have an infection. It is during this week that I see the first new-born baby since the loss. The baby is 40 hours old and perfect. As I look at her tiny fingers, the way she screws up her face, the button nose, something inside me clicks. Grief hits me in a wave that is so violent I find myself gulping for air and sobbing uncontrollably. I am shocked at my reaction. I thought I was doing ok but it is clear that I can still be reduced to tears in an instant even when I am feeling strong.

This is a difficult week. I think I had expected to be over it by now, to have moved on. Instead I am more aware than ever of the baby shaped hole in my heart. I lose my appetite but I force myself to keep eating. If I am to get pregnant again I need to be healthy and strong. I buy more vitamins and spend lots of time reading about other people’s experiences of pregnancy loss. 

Christmas happens and I start the New Year optimistic and determined to be pregnant again by my ‘would have been’ due date. 

Pregnant again. I stare at the thin blue line and I am excited. But being pregnant again is not easy. I find myself checking for blood each time I go to the toilet, analysing each symptom and worrying a lot. I can’t ignore the pregnancy so I just go with the feelings. I don’t want to ignore this baby, I want to bond with him or her from the very beginning. I work out the due date using an online tool and I lie each night with my hand on my tummy, imagining them growing. 

I am now 7 ½ weeks and I have been booked in for an early pregnancy ‘reassurance’ scan with the obstetrician. I am nervous but in my heart I feel optimistic. I’ve had my bad luck and now I’m due a good pregnancy. The Registrar doing the scan is silent for a long time. 
“I’ve found a pregnancy sac but I can’t see a heartbeat”

Horrible sinking feeling. 

Then reassurance “The embryo only measures 3.5mm and we don’t usually expect to see a heartbeat until they are 5mm” 

Relief. 

Short lived.

“But, for your dates we’d expect the embryo to be over 7mm by now”

I lie there calmly and say “so, this doesn’t look good then?”

I am told to come back 10 days later as they can’t confirm anything yet. It may be that my dates are wrong and when I come back it will have grown. The whole appointment feels very matter of fact. Miscarriage in early pregnancy is common and they deal with this every day. On the outside I am cool and collected as we are handed a leaflet on miscarriage and leave the hospital. Inside though I am broken and screaming.

I spend the rest of the day lying on the sofa crying. The next day I go to work. I can’t stay at home playing the waiting game, I need to keep busy. This time I am outwardly ok but inside I have a horrible sinking knot in my stomach. I know my dates are correct and that it is over but I cling on to that glimmer of hope that maybe I am wrong with my dates and that it might just be ok after all. 10 days is a long wait and during this time my original due date comes and goes. My parents look after the children for a night so that my husband and I can have some time away. We book ourselves into a spa hotel and escape. 

By the time the next scan comes around I have started spotting and it is a relief to have it confirmed. There has been no growth and still no heartbeat. She turns the screen around for me to see. The embryo looks like a bean and not like a baby at all. I am no longer in limbo and I can move on. The ladies doing the scan are from the same team who looked after me during my late miscarriage. They are amazing. Once again I am treated with such empathy and respect (one of them even cries when I cry) that I leave feeling warmed and lifted by their kindness. That afternoon I distract myself by baking my daughter’s birthday cake. Her party is in two days’ time and preparing for it is a lovely distraction. We fill party bags and plan crafts together. It is special and I treasure every moment.

By coincidence I start to bleed that evening. I wake in the night soaking wet. I go to the bathroom and feel clots fall from me into the toilet. It is such a horrible sensation I start to feel faint. I get off the toilet and lie on the bathroom floor with my legs up on the radiator calling for my husband. He is brilliant, clearing up the blood, changing the sheets, helping me shower and getting me back to bed. The next day is physically horrendous. My husband takes the day off to look after the children as I am incapable of doing anything. I am soaking pads and passing massive clots every 45 minutes. I ring the hospital and ask if this is normal. I’m told it is but if I feel I can’t cope with it at home then to come in. I decide I’d rather be at home with my family. The bleeding eventually eases but I am up again in the night with cramping and more clots. By the time morning comes I am light headed and exhausted. My children are so excited about the birthday party I know I have to keep going. I will not, cannot let them down. 

My friends are brilliant and so are my parents. Between them they do all the setting up, clearing away and ensure the party runs smoothly. I am made to sit down and I don’t argue. I am dizzy each time I stand so I know they are right. I worry about how lazy I look to the parents who don’t know what has happened. This is the first time I have met some of my daughter’s school friends’ parents and I am concerned about the poor first impression I am giving. Despite everything I really enjoy the party though. The entertainer is brilliant and the children’s laughter is a tonic.

It is much easier this time. Although I am breathless and weak my hormones don’t go crazy, no milk comes in and the tearful stage is over very quickly.

The visual of the scan helped so much and it is a different grief this time. I do not feel the same depth of loss for a physical baby as before. In my low points I feel pissed off though. I feel cross with my body for overreacting and bleeding much heavier than it needed to for the stage of the miscarriage. I also feel guilty for feeling this way because I have two children already. I know I am one of the lucky ones.

It’s hard to know what to say to someone who has had a miscarriage. In my experience, if your response starts with the words “at least” then don’t say it. As in “at least it was early” or “at least you have two children already”. For me, the best support came from the friends who allowed me to be sad. The ones who said “this is shit” and didn’t try to jolly it up. The friend who made me a card out of hama beads in a picture of a rainbow, some rain and a heap of poo saying “sorry things have been a bit shit”. The friend who invited me over for lunch and let me cry into my soup. My sister who sent me a gigantic jar of chocolate buttons and a note saying “shit times need shitloads of chocolate!” The friend who kept texting me from her holiday to see how I was. My wonderful boss who provided a listening ear and a hug when I needed it most. The friend who remembered each time I had a hospital appointment and always messaged me before and after to offer support. Everyone who messaged me with support and kind words. It helped so much just knowing that people care. 

During my sad moments I did feel guilty about wallowing in my own self-pity. I kept thinking of people I know who are in far worse situations than myself. So when I received this message from a friend it was exactly what I needed to hear:
Try to stay with the emotions you are going through at the moment instead of trying to push them away. It’s perfectly OK to feel the way you do and you must remind yourself this.

We will try again for a third child as we have not lost sight of our dream. For the time being though I need a break. Since July I have either been pregnant or recovering from a miscarriage and my body and my mind both need time to recover. I need to get my iron levels back up and I also want to enjoy the summer with my family without having pregnancy nausea or anxiety to deal with.