A Little Bit of All of It

This post is part of a series of posts in honor of National Pregnancy and Infant Loss Remembrance Day. Today’s post comes from Lauren of Hobo Mama. You can learn more about Lauren at the end of this post.

There’s something poignant about losing the first attempt at conception. I say this even knowing that other women have suffered far greater losses than that, but in that moment, it’s not an exaggeration to say I was devastated. It felt like my body had betrayed me, that all my hopes now for children were uncertain, and that for any subsequent pregnancy — if, indeed, I could get pregnant again — I would worry as the weeks slowly passed, monitoring each pang and obsessing over any indication of spotting.

But for now, during the miscarriage, I knew that I wanted to carry it to a close in a respectful and meaningful way: naturally.

I want to say upfront that I don’t suggest any other woman choose the path I did, or even that I was medically correct in eschewing intervention. For me, for then, it felt right. I needed to learn to trust my body, to rebuild my faith in its process, and to give the baby a gentle goodbye.

I was six weeks along when the spotting started, after a ballet class. I called the midwives I had chosen but not yet had an official appointment with, and they gave me the half-comforting, half-alarming truth: that it was either a miscarriage or it wasn’t, and there was nothing I could do about it either way. Without cramping, the spotting likely was just an anomaly. But, really, many women have early miscarriages, and there’s no way to stop it if it’s happening. They suggested lying down on my left side, more to make me feel better than to prevent any loss that was inevitable.

I quit ballet for the first trimester, lay down a lot, and worried. The spotting subsided, and I cautiously resumed my optimism. At ten weeks, my husband, Sam, and I went on a short, last-time-before-babies trip to London. On the plane ride back, the spotting started up again, this time with cramps.

We had a cat-sitting business, so we had to jump right back into work when we returned, visiting people’s houses to care for their pets. I kept sitting down while Sam performed the tasks. I felt awful, like a terrible period was coming, and the anxiety was even worse.

Just before we left our last house for the day, I went to the bathroom, and there it was: bright red blood, copious amounts. I began weeping in the car. I knew what this meant.

We went home, and I lay in bed, but it was no use, of course. We went to our first prenatal appointment a couple days later, and I sobbed through it. The midwives wondered why I’d even come in, but I needed someone to know, and give me some guidance. I hadn’t seen my gynecologist for about a year, ever since I went off birth control, and didn’t feel like going back to her for this grim purpose.

Sam and I mourned through junk food and alcohol — the things we had denied ourselves in the long stretch of preparing to conceive, trying to conceive, and pregnancy. And I wondered whether I needed medical assistance with the miscarriage, or whether to continue on as I’d begun.

Ten weeks gestation is in a sort of no-man’s-land for whether a medical procedure would be advised. With very early miscarriages, generally the uterus will absorb or expel any tissue without further intervention needed. It should be more or less like a heavy period. With later miscarriages, say, at 12 weeks or so, the miscarriage might in fact have to be like a little birth, because the fetus is more formed. (This isn’t medical advice here, just my own understanding of how it often is.) All the women I knew who’d had miscarriages (and as I told my story, it turned out there were many, all sisters in this sadness) had had a D&C, just in case, unless the miscarriage was very early. I couldn’t find anyone at my stage who’d chosen the natural route.

One reason I decided to miscarry naturally was financial and practical. We had very little money, cat sitting not being the most lucrative field. Being self-employed, we had to buy our own health insurance, so we’d chosen a plan that covered barely anything. The midwives wanted nothing to do with us until we were pregnant again (which makes sense) and suggested going to a gynecologist for followup care. If I’d gone to our gynecologist, it would be classified as an urgent-care office visit, rather than preventative care, and we’d have to pay for it out of pocket. At a more solvent time in our lives, this would not have been an issue, but we were hurting financially, and the idea of paying to be told, “Yup, you’re miscarrying,” stung. If the miscarriage was proceeding apace, there was no need for a D&C anyway, and I worried that any medical doctor would urge one on us regardless.

But, mostly I wanted to miscarry naturally, because that was how we’d begun our journey, and how we’d hoped to end it. I had conceived by going off hormonal birth control (and, six years later, I still haven’t resumed and don’t plan to) and getting in touch with my body’s natural cycles through charting. I had planned a home birth in our little studio apartment, with midwives in attendance, and the thought of ending this much-hoped-for pregnancy on a hard table in a sterile, white office seemed so far removed from my wish for this baby’s entrance into the world.

I also carried some guilt over my behavior in the pregnancy thus far. I felt I hadn’t connected as much to the baby as I should have. I had been aware of the miscarriage statistics, and when I started spotting at six weeks, I think I disconnected a little bit more, out of fear of becoming too attached to a baby who wasn’t meant to be. We hadn’t told any of our friends we were expecting, which now meant we had to tell them both items of news at once: that we had been pregnant, and that we no longer were. It was important for me to tell them, even though it was belatedly, because I was a mess, and it turned out I needed their support. Miscarrying naturally, then, was a way for me to come to terms with my love for this baby, and my grief that I was losing the pregnancy. I learned that despite it all, I had bonded with the baby, or that I was doing so now. It was like a gift that I could give this small life: a proper sendoff.

So I spent several days in the bathroom, and several weeks bleeding and cramping heavily, my own private labor of this child who was lost too soon. But then the bleeding continued, after the time when most miscarriages would have subsided. I scoured online message boards for natural miscarriage stories. Again, they were harder to come by than stories of D&Cs or the like, but at least there were some.

My bleeding waxed and waned for five months. After the first couple weeks of bright red and gushing blood, it had gradually slowed down to brown and oozing — old blood, clearly. There were days I didn’t bleed at all, and I kept thinking it was over, but then it would come back again. There was no more pain, though, and I never felt ill or had a fever or smelled anything funky. I figured I was just having an unusually long miscarriage, or that maybe this was normal but very few people had natural miscarriages at 10 weeks so I couldn’t compare. Sam and I started trying to conceive again after a couple months, because my charts seemed to indicate I was ovulating, but I wasn’t sure.

One night, I woke up in excruciating abdominal pain, the worst cramps of my life. I woke up Sam so he could be worried for me. I had been reading books about childbirth hypnosis and the connection between pain and fear. The panic over what on earth was happening to my insides was just making the sensations worse. I forced myself to tune out the fear so I could relax through the pain. Along with four ibuprofen, I took a long, hot shower, resting my head against the wall of the shower and closing my eyes as water poured over me.

When I felt somewhat better, I emerged from the shower and lay down in bed, where I relaxed enough to fall asleep despite the pain. When next I awoke and went to the bathroom, there in my underwear was a clot of tissue, about the size of a chestnut.

I inspected it, but I saw nothing that told me what it was: fetus, or placenta, or something else. I sealed it in a plastic bag and set it down in the bathroom while I wondered what to do with it. Maybe someone would want to inspect it, I reasoned.

The next day, I called the midwives, who once again told me to call the gynecologist. Finally, I decided they were probably right, and set up an appointment.

But the gynecologist’s office ticked me off with their bureaucracy, as I’d suspected they would. I had already, in such a short timeframe, become accustomed to the standards of midwifery care, and the thought of going back to a disinterested doctor who saw me for five minutes max after I sat in her waiting room for an hour and a half … yeah, it didn’t appeal. The first appointment they could get me was for three weeks out, so I took it. Then I called back and asked if that seriously was the first appointment they had. The person on the phone responded that it was the first preventative care appointment, but they could see me that week for urgent care. Reluctantly, I signed up.

My bleeding had stopped, cold turkey. Obviously the five months of spotting was my body trying to eject that last bit of tissue. I still felt fine. No one expressed any interest in examining the tissue that had come out, which was a good thing — I stupidly forgot that it would rot if I just left it out at room temperature like that. The fact that it did rot seemed to me like a good sign: It confirmed that when it had come out of my body, it had not been rotten then.

For this reason, I was very hesitant about going to the gynecologist. I suspected she would want to do a D&C “just to be sure” everything was out, but I was now confident everything was fine, given that I’d stopped bleeding. My reluctance to go manifested in making us super late to get to the doctor’s office. So late that they had taken in somebody else for my slot and they wouldn’t see me unless they ended up having another opening — I was free to wait around if I wanted. I wandered around the hallways for about an hour, calling Sam on a payphone (we had only one cellphone at the time, and he had it — he was off cat sitting for us) to get his advice. He finally said what I wanted to hear: that I could go tell the gynecologist’s office to stuff it and that I was going home. So I did, only politely, of course.

By the time my preventative exam rolled around — I was pregnant. And this one stuck, and is now four-year-old Mikko.

I tell this story of a natural miscarriage for specific reasons and not for others. For instance, I do not tell it to suggest anyone else should miscarry naturally — that it’s the best way, or that indeed it was the best idea for me, given my prolonged bleeding. Many women will be able to miscarry naturally if they want, but some will need extra help to avoid complications, and some will simply not want to go through the emotional and physical ordeal of bleeding alone at home. For me, it ended up being worth it, but that’s a very personal decision.

The reason I tell this story is simply to have a natural miscarriage story out there. When I was searching for stories of other women going through this same thing, I wanted something just like this — a message of here is what happened to me, and here is what I thought about it, and here is how it turned out.

Miscarrying naturally was safe for my body and gave me a new measure of trust in its workings. Yes, it took five months to push out that retained tissue — but it did it! No doctor would have given it five months to work, but there was literally no need to hurry it along. I was fine, and I’ve gone on to have two successful pregnancies since.

Miscarrying naturally was what I needed for my emotional health. Bleeding and cramping and working through the physical act of losing my baby was part of my process of grief, and ultimately, of healing. It connected me to what was going on in my mind anyway, and I didn’t feel like trying to take a shortcut and get it over with. It took months for me to heal emotionally, so the bleeding went along well with that. By the time the bleeding was done, I felt connected to my little lost baby, loved by him, and ready to move on.

Miscarrying naturally helped prepare me for a natural birth. Particularly in the throes of my body’s expulsion of that last bit of tissue, I had to exercise my newfound techniques of relaxation and natural pain relief. I also had to tamp down the panic and continue trusting that my body knew what it was doing, despite the intensity of the sensations. Those lessons served me well in Mikko’s 42-hour labor with a natural hospital childbirth, and Alrik’s 8-hour surprise unassisted homebirth. Despite initially feeling like my body’s betrayal, the miscarriage eventually came to represent my body functioning perfectly well: It had recognized the sad fact that this pregnancy could not continue in good health, and it did its work to minimize my suffering and help me become fertile again. (I would never say words like that to another woman undergoing miscarriage, but it helped in my own mind to hear it put that way!)

Would I choose a natural miscarriage if, heaven forbid, there’s a next time?

Yes, and maybe. If it were an early miscarriage, with bleeding and cramping that lasted at most a few weeks and gently subsided, with no signs of unusual odor, pain, or fever, then I absolutely would. In general, I prefer letting minor illnesses and other bodily problems run their course rather than seeking medical treatment if it’s not necessary. And it simply feels like a more fitting end to a miscarriage to me, to have it resolve within my own home, as I would have chosen the birth to be.

That said, if I had the same symptoms as last time, with months of unrelenting bleeding, I would now know to seek medical care. It bothers me that I was so alone and financially uncertain last time that healthcare seemed an unattainable option even if I’d really desired it. I wish all women of childbearing age could have affordable access to providers they could trust to care for them respectfully. I would try harder in the future to find a like-minded caregiver who could honor the miscarriage process but work with me to find a peaceful and health-affirming way to bring it to a close without any damage to my future fertility. Even though it turned out fine to have had retained tissue for five months, I feel in some ways I dodged a bullet in not having an infection or other complication, and I would like to be more circumspect should a similar situation arise. I’m satisfied with the way my own experience turned out, though.

It was a hard journey, and I wish miscarriage on no one. But in the end, I was glad for what I had learned from my short time with that baby (whom I named Robin) and the opportunity to give him a fitting end, and I was thankful for the lessons it taught me in trusting my body, loving my baby, and preparing for the pregnancy and natural childbirth to come.

Lauren blogs at Hobo Mama about natural and attachment parenting and is the co-founder of Natural Parents Network. She lives and writes in Seattle with her husband, four-year-old son, and four-month-old baby.