Except that it wasn’t. The test came back with a HCG of thirty-seven—a fraction of the 2063 I’d had with Z, but, still, a positive. ‘Come back on Tuesday,’ said the nurse over the phone. ‘I’m sorry; it is really just too early to tell as yet.’
On Tuesday, my HCG level was seventy-eight; still very sluggish and probably an indicator of an implantation, then early miscarriage, explained the nurse. ‘Come back on Friday—but if you get any sharp abdominal pains, go straight to emergency, just in case it’s ectopic.’
Friday, 25 February 2011
When I arrive at the clinic for my blood test this morning it hasn’t opened yet. A queue of people stretches a good fifteen metres down the hallway. Usually we only cross paths in ones and twos in the waiting room. We glance at one another and drop our gaze, respectful of our mutual privacy; we studiously read trashy magazines.
But here we all are, leaning against the wall, relieved and embarrassed to see just how many of us there are. Some women are alone, but most are accompanied by a male partner. ‘Here to support her’ are the looks they give one another, not so much ‘I just want to be a dad’. Either way, they move sheepishly when the queue starts to advance. We didn’t giggle about this type of baby-making in high school.
Seated in the waiting room, I start reading a newspaper article about the Christchurch earthquakes. An earthquake begins in me, sobs catching in my ribs, tears steaming to the surface. I want to close the paper, to stop all these sad things from happening, to un-read the headline, ‘Mother dies with baby in her arms’. I try to divert, read something else. But still, my body freezes, remembers the sensation of being pinned by twisted metal, the realisation that I can’t get out on my own, someone has to come and help me. This fear is here even without the newspaper. I take a deep breath and open the flimsy pages again and let myself weep for the mother, for her baby, and for me and my baby. All that sadness muddied together—if I could just breathe it all in, soak it all up and breathe out a sense that it will all be okay, that there is something connecting my child and I that cannot be crushed by a falling building or by the impact of a 4-wheel drive.
•
On Friday, my hCG level was up to 201. This time, I got the call from the specialist early pregnancy nurse. She asked me again about the bleeding. I explained that it had been heavy, like a normal period. That it had stopped now.
The nurse hmphed.
‘It’s clear that there’s been implantation, and that you’ve got pregnancy hormones being produced; it’s just that those levels are much lower than we’d like to see. You’ll just have to come back on Monday morning for another blood test.’
‘So, have you ever seen a viable pregnancy with those kinds of numbers?’
‘I have, but it’s important to be realistic about your chances here—realistically, it is looking very unlikely at this stage.’
I put down the phone and felt like laughing out loud. Ha ha. Realistic! The realistic view was that they had no idea what was happening, and neither did I. We were all spectators to the unfolding soap opera that was my uterine environment.
By Sunday night, though, my Zen was running out. I had fretful dreams of dodgy hotels, where one room connected to another and another and another. I kept waking, thinking it was time to get up and go in for my blood test, even though it was 3 a.m., 4 a.m., 5 a.m. I’d run my situation past my online IVF veteran friends, and heard story after story of low HCG results that were now snoring happily in the cot down the hall. A little speck of hope had got under my skin, and with it, the fear that it would be dashed.
By the Monday morning, my HCG had risen to 630. And although it was the same Nurse Realistic giving me the news, she was much more upbeat this time. She’d spoken with my doctor, and he didn’t see any need for a further blood test, just a scan in a week’s time.
‘So, this might mean that it may actually be viable?’
There was a big, realistic intake of breath. ‘Look. With all early pregnancies, but especially when your betas started low, we can’t really confirm anything until the scan; but, yes, congratulations. But if you do have any sharp pains or bleeding, don’t ignore it, go straight to emergency.’
I couldn’t help it—underneath all the caveats, the one word I heard was ‘congratulations’. Welcome, uncertainty—come on in.
A week earlier, when I’d been certain I wasn’t pregnant, I had booked a flight up to Sydney as a consolation prize. I could catch up with friends, enjoy the Gay and Lesbian Mardi Gras parade, and if the timing was right, attempt a fresh insemination with our donor. But now, the trip was a welcome distraction while I waited out the days until the next scan.
Sydney, when I touched down, was thick with memories of ‘before’. They were heavy on the ground and mostly still undisturbed because I had spent so little time there since December 2009. The sight of kids in the uniforms from the girls’ old school, the shops where I had bought ordinary, inconsequential things, the road that led to our house—all of these things couldn’t fade into the background until my brain had trotted through its ‘Last time I saw x, Haloumi was here’ routine.
I returned to one of my favourite Sydney spots: the women’s baths at Coogee. The last time I was there, my Haloumi-filled belly had stuck out obscenely between my bikini top and bottom. I had greeted other swimmers with my stretch marks. That belly was remarkable. Everyone remarked on it, speculated on Haloumi’s gender and wished me well.
I had so many pregnant and unpregnant swims there over the years. Some involved mildly athletic laps; some, snorkelling and marvelling at the starfish, shellfish and, once, even an octopus under the surface; some were splashy and noisy, with the girls; some quiet and contemplative, with no one else in the water. I’d seen it in a storm, with the waves crashing over the rock wall; I’d seen the surface sparkle with a beating sun; and I’d eyed off the greeny-blue depths when it was far too cold to swim.
And now—who knows? I was egging on this tiny speck of potential, hoping it was in the right spot, hoping it wasn’t ectopic, chemical, blighted, all kinds of words for ‘lost already’. To swim there felt like an act of love—towards my tentative self and this little question mark of cells.
I met up with an old friend who had also been going through IVF, and was now ten weeks pregnant, that odd early stage of pregnancy where you just feel fat and off-colour; a tenuous, uncertain state. We arranged a spot in the mardi gras parade on my usual float. I’d been to the workshop earlier that day, and made loopy green headdresses and tutus for us. And we danced all the way up Oxford Street, spangled with glitter and shining from the cheers of the crowd. I dared to imagine two small children who might delight in the idea they’d marched in the mardi gras even before they were born. It was our Fat Tuesday (quite literally; from the French, mardi gras)—we feasted on hope while we could.
Flying back to Melbourne, that hope solidified a little. Just being around someone else in those strange early days of pregnancy made me feel like maybe, maybe, we’d see a heartbeat too this time. Lo and behold, at the scan on Monday, there was a fetal sac in the uterus, where it should have been, but nothing else. No fetal pole, no heartbeat.
Our doctor was philosophical. ‘There are a number of possibilities here. It could be that you’ve just got a slow starter. Sometimes embryos drop a few cells before implanting, and that puts them a little behind. It’s still early days, so I think we need another scan, next week, before we make a call either way.’
On the Tuesday, I was back at work, wearing a summery outfit—new dress, new shoes—when the bleeding started. There was a heaviness, but it came suddenly, like something loosening. In the time it took for me to half-run from my office to the toilet, my new strappy white sandals and the lino floor were marked with big polka dots of blood, perfectly circular.
25
Undone
In the emergency waiting room at the Women’s, we ran into my friend Sophie, tall as always, but rounder than usual. She was coming in with her par
tner for her 38-week check-up. Soph had been at the picnic on the day of our accident. She had just been starting IVF, and there I was, heavily, smugly pregnant. When we said our goodbyes, I gave her a hug and said, ‘Good luck!’ She squeezed me back and smiled, ‘You too!’ And as I’d walked to the car, I thought, ‘I don’t need luck, I’m already there.’ How these little memories mocked me. Now, it was the best I could do to acknowledge Sophie and indicate that we couldn’t really talk.
The hospital took bloods and let us wait around for the results. My hCG levels were still rising, but we’d need a scan to get any real information on what this bleeding meant.
We went to our fertility clinic the next morning, and, despite the horror-movie bleeding, the scan showed that the little fetal sac was still there. There was still no sign of a fetal pole but the sac was persisting nonetheless. When we went back four days later and saw the same sight on the ultrasound screen—no growth, no embryo—our doctor was pragmatic. ‘Looks like nothing is going to happen with this one; I’m sorry. I can book you in for a D&C on Friday, if that suits?’
I wanted to be just as pragmatic. I would work, as planned, on Wednesday and Thursday, then go in for the D&C on Friday. Miscarriage managed—a Harry Potter-esque tap of a wand and the slate (uterus?) would be wiped clean. This is just a blip, I told myself. We will get there.
That Wednesday morning, I forced myself into some clothes and out the door. I was too shaky to drive, so I took the tram, hoping that none of my students would see me sobbing behind my sunglasses. By the time I reached work, my tears had crystallised into a hard, mean anger. Walking to my building from the tram stop, I slammed each foot down. I deliberately grazed my knuckles against walls. I locked myself in the bathroom, and wept against the wall, tapping and then knocking my forehead against the bricks. While my head was screaming expletives, there was another voice there too; the one I would speak to Z in when I looked up at her star, or leaned in close to open roses and breathed them in. Oh, honey, this is so hard. It was that voice that stopped me from punching the wall, that gently took me back outside so I could retrace my steps, get back on the tram, walk home and get into bed, send an email to my colleague that I wouldn’t be able to teach the next day, that I was having a miscarriage. Today there would be no forward motion. This pregnancy had to be unravelled before we could go on; things were not just paused, but would have to go in reverse for a while.
My colleague responded compassionately. ‘Take this week and next week off,’ she urged. I did that, and, instead of booking in for the D&C, called up my doctor’s office and asked for recommendations of where to go for the less interventionist medical version. Part of that white-hot anger, I’d discovered when I took the time to listen to it, was anger with myself, for thinking that I could just timetable my grief around my work responsibilities. But the whitest white-hot anger focused on the planned procedure on Friday and the thought of more surgery, more prodding. I had handed my body over to the IVF people so many times already. I’d never wanted a C-section, I’d never wanted to go through IVF, and the thought of more surgery triggered a kind of roar within me of Leave me alone! I was furious that my body couldn’t just sort this out on its own; yet, I still wanted to defend this small bit of turf, to retain some kind of control.
After a few hours, I heard back from our IVF doctor. Yes, a medical termination was probably possible, but you needed to be specially registered in order to prescribe it, and he wasn’t. He gave me the name of another provider, and I drove for an hour to find myself in a dodgy-looking carpark with vague signage, and, soon after that, a dingy waiting room full of brochures about ‘options’.
So this was what an abortion clinic looked like. It was a far cry from the soft lighting and tasteful art that decorated the IVF clinic where this pregnancy had started. The accusing fingers of the anti-abortion lobby had marked out pregnancy termination care as something controversial and distasteful—in the process, stigmatising the women who needed these services and the health professionals who provided them. Services like this were construed as the exact opposite of the optimistic health business of making people well and delivering living babies. Yet, here I was, straddling those categories—desperate for a living child, but needing help to evict a pregnancy.
This doctor wasn’t used to seeing people who wanted to be pregnant. When I asked if he was sure that the pregnancy wasn’t viable, he said, ‘I don’t know—if you’re not ready, wait a week and have another scan.’ I chickened out and drove home, cursing and crying at the thought of another week’s purgatory.
At home, I spoke to a midwife friend, who informed me that the Women’s Hospital could admit me as a day patient for ‘medical management of miscarriage’. I called their clinic, and when I went in for another scan, we saw the same little heartbeatless oval floating there. ‘Come back tomorrow,’ they said, ‘at 7 a.m.’
I took comfortable clothes and a good book. After they’d given me the medicine, I stared earnestly out the window. Little one, it’s okay to go now. I know, you tried so hard, it wasn’t your fault that things didn’t work out. It’s okay, little one. This time, when I bled, I was relieved rather than scared. I didn’t want to be unconscious for this. I needed to be there to know for myself that it was over. When the pains became bad, the nurses gave me some pethidine, and, when it was all over, a cup of tea.
•
On the Monday morning after my hospital visit, Rima was driving me to work when my phone rang. It was one of the pathologists from the Women’s. They’d tested the ‘products of conception’ from the miscarriage and there was a chance it might have been a molar pregnancy, a disorder with the placenta. ‘We don’t know yet whether it was molar, but testing will take about four weeks, so it’s a good idea to make sure you don’t get pregnant in the meantime.’ No chance of that, I assured her.
At work, I googled ‘molar pregnancy’; the Women’s Hospital had a helpful fact sheet. This type of pregnancy involved a genetic defect with the embryo, which meant that it was all placenta, no baby. And worse, in a science-fiction twist, sometimes it could develop into a mole-like growth that burrows into your uterus, cells dividing and multiplying and, all the while, pumping out more and more of the hCG hormones that make blue lines blithely appear on pregnancy tests. Undetected, a malignant molar pregnancy could become cancerous and spread to other organs, though it apparently responded well to chemotherapy.
‘Chemotherapy’. This was not a word I was expecting to come across in the process of trying to get pregnant. I took deep breaths, and made a cup of tea. ‘All they’re doing is further testing. And the results will take four weeks. The most likely outcome is that I don’t have this.’ Exhale. I would worry about this if and when I was diagnosed. In the meantime, I had work to do.
On the Thursday, I was working from home. There was a staff seminar scheduled for lunchtime that I would go in for but, meanwhile, I had teaching prep to do. My ‘work space’ wasn’t ideal. The secretaire in the hallway had a small drop-down desk, so I sat there, on a folding chair. The doorbell rang, and it was the postie holding an enormous brown-paper parcel the size of a small TV. I wasn’t expecting anything, so my heart lifted a little—I thought it might be from a friend. The label was typed, though, and the parcel wasn’t nearly as heavy as its size suggested. When I tore away the paper, I discovered first one empty 4-litre plastic bottle with a medical patient ID label; then another; then two more, along with a heavy letter from the Women’s Hospital. It was addressed to me, but was a form letter referring to my ‘recent diagnosis’ of a molar pregnancy.
Here was a helpful pamphlet on the different kinds of molar pregnancies. Here was a flyer for the molar pregnancy support group. Here were detailed instructions on how to collect all your urine in one of the 4-litre containers over a twenty-four-hour period, and a little map showing the location of the hospital pathology unit where the samples needed to be dropped off within twenty-four hours—one each week. I had visions of wandering nonch
alantly through the hospital sliding doors, lugging a sloshing container of my own wee. I backtracked to the letter—diagnosis? ‘What? I’d only had the call from the hospital pathologist a few days ago. I thought it was going to take four weeks to get a result?’
My stomach dropped. I frantically dialled the number on the letter. I needed to sort this out—had I been diagnosed? The first number led me to an answering machine, as did the next two, so I tried going through the switchboard and searching the hospital website for clues. An hour later, I was none the wiser but flicked back into my email account to discover an increasingly frantic series of emails from the co-convenor of the seminar series.
The seminar. The floor suddenly seemed unsteady beneath me. I’d completely forgotten about the seminar, leaving my co-convenor to somehow locate the guest speaker and chair the event in my place. I called and left a breathless message, apologising for not being there and letting her know that I’d had some upsetting medical news.
I didn’t hear anything until I received an email from my head of school, indicating that my colleague had spoken to her about my worrying news, and that they had decided to employ a casual to cover my teaching for the rest of the semester. For the third time in one day, things crumbled beneath my feet, but this time I had an overwhelming sense of shame and stupidity. They were collapsing not because of a medical problem, or an administrative error. This was a crumbling I had created directly, from my own blind panic. I wanted to disappear, to shrink into a tiny ball and roll underneath the couch. Yet there was also a small, burning fury with myself and the situation. I wanted this job, I didn’t want to be sidelined.
•
Despite the cool autumn morning, I was in the sweat of an energised panic when I arrived at work just after 8 a.m. the next day. The afternoon before, I’d done what I could to repair the damage, and had set up a 9 a.m. meeting with my boss, to plead my case to continue teaching for the semester.
Baby Lost Page 17