I Had a Miscarriage

by Jessica Zucker

  I was nervous about having another child. The anticipated juggle felt daunting, but ultimately, after taking stock of my life and that of my family’s, I landed on: doable. I began preparing—pulling dusty nursery gear out of the garage and sifting through newborn onesies our son had grown out of by his seventh week, some half-chewed wooden toys, and a jungle-themed mobile I remember tearing up over when I first unwrapped it four years earlier.

  My husband and I started preparing in other, more nuanced, heady ways as well. The mechanics of prepping our home for another human being were relatively simple, but what proved to be even more demanding was the work of readying our minds for this significant transition: going from one kid to two seemed like way more than the sum of its parts. We mulled over the intricate details of life with two children: How would we negotiate our time? How would we manage Jason’s extensive travel schedule for work? How could this shift potentially affect our respective work/life goals? We have always been the kind of parents who aimed to share the emotional labor of child-rearing as equally as we could; our marriage was built on a mutual respect of each other’s strengths. He excels at all things creative, inventive, and playful, which translates into him being a joyful, grounded, and loving father and partner. I envisioned that his warmth and joie de vivre would only flourish with more members of our family, which encouraged us to throw caution to the wind—we were sure we would figure out the logistics somehow. It became a favorite hobby to daydream aloud about how our son would take to his newfound big-brother status, and how the growth of our little family would exponentially expand the love within it. Jointly, we decided it was wise to wait to share the pregnancy news with our son—given his age and his perception of time (or lack thereof)—until my baby bump was too obvious to ignore.

  • • •

  Preparing myself at work was another story entirely. I am a psychologist who specializes in reproductive and maternal mental health. The reality of my job means that pregnancy is almost always at the top of my mind, though not usually the media version that features glowing bellies and radiant mothers-to-be. In my office, I have instead heard countless heartbreaking stories from women struggling to get pregnant, coping with perinatal anxiety, grieving miscarriages, contemplating terminating pregnancies, selectively reducing multiples, and weathering postpartum mood and anxiety disorders. I speak to women who give birth to babies born silent, left with photos of their dead babies held ever so briefly, and those wrestling with taking ailing newborns off life support. I am with them during some of the most tragic moments imaginable. I listen as these women wonder if it’ll ever be possible to put the pieces of their lives back together after all the wreckage.

  Though hard to imagine at the time of my second pregnancy, I was in my fifth year of practice, and as much as one could be, I had grown accustomed to hearing about these situations. After all, I had heard them all while pregnant with my son too. During that nine-month period, I found I had little trouble psychologically separating myself from the pain and risk that comes with pregnancy. Naivete, maybe? Hearty denial, perhaps? But somehow, pregnant for a second time, I felt their stories differently, more acutely aware of the inherent risks that come along with this significant undertaking.

  • • •

  The early days of this second pregnancy ticked by mostly without event. I broke out my maternity jeans—though slightly earlier than I had with my first pregnancy. Soon, I spent nights tossing and turning with nausea and those initial hints of heartburn. By week seven or eight, I pretty much felt seasick around the clock. Compared to my experience with my son, this pregnancy was a trial in terms of just how ill I could possibly feel on any given day. A small part of me gnawed with wonder about the health of this pregnancy, based on nothing more than how horrid I felt because of it. I tried to reassure myself by thinking about an old wives’ tale, which presupposes that the sicker you are, the more viable the pregnancy. In part because of my continued uneasiness, I was on edge awaiting the day I could receive the results of my forthcoming eighteen-week amniocentesis, an extensive prenatal diagnostic test that analyzes amniotic fluid for genetic conditions, chromosomal abnormalities, and neural tube defects.

  Two weeks before I was to undergo the test—at sixteen-weeks pregnant—I went to the bathroom in my dermatologist’s office on what should have been a standard Tuesday morning, wiped, and found cherry-red blood on the toilet paper. Seeing brownish blood discharged during pregnancy can be normal—a sign that old blood, previously stored up, is making way for new blood, vibrant and full of life. But this was different. I knew this was different. And I was alarmed beyond words at the sight of it: I’m not supposed to menstruate while pregnant. This can’t be normal. It just can’t be. Alone in that pink-tiled public bathroom, minutes from having a routine mole check, a wave of dread enveloped me as I frantically reached out to my ob-gyn. “There’s blood!” Her calm but pointed reply included the litany of requisite questions:

  “Did you exercise?”

  “No.”

  “Did you have sex?” she asked plainly.

  “NO!”

  “Did you do anything differently than usual?”

  “NO!” The panic rose in my voice.

  My dermatologist remained calm as she sent me on my way to my obstetrician. I went straight from her office to my ob-gyn’s to investigate. She broke out the ultrasound machine and we saw a strong heartbeat. The placenta was perfectly situated, everything sounded normal, fluid levels were as they should be. And so, I went on my way, reassured medically, though not emotionally.

  • • •

  On Wednesday morning, I felt well enough to head to work. My doctor advised me to do whatever felt best, and so I showered, dressed, added a pad to my underwear just in case, and arrived at my office. I was cautiously optimistic that the day would go smoothly and the crimson-red blood that had sent me into a panic wouldn’t show itself again. I was calm and focused, and somehow mustered a sense of ease as I faced a full slate of patients.

  Surprisingly, the day was okay. I got through it and, for the most part, felt good. But on my drive home, my uterus began to tighten intermittently. Like the tentacles of an octopus, strangulating discomfort enwrapped me, dissipating almost as quickly as the feelings arose. I called my dad, a doctor.

  “Is it possible to have Braxton-Hicks contractions at sixteen weeks?” I asked.

  “I suppose it’s possible,” he replied calmly.

  But I knew. I knew these symptoms couldn’t be typical. Even though they were possible at sixteen weeks, I knew deep down I wasn’t going to make it to week forty.

  Once I got home from work, I changed into loose-fitting clothes and sprawled out on my bed, vexed both in body and mind.

  Later that evening, as the cramping worsened, I asked my friend, who is a midwife, to come over and investigate my unexplained spotting, or at the very least, to check the baby’s heartbeat one more time. I was desperate for information. Insight. Answers. By phone, she suggested I have a sip of red wine to reduce the cramping and take a warm bath, then quickly drove over to our house to listen in on the baby.

  The sound emanating from the doppler reassured us yet again that everything was proceeding as it should: baby’s heartbeat was as strong as ever. This brought a momentary sigh of relief, though the cramping continued, and my mind barked a cacophonous chaos of what-ifs. I tried hard to quell these grave thoughts. I had to. There was nothing I could do to change whatever course this pregnancy was already on, and there was no way to know why these things were happening or what was wrong. So we popped in a movie for some much-needed distraction, and I tried to lose myself in a narrative that wasn’t my own. I tried to find rest in those less intense moments when the cramping slowed but my mind could not.

  It was a futile effort. I was up most of the night, roiling in thought-stopping physical torment. For ten-plus hours, I was trying to ward off—or somehow make peace with—the ebb and flow of the pain. Some moments were so intense, though
, I felt like the wind was knocked straight out of me. Unable to speak, unable to catch my breath. The spotting, at this point, was an unconvincing shade of dull red, which seemed like a positive development, but still, I was unsure of how anxious I should be. I reminded myself of the encouraging doctor’s appointment throughout my sleepless night. There was no indication whatsoever that death was lurking on the horizon.

  When things hadn’t improved by Thursday morning, my headspace plummeted, and the worry I had attempted to stave off not only resurfaced, but multiplied. Because of my sleepless night, I asked my husband to manage our son’s morning routine. The fact that my pain level was too severe for me to be involved was concerning to my husband. But he, like I, was not fully prepared to face the ramifications of any outcome other than the one that would end five months from that moment with us bringing home our second baby. He, like I, hoped this tornado of pain, uncertainty, and emotional overwhelm was temporary.

  Still, I called a friend to ask if she’d be able to take our son, Liev, home from preschool at the end of the day and keep him for a while, just in case I still felt like this in the late afternoon. My husband was incredulous: “Why would this random Thursday be the time for our child’s first-ever sleepover? Isn’t he still too young for that?” The answer was probably yes, he wasn’t quite ready for a sleepover, but neither would he be prepared to see trauma unfurl before his fledgling eyes. While I couldn’t have anticipated in my wildest dreams (nightmares, more like) what was about to happen, I still didn’t want to take the chance that my sweet boy would have to witness anything grim.

  The last thing I wanted was to be alone, but I didn’t ask Jason to stay either. He had an important workday ahead, and I figured I’d be uncomfortable at best and unable to play cars with my son in the afternoon at worst. So my husband left for work, my son for school, and there I was. Alone.

  And that was when I realized there was no going back. There would be no going back to unbuttoning my jeans after a meal to make room for my growing belly. No going back to joking about how badly I wanted a beer with dinner—a hoppy IPA I could almost taste even though I was entering my fifth month without one.

  Then, there would be nothing but going back. Back in time. Losing the pregnancy, and becoming a mother of one again. I miscarried, in my home.

  • • •

  As the cramps strengthened through the morning hours and the color of the blood changed from dull to bright once again, I began to pull my pants on to go see the perinatologist. I hoped seeing this maternal-fetal expert, a subspecialist of obstetrics who performs the twenty-week anatomy scans, genetic amniocentesis, and other such procedures concerning fetal care, would give me answers, even though it was unlikely he’d have any additional information than what I had ascertained two days prior at my ob-gyn’s. But I was desperate. I was determined. I was obsessed with finding a way, any way, to keep a tight grip on a future that, on some level, I knew was slipping away.

  I never made it to his office that afternoon. As I shimmied myself into one of my maternity tops, panic overtook me. My palms began to sweat, my heart raced as if I’d just run a half marathon or downed gallons of undiluted black coffee. I felt light-headed and sure I’d lose consciousness. Somehow, I made it to the bathroom, shuffling slowly. I thought if I could simply empty my bladder, calm my breath and apply a cold compress to my face, I would resume normalcy.

  Breathe.

  I didn’t know it then, but I was in the active phase of childbirth, in what is termed “transition.” Moments from expelling a baby, the body rejiggers for release.

  • • •

  I heard a pop. Or did I? For better or worse, I simply do not know anymore. Maybe there was a distinct sound; a warning, as if my body was trying to say, “Please, get ready.” Perhaps there wasn’t, but in the recesses of my mind I have created an audible line in the sands of time that distinguishes the “before” and the “after.” Before and after I felt an urge, almost a compulsion, to howl a guttural “no” in sheer and utter disbelief. Before and after I looked down. Before and after I saw her.

  When I started to urinate, something I to this day have trouble even recalling occurred. Something that would change me in ways both diminutive and profound. Something that, unlike the “pop” that may or may not have occurred, I cannot force my mind to question. My baby slid out. I saw her there, dead, dangling from me mere inches from the toilet-bowl water. There was some movement—maybe just from falling? I don’t and will never know—and, just like that, I was overcome with physical relief, after having labored for hours. A relief that anyone who’s experienced childbirth will understand: the quick kind that’s instantly replaced with an overwhelming gravity. My window-clad house should have shattered from the pitch of my prolonged primordial scream. It didn’t.

  I did.

  • • •

  I frantically texted my doctor; somehow I had the presence of mind to know that if I didn’t, not only would my daughter die, but so could I. She called immediately. I was loud, clamoring for instructions on how to handle the medical chaos.

  Her first direction was to get a pair of scissors. Scissors! I walked from the toilet to the medicine cabinet for a pair that had previously only been called to duty for eyebrow trimming. I reached down and held the baby, clutching her close to my vagina, which was all the umbilical cord would allow. I knew I had to get back to the toilet to make the cut—to be near the phone and my doctor’s counsel; to spare my hardwood floors. One can’t explain the places our brains go in these moments. Nothing can prepare us for these confounding traumas—nothing—so I try to grant myself the grace that comes with knowing I survived as best I could. I cared about the hardwood floors, because some part of me knew my mind could not focus on much more.

  I crouched over the toilet and cut the umbilical cord, then immediately began to bleed in an obviously emergent way. She was in my hands ever so briefly. She. But as the medical emergency I knew I was experiencing grew more dire, I placed her on a nearby hand towel. No longer part of a symbiotic union, dizzy with despair and confusion over this separation, I somehow found a way to stay the course on the practical matters of caring for myself: attempting to get dressed, stuffing towels into my underwear because the hemorrhaging wouldn’t stop until the placenta was delivered. My doctor talked me through what to do, stressing the need to get to her office, and quickly, with my baby in a bag to send to the lab for testing.

  I wish I had had it in me to spend more time with her connected to me, before the cutting and the bleeding and the primal rush to save my own life; before the hand towel and the completely incongruous plastic grocery bag. But it didn’t feel possible. Things were moving fast. My heartbeat. My doctor’s words. The blood.

  Alone with her in my bathroom—the bathroom where I had envisioned giving her a first bath, or watching her and her older brother splash playfully in the tub—I continued to flush the toilet over and over as the bowl refilled with my blood. This was an emergency situation, but I knew if I called 911, I’d have to somehow make it down four flights of stairs, including ones outside, to let the paramedics in. I couldn’t manage it, nor did I really want a group of strangers running through my home in the midst of this intimate collapse of my life.

  And there she was. She. She was bigger than I would’ve expected at sixteen weeks along. She seemed robust. She seemed possible. In her face, I saw such a clear resemblance to my sweet little Liev, my son who had just been robbed of a sibling.

  My doctor insisted I stay on the phone with her until Jason arrived, as he darted through Hollywood traffic to get to me. He ignored red lights and stop signs, but still needed to weave up jam-packed Laurel Canyon Boulevard. I had texted him in the late morning with an update about the change in hue and intensity of the blood, and so when the baby emerged there on the toilet, I texted again in earnest. “The baby fell out. I need you. Please come home,” I wrote as my hands shook. (On that particular day, he was working in close quarters with collea
gues, hence the texting instead of calling.)

  An eeriness set in after the initial rush of adrenaline—a surreal, documentary-like feel. My mind slowed. This level of intensity was something I had only seen in movies, I thought, and was aware that I could either die here or summon the fortitude to push on.

  • • •

  The truth is, at sixteen weeks pregnant, I had thought I was out of the woods. I assumed braving the first trimester and making it into the second meant I was in the safe zone, where pregnancies stuck and fetuses were bound to become babies. Somewhere around eight or nine weeks, I shared the news of my pregnancy with family and friends. I wasn’t necessarily a proponent of waiting until the second trimester, as our culture tends to advocate, but I’ll admit, a tiny part of me was concerned that sharing my news early might somehow jinx it. I had long figured that if I were to miscarry, I would surely want my cadre of loved ones in the know, tucked in by my side and supporting me.

  My belly bulged, prompting patients to ask about my current state of affairs. “Yes, I’m pregnant,” I’d reply. “Due in the spring, early April.” I’d answered the standard gamut of questions: “How are you feeling?” (Like crap, mostly.) “What are you having?” (A girl. This time we found out the sex, unlike my pregnancy with Liev, in which we decided to keep that a surprise.) I suddenly realized I had a lot of people to reach out to when catastrophe struck.

  Sitting there on the toilet, in an effort to galvanize physical and emotional wherewithal, I fervently texted a few of my closest friends and family “I HAD A MISCARRIAGE.” I could not summon them to physically be by my side, but as the blood continued to drain from my body and she remained in my presence—both of and not of this world—I found myself reaching for some semblance of community, of comfort, of a way to tether myself to the living as I remained in the presence of death.

  In the meantime, Jason had made it home, and I had instructions to relay to him from the doctor, who was still on the phone.