I Had a Miscarriage

by Jessica Zucker

  The next time I saw Claudia, her daughter was three weeks old. She brought her to our session, and as her sweet baby calmly nursed, Claudia told me about the labor and delivery process and how things have been going ever since. Still hesitant to fully sink into motherhood, she spoke of her simultaneous enormous love of her daughter and her detachment. As we waded through these ubiquitous feelings, I found myself mentally revisiting the unimaginable loss sustained by my mother-in-law.

  She had not gone to therapy after the birth and death of Chaya. She didn’t have much support. So how did she fare? Was she afraid to get pregnant again? What was she thinking and feeling throughout her pregnancy with her twin sons and in those early days after giving birth to them? How, if at all, did those thoughts and feelings affect the initial period (or even the long haul) of parenting? Did she feel alone?

  These were things I hadn’t thought enough about until that moment in session with Claudia. Just as I started to feel guilty about never considering these questions before, my focus returned to Claudia and her little girl lying across her lap. We talked about her anxiety and how it swirled at particular times of day. We discussed how the vulnerability of being alive comes that much more into view after loss, and how this newfound look at mortality can hover during the transition to motherhood. It becomes difficult to wholeheartedly open yourself to this experience once you become conversant in holding back on hope. To believe it’ll last. The perverse what-ifs might hauntingly make their way into the nursery. They might. Or they might not. For Claudia, they did.

  • • •

  I fell in love with her at first sight. Noa Raye. I really did. But like Claudia and countless other parents who journey through pregnancy and parenting after pregnancy loss, I hesitated to open my heart fully, albeit unconsciously. Time, of course, has allowed for the softening of the past and the fear that came along as a consequence. But when I learned I was pregnant not long after my miscarriage at sixteen weeks, I was simultaneously ecstatic and terrified. I’m a lover of the state of pregnancy—through and through—but after my loss, I was awash with fear that translated into emotional distance—trauma’s residue. What-if what-if what-if. What if–ing felt like a full-time job.

  Parenting after loss can be copiously complex. It can range from the challenging—the piercing anxiety and the residual effects of PTSD—to the overwhelmingly positive, for what has allowed me to marvel at my children’s existence at new heights I’m not entirely sure I would have reached without having experienced miscarriage. Before my loss, I think I’d really taken for granted the mere wonder of this fragile and unpredictable life. That blissful state of unknowing is long in my rearview mirror, and in its place now sits a magnified sense of wonderment over the lives of my two children and the loss that, to this day, lies in between. What was born from the mess of it all was the realization that immense gratitude and love can often and easily live alongside complicated feelings of grief and anxiety. Mothering can be complicated beyond our expectations, no matter how deeply we yearned for the role.

  I was not the same kind of mother after my miscarriage. On one occasion, shortly after we’d introduced Noa to solid foods, she woke up from a nap spitting up in a way I’d never seen before. Instead of seeing this as a normal occurrence, cleaning her up, consoling her, and moving on, as I’d done so many times with Liev in his infancy, I panicked. This seemed different. I was alarmingly convinced that this could be Noa’s end—that somehow she’d throw up again and again, that her body would purge its stockpile of resources, and then poof, she’d be gone. I called the pediatrician straightaway as I watched Noa go from her usual pinkish color to opaque to a camouflage green. I explained what had happened to the nurse on the other end of the line. She instructed me to hold Noa upright and monitor her as we remained on the phone together. The nurse compassionately listened to what felt like a big ordeal to me but was a small one (if an ordeal at all) to her. Noa was perfectly fine—thankfully, she resumed normalcy within a minute or two—but this was the turning point that alerted me to the fact that maybe I was not.

  A few weeks later, as I drove along Mulholland Drive’s winding curves on my way to work, I found myself keenly aware of the lack of guardrails along the road’s steeper edges. I’d been driving this road without a second thought for as long as I could remember—music blasting, dancing in my seat, enjoying the glorious view—straddling the San Fernando valley and the hills of Hollywood. But on this particular morning, amid the clear, blue skies and the all-too-familiar surroundings, my mind veered from taking in the beauty to realizing it was possible I could actually slide off the edge. With these eerie and porous feelings encasing me, I had to coolly talk myself off the proverbial ledge as I continued along my drive to the office. But this disquieting experience drove home something unfortunate: the ubiquitous aftereffects of PTSD were still clawing on, showing themselves in ways that felt unbearable. Hard to swallow was the fact that this new stage—of mothering my little rainbow baby and her older brother—was accompanied by an intermittent, pervasive ticker tape of what-ifs.

  • • •

  Claudia wasn’t aware of my loss history. Not to my knowledge, anyway. When she came to therapy, I was already out of the baby-making phase of my life. It’s possible she was privy to my writing on the topic of pregnancy loss, but we hadn’t discussed it face-to-face. I was struck by how different this felt, how interesting it was, to sit with Claudia (and other newer patients) as she (and they) often described feelings I knew too well in my own life, but which I had good reason to believe they had no clue I could precisely understand. I got them in a way they might not have known, or ever assumed. What a different phase of my career this turned out to be.

  With my specialty area now bound to me corporeally as well as metaphorically, I was rendered uniquely able to identify with my patients in an entirely different way from before. For better and for worse. I’d pursued emotional work; I knew that from the get-go. I loved the idea of sitting with people as they bravely poured over the particulars of their lives—making meaning, solving relational riddles, exploring long-held beliefs. But what I didn’t know was that a handful of years into private practice, my work would no longer be nebulous or simply the stories of others. It would now be my story too. If patients ask about this area of my life, I tell them. But if they don’t inquire about my personal experience with loss in motherhood, I keep it to myself.

  When Claudia’s daughter was just shy of four months old, Claudia made an important decision. A well-thought-out one. One she had been hesitant about since her daughter’s birth, when it weaved its way into the ruminating thoughts as yet another anxiety-producing thing to consider in this nascent transition. Her anxiety hadn’t let up. In fact, it had only worsened. Sometimes, time alone does not make a dent. And sometimes, talk therapy isn’t enough either. Sometimes, something more is necessary. In this case, it was. Claudia decided to pivot and try something new. She started medication, under the care of a perinatal psychiatrist I recommended after seeing how deeply she was struggling.

  Within six weeks of taking the prescribed SSRI, Claudia described feeling like herself again. The medication sufficiently cut through the anxiety, and though the initial side effects were off-putting, the benefits were substantial. The constant loop of what-ifs faded into the background and eventually fled the scene completely, allowing her to relish more subtle and enjoyable feelings, like joy and contentment—giving her access to being more fully present. She was still human, of course, and experienced the expectable ups and downs, but since she was no longer lambasted by unruly thought patterns, things were looking up. She’d been tentative about going this route, but now that she was reaping the benefits, she was more resolute than ever that this was in fact a wise move.

  The stigma associated with attending to mental health in our culture is chronic. Talk therapy is troubling to some, yes, but oftentimes, medication is even more taboo. Seen as a stealth thing, taking pills is often done in private and
shared with no one, or if revealed at all, it’s done so sparingly. I could relate with Claudia in more ways than one. I’d been there too.

  After my Mulholland Drive incident, I knew it was time. It was time for me to address my anxiety in more ways than one. Talk therapy was grounding and illuminating, but it wasn’t able to affect my biology the way my anxiety was unabashedly screaming to be addressed. Too many incongruous instances were now under my belt. I had mixed feelings about starting medication, though. I bargained. I kept hoping time would do the trick and I’d get to skip this step.

  The biggest stumbling block—which I perennially used as an excuse—was breastfeeding. I half joked that Noa might’ve wanted to nurse until heading off to college—that’s how much she enjoyed that bonding time. I didn’t want to stop. I loved our time snuggled up together like that too. Noa had been eating solids for a long time—she was in no way reliant on my milk for sustenance—but I knew that if I were physically near, she’d inevitably yearn for the breast. For comfort and closeness. And I’m sure I would’ve wanted that, too. I thought that push/pull might rev up my anxiety all the more. Although SSRIs and breastfeeding can safely happen in tandem, considering this option became yet another source of anxiety for me. My chorus of what-if what-if what-if played on loop about this too. About traces of medication she’d possibly be exposed to, about what this could mean for her health, about my role in it all. It felt too delicate and too difficult to decide.

  Finally, sick and tired of gritting my teeth to get through it, I asked friends how they’d gone about this transition (since Liev weaned on his own at sixteen months), and promptly took their suggestion to step out for a couple of days to change up the pattern. I booked a hotel room and, after twenty months on the breast, I weaned her over my birthday. It worked. Not without its associated feelings, of course, but it did work. And it was then—when my breastfeeding days were up—that I started an SSRI, with the hope of puncturing the what-if cycle once and for all. It took time, but it happened. The softening of my senses and my perceptions of them was palpable, and like Claudia, I felt much more like myself again.

  Anxiety has the capacity to temporarily steal joy. It can wrangle the mind—baiting it to singularly focus on negative possibilities, whether true or false. In so doing, anxiety surreptitiously stomps out a spectrum of other feelings that actually exist simultaneously. A tough way to mother, it was quite a relief to have nuance back and to reconnect with ease and calm once more.

  • • •

  Opal came to see me after learning she would not be able to carry a baby. She’d been diagnosed with a unicornuate uterus—a type of congenital uterine abnormality. She found this out the hard way. She was twenty-four weeks along in her first pregnancy when her baby’s heart stopped beating. After several doctors’ appointments and an eventual X-ray, it was clear she wouldn’t be able to safely proceed in getting pregnant again. As if grieving the loss of her son wasn’t difficult enough, now she was faced with a whole different kind of grief entirely: the loss of future pregnancies. “You’d think losing my son would make me exempt from additional heartache, but no, now I’ve been slapped with this other horrific piece of information about my body that means grieving pregnancy and the chance to give birth altogether. Loss piled on loss. It’s all just too much. I can’t win. It’s so unfair.”

  I’ve heard similar thought processes numerous times over the years: the notion that a major hardship should somehow prevent future ones. I could relate, as I felt a variation of this way, too, after my loss and into the next pregnancy with Noa. There’s no way I can endure more. Lightning does not strike twice. It just can’t. But it can. And sometimes it actually does. And it’s quite clear that no one is keeping score on the severity of trauma or the amount of it that each individual can endure.

  “I used to think God had a plan, but how could all of this be part of my plan? Or his plan for me? What could I have done to deserve this?” Opal wondered, simultaneously enraged and defeated. Sometimes religion and spirituality seem to anchor people as they attempt to make sense of their tragic losses—providing a belief system amid the chaos, a sense of connection and community, or a linear pathway for thinking about life and death. But what happens when the betrayal of one’s body, as in the case with Opal, feels so incongruous with these long-held beliefs, or upends a lifetime of thinking that things were one way, then they turn out to be something else completely?

  Opal has been dead set on being a mother ever since she was little. She talked about her childhood with fond memories, filled with daydreams about mothering in her eventual adulthood. As a kid, she practiced. When she played with dolls, she almost always appointed herself as the mother among them. And within her family of origin, Opal had taken to mothering her younger siblings ever since she was old enough to change diapers. When she grew older, Opal was a conscientious student and relished a fruitful career, but she shared with me that motherhood was the role she wanted more than any other. Several months after her stillbirth and the subsequent news about the shape of her uterus and its implications, she and her partner began researching surrogacy. An option previously not on her radar—not in her wheelhouse. She didn’t come to this easily, as she sorted through conflicting feelings—based on her faith—about creating embryos she may have to destroy. “I feel like I’d be playing God and that just isn’t right. It goes against my beliefs. What if we get loads of healthy embryos and we only use two? Then what?” she said as she reckoned with next steps.

  She proceeded with the injections, supplements, acupuncture, and two rounds of IVF. From these, she got five healthy embryos. She’d envisioned having three children, and this remains a thorn in her side: having to—at some point—decide what to do with the extras. Opal’s grief hovered over her through this period of her life, as she desperately missed the son she didn’t get a chance to mother. But she tried to convert this energy into hope during the “two-week wait.” They’d chosen a surrogate, done the procedure—transferring two embryos—and now Opal was on pins and needles awaiting the outcome. That two-week wait until pregnancy testing: a nerve-wracking, pregnant pause.

  Opal reported that she stayed busy and tried to distract herself. She turned to prayer mostly, and met with her priest. She didn’t want to stress over this, but it was inevitable. Those two weeks, she told me, felt more like two excruciatingly long years. Opal was scared that it wouldn’t work and also scared that it would. She was scared to be faced with yet another pregnancy loss. She was scared, most of all, of allowing hope to spike—if the results were positive—with no guarantee pregnancy would last.

  When she received the call from her doctor with news, she was trembling. “I literally couldn’t speak. I was so overwhelmed by my emotions. I had so many. I just wanted to know: Was it a yes or a no?” She wanted more than loss motherhood so badly. She didn’t want her maternal story to begin and end with stillbirth, but understandably feared it might. Opal constantly worried this would be the extent of her parenting experience: giving birth to a twenty-four-week-old baby who never took a breath in the world, never cried, never crawled. She recounted how she threw the phone to her husband, flustered, as the doctor began to speak. Too overwrought to listen in on the conversation, she intently scrutinized her husband’s body language to see if she could surmise if the news was good or bad. It turns out it was both.

  The surrogate did, in fact, get pregnant, but she was pregnant with a singleton, not twins. Awash with mixed feelings upon learning one embryo was thriving and the other was not, Opal took time to digest this information. But as the weeks ticked by, she eventually settled into picturing a healthy singleton and had her heart set on it.

  Opal’s son was healthily born without a hiccup. She’d struggled throughout the pregnancy process, but she got there. The birth was seamless and standard, and as soon as the surrogate pushed him into the world, Opal recalled how she burst into tears—tears that streamed down her face, landing gently on her son’s as he cuddled i
nto her chest. Utter relief filled the room and, at long last, Opal began a new type of motherhood odyssey. With a cooing baby in tow, tiny toes to tickle and marvel at, and diapers to change—as she’d practiced so many times with her siblings—she’d finally reached a destination she had imagined for decades.

  Back in session some weeks after the birth, she reported that despite her dreams finally coming to fruition, she felt nothing. She loved her baby through and through, but couldn’t locate herself. She was all smiles in front of friends and loved ones who came to visit, including her partner, but on the inside she felt empty. Vacant. Zombielike. Quick to anger, unable to sleep, and lacking in appetite, Opal felt inadequate and hopeless and wondered how it was possible she felt this removed from a life she’d wanted for as long as she could remember. She turned to exercise, meditation, church, and therapy. She turned to her midwife, a doula, and vitamins. We spoke about how common it is to experience postpartum baby blues, but we also talked about the fact that her symptoms were worsening with time, rather than clearing up.