This is Chapter 3 in the Infertility Memoir. Read previous chapters here.
While we acknowledged our sadness, it was hard to take the time we needed to process our loss. We were so focused on getting through the PCS, getting follow-up care and everything else, that grieving was almost an afterthought. Maybe that was a good thing, maybe that’s what we needed to do, or maybe that’s how we were forced to grieve by our circumstances.
In June 2019, we were able to shift our focus to getting settled in our new home. It was also time to establish care with a new fertility clinic, which if you are a military family reading this, you know the referral process is long. I took time to research which clinics in the area accepted TRICARE. Even though IUI and IVF aren’t covered, things like diagnostics are covered, so we still needed to use a clinic in the TRICARE network. Another key feature I was looking for was whether or not the clinic offered a military discount because treatments and the medications needed are very expensive without insurance coverage. Luckily, we found a nearby clinic that had a discount and a highly-rated doctor who was accepting new patients.
We were surprised that we only needed to wait about a month to have our initial consultation. When we met with the doctor, she informed us that we needed to redo all of the diagnostics because their policy was to run their own diagnostics rather than use our medical records. So I had to redo all the bloodwork, ultrasounds, hysterosalpingography (HSG), and sonohysterogram (SHG) which ended up taking about a month and a half to complete. Have I mentioned how painful those tests can be? Let’s just say they can be more painful than menstrual cramps, mixed with the awkwardness of having your annual pap smear and they involve catheters.
After all of the testing, our new doctor agreed with our doctor in Arizona, that the best course of action was to try three IUIs before moving to IVF (per the Cleveland Clinic, during IUI, sperm is injected directly into your uterus. IVF is a multi-step reproductive technology that involves egg stimulation, retrieval, lab fertilization and transfer). Our doctor tried to ease our minds about trying again after our loss and rattled off statistics that most people go on to have successful pregnancies after experiencing miscarriages. She also planned to change our medication protocol a little bit by adding progesterone to help sustain our next pregnancy in case that was a contributing factor to our miscarriage. I remember feeling hopeful listening to that information, but still worried. In the back of my mind the question “What if it happens again?” was there, and I tried so hard to push it out. I tried so hard to be hopeful, but losing a pregnancy is so incredibly painful and difficult to move past.
But bravely and a little fearfully we started our next IUI cycle. Our second IUI was done in August, and the two-week wait (TWW) was the most excruciating time. I had read that a lot of people get pregnant right away after experiencing a miscarriage and was hopeful that it would work. Then a day before I was supposed to go in for a blood test, I caved and took an at-home pregnancy test. I just needed to know, and I knew that the fertility drugs that can cause a false positive were out of my system. I was shocked, scared, and elated all at the same time: It was positive. I ran downstairs to tell my husband. While we were happy, I don’t think either of us trusted that it was true just yet.
Sure enough, the fertility clinic confirmed the next day that we were pregnant. The following week I went in every other day for bloodwork to confirm that my levels were increasing, and then scheduled our first ultrasound. I was absolutely terrified about that appointment, all of the negative scenarios crept into my mind. I wasn’t sure that I could go through another loss again. But, everything was great, our baby was growing right on track, my uterine lining looked good, and all my levels were right where they should be. I was feeling more confident and hopeful. We counted down the days until our next ultrasound a week later.
Near the end of September, we had our second ultrasound, and we were relieved to see our baby’s heartbeat on the monitor. A 1,000 pound weight was lifted from me because I knew the risk of having another miscarriage dropped significantly once a heartbeat was detected. This also meant that we were graduating from our fertility clinic and could start seeing my obstetrician. We felt like all of our fears and years of trying were really coming to an end this time.
As soon as we got home from that appointment I got on the phone to get my first appointment with the OB’s office scheduled. I was relieved that they wanted me to come in the next week for an eight-week ultrasound. They informed me that the nurse practitioner usually does the initial appointments and that I would rotate between all of the providers. I was a little nervous that the only appointment available was during drill, and that my husband wouldn’t be able to come. Especially because the morning sickness had kicked in, and I didn’t want to drive myself.
That morning I reluctantly drove myself to my appointment, but was excited and relieved to get another glimpse of our baby so soon. They were a little beyond schedule, but let’s be honest, is there ever a doctor’s office that is on schedule? Once I went back, introductions were made, and medical history was taken, which was traumatic because you have to answer questions about pregnancies and live births. This is the one part that I have never understood, and this was my second time being seen in this office in less than six months. Yes, I had a miscarriage a few months ago it should already be in my chart, do I really need to relive every date and detail for you again? But anyway, when it was finally time for the exam and ultrasound, there was only silence. The nurse had this troubled look on her face, and then eventually said she was having trouble and needed to get one of the doctors. My heart sank and the tears started falling from my eyes. This couldn’t be happening again.
I remember the doctor coming in, introducing herself, and then resuming the exam. After a minute or two she confirmed what I already knew, we had lost our baby, and that I was experiencing a missed miscarriage. I just cried, alone in a room with strangers. It was a four-day drill weekend and my husband wouldn’t be able to come home. How was I going to tell him? After a few minutes, they came back with some information and told me that someone would be calling me that afternoon to go over our options.
I sat in our car for a few minutes and just cried. I finally got the nerve to call my husband to tell him what had happened and to discuss when I needed to come to pick him up from work because we only had one car. That was one of the hardest calls I’ve ever had to make. Our world came crashing down; we had been so hopeful, and we had started making plans but it was for nothing.
To our surprise, my husband’s unit sent him home and excused him from the rest of drill weekend. We cried and waited for the doctor to call. She gave us three options: let nature take its course with the possibility that they would need to intervene, I could be prescribed pills to end the pregnancy since my body hadn’t recognized that the baby died, or we could have a D&C (dilatation and curettage, which removes tissue from the uterus) done. After a lot of thought and discussion we elected to have the D&C done since the other options still could have resulted in the need for a D&C. Another factor was that we were leaving in less than two weeks to visit with family in Texas and then onto Pennsylvania for a family wedding. The finality of the D&C made sense for us. It was still a muddy path to navigate full of emotions heightened by the still ever-present morning sickness and hormones.
Waiting days for the procedure was pure torture. My body still thought our baby was alive and growing when in fact he or she had died days ago. It was so surreal. I questioned everything I did and blamed myself because it seemed obvious that something was wrong with me. I asked over and over why this was happening to us, and was just utterly crushed. At least this time around I could curl up into a ball in my own bed and cry. I could mope around, veg out in front of the TV, and do all the ugly crying I wanted because we were home.
A day before the D&C was scheduled, we decided that we needed to tell our family what was going on, since I was having a procedure the next day. It was incredibly difficult for us to open up and admit that we had been struggling to get pregnant, that we were pregnant but that we lost the baby resulting in needing surgery. But we could feel the weight lifting off our shoulders from releasing our secret struggle.
On the day of the procedure, we went to the hospital, and I was not expecting to need to make any of the choices that were thrown at us that day. We were asked what we wanted to do with the remains, did we want to pay for burial, cremation or to have the remains discarded? I instantly started crying because the whole situation was so overwhelming. I remember thinking this is information that should have been given to us in the days leading up to the procedure so we could properly answer, instead of making a hasty decision. I think we made the right choice but it was something that we never expected.
Thankfully everything went well and I was able to go home that night. Having the D&C allowed me to finally process the loss; it was real now. My body physically felt the loss and I no longer felt pregnant. I remember scrolling on Facebook and seeing a post about an event the following week for Pregnancy & Infant Loss Remembrance Day. Something shifted in me.