How Common is Miscarriage?

We are approaching the beginning of September.  Where did the time go?  I feel like I went to sleep in May, woke up and now it's almost fall!  Fall brings on a whole new set of emotions for us.  October was the month that Lindsey was due, actually she was pretty much due right around my birthday on the 22nd.  Sometimes it seems so long ago and sometimes it feels like yesterday but more than anything it feels surreal.  How many people does this actually happen to?  It is not something that is generally openly talked about but I truly think it's important for people to know.

Infant loss and miscarriage are a taboo in our society.  No one talks about it and no one really knows about it.  I never had a clue, I mean babies aren't supposed to die these days, right?  That is something that only happened hundreds of years ago when medical care was basically non-existent.  However, up to 25% of all recognized pregnancies end in miscarriage.   Sometimes women may not even know that they are pregnant as the pregnancy can end at the same time their period is expected and they will never know about that pregnancy.  A miscarriage is any pregnancy that ends on it's own before 20 weeks.  These seem like high statistics don't they?  I'm not hear to scare you but just to educate you about how many women really do experience this in their lifetimes.

I can tell you I have found out that about 10 women than I know personally have revealed to me that they have also had a miscarriage after they found out about mine.  Remember that those are the women that actually told me and I am sure that there are more that have not said anything.  On top of that I have found even more people that have admitted to me that their wives or aunt or someone close to them have also experienced miscarriage in the past.  There is only one woman that I know personally that had lost her baby in the second trimester, the same time frame that we lost Lindsey.  I want to point out that second trimester losses are much less common than first trimester losses.  I was just shocked at the number of people that I knew personally that have struggled with this without anyone even knowing about it.
If you knew about how many things have to go just right to create life it would make more sense to you as to why things just don't work out sometimes.  It's a sad fact of life but it's real.

That being said; I think it's important to go into a pregnancy with a positive attitude. Those who have had a loss I say that they have lost their pregnancy innocence and if you are allowed to keep that innocence I am so very happy for you but please be thankful for your good fortune and enjoy your pregnancy every day no matter what symptoms you may be experiencing!
Believe me, with my next pregnancy I will be hoping and praying to vomit every day!  Those dramatic symptoms are a good sign that the baby is strong and healthy!

Angel Moms

Angel Moms are Moms of children who have passed away and we are forever bonded by that grief.  I really believe that they are absolutely the strongest of women.  I have met a lot of Angel Moms these past 3 months and I always walk away amazed at the strength, determination and faith that we all have.  We understand how precious life is and how easily and quickly it can be taken away.  It is our job to support each other and the new Angel Moms that unfortunately joining us daily.  We raise awareness of miscarriage, stillbirth and infant loss and hope and pray that no other parents have to join us.

One common myth that I continuously come across is that those of who have have experienced a miscarriage and loss of a child get over it as time passes.  Let me correct that for you, we don't.
It doesn't matter if we have lost a child at 6 weeks, 5 months, 37 weeks, a 4 month old child or a grown up child; the pain and the memories are still there and I know that they will never disappear.  

I was talking to a woman who had a miscarriage 20 years ago and she could tell you how old her baby would have been today.  The phrase "time heals all wounds" can be true for some things but sometimes the wound leaves a scar.  Many women, especially those that have had an early loss that hadn't told many people about their pregnancy will keep their miscarriage to themselves.  That is completely fine and normal to do that and feel that way, but it should also remind us that we don't know what others have been through in relation fertility and children.

I can tell you that one of the most painful questions that you can ask an Angel Mom is "when are you going to have kids?".  This is an innocent question and unbeknownst to the person asking, this woman has had a loss and this question brings up the most painful of memories.  I have personally been asked this question after my first m/c and after losing Lindsey by a few different people that did not know.  I'm sure that when I respond with my reproductive history that the people feel completely awful but it still feels like someone just punched me in the stomach.  You get that butterfly feeling in your chest and stomach, you skip a breath,  your mind just goes blank for a moment and then you answer that dreaded question.  Angel Moms understand that people just don't know and that they don't mean any harm, but that doesn't stop the pain we feel when asked.

Please remember that no matter the age of the baby or child when he/she was lost, the memory of our children will be carried with us for a lifetime.  We will never get over their passing or forget about them.  Please remember that you do not know what everyone is going through in relation to fertility so please don't ask that seemingly innocent question of "when are you going to have kids?.

So what’s the plan?

Despite what has happened this past year we still have a strong desire to be parents, maybe even more so than before.  Losing a baby is probably one of the most traumatic things that a mother and father can go through and for some; this puts a halt to their journey to parenthood.  For Angel Moms and Dads, all subsequent pregnancies are tough.  We know too much to enjoy all the aspects of pregnancy that most parents do; we are no longer carefree, we have lost our innocence, as we Angel Moms say.

I believe the most important thing to do is research to fully understand what happened last time and what treatments are available to treat you and your LO next time.  Of course, another very important thing is to have a doctor that understands and can deal with your specific situation.  A good doctor will have a plan for subsequent pregnancies and will communicate that with you as my doctor has. 

All of my pregnancies from here on out will be considered high risk.  This simply means that my baby and I have a higher probability of something going wrong than a normal mother with no history of complications.  Having lost a baby at almost 19 weeks and likely having IC puts me at higher risk for complications such as preterm labor, PROM (pre-mature rupture of the membrane), infection and so on and so forth. 

As you can see in my previous post “SHG and MRI” I have had a few tests done to check for polyps, uterine abnormalities and any significant structural issues. 

So here is the plan now:

Once I get a BFP your hCG (human Chorionic Gonadotropin) levels are generally checked by doing multiple blood draws.  This is the hormone is produced by the cells that make up the placenta and is also the hormone which gives you that BFP!  They should double every 48-72 hours. 

My progesterone levels will also be tested at this time.  Progesterone maintains the pregnancy until birth.  My levels were on the low side of normal in the past so I generally use progesterone creams. 

I will also be requesting a CBC (complete blood count) to check my white blood cell, RBC, iron, etc. 

A cerclage will be placed at 13-14 weeks, or sewing the cervix shut.  Done at this time, it is called a preventative cerclage.  For the weeks after the cerclage is placed I will be on BR and antibiotics to ensure there are no infections. 

After that I will be monitored every week to every other week.  Cervical length will be checked at this time.  As long as my cervix does not shorten I should not have to be on very strict BR but will have to take it easy.  That means no working, no standing or walking for long periods of time, no exercise, no vacations or leaving the city and a lot of other “no’s!”.

Well, I think that’s enough info for now!  This process is very long and detailed but we are just hoping for the best at this point!  

Cerclage - Photo provided by Laura L. Oliver

Appreciation

I have found a new appreciation for life this past year. 

Death does that to you I guess.  You can either learn to appreciate what it has taught you or you can choose to let it drown you in grief and anger. 

Of course, everything takes time and most people will go through all of the stages of grief, but at different rates.  I would say that the first two months after losing Lindsey were the hardest.  The events that had taken place were fresh in my mind, seeing everyone for the first time and doing everything again since our loss were the most difficult things.  It is hard to explain how your feelings and emotions change as time goes on.  It isn’t easier but it is different.  I haven’t quite found the words for it just yet.  All I know is that this past month I’ve been able to appreciate the little things again; things seem brighter. 

On one of my many walks around our neighborhood I realized that I was appreciating the warm sunshine and the beautiful blue sky again.  During the first few months after our loss even the brightest and sunniest of days seemed dreary and insignificant.

Death, especially of a person so very close to you, remind you just how quickly life can be taken; without any warning, reminding you that it is something that you cannot control.  I believe that the unknown and the things that you cannot control are the scariest for most people but you have to learn how to live with it.  Learn to relax and let things happen.  Of course, do what you can to make everything the best it can be but sometimes we have to learn how to deal with the things we cannot control.  For me, it makes me appreciate every minute of every day.  I have been taking time out of each day to appreciate the day and to do something that I enjoy doing.  Generally this involves taking a walk, painting or sitting outside with a good book.  I have recently signed up for level II of a painting class that I started last fall with a local artist. 

We struggle sometimes.   Some days are good and some are not so good but we have to learn how to deal with that and move forward.

So I guess I am just reminding everyone to appreciate life and take time to “stop and smell the roses”.  

SHG and MRI

My SHG showed no fibroids, polyps or major concerns.  It was simple and quick.  The only pain I felt was when the water was injected into my uterus as my uterus was expanding I had a lot of pressure and some pain.  They told me it would feel like cramps but it felt more like severe cramps to me!  The good thing is that part went quickly and the whole procedure was soon over.
The only side affect afterwards was leaking water throughout the day….fun fun, and spotting which lasted only a few days.  Generally any time that the cervix is messed with you will end up with spotting so no surprise there.

My MRI was yesterday.  It was an MRI with and without contrast.  I had to arrive at 7:30am at RMH.  For all procedures like this you must get pre-approval from your insurance company or they will not pay for it.  My doctor's office got all of that done for me before I even scheduled the appointment and I had also received a letter in the mail reassuring me that it was an approved MRI.  Of course, with an MRI you cannot wear any metal of any kind and they ask you many questions before hand to ensure that there is no chance of metal being in your body.  The MRI machine uses magnetic fields and pulses of radio wave energy to look at, in my case, my pelvis including uterus and ovaries.  WebMD explains what an MRI in more detail.

For MRI study of your pelvis you have to lay on your back and they put this coil over the lower half of your body and kind of strap you in.  I was thankful that I did not have to go very far into the tunnel of the MRI machine, I wouldn't say I am claustrophobic but who likes to be stuck in very small space like that?  I was given headphones with music playing.  However, when the machine was going I could only faintly hear the music.  The machine makes loud taps and pulsing noises during the sets.  In between the imaging sets I was allowed to move or adjust if I needed to, but while the machine was going you are not to move in any way!  For the last two sets I was injected with contrast.  It was injected into the vein in my arm in which blood is usually drawn from.

Thankfully, I received the results the same day!  They had been reviewed by the radiologist at the hospital and then by my doctor.  The results only showed what we had already learned from the SHG.  I have an arcuate uterus.

A. is a normal uterus. B is  unicornuate C. is arcuate (which is what I have) D. Septate E. Bicornuate    F. Didelphic uterus with a septate vagina 

These images are from GLOWM.  

My doctor said that an arcuate uterus is not known to cause any pregnancy complications so she is not concerned and believes that I can carry and deliver a healthy baby.  

Next week is my fertile week so KMFX for a BFP in the next few weeks!