What Happens Next

CW: pregnancy, pregnancy loss, blood, medical procedures.

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October 2020.

I never used to be someone who cries a lot, but then I had four miscarriages.

Now, I am someone who sneaks away from social events for a quick, private weep. I am someone who burst into tears in waiting rooms when I am told the blood tests I need will be slightly complicated. I am someone who has sobbed all over anaesthetists prepping me for surgery, broken down suddenly and unexpectedly in the middle of sex, blubbered as sonogrammers shoved ultrasound wands inside me, and bawled while eating famous scallop pies and trying to be on holiday.

I cry now because we’ve opened Pandora’s box again, and we can only wait as all the familiar monsters come out.

I’m pregnant for the fifth time, and we are on our way to an early pregnancy ultrasound.

What happens next is it won’t be gone, not on this scan. It will just be ‘a bit behind.’ Someone will say, ‘well, maybe your dates are a bit out, that happens all the time.’ They always start with that because it does happen all the time. Just not to me.

There will be a heartbeat, but it will be slow. I will have to wait a week, two weeks, three weeks, four weeks having scan after scan, and it still won’t be gone. I will watch as it fails to grow, as the heartbeat slows, weakens, fades to nothing. The whole time, I will keep having symptoms. I will have nausea all day every day. I will vomit.

And as I wait, I will turn into emotional jenga. My side pieces will start coming out. Holes will open in my heart, gaps in my body, spaces in my mind. It will be all I can do to handle them gently and add them back to the top of the stack without losing structural integrity.

Maybe I will start bleeding and the miscarriage will be natural, but that’s only happened to me once. More likely, once the heartbeat finally stops, when there is no chance, I will be given the choice to either keep waiting for it to pass on its own or to have medical management. At that point, which will probably be over a month from this car trip, I will choose medical management.

The medical options are minor surgery or medication. The surgery is a very safe, only a ten minute procedure, but if you have it many times it can start to increase your risk of pre-term labour in future pregnancies. I have already had it three times; for the first two losses, and then for a hysteroscopy to scan my uterus after the fourth. The increased risk is still very small, but I don’t want to let go of the idea that pre-term labour might one day be something I have to worry about. So I will pick the medication that triggers bleeding, like I did the third time.

I will have to go to hospital and stay there all day to be monitored. It will be boring. It will hurt. It will be lonely. I will bring a book to read, like I did the other time.

I will try not think about the fact that the reason the nurses are always in and out is to collect the ‘product’ of the pregnancy from my pads and from my urine so it can be tested. I will try harder not to think about whether or not I am leaving my not-baby in a bucket of pee on the bathroom floor.

I will try not to worry that I will have to stay in a whole second day if I do not pass enough the first day, like I did the other time. That time, a friend had visited with a gift-book so I was covered for entertainment on the extra day, but this time I will be ready and bring extra books from the start.

We don’t talk about miscarriage enough. Certainly not with people who haven’t had one themselves. And because we don’t, when it happens to you, there are two choices. Both have a price-tag.

You can hide it and remain silent, and the price is silence. You have to pretend every day that your baby didn’t happen. You have to pretend to be happy, or at least normal. You get to avoid dolling out bad news. You get privacy. You get no understanding, no support.

I choose option two. I spoke up.

I don’t regret my choice. Silence is cold and terrible, and I never choose it while I have strength. Option two brought me a lot of kindness and support and love.

But when speaking up is unusual, it has a price-tag too. And the price is you have to keep speaking up. Even on the bad days. Even when the questions punch right through you. Even when it’s the thousandth time you’ve said it. Because you are an educator now.

And because maybe, maybe, if enough people choose option two and enough questions are answered enough times then it will all slide into the pool of general knowledge and option two won’t have a price-tag anymore. Maybe it can be a little easier for the next person.

I hope so.

Because what happens next, when I’m out of hospital, is that I will be asked,

The chorus started after the first miscarriage and grew in volume. It reached its peak by the time of the third miscarriage. I tried to block my ears to the two silent words I always heard at the end.

(with you)

How do you answer a question like that? I still don’t know, but I had to say something, somehow. That’s the price.

I had responses rehearsed:

We don’t know. There might not be a problem. Miscarriages are more common than people think, and most of them are never explained. I couldn’t have prevented this. But the doctors do want to run some tests now that I’ve had so many.

I lost count how many times I said some variation on that. And every time I said it to someone else, I said it to myself too.

No, it’s a myth that stress causes miscarriages. Besides, I wasn’t stressed until after the miscarriages started. I couldn’t have prevented this.

I had blotted out the self-blame after the first miscarriage and the second, shut my eyes and stuck my fingers in my ears and shouted “lalalalalala” every time it tried to intrude. But three times is too many.

Yes, I have been taking the proper vitamins. Plenty of people don’t and still have healthy pregnancies. I couldn’t have prevented this.

And there’s so much judgement around parenting already. People who honestly and idiotically believe it doesn’t count if you have a c-section or feed the baby formula. People who think childbirth is an integral part of being born with a uterus and you can’t live a full life without doing it at least once. People who know the right way to do everything and are always on the lookout for people doing it the wrong way.

No, I haven’t been smoking or drinking. I’ve never smoked at all. I completely stopped drinking whenever we were trying, and I’d rarely had more than one drink in a sitting for years before that. Yes, I stopped caffeine.

I held it off for a long time, but in the end it crept in. The idea that I must have done something differently, must have done something wrong, must not be right for this, must not want it enough, must be broken. And it didn’t matter how many times I said

I couldn’t have prevented this.

I didn’t believe it anymore.

I was done being an educator. I tried not answering. I tried saying I didn’t want to answer. I tried getting my husband to pre-emptively mention to people we’d be spending time with that I didn’t want to be asked anymore, I wasn’t coping, and please, please don’t do it.

None of it worked. I had already chosen option two, I couldn’t unchoose it. In the end, I answered every single time.

I couldn’t have prevented this.

I couldn’t have prevented this.

I couldn’t have prevented this.

What happens next is that I will remember the third time I miscarried, in the cruel window when I was still pregnant but the baby wasn’t growing and the heartbeat was slowing, and the nurse who took my blood for a test telling me that I must not want the baby because I didn’t look excited enough. I wanted to melt away in shame. I wanted to explain what it was like, knowing what comes next.

But I just said ‘thank you’ when I left.

I couldn’t have prevented this.

What happens next is I will see another specialist. Even though my GP ran all the tests she knew about. Even though she’s already sent me to specialists to run the tests she didn’t know about. The new specialist will be impressed with the number of tests we’ve already had done, warn me that more often than not miscarriages are never explained and I should be ready for that outcome, and then run a few more tests.

After the third miscarriage I had something called a HyCoSy. Basically, that’s an ultrasound taken while they shoot saline up into your uterus and fallopian tubes so they can make sure everything is the right shape and not blocked.

Allow me to set the scene. It was an old house made over into a doctor surgery. The hallways still had gorgeous floorboards, the waiting room looked like a perfectly sterile magazine living room, the receptionist was definitely the sort of person who would wear a colour like taupe, and everything smelled expensive.

Enter me.

Chronically ill, professional disaster, mix of dark humour and puns, rarely wears make-up and frankly doesn’t see the draw, never grew out of finding farts hilarious, known to wear dinosaur-print dresses or sometimes men’s clothes, definitely leaning more non-binary than female.

Also, I was wearing leggings as pants.

Fortunately, the surgery room itself wasn’t so scary. It was all linoleum, stirrup-ed seats and ultrasound machines. Things I had been around a lot and was very, very comfortable with by this point.

So, there we were. My pants (leggings) are off, my feet are in stirrups, my husband is holding my hand and a stylish lady in heels I only met five minutes earlier sticks an ultrasound wand and a supersoaker up my vagina.

I would like to preface this next bit by saying I have spoken to other people who have had this procedure and most of them described it as kind of uncomfortable but not the end of the world. That’s what I was told to expect, and if you are ever in this position, it’s probably what you should expect. I have also talked to people who had a similar experience to me, but we’re in the minority. I don’t want to make people nervous about this. This isn’t the usual way it goes.

Okay?

Okay.

It was weird.

I could feel the water. The sloshing. The cold. It went up my fallopian tube, and I could feel that, could have traced the path on my abdomen with my finger if I wasn’t distracted by the fact iT HURT A FUCKING LOT.

This isn’t news for approximately half the population, but cervixes don’t like getting poked. And, turns out, some of them not only super hate it but are downright vengeful about it and stress out your vagus nerve if you dare.

That is to say, I fainted.

If I was someone who looked pretty even when they cried, I daresay I would have come around fluttering my butterfly-wing eyelashes saying something like, ‘where am I?’. If I was wearing taupe and could use perfume without my skin itching, I’m sure I would have at least managed, ‘what happened?’ or possibly ‘I want to speak to the manager!’

Look, I went before we left home. I’m very organised like that. So I’m claiming it was further vagus nerve shenanigans that caused my bowel to twist up and initiate voiding procedure. It’s definitely linked to your gut. I Googled it.

The specialist wanted me to lie down until I felt better, but I was not going to last that long. So, even though things were still a bit grey around the edges, I got up and tried to put on my pants (I mean, yeah, leggings).

Unsurprisingly, this wasn’t a great idea. I immediately had to drop to the floor and put my head between my legs when I started fainting again.

Still without pants.

So my husband and the very stylish lady in heels I only met fifteen minutes earlier got down on the floor with me and wrestled my pants (YES LEGGINGS. With holes, since you have to know. Cut me some slack, I was having a medical procedure and I dressed for comfort).

Also, this whole time my uterus was squeezing itself out like a dishcloth. On the pain scale, I was at ‘literally writhing in’.

When I was successfully wearing my holey-leggings-as-pants, I had to be supported out the examination room, back through the photoshoot-ready waiting-room … all so I could violate an orchid-infused bathroom definitely within earshot of the horrified receptionist.

Anyway, what we learned (other than my cervix needs anger management classes) was that the miscarriage hadn’t quite finished.

A month after I had sought medical management for my third miscarriage and spent two days in hospital with nurses collecting all my blood and ‘product’, and there was still some left inside me.

It wasn’t over.

What happens next is I will have to deal with it for a lot longer than people expect.

Once the fourth miscarriage appeared to be done and dusted, I started bleeding again. It was several months later—my period had returned ages ago and everything had seemed back to normal. Except this bleeding was a little early for where I thought I was in my cycle. Still, that can happen. So I got a pad and settled in to watch a movie with a heat-bag to help with the weirdly-terrible cramps I don’t usually get.

A short while later, I went to the bathroom and…

This, for anyone not familiar with periods, is not remotely normal. You aren’t supposed to totally saturate a pad edge-to-edge to the degree of sodden-ness where if you hold it up, it drips. You aren’t supposed to soak your underwear as well. Or lose blood clots the size of an adult’s fist. You especially aren’t supposed to have all this happen in a little over an hour.

The bleeding slowed, and I was deemed a waste of the ED’s time and sent home.

But it wouldn’t quite stop. Every few days it surged back to the massive-cramps and fist-sized clots degree. An ultrasound revealed nothing more than that my uterus was indeed full of blood. So, since my specialist wanted to get a scope in there anyway to hunt for anything that might be causing miscarriages, they took the opportunity to combine that with the surgical medical management option to clear any teensy lingering bits of pregnancy, which was everyone’s best guess at what was causing the bleeding.

It seemed to work.

What happens next is I will fail at my job. I will not be able to write or draw amusing things. I will not be able to concentrate. My time will trickle away, wasted. It won’t matter how frustrating I find it. It won’t matter how much I want to get things done. None of this is ever optional. My body, my brain, will hibernate without my permission.

Everything I have shoved down will come back up. I will step into dark rooms and flash back to that first dark room, the first time something was wrong. I will close my eyes and see the grainy ultrasound screen with the huge yolk sacs of my twins with no embryos attached. I will shut a door and it will be a hospital bathroom door and I’ll know that behind it is a bucket of pee, abandoned on the floor, that may or may not have contained some cells that once had the potential to be a baby. I will see any blood as a nightmare, the beginning of the end.

I will shove it down again.

I will not be okay

What happens next is that I will think about life without kids. I want kids, I know this. But I also know I can be happy without them. What I can’t be is happy in this endless cycle, this limbo, this hellish groundhog day. I can’t be happy knowing exactly what happens next, and that it’s always horrible.

I will look around me for other people who can’t have children. I’ve met one or two, in a once-removed sort of way, but no one who is close. I don’t know any people my parent’s age without kids (if not biological, then of the step variety), and no one else in my close friend group has even tried.

I will look around for them in public life. I see them sometimes, but rarely. Mostly these people are child-free by choice, which is great but isn’t me. And mostly, at least if they are women, I will see them questioned, undermined or even demonised for that choice.

I will look for them in stories. When I find them they will be peripheral. Sad shadow-creatures. Objects of pity who are always a bit haunted, who can never be complete. Who willingly die to save other people’s kids or other people with kids. Who are permanently damaged.

I don’t want to be permanently damaged.

I think I’m already permanently damaged.

So I will make my own version. I will daydream that it’s years down the track, the cycle is broken, I stopped trying and am at peace. Maybe I will foster or adopt, but those can be difficult and expensive processes, and I have health issues so I might not be chosen. Either way, I will be okay. I will have a future, and not just one where I exist but one I like and can enjoy.

And in the present, the daydreams will make me happy.

But, eventually, what happens next is that I will try again. Despite my better judgement. Despite the hopelessness. Despite just wanting it to be over, to move on. Because I can’t move on. Because none of the tests have said I can’t carry a child to full term. Because the last monster to comes out of Pandora’s box is the most destructive of them all.

Hope.

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A note to update:

That was October 2020. I am now in the third trimester, only a couple of months to go, and the baby has been doing great. It’s actually kicking me right now. Although it hasn’t entirely been an easy pregnancy (most notably first trimester nausea, all trimester fatigue and general emotional baggage from the last four years), and we’re not at the finish line yet, I’m much, much happier. I do still cry a lot, but now my reasons tend to be things like That Puppy Is Obscenely Cute or Someone Said Something That Reminded Me Of The First Few Scenes Of The Animated Tarzan Movie. (i.e., It’s a hormone thing).

A please-don’t-attack-me note:

You are correct, I didn’t mention or portray any pandemic safety stuff in the bits that took place during 2020. This isn’t because I am an irresponsible dickhead, it’s because I live in Australia and covid was very much under control at the time of that scan (however, the story of my 12 week scan, which took place during a local outbreak, would have looked very different). Over here, any time we don’t have covid cases in the community (i.e., most of the time), things are pretty normal. In fact, I am incredibly lucky that thanks to the quick action of authorities and the consideration of most Australians in following advice and restrictions, planning a pregnancy during the pandemic didn’t feel too risky.

A note for readers:

The books I was reading in hospital were:

• Into the Drowning Deep, by Mira Grant (pseudonym of Seannan McGuire)—entertaining monster horror with queer and disability rep.
• Illuminae, by Amie Kauffman and Jay Kristoff—YA space opera told through an (effective, not annoying) epistolary format.

I recommend both if they sound like your sort of thing.

A note on terminology:

Some people who have had miscarriages do not like the term ‘miscarriage’. The idea is that it makes it sound like your fault. I.e., you carried the baby wrong. And self-blame is something that many people who have had miscarriages struggle with.

The other term used is ‘pregnancy loss’. Personally, I don’t see how saying you ‘lost’ the baby is much different from saying you ‘miscarried’ it, and since I am talking about my own experiences here, I have gone with the terminology I feel comfortable with.

Which is ‘miscarriage’ … but with a caveat.

I lean away from using it as a verb. I.e., I tend not to say ‘I miscarried’. That does feel blame-y and ick and I don’t like it. However, I am okay with using ‘miscarriage’ as a noun. I.e., ‘I had a miscarriage’ or ‘the miscarriage’. And I think it works the same way with ‘loss’. As a verb (‘I lost the baby’) it’s blame-y and ick, but as a noun (‘I suffered a loss’ or ‘the pregnancy loss’) it’s fine. I don’t get angry or upset when other people use either of those words as verbs, and I’m not asking you to do that, it’s just what I personally prefer to do.

That said, everyone is different. If you know someone who has had a miscarriage and they have mentioned they do not like ‘miscarriage’, please do respect that around them. Definitely don’t use my acceptance of the term as reason to ignore their feelings.

The usual end note:

If you love my stories and comics, check out my Patreon page. You can support my work and get unique rewards! Along with the usual merch you can now get facemasks in my store. Specifically here.

(Actually, since we’re about to get an additional mouth to feed this would be a particularly great time for you to do either of those things.)

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