Decisions, decisions.

It wasn’t a pill to swallow and apparently we still had more to learn about pregnancy loss even after everything we have been through and even though this was our fourth loss.

Getting ready to go to hospital everything seemed surreal. I chose a summer dress that I thought to myself I will probably never wear again. I applied my mascara and it crossed my mind that there was no point as I would most definitely cry it off. I guess I was just going through the usual mundane getting ready routine.

When I arrived I walked through the doors on my own. I have never had to face this on my own as I always had my wonderful husband by my side. However Covid19 meant that I had to summon the strength and bravery to do this alone. While Neil found the strength to stay in the car not knowing what was happening.

I got to the desk and the woman asked if she could help me. I couldn’t speak, my throat contracted and tears forced their way out. No matter how hard I tried my name would not leave my lips. A kind lady sat nearby showed me where the tissues were and when my name finally escaped my mouth I took a seat as instructed.

I sat quietly sobbing too embarrassed to get up and get another tissue and hoping that they would call me quickly.

Fifteen minutes passed before I was asked to come through for the scan. The sonographer finished the scan and stated “I’m sorry it’s not good news today, I can’t find a heartbeat in the chest”. I found this very strange as I already knew this and I wondered if they had actually listened to anything I had just said.

What came next though was a battle I didn’t expect. She told me my “fetal pole” (baby, to most human beings) measured only 4mm and therefore shows I was 5 weeks pregnant. Due to this they wanted me to go away and return for a scan in a weeks time as they do not carry out a medically controlled miscarriage under 7mm.

I was 8 weeks pregnant. We had seen the baby’s very strong heartbeat at 6 weeks 1 day. We had been to three scans. We had the confirmed due date of the 6th of January. We have a recording of our babies heartbeat. I explained this and the fact that I seem to have small babies (Kora and Ava measured at 13 weeks when they were 16 weeks when they passed) but I was ushered into the butterfly room to await the nurse.

I knew that they were going by the measurements and that they would be concerned that I had my dates wrong. A baby at 5 weeks does not have a heartbeat as the heart doesn’t develop until 6 weeks. Therefore if I had my dates wrong then they could be medically miscarrying a successful pregnancy.

My frustration was boiling. We have been trying to conceive for 2 years, we have had four pregnancies in under 2 years, we have lost 6 babies. Did they really think I would have got my dates wrong or that I was mistaken about the heartbeat we had seen?

The nurse (Jane) was very sympathetic and understanding and decided to get a consultant to talk to me. I was hesitant about being in the Early Pregnancy Unit as our experiences before have not been positive and I have self discharged early on two occasions because of the treatment received.

However, both the nurse and consultant were very professional and listened intently. They went against their protocol after we called the private clinic to get my ultrasound report. This report showed our baby had a heartbeat therefore confirming that the pregnancy had stopped and I was in fact 8 weeks. I no longer needed to walk around for a week with our dead baby inside me, they were in agreement to give me the medication.

I left the hospital after 2 and a half hours with the medication in hand. When we lost Kora and Ava I had to take a pill that I swallowed. However as this baby was under 12 weeks (first trimester) I had been given 4 tablets to insert up my vagina to induce the uterus and miscarry the sac and baby.

I inserted the tablets at home and laid down for 1 hour. I have had to phone the hospital (with no avail) as 3 of the 4 tablets came out an hour later. Apparently this is ok and normal. We are unsure if anything has worked as I am not in pain as they stated and I have had minimal bleeding. We are trying to contact the hospital to find out what is happening. In the meantime our thoughts are running away with us. We are consumed with yet more grief. We have no idea if what I have passed is our baby.

There was a mass that passed after 1 and half hours. It was much smaller that the nurse described so we are not sure if that was our baby I flushed down the toilet.

You might be wondering what decisions Neil and I had to make and I have briefly mentioned one already. We had to have one of the most difficult conversations.

Previously we have had to decide whether we wanted a visual autopsy or full autopsy on our identical twins. We had to decide if we wanted them to be buried or cremated. We had to decide what we wanted in the service and what music we would play.

These were extremely difficult decisions to be made and ones that no parents would ever chose to make. Here we were again with more difficult decisions.

This time our decision was and I quote from the leaflet we were given, “You may decide to simply flush the toilet…flushing it down the toilet may seem right or it may not. You might decide to bury the remains at home, in the garden or in a planter with flowers or a shrub”.

So that was the decision this time…do we flush our baby down the toilet or do we scoop it out and do something else? It is a conversation and decision we never expected to have. It felt inhumane to flush our baby down the toilet but the thought of opening up the sac and finding the baby not knowing what we would see was also traumatic.

We agreed we would make our decision when we saw what came out if we could even tell. I think both Neil and I are surprised with just how many difficult topics and decisions we have had to make in our fertility journey. When we have been overwhelmed in grief we have had to find the strength to deal with conversations and questions you can’t even begin to imagine.

Another decision we have had to make is in relation to our future and the embryos we have frozen and waiting. We were offered by the IVF clinic to have them tested (for a further £2000+). The tests will tell us if they will be a positive or negative pregnancy test and if there are any chromosome problems. 90% of miscarriages in the first trimester are due to chromosome problems. (Problems is not the word I personally chose to use it is the medical explanation).

The hospital have now also referred me to have my blood tested. As it could be my blood that has a problem and stops me carrying full term. They also said that now we have suffered 4 loses they will see us instantly as soon as we know we are pregnant and they will scan us every two weeks and give me medication to support the pregnancy up to 16 weeks. This includes something stronger than aspirin and pessaries to insert for 16 weeks.

Of course it is comforting to know that we will be looked after if we were to fall pregnant again and that we have options. Finding another £2000 pounds now after Covid19 is an impossible task. Yet the anxiety it would alleviate and the hope it would bring is undoubtedly the best option. Even though the testing goes against my nature and doesn’t sit comfortably with me.

In the meantime our hearts are broken and we are still miscarrying this baby. We need time to grieve and physically cope with this baby before we can think now about our future. We understand why professionals are giving us options and information and are grateful for this.

What we do know is that we are not ready to give up our dream of being biological parents together but we just feel we can’t deal with this heartache again, we don’t know if we have the strength, we can’t face a further loss.