What It Is Like To Have A Miscarriage

Oh where do I even begin?

It’s taken me nearly a year to be able to write about this and be able to actually put words together that would make sense to describe what I went through. Grab a coffee because this one is going to be a long one…

Miscarriage sucks! The whole thing sucks. In so many different ways. Let’s start off with the actual word ‘Miscarriage”. The prefix ‘mis’ stands for mistakenly, in error, or wrong/bad. This literally means that when you have a miscarriage, you have ‘failed’ to carry your baby to term as if the fault was in something you did or didn’t do. When in fact, most miscarriages are caused by some type of chromosomal anomaly and your body understands this and stops investing resources and energy into continuing a nonviable pregnancy. There is likely nothing one can do to prevent most cases of miscarriages.

I had what is called a missed miscarriage. My fetus stopped growing around 10-12 weeks but it took me until 20 weeks to find out when I went in for my anatomy scan. I did not have any signs of a miscarriage.

I attended an Early Pregnancy Loss clinic the next morning. I had a nice and compassionate nurse give me her condolences, ask how I was coping, and check my vital signs. She went over the available options and once we chose which one we wanted, the doctor came in for 30 seconds to write up the prescription and proceeded to walk out.

I don’t remember the doctor’s name or what she really looked like. I do remember the nurse and her name. She looked me in the eye, she listened to me and she didn’t rush us out. She handed me a tiny teddy bear to keep as a memento, along with pamphlets for additional resources should I need it. She also went over the signs I should look out for and when to go to my closest ER.

There are three options that are usually given when you have a missed miscarriage.

Option #1 “Expectant Management”

This is where you wait for your body to do its thing. I quickly dismissed this option as it had already been about 10 weeks and my body was still holding onto the pregnancy.

Option #2 “Medical Management”

Using two medications, Mifepristone and Misoprostol, this approach facilitates the at-home passage of fetal tissue and placenta. Its success depends on gestational age, with reduced effectiveness the further along you are. Mifepristone blocks the hormone progesterone, leading to uterine lining breakdown, while Misoprostol induces uterine contractions to expel the contents. These are the same medications used in induced abortions, usually up to 10 weeks gestation. Induction of labour with medication is also possible to be done at a hospital and is usually the case for fetuses that are further along and require more medication for more dilation of the cervix.

Option #3 “Surgical Management”

This is where you come into the hospital for a one day procedure called a D&C (Dilation & Curettage). This is a procedure done to clear the lining of your uterus and remove all the contents from inside such as the placenta and the fetus/fetal tissue. When the medication route alone is not successful, and there are “retained products of conception” (the medical term widely used), then you still have to go in for a D&C making it twice the ‘fun’…

I opted to take the pills at home instead of doing a D&C. It was a bit of a risk since I was estimated to be between 10-12 weeks and the further along you are, the less chances of success. I decided to take the risk. I really did not want to have to go through a medical procedure in the hospital. I just needed to be home alone with my husband.

For those unfamiliar, I work in a perinatal unit, as a registered nurse. We care for women before, during, and after labour. Sometimes, we care for women who are having/have had a miscarriage or stillbirth. I attended a Pregnancy & Infant Loss Workshop earlier this year through the PAIL network for healthcare workers, and one topic that came up was how tough it is for these women, who've just lost their baby, to stay in a postpartum or labor & delivery unit.

This situation is made even more painful by hearing babies crying and knowing there are newborns being welcomed in that same unit. Not to mention the possibility of encountering families leaving the unit with their newborns while you exit empty-handed. But then again, what's the alternative? Being in a medicine unit with sick folks?

All the available options kind of suck.

Honestly, all the available options kind of suck. There's no dedicated hospital unit exclusively for families dealing with a miscarriage, stillbirth, or neonatal death. It's a gap in our healthcare system.

I luckily never had to go through the ER. That is usually where most women go when they start to bleed and don’t know what is happening. They have to wait for hours in the ER until a rapid scan can be done to see if there is a heartbeat. Sometimes the results are inconclusive and you are sent home and told to return. Sometimes the results are conclusive but they are too busy to be able to take you in for a D&C so you are sent home and told to come back the next day or even a few days later.

I’m so sorry if you had to go through that and had to sit across from strangers for hours while you were bleeding and not knowing if your baby was okay. Unfortunately our health care system is not well equipped to deal with these situations exclusively and women and their partners are the ones who suffer greatly as a result of the way these things are usually managed.

The medications ultimately worked for me, sparing me from a D&C. However, I hadn't anticipated the excruciating physical pain that accompanied it. It was the most intense pain I'd ever experienced. Within 30 minutes of taking the second medication, the cramping began. I spent most of the evening alternating between my bed and the bathroom. By the end I laid on the makeshift bed my husband made me in the bathroom and laid there in agonizing pain until 4am. My husband was my saving grace, doing everything he could to support me.

From diarrhea to vomiting, to heavy bleeding and crippling contractions, I found myself lying on the bathroom floor in utter silence, unable to vocalize my pain. All I could do was rub my hand against a nearby wicker basket, attempting to divert my focus.

The physical pain was the worst I’ve ever felt. I wasn’t expecting it to be that bad. I don’t recall them ever mentioning how bad it could get when they gave me the prescription. But the agonizing physical pain was temporary.

I work in this field, I knew the odds of a miscarriage. I was prepared for it. Or so I thought, until I reached the 12-week mark—the point at which it becomes socially acceptable to announce your pregnancy to the world. We had started planning for our future as a family of 3. We started thinking of names, buying some second hand baby items and receiving gifts from our closest friends and family.

The hardest part was the mind shift. I had convinced myself that in a few months my whole world was going to change and I prepared for that. Once you go through a miscarriage, all the plans and life changes you had envisioned and believed were going to happen, are suddenly all gone.

There was suddenly this emptiness, a void where plans for the following year used to be. My due date had been mid-January 2023, and the miscarriage occurred in early September. It felt surreal to start making new plans for 2023 and accept that, despite our best efforts to plan, life remains unpredictable.

As I write this, it has been almost a year since that fateful day. And you know what? I'm doing alright now, even though this journey has been long and challenging. It's important to understand that healing isn't a one-way street; it's more like a rollercoaster with ups and downs. So, if you're dealing with grief after a loss, go easy on yourself. From my own experience, I've noticed that as time goes by, those waves of sadness tend to show up less often. Take all the time you need to heal. Everyone heals at a different pace and everyone deals with grief in different ways and that is okay.

If you've experienced a miscarriage or know someone who has and need additional support, please consider reaching out to the PAIL Network, which provides invaluable assistance. I understand that reading this may have evoked painful memories for those who have gone through a similar experience. Thank you for being here with me.

If you would like to share your experience with me, I would be honoured to hear your story. Please reach out via the contact me page.