Miscarriage

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Depression after miscarriage

depressed woman
PHOTOS.COM
SAD TIMES: Miscarriage is a powerful, disorientating experience.

A few weeks after Kris and I started seeing one another, my period didn't arrive as expected. Days passed. Kris and I joked about it, but as the tension rose those jokes became more forced. We decided that if I was pregnant then we would name the child Grgr, a tribute to Kris's vowel-deprived Slavonic heritage. If it was a girl, then of course we'd opt for something softer and prettier, like Grgrina.

As I said, the champagne comedy was not flowing quite as freely now the fear of unplanned parenthood loomed. Then one morning at work, I fin-ally started feeling those telltale cramps and I knew that I wasn't pregnant after all. It was just a late period. I rang Kris, told him that either the painters were finally in or poor little Grgr was no more. Heady with relief, this idea struck us both as hilarious. Kris countered, suggesting that we should perhaps hold a memorial ceremony for Grgr, maybe in the Botanic Gardens. I suggested that, in the absence of a body, we might bury my tampon in a cigar case.

Many years later, when I experienced a real miscarriage, I recalled all this as I sat on our blood-smeared toilet holding a sanitary pad with a gestational sac the size of a large walnut resting on it; the tiny miscarried embryo that had just passed from my body. I was crying, my toddler was trying to get into the bathroom to see what was wrong, and I was calling to my husband to come and help, screaming out, holding the door closed with one arm so my son wouldn't see me like this. Finally, Kris came and took that little sac away, and I never saw it again.

Even now I wish that I'd buried that tiny sac, and even given it a name. I wouldn't have told anyone, not even Kris, but I wish I'd done it nonetheless.

My miscarriage story is far from unique. Yet the relatively modest setback of having an eight-week miscarriage did make me profoundly sad, a sadness that lingered and startled me with its intensity. For a long time I would cry at the least provocation. I stayed in bed like a hungover teenager. When I tried to work I struggled to concentrate, whole days disappearing with nothing to show. I didn't see myself as "depressed" in the clinical sense of the word, because I knew what had triggered my sadness. I just didn't know why it was so overwhelming and so disproportionate.

As a committed feminist, I'd always been quick to sermonise about the rights and wrongs of abortion. Many were the times I insisted an early-term embryo is a mere jumble of cells, a jumble that could be aborted without any moral qualms. But now here I was, seriously thinking about naming my jumble Grgr and giving it a funeral.

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Looking back, I realise many women had told me how powerful and disorientating the experience of miscarriage could be. I'd just never listened to them. Now it was my turn to be ignored, patronised and dismissed, and I didn't like it; not one bit. In response, I divided my social world in half: those who'd experienced pregnancy loss and those who hadn't, those who got it and those who didn't.

Once I started talking about my experience, I discovered that there were far more women in the first category than I'd previously realised, women who now felt they could tell me about their own miscarriages, often in hushed tones like an embarrassing secret. There's a social awkwardness about the subject, but there's also a problem with expressing yourself, a want of vocabulary. Like giving birth, losing a pregnancy is an experience that defies simple explanation.

From those who hadn't been there came banal reassurances. It was better this way, they said, because the embryo must have been "wrong", and the only thing worse than a wrong embryo is a wrong baby. Anyway, it could easily be replaced with a new baby, so no need to make a fuss.

Then there were the happily pregnant women. They didn't have to say anything to annoy me. Just standing there looking expectant was enough.

But if I was pissed off at the world for not crediting my sadness, I was more frustrated with myself for feeling it. After all, it hadn't been a real baby I'd lost, just the possibility of one. I hadn't suffered any lasting physical harm and I was young enough to try again. So why was I making such a fuss?

Physiologically speaking, my miscarriage was fairly typical. I was eight weeks pregnant when it happened, or I thought I was. In fact, the embryo had already been dead for some time, but my body hadn't told me yet. I was still focused on my upcoming 12-week ultrasound, which I'd dutifully booked - the moment when the new pregnancy would be official. I would see my "baby" for the first time and I'd then announce it to the world.

I'd been telling myself that I was having the first trimester that I deserved, reaping the pregnancy karma earned by the months of vomiting I'd suffered the first time around. I was exercising, working efficiently, eating well, feeling fantastic.

Then, at the eight-week mark, I spotted blood. Over the next few days, the spotting got heavier. At first I told myself that there was nothing to worry about. Maybe I just had a sensitive cervix. That's a thing, right? The internet offered me a smorgasbord of interpretations, from the grim to the utterly benign. I chose the benign.

When Kris questioned me, I gave him the obstetric version of the "My Uncle Smoked Three Packs a Day and He Lived to 100" story, citing my friend Annabelle who had bled all through her pregnancy and yet delivered a perfectly healthy baby at the end of it. Who could argue with that? When he did argue, I emailed him selected quotes from the most optimistic of the websites: "Bleeding during early pregnancy is not necessarily a sign that there's anything wrong." I carefully edited out the sentence that followed: "But you should definitely see your doctor."

Fooling myself was a bit harder. I'd read that if you need to change your sanitary pad multiple times in a single day then there's most likely something wrong, so I stopped wearing panty liners altogether. Instead I changed my underwear multiple times a day. It was when I found my undies drawer empty, even though I knew it had been full two days earlier, that I admitted defeat and rang the local maternity hospital.

The nurse on duty asked me how long I'd been bleeding and how heavily. I told her. I wanted to tell her about the reassuring websites, too, the story of "Annabelle Who'd Bled", but I could hear she wasn't interested. She simply told me to come down to emergency for a scan - immediately.

As my husband struggled to keep my toddler amused, I sat in the waiting room of the hospital's Early Pregnancy Assessment Clinic, or EPAC: a long room nestled next to the emergency section of the maternity hospital: clean, efficient, neon-lit, hard plastic seats and a TV that might have served as a distraction except that the sound was too low. The woman next to me was weeping, making it even harder to hear what Ridge was saying to Brooke on The Bold and the Beautiful, yet no one was game to ask her to keep it down.

Maybe it's just the Catholic in me, but the EPAC waiting room made me think of Limbo. Upstairs are the birthing suites, where the blessed will ascend to have their babies, to enjoy the sunshine of eternal motherhood. Off to the other side are the private meeting rooms, where the sinners are taken, the miscarriers who failed to keep their babies alive. For their sins, they will suffer the torment of counselling. And in the middle is the waiting room, where you wait. Which is what I did.

Every so often, a woman would be called into one of the examination suites. This was where judgment would be pronounced. We'd watch her go, then about 20 minutes later, she'd reappear. Occasionally, she'd be smiling at her partner - it lives! - but more often than not, she'd be weeping or trying not to weep, staring ahead, avoiding the eyes of all the other women. Fail.

Finally, I was called in. I was told by the technician to take off my underwear and get onto the examination table. She then pulled out the wand - a long, sheathed, cold object used for early-term ultrasounds. It's a bit like being penetrated by a lightsaber, except without the frisson of it being wielded by Luke Skywalker.

The first thing I asked after she'd inserted it into me was, "Is there a heartbeat?" She clearly wasn't given to small talk or tact. She turned the screen so I could see for myself and said, bluntly, "There's the sac. No heartbeat, no nothing. It's dead."

Then she told me what I should expect over the coming weeks, that I'd bleed for a while until what was in me had all passed. Most likely, I wouldn't see anything, she said, just a clot.

It wasn't the blood but that tiny embryonic sac that got to me. I'd never seen anything like it: a clear, walnut-sized balloon that had come from inside me. It was something I was never meant to see, something that would normally have remained secret within me: a tiny alien pod that had unsuccessfully used me as its host. It frightened me, as if I was doing something profane, holding it like that on a sanitary pad. Yet I could see nothing resembling a baby inside it, so why did it upset me so?

Looking back, I feel shame that it scared me like it did, and that I'd screamed for my husband to take it away. I realise that, far from being a dreadful thing, that little sac was the only concrete evidence that I was crying for something real, rather than imagined. So what had I been so afraid of?

I was taught that when you fail you should try, try again. My plan was to get pregnant again before my previous due date arrived. The new baby would grow up, magnificent, and I'd always be able to tell myself that this wonderful child would never have existed if I hadn't miscarried.

Indeed, the first question I asked the nurse at my follow-up visit was when I could get pregnant again. She told me the official position: it would be better if I waited a few months while my cycle returned to normal. Then she dropped her voice, "But I'd ignore that. You can start again straight away if you like." I thanked this naughty nurse profusely. "Don't worry," she said with a wink, "I know how stressful these things can be."

Sure enough, I did get pregnant, just inside the nine-month window I'd allowed myself. Yet this still didn't quite have the desired effect. When I thought about the new baby I did feel happier, excited even, but for a long time afterwards my sadness lingered. I can still summon it now, without too much effort, so I know that it's still there, hovering below the surface.

Edited extract from Things I Didn't Expect (When I Was Expecting) by Monica Dux, published by MUP this week.

- Essential Baby

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