Everything I Thought I Knew About Miscarriages Changed When I Had Two ‘Silent’ Ones

It feels like a rite of passage for a pregnant person, that first OB appointment when you hear the heartbeat.

My husband and I had already been through the drill with our first daughter. We had an appointment around eight or nine weeks full of hand-holding and laughing as the doctor took out the wand, and that magical little flicker of a heartbeat on the ultrasound screen.

Except, with our second pregnancy, there was no flickering on the screen. During a nine-week checkup, my doctor moved the wand around, frowning as she searched for a heartbeat. Finally, she gently delivered the bad news—she couldn’t detect a heartbeat, because there was none. My pregnancy had stopped developing the previous week, she suspected.

My husband and I struggled to make sense of what had happened—or, rather, what hadn’t happened. I didn’t bleed, I didn’t feel pain. The only symptoms I’d experienced over the past nine weeks were things I had always believed signaled a healthy pregnancy, like morning sickness, sore breasts, mood swings, fatigue so pronounced that I was falling asleep by 8 p.m. every night. Everything I’d ever known or read about miscarriage seemed to touch on bleeding and tissue expulsion—noticeable and detectable symptoms.

But my miscarriage was quiet. Invisible.

It turns out I was suffering through something that is sometimes described as a missed miscarriage (or a “silent” miscarriage), in which your body fails to recognize that the baby it carries is no longer living; the pregnancy has stopped developing but your body hasn’t physically passed it. It felt like a double failure, an extra helping of injustice. Not only did I feel like I failed to provide a safe environment for my baby, but my body didn’t even realize the baby it’s supposed to protect and nourish was no more.

This is absolutely not to say that any version of a miscarriage—with symptoms, without symptoms, climactic, anticlimactic—is more or less traumatic than another. But I felt like I was in this strange position: I was praying for the physical miscarriage to happen while still desperately wanting this pregnancy.

Luckily, we had choices. I say “we” because, although it was my body going through the physical miscarriage experience, it was a joint emotional one, and my husband’s input was essential for me through the decision-making process. It helped remind me that I had support and love, and that we were in this together.

I could wait it out to see if my body would finally catch up and complete the miscarriage on its own (something referred to as expectant management, or watchful waiting). Or I could take misoprostol, which is a medication that essentially can induce the miscarriage and move the process along. I also had the option to go through a surgical procedure known as a D&C (dilation and curettage) to manually remove the tissue.

After three long weeks of watchful waiting to see if my body would recognize what had happened and finish the job—three weeks of denial, tears, and increasing physical discomfort—my husband and I talked through it and finally decided to go the D&C route. I was told the outpatient surgery would be quick and painless (it was) and would allow us to test the fetal tissue. Our results came back two weeks later and revealed that we would have had a girl. But our baby girl had developed with a genetic anomaly known as mosaic trisomy 14. It’s a (rare) genetic disorder that can happen at random. And while it’s not always problematic or fatal, it can cause developmental abnormalities and interfere with proper intrauterine growth.

A chromosomal fluke. Better luck next time.

We named her August.

After August, sadly, luck never came. Over the next six months, we had two more miscarriages in a row. The second miscarriage was a natural pregnancy loss at six weeks, with minimal symptoms, and the third, another “missed” one at nine weeks.

Once again, we were faced with decisions. How did we want to handle this? What medical procedure should we choose?

Even though my previous D&C experience had been fine, I don’t like being under general anesthesia and wanted to avoid another surgery if possible. So, I gave Mother Nature another fighting chance—we did watchful waiting for three more weeks, praying yet again for my body to have that physical miscarriage I never wanted—until finally it was time for medical intervention. At this point, having now gone through the processes of expectant management and also a D&C, we decided I’d try misoprostol this third go-around.

I had a half-hour phone call late one night with my wonderful doctor. We talked through the options. I cried on the phone. We also made a game plan for future pregnancies. My doctor—knowing me, my husband, and our medical history—reassured me that, whatever was ahead, we’d get through it.

I felt in that moment, dare I say it, lucky.

I live in California, a state with lawmakers and representatives that have been early, enthusiastic, and continued champions of reproductive rights. In the lowest physical and emotional place of my life, I was able to make a plan with my husband and doctor, walk into my local pharmacy, and go home with the pills I needed for my miscarriage.

I hunkered down on the couch with a heating pad and remote control as tears slipped down my cheeks, and another precious life slipped from my body. I felt lucky because nobody had inserted themselves into that very private, personal decision I made about what was best for my body.

Yes, my circumstances, like those of so many other pregnant people, were complicated. In the end, the pill didn’t even fully work, and I required further medical intervention to remove the so-called “products of conception,” as my doctor referred to them, from my uterus. Having exhausted all options during what amounted to a three-month miscarriage—and knowing that I didn’t want to receive general anesthesia—I made another choice. I decided to have a D&C in office with a pain medicine injection, a painkiller, and my husband holding my hand.

It wasn’t pleasant. It certainly wouldn’t be the preferred option for everybody. But it did finally free me from the physical hell I’d been in and opened the door for me to begin to heal emotionally too.

Most importantly, it was the right choice for me—and I’m so grateful I was given the bodily autonomy to make it.

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