My 81-Day Miscarriage

The day we learned our son’s heart had stopped beating, I created a note in my iPhone and titled it, “Put your pain here”. Sometimes, I would open the note and enter a single sentence. Other times, paragraphs and paragraphs would effortlessly flow from my fingertips just as fast as the tears were flowing from my eyes. This iPhone note became a reprieve, the place I would visit when the grief was spilling out of me with nowhere else to go.

In parallel to my own writing, I began desperately searching online for other miscarriage stories. I distinctly remember the first time I found another woman’s account of her pregnancy loss and suddenly, I didn’t feel so alone. Then, when we were ready to share our loss publicly on social media, my inbox was instantaneously flooded with messages: “Me too”, “I just lost a pregnancy”, “I am miscarrying right now.”

In an instant, the statistic that 1 in 4 pregnancies end in loss was no longer theoretical, it was very, very real. The truth is, pregnancy loss is happening all around us but as Jessica Zucker, psychologist and author of I Had a Miscarriage, explains, pervasive societal stigma and shame force women to be silent about it.

In honor of National Pregnancy & Infant Loss Awareness Month, I have decided to share a compilation of my journal entries strung together into our perfectly unique, and yet devastatingly common, experience with pregnancy loss.

This story is a gift birthed from the rawest and most vulnerable parts of my heart. It is my offering to the many people who have walked this path before me and to the many more who will walk it after me:

You are not alone, you did nothing wrong, and you do not have to suffer in silence.

Put your pain here.

It was an ordinary Tuesday morning in November.

We opted for the 8:30 a.m. appointment so that it would cause minimal disruption to our workdays. It was our first appointment in the second trimester, a milestone I had been anxiously awaiting as I knew the risk of miscarriage dropped significantly after the first trimester was behind us. The midwives’ protocol for this appointment was to perform a full physical exam. At the end of the appointment, they would listen to the baby’s heartbeat, as was standard during each visit.

The physical exam was mundane — I was eager to get to the exciting part! Finally, it was time to listen to the heartbeat. The midwife slowly and methodically moved the doppler up and down my belly. The doppler was picking up on my heartbeat but it was proving difficult to find the baby’s. The midwife assured me that she would eventually find it and I assured her that I wasn’t at all concerned. It had taken a while to find the heartbeat at our last appointment but once they finally found it, it was booming. I remember the midwife exclaiming, “The little turkey was just hiding from us!”. We had heard the heartbeat so many times, I naively assumed our little turkey was just hiding.

After she had scanned my belly many times, she said she was going to get a more senior midwife to assist her. Looking back, perhaps this should have been the first sign of trouble, but I was still basking in my last few moments of pure innocence, completely unphased by what was transpiring around me. After a long wait, they returned with a bedside ultrasound machine and I excitedly asked, “We get to see him?!”.

They squeezed the freezing cold jelly on my stomach and in what always felt like pure magic, our sweet boy instantly appeared on the screen. She continued to move the wand, looking at the baby from multiple angles. Then, she drew in a very long, very deep breath and in that exact moment, I knew something was wrong. I just didn’t know what.

“I am not detecting any fetal movement.”

I still wasn’t exactly sure what she meant but I could tell by the tone of her voice, it wasn’t good. “You sound worried”, I said. “Yes, I am very concerned,” she responded gently. “It’s a good thing you came in the morning. It will give us the rest of the day to get you scheduled for a STAT ultrasound at the hospital to confirm whether or not you’ve lost the baby. We’ll work with our scheduler and come back with more information as soon as we have it.”

I asked them to keep the lights turned off. My husband Thomas held me tightly in his arms and I sobbed repeatedly into the darkness, “I’m so sorry. I’m so sorry. I’m so sorry.”

After what felt like an eternity, the midwife returned and let us know we had an ultrasound appointment that afternoon at 2 p.m. We survived the day by allowing our hearts to believe he was simply asleep. I drank a cup of coffee and orange juice and convinced myself that with a jolt of caffeine and sugar, he would surely be wide awake. My heart was hopeful, but my brain knew better. If he was alive, they would have been able to find a heartbeat.

The afternoon ultrasound confirmed what we already knew. “Can you check again?”, I begged. “Yes, I’ll let your bladder fill up a bit more, and I’ll check again.” After giving it a few more minutes, the ultrasound tech gently touched my arm and said, “I am so sorry, I am just not seeing a heartbeat.”

The room was silent but full of love as we gazed at our little boy — perfectly still and yet still perfect.

Hospital protocol required that a neonatologist come in to “officially’’ interpret the results of the scan. His approach was colder, very matter-of-fact. He was older and it was quite clear he had given this “talk” countless times throughout his career. He rattled off memorized statistics and explained that this miscarriage would not impact our chances of having a successful pregnancy in the future. He said, “Often times miscarriage is nature’s way of protecting you from having a chromosomally abnormal baby.” I understood the sentiment and also thought, “Fuck nature, I wanted this baby.”

We were instructed to go home and wait for a phone call from our midwife who would counsel us on our options so that we could make an informed decision about what to do next. We sat on the couch anxiously awaiting the call, while simultaneously hoping this was all a nightmare and the phone would never ring. When the phone eventually rang the ensuing discussion was a graceful balance between empathy and brutal honesty as we walked through each option.

Option 1: Expectant Management

I could do nothing and wait for my body to realize what had happened. Nature would eventually take its course, but it could be several weeks or even months before that happened. Once the physical miscarriage began, it would involve laboring at home and blood, she said, “there will be a lot of blood”.

If I chose this option, she would arm us with the education we needed to recognize when normal bleeding became hemorrhaging. This would help us know when it was time to go to the Emergency Room. She also gently reminded me that if I chose this option, I needed to mentally prepare to deliver a very recognizable baby, about the size of a lemon.

Seeing the baby didn’t scare me. If I’m being honest, I wanted to see him. Somehow, I had convinced myself that if I could just hold him in my arms, it would make me more of a “real mom” than simply having held him in my womb.

But the risk of emergent hemorrhage, that scared the shit out of me.

Option 2: Medical Management

I could take medication that would induce a miscarriage. It would save me the weeks or months of waiting but the labor process, risk of hemorrhage, and mental preparation to deliver a baby were all the same.

Option 3: Surgical Management

I could elect to have surgery (a Dilation and Curettage or “D&C”; a medical abortion) and an OBGYN would remove the baby from my uterus. I would be put under general anesthesia and the procedure would take about half an hour. Like any surgery, there were risks (the development of scar tissue that could impact future pregnancies, an accidental puncture of my uterine wall, etc.) but given how far along I was, this was the strongly recommended option. “Can I see him after he is taken out?”, I asked naively. “I am sorry this is graphic” she said, “but he will not be in a state for you to see.”

The Midwife made it very clear that her job was to thoroughly educate me on each option, but the choice was mine alone to make. In a situation where I felt overwhelmingly powerless, being given complete control over what was going to happen next felt profound.

I chose option 3.

Because midwives are not trained to perform D&C’s, my care was transferred to an OBGYN. Prior to scheduling surgery, we were required to have an intake appointment with the OB. We were able to get in on Thursday and when we arrived, the intake paperwork asked me to list all of my pregnancies. Angrily, I asked if I should list the pregnancy I was there to end. Thomas looked at me lovingly and said, “Do you want me to fill the paperwork out for you?”. I know one thing for sure, I would not have survived any of this without him. Stubbornly, I finished the paperwork myself and made a mental note that I would need to be more prepared to answer that question on all future medical paperwork.

The Medical Assistant called us back and escorted us to the ultrasound room. I had not emotionally prepared myself for a third ultrasound of my dead baby in two days and I began to cry. Visibly upset, I escaped to the restroom to gather myself. When I returned, the doctor said I could decline the ultrasound but quickly followed up with:

“As a mother, I believe you deserve final confirmation.”

An intense wave of grief and pride washed over me simultaneously — it was the first time a doctor had ever addressed me as a mother. I consented to the ultrasound and used it as an opportunity to say goodbye. Once again, the doctor listened for a heartbeat and said compassionately, “It is pretty quiet in there.” I asked for his final ultrasound photos to be printed and I will cherish them forever.

After the ultrasound, the doctor brought us both into his office. He discussed the details of the procedure but, surprisingly, spent significantly more time speaking to us about grief. He talked to us about the different stages of grief and reminded us that we would feel each one. Then, he addressed Thomas directly and shared that it can be difficult for men to fully understand or relate to the experience of a woman going through a miscarriage because a death has occurred within their body.

I remember feeling struck by the doctor aptly putting into words the deep chasm I was seriously struggling to bridge in my mind — my body had once held life, and now, it was holding death. My uterus was my son’s cradle and now it was also his grave.

But I also remember feeling sad that Thomas’ unique grief as a father was somehow being invalidated simply because it was different from mine. When we got back to the car, I looked at him and said firmly, “I want you to know that your grief matters, too.”

Much to my relief, the first available surgery appointment was the very next day, Friday. The only catch was, it wasn’t his day in the hospital so it would have to be performed by another OBGYN in the practice that I had not met. Between the midwives, the ultrasound techs, the neonatologist, and the OBGYNs, the continuity of my care was crumbling and the physical and emotional toll of continuing to carry a child who had passed away was unbearable. We opted for the next-day surgery appointment with the doctor we hadn’t met, a decision I would later regret.

We arrived at the hospital early the next morning. The man at the front desk instructed us to walk all the way down the hallway and when we got to the end, take a Right towards Women’s Surgery. As we approached the end of the very long hallway, we realized it was Labor & Delivery. Searing hot tears burned down my cheeks, extinguished by an already soaking wet face mask. I squeezed Thomas’ hand and choked out, “That’s where people get to go to have healthy babies.” Silently, I prayed that one day we would come back and be able to keep walking straight.

We took a Right and checked into Women’s Surgery. My pre-op nurse shared that the majority of their staff had been on my side of this situation, which created an immediate sense of connection and trust. She explained that anesthesia has a tendency to reduce inhibition, which can cause a lot of emotions to come out. Because of this, she didn’t want me to be surprised or embarrassed if I woke up in recovery crying, she assured me it was actually quite common. At this point I had been crying for 3 straight days, so it would be nothing new.

Thomas and I shared a tearful goodbye as he rubbed my belly one last time. They wheeled me back to the freezing cold operating room and right before the anesthesia was administered, I, too, placed my hand on my belly for a final time and whispered, “I love you, Amare Lee.”

Much to my surprise, I woke up in recovery feeling a deep sense of peace. I knew Amare’s spirit had left me many days ago and it was now time to let go of his body. In the days, weeks, and months that followed, when intense feelings of grief enveloped me, I closed my eyes and brought myself back to the serenity I felt in those first few moments of wakefulness. I believe Amare visited me briefly to let me know he was OK.

When we left the hospital, we drove to the pharmacy to pick up my prescriptions. When the Pharmacist saw the combination of pain medications I had been prescribed, she innocently exclaimed, “Aww! Did you just have a baby?”. Stunned, Thomas replied, “No, we just lost one.” “I’m sorry” she said, “It was that or kidney stones.”

We spent the rest of the day in bed watching movies, cuddling, and crying.

I returned to work 3 days after surgery. I bled for 16. Every trip to the bathroom was a painful reminder of what could have been, and what would never be. The prolonged bleeding wasn’t normal so at my follow-up appointment, they did another ultrasound and it didn’t take long for the doctor who performed my surgery to diagnose the issue, “There are retained products of conception still in your uterus. We can schedule a second surgery to get the remaining tissue out or we can prescribe medication to induce your body to expel the tissue.” I hated both options but opted for the medication.

On the ride home, I was seething with anger. How could the doctor not have gotten everything out? I beat myself up thinking I should have waited until the other doctor was available to perform the surgery. I cut through my anger with humor. I turned to Thomas and asked, “What do you think is left up there — his arm or his leg?”. We both cracked up laughing. I repeated the joke to a few friends but no one laughed. The truth is, when you’re in that much pain, dark humor is a welcome reprieve and an appropriate coping mechanism. Also, it’s a funny fucking joke.

We picked the Misoprostol pills up that night. I remember viscerally feeling terrified to take them.

Prior to conceiving, I have to admit that I had quite a utopian view of pregnancy. In my mind’s eye, it was a beautiful and sacred rite of passage to bring life into the world. And now here I was, shoving eight pills as far up my vagina as they would go begging my body to end this pregnancy once and for all. This shit wasn’t sacred or beautiful, it was traumatic.

I anxiously laid in bed waiting for the cramping to begin but it never did. Apparently, a small percentage of women don’t respond to Misoprostol and I am one of them. Next, we were instructed to try another medication, Methylergonovine. More pills. Still no response.

At my next appointment, I was intensely pressured to have a repeat D&C. “If a bad infection develops, we might have to perform a full hysterectomy!”, the doctor warned me. While infection was in fact a risk factor of not getting the retained tissue out, I knew in my gut his comment was an unnecessarily cruel scare tactic to manipulate my sincere desire to become pregnant again in the future. I asked him to prescribe me a precautionary antibiotic and informed him I would be seeking a second opinion.

At this point, I was coming undone, and I had had it with being treated by male doctors. I intentionally sought a gynecological practice with exclusively female providers. I found exactly the practice I was looking for and when I explained the full history of my ongoing miscarriage, she said, “Your body is telling you it can do this on its own.” After weeks of despising my body for the miscarriage, a sincere vote of confidence in its innate abilities was an unexpected breath of fresh air.

The new plan was to wait for my cycle to return and allow the tissue to pass naturally. After a few cycles (in addition to regular acupuncture and Chinese herbs), it finally did. And for anyone who may be wondering, it was not an arm or a leg.

From the day we learned Amare had passed away to the day I got the “all clear” ultrasound confirming that my uterus was void of all remaining pregnancy tissue was 81 days.

My miscarriage lasted 81 days and required 1 surgery, 7 ultrasounds, 1 round of Misoprostol, 1 round of Methylergonovine, 1 round of antibiotics, and 5 blood draws.

You see, people often think of miscarriage as a single moment in time, a bloody trip to the bathroom and it’s all over. But what almost no one understands, unless you’ve experienced it personally, is that miscarriage is a process that can last for days, weeks, or even months at a time. And even when the physical miscarriage comes to an end, the emotional journey towards healing is often just beginning.

When a pregnancy ends in loss, it is easy (and very justifiable) for the entire experience to be overshadowed by sadness. But with time comes the gift of hindsight. Nearly a year after our loss, I have come to appreciate that while my pregnancy did not result in a baby to bring home, it still brought a tremendous amount of joy and love into our lives.

I will never forget Thomas’ reaction when I told him I was pregnant. The first words out of his mouth were, “No way! HOW?” We had been actively trying to get pregnant, so I seriously wondered if we needed a refresher on the birds and the bees.

I will never forget boarding an airplane to Albuquerque and surprising my twin sister with the news that she was going to be an aunt. Or reflecting on the reactions of our parents — it didn’t matter that Amare was going to be the first Robie grandchild and the sixteenth for the Harris family, their reactions as Grandparents were nearly identical and equally excited.

And, most of all, I will always cherish our 12-week ultrasound when the tech said, “This NEVER happens but the baby just opened their legs and if you’d like to know the sex, I’d be happy to tell you today.” What she didn’t know is that I had always dreamed of learning the sex at a live ultrasound, but I worried I wouldn’t have the patience to wait until the 20 week anatomy scan. “This baby is all boy” she said, and before we even left the ultrasound room, Thomas was shopping for baby Nikes.

Amare Lee Harris — From the very first moment we saw two pink lines on a pregnancy test, our whole world began to revolve around you. I carried you for your entire life, and I will love you for the rest of mine. Thank you for making us parents.

~Alex Robie Harris

Dr. Alex Robie Harris is a Senior Project Director at The University of Arizona where she manages and implements high-priority projects for the President and University Administration. Following her experience with pregnancy loss, she successfully advocated for paid parental leave to be extended to University employees following a miscarriage.