Our Pregnancy Loss Journey

Now that I am about 40 weeks pregnant, I have often thought how lucky I am to have had such a smooth pregnancy and how lucky I am to have found my birth care providers. But I am more than just lucky. I make decisions because of this story I am about to tell. This is the story that changed everything for me. Pregnancy loss and medical trauma will always be a part of my reason why and it is why I am who I am today. I would never say that I am grateful to have had this experience, but I am grateful for what it has brought me now.

In October 2021, we had our second pregnancy loss.

But this one was different. It was a suspected ectopic pregnancy and involved multiple trips to the doctor and ER. I experienced medical trauma and neglect from our situation. I didn’t trust myself, I didn’t know how to advocate for myself, I had no idea how to handle anything that was thrown our way. It was one of those things where you can’t be prepared for it, but have to hope you are in good hands. But what happens when you’re not in good hands and don’t trust your providers? This is a situation that I never want to be in again.

I was tracking my cycle using LH test strips and my temperature every morning so I was very aware of my cycle and how I felt every month throughout it. I had some spotting around the time my period was to be expected. I thought maybe it was a light period but I started having some early pregnancy symptoms so I took a pregnancy test (the first of many) a week later and it was positive! I was overjoyed but also nervous and hesitant. I had just gone through a very early miscarriage a couple months prior. Your mind goes to this place of wanting to be happy but also scared of what might happen again.

As happy as I was, I had a feeling something was off since I had been bleeding the week prior. I wanted to track my true HCG levels, so I scheduled an appointment at a Labcorp to get a baseline while I tried to find an OB. Since I was new to New Jersey, I didn’t

have a care provider here yet. I started calling around trying to see if I can get an appointment where I could get an ultrasound done as soon as possible. I finally found an OB's office that could see me within the next week.

In my head I started thinking, maybe everything is okay.

By the time we had our first OB appointment, I had been to Labcorp a couple times and my HCG was rising as expected. But that quickly changed the day of our first appointment. I was already really nervous and stressed about how everything was going to go. We get to the doctor's office and they tell me they don't have ultrasound technology in their office, even though that's what I specifically had asked for when I scheduled the appointment. Then, they told me that Mat wasn't allowed to come back with me because of covid rules. There was a sign on the wall stating that partners were allowed in the room for only one visit through the whole pregnancy, so I asked if this could be my one visit. They of course said no because I was a new patient. That really did it for me. I had a rush of adrenaline and might have had a few choice words for the front desk staff. All I wanted at that moment was to not do this alone. They said he wasn't even allowed to wait in the waiting room and he had to actually go back to the car. He hugged and kissed me before leaving, as I was handed a pee cup to confirm the pregnancy. Because I hadn't already taken a bunch of those *insert eye roll*.

Looking back at that moment of stress and rage I think it sparked the next event to happen. While in the restroom, I had a gush of blood so I immediately thought I was for sure miscarrying this pregnancy. I went back to my patient room and let the nurse know. At this point I was on the verge of tears, trying to hold back any emotion towards the staff because I as so upset at how everything was being handled. Thankfully she was kind and when she left the room she called Mat to come back to be with me. A few minutes of waiting by myself he walked in the door and I just burst into tears.

We were sent to radiology for the ultrasound.

They were unable to find anything on the ultrasound, at that point we thought it was either because I was no longer pregnant or the pregnancy was too early to see on the ultrasound. Two days later, I got a call from that same PA. My blood work was back and my HCG levels had spiked significantly and I needed to go to the ER immediately. I was told that at that HCG level, something should have shown on the ultrasound so she was worried that it might be an ectopic pregnancy. An ectopic pregnancy is when the embryo implants outside of the uterus. It is always fatal for the fetus and can be very dangerous for the mother if it is mismanaged because you risk internal bleeding and rupture if the embryo grows too large.

I rushed to the ER and was luckily seen very quickly by the OB on call. But again, we ended up leaving with more questions than answers. They took my blood to check my HCG levels and did another vaginal ultrasound. My levels were still rising steadily and nothing appeared on the ultrasound. The possibilities at this point: I might have miscarried and there was tissue in my uterus still causing my body to think I was pregnant, a possible ectopic pregnancy, or it could be twins. She told me she would see me at her office Monday to see how my HCG was changing and repeat the ultrasound.

At the office Monday, the ultrasound results didn't change so we discussed options.

My options were a D&C, laparoscopic surgery, or a shot of methotrexate. A D&C would remove the tissue in my uterus, this would have been the best option if we knew it was a miscarriage and my uterus was unable to shed the lining. Laparoscopic surgery would involve making incisions in the abdomen and using a camera to look for an embryo outside of the uterus and removing the embryo if it was found. Lastly, methotrexate was the least invasive option but had its own set of risks. Methotrexate is a chemotherapy drug that would slow the growth of the embryo, hoping the body would be able to miscarry on its own. With this option though you still risk internal bleeding because it takes time for the medication to work. I had no idea what to do and felt like we had no answers on what was really happening. Looking back, I think I had miscarried and my body just wasn't catching up yet.

Tuesday morning I got a call from the Doctor's office saying I needed to go back to the ER that night when she would be on call again and choose a course of action. I was told my HCG levels were significant and I risked rupture. She was very certain that it was most likely ectopic, but it was still a guessing game since there was no evidence of it being ectopic either.

I had no idea what to do.

I had none of the symptoms that came with an ectopic pregnancy but had no clear path on what to choose because I was being told my life and fertility were in danger. It was pure fear mongering from the doctor. I was an anxious mess waiting for something bad to happen the moment I found it might be ectopic. Now, I felt like I was being pushed into something I did not want, but did not know enough to make an informed decision, nor did I trust my provider to counsel me.

It just didn't make sense to me, "make this decision quick because your life is in danger, but wait to go to the ER when I'm on call".

I decided I wasn't going to wait for her to be on call at the ER and I wanted a second opinion. In my mind there was still the fourth option: let my body sort out this miscarriage. And even if this wasn't a viable option, I wasn't going to wait around for my tube to rupture. So I decided to go back to the ER to see someone new who was on call that morning.

And this is when I realized how messed up the system actually is. I got to the ER, explained everything to the nursing staff, and waited for the doctor. I was really excited when I found out who the doctor was. He was a prestigious doctor with a local practice that I had actually wanted to originally see the week prior. He was also director of the OB department at this hospital. I thought "how perfect”, I really want to know what he has to say about my situation.

Except he never showed up. He refused to see me.

When he heard about my situation, he had called the other OB I had seen to get an update on my case. She claimed that I was her patient and he wasn't in the bounds to "overstep her medical opinion" and "take me away as a patient". Some head of the department he was.

It was like a game of telephone with his PA. I let her know how badly I wanted his opinion and wanted to see him. She kept trying to convince the doctor to see me, but he wouldn't. The only information I got from him that day was that he disagreed with the course of action but would not give me more advice. He wouldn't even explain this to me in person, only through his messenger. So instead, I waited in the ER for about 7 hours until the original OB was back on call.

I still had no idea what to do but was I pressured into a decision.

I was beyond frustrated and felt stuck, neglected, and uninformed. I chose to go the least invasive route, taking methotrexate, even though everything in my body told me this was a miscarriage and I didn't need intervention. But again, I was not at the part in my journey where I trusted my intuition fully, I was pressured into this decision through fear mongering and medical neglect. I was given the roundabout by these doctors, and I was exhausted and scared.

The next few days were brutal; I had the worst cramps of my life, I was bleeding, I was tired, I was emotionally drained and sad, and I felt used and regretted my decision to put this harmful drug into my body.

A week after getting the chemo shot, I had to get my blood drawn again to check that my HCG levels were going down. But they hadn't, instead my levels had risen more. Back to the ER I went to get a second dose of Methotrexate. Except this time I trusted my gut. I waited a few hours, changed my mind, and left without getting the second shot.

Some might say I need to listen to doctors, but I needed to listen to my intuition instead. This was the first step in getting that piece of me back.

I wanted to write this story as a way to work through my own healing and bring peace to this chapter. Yet, I also want to bring awareness and inspire others to share their stories. I would love to hear from you and how your journey has made you grow today. If you feel inclined to share your story, find me on Instagram @connecting_SLP