Fragments, Part Three

Part One
Part Two

Sometimes it’s the subtle things that tell you everything you need to know.  That’s how I felt when I saw the doctor walk into my room.  I knew my worst nightmare was coming true.  I knew I had lost the baby.  Until this point in my ER visit, I hadn’t seen a doctor – only nurses, techs, and PAs. The fact that I hadn’t seen her before stood out to me, too.  My news was “above the pay grade” for the other people who had cared for me, I think.  Who in their right mind voluntarily agrees to tell the infertile-come-pregnant woman that her baby is dead on Mother’s Day?  No, I’m sure the doctor came to tell me because she was the only one not allowed to say no.  But she didn’t even have to tell me.  I knew it when she walked into the room.

She kindly introduced herself and asked me for a little bit of information about why I came in.  I repeated the same story about how I’d heard the heartbeat at noon and couldn’t find it this evening and felt it would be wiser to get checked.  She nodded and told me that unfortunately the baby’s heart didn’t have a heartbeat anymore and I was having what she called a missed miscarriage.  She explained that first trimester* miscarriages are very common and almost always related to genetic issues and that I would need to contact my ob/gyn in the morning for further instructions.  This completely infuriated me; first, regardless of what you call 12.5 weeks, spontaneous miscarriages are not particularly common past eight weeks.  Some aren’t diagnosed until later, but most first trimester miscarriages have taken place by the eight week mark.  The fact that I’d had a clinically excellent ultrasound a few days earlier coupled with having heard the heartbeat Saturday afternoon automatically negated what she told me in my head.

(* Although my emergency room doctor told me I was having a first trimester miscarriage, others weren’t so clear.  Some called it a second trimester miscarriage.  For some reason, thinking of it as a second-trimester loss made me feel better, and since there’s some disagreement about when the second trimester begins, I choose to think of it as such.)

Also, I burned when she implied that the baby was genetically abnormal.  How dare she say such a thing?  How did she know that?  How could she feel comfortable passing along that “diagnosis” even though she had no evidence?  The truth was she didn’t know.  She had no way to know that a structurally-normal-on-ultrasound fetus was genetically abnormal just because it died.  Especially when I had so many complicating factors.  In fact, further research told me that babies miscarried later in the first trimester and early in the second trimester are more often related to uterine abnormalities, umbilical cord abnormalities, placental issues, and cervical problems.  Although she could rule out the cervical problems, each of the other potential issues could still have contributed and were just as likely – if not more likely – to have created caused our loss.

I struggled to maintain my composure with her.  Partly I was angry with her lack of knowledge and willingness to treat my loss in such a “glossy” way.  Partly, I was angry at the situation, not sure which end was up.  Mostly, however, I struggled to maintain my composure because Gabe was still in the room and I didn’t want to traumatize him.

The doctor talked with me about my options.  The idea of miscarrying on my own at home had always tormented me, and given the stage of my pregnancy and the delicate instability of my emotions, I didn’t feel strong enough to deal with that possibility.  She explained that the hospital wouldn’t do a D&C on a Sunday and that I needed to involve my OB since it wasn’t an emergency situation (i.e. since I wasn’t hemorrhaging).  Realizing that I was headed home with instructions to call my doctor’s office in a few hours, I summoned up my remaining amount of courage and asked her to give me something to help me sleep.  What I really meant was that I wanted something to help me hold on emotionally, but I’m not sure there’s a pill that takes away heartache and brings back dead babies.  She kindly obliged, ordering a stronger version of Xanax than I normally take.

The doctor also spent some time talking with me about trying again.  I don’t remember all the details of this conversation; it wasn’t an inappropriate conversation and didn’t anger me. She had experienced something similar – the birth of a child followed by unexplained infertility and a later miscarriage, only to go on and successfully birth another child.  I insisted that we were done – that this was it and we wouldn’t be having any other children.  She encouraged me not to make that decision immediately and that my mind might change over time.  In spite of the fact that I “knew” she was wrong, I’m glad she encouraged me to keep an open mind.

And then she left.

And it was over.

Except it had only just begun.

Because I could see only one thing before my eyes – Gabe.

With hardly a moment to center myself, I looked up at Gabe, sweet and confused, still playing on his Leapster.  When he woke up in the car on the way to the hospital he had become quite insistent in his requests to know what was going on.  Eventually, I told him that when I used the special heartbeat tool I couldn’t hear the baby’s heartbeat and we were going to the hospital because we wanted them to check on the baby to make sure it was okay.  We repeated this explanation several times throughout the night, adding specifics when necessary, and always following it up with something to the effect that it was possible that the baby was not okay or it was possible that the baby was fine.  I’m thankful for that foresight on our parts.  I incredibly grateful that we had the courage to speak honestly to him without glossing over the situation.

Tahd lifted Gabe from the hospital chair onto the bed, snuggling him between my left arm and the bed rail.  I wrapped my arms around him and with surprising composure explained that something had happened and our baby’s heart had stopped beating.  Simple.  Truthful. I just said it.  Some people would think those words might take courage, but they didn’t.  They were what needed to be said, and I was his mother – the one who should say them to him.  This – my parenting amidst shared heartache – was the first inkling I had that I was stronger than I thought.  I needed that.  I needed to know there were untapped reservoirs of strength available within me, ready to help me survive, recover, and reclaim.

I told Gabe that the baby’s body was still in my belly but its soul was in Heaven with Jesus and that He was taking care of our baby there.  I assured him that our baby was happy and safe and that we would see our baby again someday.  I talked about the ultrasound we saw together and how lucky we were to get to see our baby and how special it was that he got to talk to our baby and “tell it” what to do.  At some point I believe we prayed, too.  I wish I could remember more of the specifics – questions he asked or other things we discussed.  I know he didn’t cry, and I also recall that my mother had recently taken him to Kohls so he could buy an outfit for the baby.  Not knowing the gender of the baby, he bought two, a blue onesie and a pink onesie, just in case.  He excitedly exclaimed that now we wouldn’t be needing those anymore so we could take them back!

Woohoo.

What great news.

At some point in the process, Tahd completely dissolved, kneeling on the floor beside my bed and crying loudly.  Bewildered, I tried to make him stop, both because I was nervous about Gabe’s response and also because I felt like I was in no position to “care” for him.  He left the room to go to the lobby and use his phone to call my parents, and when he stumbled back his spirits were no better. “You have got to pull it together,” I told him, angrily, an emotion I wasn’t sure how to handle in the moment.  I wanted to fall apart.  I wanted to cry inconsolably.  I wanted to get lost in my head and stop thinking about the outside world.  But I couldn’t, and I felt a strange mixture of anger, confusion and relief – anger at the obvious, confusion because I had never seen Tahd fall apart, and relief because he actually did.  His grief, however infuriating for me, made me feel like my grief was legitimate, too.

Of course, my grief was legitimate, even if Tahd had faced our loss with logic and stoicism.  But the fact that I looked at him as a gauge for my own emotional response betrayed how overwhelmed I felt.  My worst nightmare was playing out before my eyes, and everywhere I looked there was no way out.  I don’t know how I functioned in those moments, getting myself from the hospital room to the exit to the car and then into the house in one piece and on my own two feet.  The sun had just begun to rise – the beginning of a new day but the end of a coveted era for us, and the entire world seemed to stand still as we left the hospital and returned to our little sanctuary of a home.  It was all so, so surreal, and the only thing that provided me with any sense of normalcy was Gabe and knowing that he needed to be cared for and parented through this situation.