Miscarriage: A flicker of life

According to WebMD as many as 15% of all pregnancies end in a miscarriage and a loss early in the pregnancy has few physical ramifications. But the grief that the woman experiences far exceeds her physical pain and may last a long time. 

Here, three women share their experience of having miscarried in the first trimester.

Maham Hussain*: The thoughts and emotions of a woman on the day she miscarried

One moment, there was still hope — the secret joy that I was continually hugging to myself, smiling over and dreaming about. The next — the bubble had burst. I had passed it out without any effort, almost without any pain — a little blob of bean-shaped flesh, slick with blood.

I cried a little without knowing why exactly, an ache blossoming endlessly in my heart, more potent than the persistent pricks of pain in my abdomen. I had ignored for so many days this strange, uneven pain. What could it have been? Muscular ache? The routine inconvenience of motherhood? But I had been determined to sail through this — knowledgeable, competent, heroic and, most of all, self-sufficient.

Only half-realising what had happened, I called Mohsin* and told him, knowing it was no use telling him — he could hardly be expected to know what to do. And even while willing myself not to, I broke down into sobs at the sound of his voice and endured, for this lapse, his platitudes and jokes, failed attempts to lift my spirits.

Uncertainly, carefully, I changed out of my stained clothes. Then I lay on the bed, calling the hospital, reading, Googling up ‘miscarriage’ on my laptop. Finally, I summoned the will to clean up the mess. I picked the foetal matter off my clothes and transferred it to a clean jar to take to the hospital. As I carefully peeled it off the fabric of my pajamas, I detachedly recalled that only a few days ago, I had been wondering if it might be a girl.

Then, armed with medical records, I set off for the hospital. As I sat in the waiting area, a strange tranquility came over me and I found myself smiling at a three-year-old girl who was skipping around the hospital. Her heavily pregnant mother reprimanded her sharply but the little girl remained blithely unaffected, cheerily continuing on her little adventures and accepting snacks from strangers in lieu of her charming smiles.

It was a long wait. I had shown up without an appointment and I sat for many hours as pain pulsed through me, feeling weaker and weaker, periodically shivering. To kill time, I flipped through parenting magazines, reading with stupid, absorbed interest heroic accounts of women giving birth on the road, pregnancy advice and articles on baby shopping.

The last time I had visited my gynaecologist, it was to make sure that I was in optimal health to conceive a baby. She turned to face me: “So are you pregnant now?” she asked.

“Well, not anymore,” I replied coolly, holding aloft my prized jar of foetal matter. She was momentarily taken aback — I suppose not many people take the trouble to collect the pregnancy material their bodies have just expelled and bring it dutifully to the doctor for inspection. The nurse used a plastic instrument shaped rather like airplane cutlery to scrape it out of the jar and in the formaldehyde, it expanded and became plump once more and I felt certain that the whole thing had, in fact, come out.

Of course, there was the agony of a physical examination, which never gets any less embarrassing, no matter how many times you’re subjected to it. Then I was advised an ultrasound to make sure that  nothing remained inside that could cause an infection.

As I waited for the radiologist to roll the probe over my tummy, she asked when the abortion had taken place. “11 am,” I told her, at which she asked if I had ‘gotten it done’, a question so unexpected that my eyes popped out, and she fumbled to justify her query. It was a spontaneous abortion, I clarified, using the technical term that had been the fruit of an hour’s worth of Googling.

It was a day of endless waiting, of running from one doctor to the next, explaining all that had gone on before, a slow accretion of information — ultrasound, lab test, physical examination (yet again) — which amounted only to what I had known since that morning. I had it and then I lost it.

I was prescribed a course of antibiotics and misoprostol, to be followed by another ultrasound. Back at home, I lay on my bed, shivering as the light, mocking pain fluttered through me, trying to make sense of what had happened. And I kept looking at my son, my big, miraculous son, rolling out his play dough and cutting out shapes with capable hands, appraising my condition with dark intelligent eyes, and as I looked at him, my gratitude kept pace with my sadness.

I waited for my husband to come back, straining to hear the click of the door, eager to see him despite knowing that we could never really talk about this, that he could never fully understand. And so it was. Each stilted sentence dropped like a brick between us, building a wall there was no breaching.

And when finally the day ended, I was left with a tiny vacuum, a little bit of heartache. But these things happen, I told myself. They happen all the time.

Somia Ghani*: A woman who miscarried talks about her loss

It had been a total of two days since Somia Ghani* had sat anxiously in front of a home pregnancy test and discovered she was pregnant, exactly one day since she had gotten a blood test done to confirm that she was in her first trimester — something she had been suspecting for the last week — and in these 48 hours she had passed through every emotion in the spectrum. From bitter sadness for all the plans she’d have to eventually let go to debiliating anxiety about motherhood and whether she was mature enough to handle this change. And finally all these feelings were replaced by a more permanent state — that of a rollercoaster-like exhilaration for the little bundle of joy to come, and excitement about telling her mother and grandparents.

But all those dreams of finding perfect names and buying adorable little clothes were cut short when a pain reminiscent of severe menstrual cramps started. At first, Somia smiled to herself, thinking this was one of the normal lows of pregnancy. But once they became too hard to bear, she called her mother. The cramps gave way to clotted bleeding. And right then, she knew, her dream was over.

From that moment on, she says, everything was a horrid blur of long hospital visits, cold, expressionless faces of the doctors and every other person telling her: “This isn’t a big deal; it happens all the time.” Somia thought, it must happen all the time, it probably does, but it still is a big deal for me.

She went to one of the best hospitals in the city, but none of the gynaecologists or fertility doctors recommended psychological counselling. It was such a routine thing to them — it didn’t even require a D&C. Her husband was shaken up too, but not by the loss as much as by Somia’s sad eyes. She wanted him to feel the real loss, not just her sadness — but he simply couldn’t.

For a long time, Somia could not wash off the feeling that God thought she didn’t deserve this baby. Was this a punishment for her wild youth? A sign of divine anger? She abstained from trying again, unable to come to terms with her loss. Perhaps it was because she would have made a bad mother that God gave her a glimpse of that dream and then took it away from her. But now, three years on, Somia says she’s completely ready. She’s more positive than before, and the fear of it not working out won’t get the best of her.

Mariam Ahmed*: Recalling how the experience changed her — permanently

It wasn’t the ideal time for me to get pregnant. My daughter was barely a year old, and I was a mere 23, eager to have fun and go out with my husband. As a conscientious mother I found that caring for a small child took up most of my time; the last thing I wanted was to be overwhelmed with another infant. The discovery that I was expecting again, then, came as a shock. Thoughts of dreary days when the chores just don’t end, sleepless nights spent nursing a colicky baby and late night visits to the Emergency Room came rushing to me. But after a few days spent fretting, I settled down with the idea of my pregnancy.

It was the 8th week of my pregnancy, and I was on a routine doctor’s visit, commenting on how well I felt when my gynaecologist told me that I had miscarried. There was no foetal heartbeat and the pregnancy had terminated.

My first thought was: “I shouldn’t have done yoga.” I had been exercising at the time and immediately, I figured that the light aerobics and yoga were to blame.

These thoughts were soon followed by intense guilt. Perhaps God had punished me for not wanting another child so soon. Even though my doctor took pains to explain that the miscarriage was not caused by anything I had done or neglected to do, for many weeks, all I did was browse the internet for hours, researching the causes of a miscarriage, going to each and every website and discussion forum that addressed the issue. Mentally, I’d go through everything that I’d been doing prior to the miscarriage that could conceivably have caused the pregnancy to end.

At that time, I was paranoid, wondering if I had indeed miscarried, mistrusting my gynaecologist’s judgment and advice. She told me that I needed a D&C but I didn’t trust her. What if she was wrong? What if the foetus was alive? I was young, naïve, and extremely confused. But I was also fortunate as far as my doctor was concerned; she gave me a shoulder to cry on and her emotional support and understanding were crucial in helping me come to terms with what had happened. When I said that I was reluctant to get the D&C, she told me to take it easy. There was a wedding coming up in the family and she advised me to attend it with an unfettered mind: “Enjoy yourself, wear high heels and dress up,” she said. “We’ll take care of that D&C later.”

For 10 days between miscarrying and actually going for the surgical procedure, I carried a foetus that was already dead but those days were crucial in allowing me to face my doubts and fears.

As news of my miscarriage became gossip, every other woman in the extended family came to share her own tale of miscarrying. Far from giving me strength, these stories belittled my own loss and grief and made me feel even more confused. One constant refrain that I heard was that since it had all happened so early in the pregnancy, it made little difference. At that time, what gave me strength was the fact that my own mother felt the emotional loss almost as keenly as I did.

My emotional trauma was great but difficult to communicate. My husband was young and we already had a child, so the loss of this pregnancy made little difference to him. For the most part, he was immune to what I was going through and could not share my grief. In fact, sometimes I felt as if he too blamed me for what had happened — after all, the baby had been inside me and was affected by what I had been doing — eating, drinking, exercising.

When the night of my cousin’s shaadi rolled around, I got dressed, taking my time to get ready, putting on make up. As I put on my high heels, I had a fleeting thought that they might harm the baby, if it was still living. Then I shook it off. At the shaadi, people would come up to congratulate me, thinking that I was still pregnant. Then I’d grit my teeth and tell them that the pregnancy had terminated and I would soon be having a procedure to remove whatever was left in the uterus. I must have recounted that explanation twenty times that night.

The procedure itself turned out to be quite painful. Though the D&C was performed under anesthesia, prior to it, the doctor gave me medicines that led to intense pain resembling labour pains. I vomited and bled through the night but once it was over, I felt relaxed — almost as if nothing had happened.

Harrowing as a miscarriage is, perhaps the most stressful part of the experience was getting pregnant again. My doctor advised me to refrain from trying to conceive for at least the next four months but I felt as if I simply couldn’t wait to have another go. I became sad and fearful, mistrustful of the future. People would tell me, “Aur ho jayein gay” but I used to fear that the same thing would happen to them all.

In the meanwhile, I joined a pre-school as a teacher. I used to look at the little children longingly, becoming more emotionally attached to them than was prudent. I also became paranoid about my daughter and would lavish attention on her.

One long-term effect of the miscarriage has been that I simply can’t exercise anymore. Every time I start doing aerobics, I wonder if I might be pregnant and if the exercise would harm the baby. Even today, if I try to do bends and stretches, I just freeze with fear in the middle.

But in some ways, I have become a better person for that experience. For one thing, I am more loving towards children — whether mine or someone else’s — and whenever I see an angelic little face I feel an urge to smile at the little one and contribute to the happiness and love in his/her life. Because of my miscarriage, I began to value from an early age the pure love that children both demand and give, and thought nothing of sacrificing personal enjoyment, shopping sprees and relaxation to spend time with kids.

My sad experience was followed by a very happy one three years later when I gave birth to a beautiful baby boy.

*Names have been changed to protect privacy

Published in The Express Tribune, Ms T, September 23^rd, 2012.

Like MsT on Facebook and follow at @TribmagMsT for your dose of girl talk