Sarah, my guest blogger today, talks about the care she received during her missed miscarriages. A missed miscarriage is one where the baby stops growing but the body does not recognise this. Most missed miscarriages are discovered when the woman goes for a scan. Some women have experienced pain or bleeding and may already suspect something is not right. For some women, like my previous guest blogger (also confusingly called Sarah), it comes as a complete surprise.
Please help us spread the word. It is not right that women should have to pay for private reassurance scans if there is a risk of a miscarriage. This is all very well for those who can afford it, but what of those who simply do not have the money to pay for a private scan. It is vital that women are taken seriously and scanned if there is a risk of miscarriage, particularly when they are in pain.
You can help by emailing your MP, to find out if he/she has signed the Early Day MotionÂ and if not, ask him/her why. Contact your local Health Care Provider, and write to the Health Secretary Andrew Landsley.
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My Silent Miscarriages
I have had two miscarriages, both silent. The pregnancies themselves announced themselves with much fanfare. With each I remember realising very quickly that I had conceived – the symptoms of pregnancy started within days â€“ nausea, metallic taste in the mouth, sore breasts. It was different when I became pregnant with my sons, the symptoms appeared more gradually.
The first time, a month after my husband and I were married, I distinctly remember walking into the office ecstatic. Everyone commented on how happy I looked. I thought (a little smugly perhaps) â€œof course I am: Iâ€™m going to have a baby!â€
I wasnâ€™t. Well not that time anyway.
A couple of weeks later, when I was only four weeks pregnant, I visited my GP to register my pregnancy. He asked me if I had any questions. â€œIs it meant to hurt?â€ I asked. I explained that I had experienced some minor abdominal twinges. â€œNoâ€ he said and rudely reached his hand to my lower abdomen and prodded it. â€œDoes that hurt?â€ he asked. I frowned, â€œNo.â€
â€œThatâ€™s fineâ€ he answered.
The weeks went on and we started to get excited about having a baby but I had niggling doubts at and niggling pains in my abdomen, especially in the evening. They were not serious but just significant enough to make me wonder if things were not as they should be.
At around seven weeks I had a slight bleed after intercourse and called the Early Pregnancy Unit. They reassured me this was normal, as were slight twinges. â€œYou would know about it if you were having a miscarriageâ€, they said.
At nine weeks my pregnancy symptoms started to diminish a little. I spent hours obsessively Googling about miscarriage and discovered that miscarriage without bleeding (a silent or missed miscarriage) is reasonably unusual. I am a worrier by nature. I was just worrying, I told myself.
I still had the niggling pains and the niggling doubts became stronger so I booked a private scan. â€œIs it for reassuranceâ€ the receptionist asked over the phone. â€œYesâ€ I replied. But I was thinking â€œIâ€™m not sure that this will be reassuringâ€.
We went to France the weekend before the scan which was to be first thing on Monday morning, at ten weeks, before work. I felt tearful and sick to my stomach all the way home from France with such a sense of dread. My husband found my reaction difficult to comprehend. We really had no reason to worry.
On the morning of the scan we were shown into the waiting room. We waited. We were shown into the scanning room. As I was ten weeks pregnant the sonographer decided to conduct the scan trans-abdominally. My bladder was too full. The sonographer could not find anything. She asked if I was sure of my dates. I was. She then asked me to go to the toilet and told me that she would conduct the scan trans-vaginally on my return. My eyes welled up with tears. â€œDonâ€™t worryâ€ my husband tried to reassure me. â€œI-â€œ I started. Trying to warn him that we were about to receive bad news but unable to find the right words.
When I returned the sonographer asked me to insert the vaginal probe, switched off the lights, turned the viewing screen on (I wished she hadnâ€™t but couldnâ€™t bear the thought of it being off either) and set off to look for an embryo.
â€œYou are pregnant Sarah but the embryo is much smaller than we would expect for this gestation. And I canâ€™t find a heartbeatâ€.
A moment of relief. The relief of having an answer. A truth.
Then, I had a feeling that I had never had before, and that is barely describable. A physical and emotional punch, a collapse. White noise filled my head with the sound of the kind but meaningless voices around me. The sound of crying, my own.
The sonographer called her colleague in to the room to confirm that the pregnancy was not viable and they told us that the embryo probably stopped developing at about six and a half weeks.
We were shown to a quiet room to wait for a doctor from the early pregnancy unit to come and meet us to discuss our options. After some time I felt the need to call my Mum. â€œMum, the baby diedâ€. Pause, â€œOh, Sarahâ€.
The consultant came to see us and advised us that our options were either to wait for nature to take its course or to have an operation called Evacuation of Retained Products of Conception (ERPC) to remove the embryo and associated tissue. Other hospitals, she explained, offered Medical Management (using drugs) but that was not something that was offered here. She gave us time to ask questions and we were told that we didnâ€™t have to decide straight away.
We went home and cancelled all commitments for the rest of the week and sat down to think, to cry, to stare into space and wonder where all the happiness had gone. My parents were away on holiday but were able to meet us the following day to help us talk things through.
Eventually I decided that it was not possible to predict how long it might take for my body to realise that the pregnancy was not viable and that I would prefer to have the ERPC so that we could grieve and move on.
The ERPC was booked for Friday. I remember doing puzzles with my Mum to distract myself from it all. Life went on around me. My Manager called to say I had been promoted at work but also to reassure me that it was alright for me to take my time.
By the time I needed to go in for the pre-med I was feeling angry, a feeling that was fuelled by the detached and matter of fact manner of the doctor I saw that day.
Friday finally arrived. It was a wonderful, cathartic day. It still feels uncomfortable to say that but I have such comforting memories of it. There were dark days before and after but the day itself was different. A little like a funeral and a wake I suppose.
Maybe it was unusual. When I arrived on the ward I found that the woman in the bed next to mine was someone I had known a little for the past decade who was, sadly, there for the same reason as me. The sons we each had subsequently are three days apart in age.
I was given a pessary to help start the bleeding. Nothing happened. Apparently that didnâ€™t matter too much. I think it meant they had to work quite hard to remove the tissue though and I felt very sore afterwards.
The anaesthetist came to see us before the operation. Everyone was very kind and, one by one, each of the four women who were there for the same operation were taken down to theatre. A routine performed at this hospital several times a week.
When we came round we were given pain relief and, after a while, a cup of tea and a sandwich. Once the ward sister was happy with our state of health we were allowed to go home with plenty of anti-inflammatories with us.
So that was it. We had a quiet weekend and I attempted to return to work on Monday morning. I then had two weeks off sick when I realised that I was attempting to do too much, too soon.
I canâ€™t say I recovered really. It took a while for my periods to start again and I tested positive for pregnancy for a couple of months (who knows why I was testing). When I fell pregnant with my first son I dreaded every scan but also had an early scan to check that the baby was alive. I visited the midwife every week from sixteen weeks so I could make sure there was still a heartbeat (although when I was expecting my second son the midwives were no longer allowed to listen to the heartbeat until after twenty one weeks because they found they were having to refer a lot of worried women when a heartbeat could not be detected but the pregnancy was usually fine). I didnâ€™t even look at baby clothes until I was thirty weeks pregnant. I didnâ€™t trust my body to tell me if there was something wrong.
The story was very similar with my second (also silent) miscarriage, between my two sons. I had mild abdominal pain and requested a scan on the basis of my previous history. My GP referred me but the hospital refused to scan me as the pain was not significant and there was no bleeding. That time I found out at eight weeks after booking another private â€œreassuranceâ€ scan.
When I became pregnant with my second son I had mild abdominal pain at around five weeks. This time I decided not to go to my GP but to call the Early Pregnancy Unit directly. They wanted me to come in as soon as I could so that they could rule out an ectopic pregnancy.
The consultant that scanned me that day was the same, kind, consultant who discussed our options with us the first time I had a miscarriage. She told me that any woman of childbearing age presenting with abdominal pain should be automatically treated as potentially having a life-threatening ectopic pregnancy. She also told me that this embryo was in the right place, had come from my left ovary and had a heartbeat that had only started a few hours before the scan. We were so relieved but, again, extreme nervousness plagued me until I could feel the baby moving regularly.
My family complete, I feel that Iâ€™ve moved on from my miscarriages but the little people that I lost still feel real to me â€“ in both cases I was pregnant for just long enough to start imagining who they would be.
In hindsight I wish that I had trusted my instincts a bit more but I suppose no-one wants to believe that their pregnancy is not going to continue to a happy conclusion. This is why it is imperative that medical professionals refer patients presenting with pain. In that respect I was lucky â€“ the embryos were not ectopic, my life was not in danger.
I also wish that an understanding about the effect of previous miscarriage on womenâ€™s experience of pregnancy and subsequent miscarriage was reflected in the care given to women. From an emotional perspective, in the way that Health Care Professionals communicate with women and, in a more practical sense, by providing access to early scans and other means of reassurance.
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