Miscarriages are devastating and we need to stop keeping them secret

A long, tiring journey.
A long, tiring journey.
Image: Photo courtesy of Kristina Liljas
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One year ago, I lay down for an ultrasound at my doctor’s clinic in central Hong Kong, sick with anxiety. I was eleven weeks pregnant and two days earlier I’d awoken to thick blood running down my thigh. My husband Per and I immediately went to the hospital and tears of relief ran down my cheeks when I spotted the tiny heart flickering away on the monitor. Everything looked fine; the heartbeat was normal and my doctor couldn’t find any explanation for my bleeding.

Now I was back for a routine check. There was no cause for alarm, but I still feared the worst: anyone who has had multiple miscarriages knows not to take anything for granted.

My doctor remained silent, rubbing around with her probe over my belly. We both saw a perfectly still fetus. I shifted my gaze to the ceiling as tears started streaming down. This can’t be happening again, I thought, it just can’t be happening. Again. I took a seat in the clinic’s waiting room while my doctor called the hospital to arrange for my abortion. My sixth procedure, after four miscarriages and the removal of an ovarian cyst.

I’d lost more pregnancies than I’d like to think of. The process that followed had become routine, but once I had reached my assigned room the sadness and sorrow overwhelmed me. How could it be that one minute there was a living baby in my body and the next minute there wasn’t? How can it be that this had happened to me every time, around the same week of my pregnancy, and no one could explain the cause?

It was not as if I’d relied on blind luck. I’d done all the tests in the book. I’d met with more doctors and specialists than most people do in a lifetime. I’d spent a few thousand dollars on special blood tests sent to labs in the US, I’d had a surgery to remove part of my thyroid (I had a type of benign tumor which, while considered harmless, has been linked to miscarriages) and had an hysteroscopy (an examination of the uterus)—nothing seemed to make any difference and no one was able to explain why I kept miscarrying.

According to statistics, an estimated one in five known pregnancies result in a miscarriage. Two miscarriages in a row is considered very unfortunate. But after three or more back-to-back miscarriages, the risk of having another rises to 80-90%. At this point I had miscarried five times—three in just the past year—all occurring around week twelve. This basically meant I’d been pregnant most of the year, except for when my body was recovering. Clearly, there was nothing wrong with my fertility; it was keeping the baby that was the problem.

Doctors had recommended everything; some bluntly suggested I give up, others told us to sign up for adoption (which we had) and others still pointed toward costly blood transfusions, arguing that my blood was rejecting the fetus.

In medical terms, a missed abortion happens when the body can’t get rid of a miscarried baby on its own. You can go for weeks, even months, without noticing that anything is wrong. And then you discover the lack of a heartbeat on the ultrasound. Four out of five of my miscarriages have been missed abortions, meaning the fetuses have had to be surgically removed.

Having an abortion is one of the most painful procedures one can go through—physically and emotionally. Even though the baby is tiny, the contractions feel similar to those that occur during normal labor, and you need to push every last bit of the body out of your system. After ejecting the dead fetus, it needs to be collected and sent away for testing. I will spare you the details; but I wouldn’t wish the process upon my worst enemy.

For some reason, miscarriages are a hidden tragedy. Like something to be ashamed of, you carry the tears inside, and don’t talk about it. I was relieved to leave with Per for Japan and sakura (the cherry blossom season) the day after the abortion. I did not want to, once again, have to go to work and  hide behind my desk concealing tears. It had happened so many times I was no longer able to explain the reason to my colleagues. I knew it would make them and me equally uncomfortable.

Once in Japan, I cried. I cried because all the hormones that had filled my body during the first twelve weeks of pregnancy were still there, and my body didn’t understand that it wasn’t pregnant anymore. It can take weeks, even months before these hormones go away. After one of my miscarriages I produced breast milk for almost two months afterwards. It was like being punched in the stomach every time I showered and the milk came out. There I was, with breasts full of milk but no baby to feed.

A month or two passed. I spent all of my free time and late nights reading about recurrent miscarriages. I couldn’t accept that there was no explanation. I would not give up. Could not give up. I joined online web groups and ordered every book there was on the subject. Through this I found both consolation and encouragement. I found other women out there who were struggling to have healthy pregnancies—and many who, with the right treatment, eventually managed to have their longed-for baby.

Shortly after last summer, I started bleeding before boarding a flight for a work trip to Sweden. I assumed the bleeding was because of two cysts I had developed, one in each of my ovaries. Once in Sweden I found that:

  1. the cysts were still there but had shrunk;
  2. I was six weeks pregnant (I saw the blip of a heart myself);
  3. I had a hematoma (blood clot) in my uterus that was causing the bleeding.

It was the first time I had heard of a hematoma, but I learned that it’s a fairly common cause of bleeding in early pregnancies. So here I was again—my sixth pregnancy and, adding to my already high risk, a hematoma, which posed an extra risk for miscarriage. There was nothing they could do about the hematoma, but based on the research I’d done I insisted that for this pregnancy I wanted to be treated with, among other things, daily heparin injections, low-dose cortisone, and levothyroxine for my thyroid levels. I had read in several medical publications that this regimen was a potentially effective, low-risk therapy and while my doctor was not aware of this treatment, she supported it once I shared my research with her. I was told not to fly and keep movement to a minimum until the hematoma (hopefully) would recede.

The waiting game of the first six to 12 weeks of my pregnancy was torture, a constant balance between hope and despair. I kept working as usual from Sweden as it alleviated my anxiety. I kept bleeding, and even though I knew it likely was because of the hematoma, my heart kept stopped every time I went to the bathroom. During the eleventh week, a gush of blood suddenly penetrated everything I was wearing. Rushing to the toilet, I felt a big clot passing.

Paralyzed with fear I called the ER only to have the nurse tell me matter-of-factly that I had miscarried and that there was nothing I could do. I would just have wait until everything passed through. She immediately triggered feelings of anger and self-defense—how dare she say that, how could she know for sure? How could she be so callous in the face of something this tragic?

Persistent as ever, I insisted on going to the hospital, bringing the fist-sized clot with me. The gynecologist who met with me is the best I’ve ever had (and I’ve met a few), and through my tears she calmed me down, telling me that it’s normal to pass large clots with a hematoma. Still bleeding heavily we did the ultrasound and there it was—a little miniature baby paddling around, seemingly oblivious to what had just happened.

I couldn’t believe it. I was eleven weeks pregnant and the baby was alive and kicking, even after a big bleed.

As the twelfth week approached, something inside told me that this time it would be different. This time the scan would be positive. Indeed, after the scan Per and I stepped out of the Mama Mia clinic in Stockholm with pictures of a living little creature of twelve weeks and five days,  laughed and crying.

After a couple of weeks, the bleeding stopped. From one day to the other the hematoma disappeared, as though it never had existed.

On Mar. 21, at 14.35 that little creature on the monitor, with a small, but vigorous and determined little flicker of a heart, came out. Adam Nils Rickard was born through a planned caesarean, 3,4 kilos of pure love. Words cannot describe how happy we are. I’m overwhelmed by emotions and can’t look at our little son without tears flowing down my cheeks. The little fighter that he is.