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At a loss

grievingAfter years at P&N, I’d heard the statistics many times: Approximately 1 in 5 pregnancies end in miscarriage. Your risk climbs with your age, but I was in my mid-20s and healthy—so I didn’t worry. When a test revealed two pink lines, I was over the moon. But in a matter of days I went from one of the highest emotional highs to one of the most devastating lows. It was exhausting and excruciating (not physically, though the cramping was no picnic). The doctor declared it a chemical pregnancy, and in an attempt to comfort me, she said that it happened so early I might not have ever known if I hadn’t taken the test.

But, the thing is, I did know. And the sweet little secret my husband and I shared was gone. I was heartbroken, but I knew miscarriages happen. Now that one had happened to me, I thought my “turn” was over. Soon I’d move on with a healthy pregnancy.

One month later I was staring at another set of double lines. I was cautiously happy while still bracing myself—just in case. But nothing happened. There was no bleeding, no cramping. Instead there was nausea, fatigue and two very sore breasts. This time was going to be different. I could feel it. Literally.

I made it to my eight-week appointment without any scares. I was finally starting to breathe easy and let myself enjoy this wild ride. As I lay back in the chair, the doctor flicked on the ultrasound screen. I waited to see the fuzzy gray bean that was our baby. Only there was nothing there, nothing but black and emptiness. I was stunned. I couldn’t find words. I just nodded as the doctor noted that things looked to have stopped progressing around six weeks. The rest of my body hadn’t figured out that vital piece of information, so I was still experiencing the usual symptoms. It felt like a cruel trick, but there was no one to blame. I waited two weeks for my body to do its thing naturally, and when it didn’t, my second miscarriage ended with a D&C (dilation and curettage, a surgical procedure to remove the lining of the uterus) and a heavy dose of pain meds.

What it feels like
A miscarriage is oftentimes a private loss because it typically occurs in the earliest weeks (when you haven’t yet announced anything on Instagram). Because so few people know about the baby and because it’s such a personal grief, having a pregnancy unexpectedly end leaves you feeling isolated and alone. But—and this is key—you aren’t alone.

According to a survey in Obstetrics & Gynecology, most respondents mistakenly believed that miscarriage occurred in 6 percent or fewer pregnancies. In reality, it’s closer to 20 percent. A miscarriage isn’t a rare anomaly. Nearly a million happen in the U.S. every year, so chances are you know someone who’s had one.

Take comfort in the fact that no matter how lonesome that journey feels, you can walk it with support from women who’ve been there. So, talk with someone—a woman who has miscarried or even a close friend who hasn’t. A bent ear and a shoulder to lean on are invaluable. As much as it hurt to say the words out loud, as soon as I did, my sorrow didn’t weigh on me as heavily.

From a purely physical perspective, having a miscarriage feels similar to an intense period. Whether you miscarry naturally or you have a D&C procedure, be prepared for painful cramping in the abdomen and lower back, as well as vaginal bleeding, which may contain clots or tissue, that lasts for a few days.

Why it happens
One of the hardest parts, at least for me, was grappling with why. I spent weeks after each miscarriage wondering if there was anything I could have done differently. Was it that cup of decaf coffee? Should I have gone with the other prenatal vitamin? Did I not exercise enough? I wanted some tangible answer that I could hold onto to reassure myself that it would never happen again. But, of course, I had no idea if it would happen again.

There are numerous causes of miscarriage, but most can be broken down into five categories:

  • Genetics: Something goes wrong as the cells start to divide.
  • Infections: Such as chlamydia, gonorrhea or mycoplasma.
  • Anatomic problems: A defect of the uterus.
  • Clotting disorders: A blood clot formed in the placenta.
  • Progesterone deficiency: The body isn’t producing enough progesterone.

What you will not see on that list are the questions that ran through my anxious mind, so resist the temptation to blame yourself. Miscarriages are not caused by sex or stress. Yes, it is happening inside your body, but it’s not your fault. When those feelings of guilt or shame creep in, remind yourself that a miscarriage is nature’s way of ending a pregnancy that isn’t going right.

One upside of having a D&C was that my doctor could pinpoint exactly what went wrong, something I’ll never know about my first. It turns out the baby had a rare chromosomal abnormality called triploidy, which essentially means that instead of two sets of chromosomes, there were three.

Eighty percent of miscarriages happen in the first trimester, and the bulk of those are the result of genetic problems, which are determined at fertilization. In other words: It’s out of your control.

When to try again
Should you have a miscarriage or if you’re walking that path right now, the most important thing is to be gentle with yourself. Take time to mourn your loss in whatever way you’re comfortable. Be mad. Be sad. And let someone be those things with you. It’s an emotional time, and the fluctuating hormones don’t help.

Talk about when you can try to get pregnant again with your care provider. Her advice will depend on how your miscarriage went and how far into the pregnancy you were. My first happened so early that my OB said we could try again right away. With the second, she suggested waiting about 8 to 10 weeks to give my hormones a chance to level out and let my cycle return to normal.

If and when you are ready, it can be tough to swallow the fear that it might happen again, but know that the vast majority of women who have miscarried go on to have successful pregnancies.

In fact, most OBs won’t advise further evaluation by a fertility specialist until a woman has had at least three miscarriages.

Not long ago, I was teetering on the edge of three, and the thought of going through another loss terrified me. I didn’t know if I could take it—at least not anytime soon, so my husband and I decided to table it for a few months. The pressure was off, and, perhaps not so surprisingly, I got pregnant almost immediately. As of writing this, I’m at 19 weeks and counting. My journey toward motherhood included a few bumps I wasn’t expecting, but that only makes me cherish every step forward even more.

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