Mother's Day 2021: "The little family that wasn't"
The words of Leigh Rose from Calgary on her family's struggles with pregnancy loss. Originally submitted to the AWHF as part of the Mother's Day 2021 campaign to acknowledge the unique struggles of women and mothers this year, and help make a difference in women's health.
Mother’s Day 2021: “The little family that wasn't”
2020 was an extremely difficult year for everyone, I don't want to discount that. But adding to the general fear and chaos for me was also the successive loss of both of my only two pregnancies.
My husband and I got married in March 2019 and—being what some doctors would refer to as 'geriatric' from a reproductive perspective (35 at our wedding)—didn't want to wait too long to start growing our family. What we didn't realize of course is that 'growing our family' would be a lot more complicated than we expected and that we’d soon earn our admission into the unexplained recurrent pregnancy loss club via two successive missed miscarriages.
We didn't have too much trouble conceiving our first in January of 2020. When I saw the positive test I was shocked—I thought it would take us a lot longer. I proceeded to take a handful more tests—which of course were positive—then shared the news with my husband. We were shocked, but so excited. I visited my GP who confirmed the pregnancy and provided us with some information booklets and then I quickly submitted an application for a midwife. When we were successfully accepted to a midwife practice close to our home we were thrilled. Everything was going so well!
The dating ultrasound was such an incredible day. Falling just before the craziness of COVID, my husband and I were together when we first saw that flicker of a heartbeat on the screen. They dated us about a week behind what I had calculated but said everything looked perfect. Suddenly it became real—we were going to be parents!
We had been planning an international trip for August of 2020 with family to host a wedding reception for family who didn't make it to our wedding, so we announced our big news early because we'd need to cancel the trip. I'd be in my third trimester by then so we knew it wouldn't be possible. We spent the weekend celebrating.
Shortly after our one-year wedding anniversary was our 12-week ultrasound. It was now early April and the pandemic had forced everyone home, so I would be attending this one alone.
I arrived eagerly at my appointment—dressed up for the first time since being sent home a few weeks earlier and filled with excitement to see our baby again, this time as more than just a flicker on the screen. But the technician seemed to be struggling and I couldn't see anything on the screen, and she told me we would need to do an internal ultrasound. My stomach flipped and my heart started pounding—this was my first pregnancy, but I knew from message boards that by 12 weeks you can see everything with an external scan if things are progressing normally. I emptied my bladder in a daze and returned to the room. The internal exam confirmed what I expected—I could see the stark and heartbreaking ‘0’ on the screen right where our baby's heartrate had been just a few weeks earlier. The tech wasn’t able to tell me anything (not like it's hard to figure out though) so she tells me to get dressed and that the doctor would speak to me in the next room.
When she closes the door I burst into tears of disbelief, sobbing—all alone—in a dark room faced with an image of what was just minutes before the biggest hope I had ever had. I didn't understand what happened—after a heartbeat the chance of loss was so low that I hadn't even considered it. I was still suffering from morning sickness, even taking Diclectin. I still had all the symptoms I'd had at our dating ultrasound. It made no sense.
The doctor was male, I don't remember his name. He told me there was no heartbeat, that our baby measured around eight weeks so must have passed away shortly after the dating ultrasound. He was not compassionate, even though in front of him I sat sobbing and alone after losing my first and only pregnancy.
He offered no condolences, only asking if I drank, smoked or did drugs (none of which I had). Aside from my age I have no risk factors for miscarriage—I don't drink, smoke or do drugs, I am not overweight, and I have no known health conditions. He mechanically told me I could wait for it to pass on its own or go for a D&C (I had no idea what that was) but didn't provide a process for either. So, I left, walking out the same doors I had come through just minutes before full of excitement and hope.
I left feeling like it was my fault.
Was it the half-caff coffee I had been drinking? Or the fact that all I'd been able to eat was bread and crackers? Or was it because I was so stressed out?
The following days were a blur. My husband—in his innocent (and warranted) excitement—had told almost everyone he knew our news and now had to 'untell' people. We don't talk about miscarriage in this society—nobody knows what to say. What they do say is often unhelpful and hurtful, even if it is meant well.
To add to the despair of those days, arranging a D&C was stressful and difficult. It was hard to exist knowing I was carrying the remains of what could have been and there was nothing I could do about it.
There is no continuity of care—I had to contact my midwife and ask for a referral to set up a D&C and it was more than a week before they could get me in for the procedure.
That week carrying around the remains of our baby was one of the worst of my life.
Every moment was unbearable knowing it was there. The only clinic available—because of COVID restrictions and related changes to operations—was the Kensington clinic. The 'abortion' clinic—which I pictured in my mind surrounded by protestors (it wasn’t). I would have to go to a place where women who have chosen to end their pregnancies go and sit there mourning the loss of a baby that couldn't have been more wanted. It was excruciating.
The D&C too was another process I went through alone because of COVID restrictions. It took about four hours from arrival to discharge and was uneventful. I sobbed before the actual procedure and all I remember is a nurse who had the most compassionate eyes wiped my tears for me and held my hand. It wasn't painful and was quick. The recovery is about 20 minutes and then they walk you out to your ride.
There was no follow-up from that procedure, from anyone. No ultrasound to make sure there's nothing left, no call to make sure I was doing ok. You're not pregnant anymore so off you go back to normal life and you don't require any kind of special care.
I spent the next few months recovering—emotionally and physically—from the ordeal. I still had hope, I have friends who lost their first and went on to have families. I focused on losing the 10 pounds I gained and tried to enjoy the summer. It took almost three months for my cycle to return, so it wasn't like we had any choice. There were no answers as to why this happened from my doctor—it isn't something they investigate until you have three. So as difficult as that was to accept, I did. And I just tried not to think about it.
We got pregnant again on the second or third cycle we tried after that—with a solid "Pregnant 1-2 weeks" on a digital screen in late October of 2020—the same month we should have been celebrating the birth of our first child. This time I only felt passing excitement, having learned that a positive pregnancy test does not equal a baby. One of the hardest things about losing your first, I think, is that it steals all the innocence and joy from subsequent pregnancies. Mostly I felt scared.
So I followed the same process, reconnected with our (wonderful) midwife and set up our first trimester appointments. I was anxious but promised myself (and my husband) that I'd stay off the message boards and WebMD and other generally unhelpful sources of misinformation and fear. Those first few weeks were like the last time. I was exhausted and had terrible morning sickness—and was taking Diclectin again.
For some reason, my husband was allowed in for our dating ultrasound (I don't know if they had changed procedures or if it was because of the previous loss). So we attended that appointment with trepidation. Again, the ultrasound was internal—but I knew that was fairly common for a dating ultrasound. And there it was—a flickering heartbeat! A little bit slower this time (which I would spend the coming weeks agonizing over) but the doctor assured us everything looked great, and we were congratulated and awarded on our way out with that highly coveted picture of our little bean (unrecognizable of course at that size) which I clutched tightly.
I would later make a calendar for our parents that had pictures of our ‘fur children’ (we have two big rescue dogs who are their 'grand-dogs') for every month except July—when their human grandbaby was due. For that month we had our dating ultrasound scan picture. We were going to surprise them at Christmas with this calendar since it would be right around 12 weeks then. All but one of those calendars was thrown in the garbage and none of our parents even knew they existed.
Around 10 days after the dating ultrasound I woke up in the middle of the night with a start and knew something was wrong. I just didn't feel pregnant anymore.
I sheepishly called my midwife—she had been so understanding and told me that she would get me an emergency ultrasound if I really needed reassurance considering the first loss. She was able to get me in the next day, and my husband was able to join me. I hoped it was just my anxiety and nothing was wrong, but there was just something deep down telling me that there was.
I was right. The ultrasound technician was unable to see anything externally, so again we opted for an internal scan. Immediately I saw the stillness, and another ruthless '0' on the screen where a heartrate should have been. She again wasn't able to tell us anything and we waited for the doctor. He came in and asked us if we wanted to know or if we wanted to wait and talk to the midwife. I told him the result was clear on the screen, and that this is the second pregnancy we had lost in less than a year—both of the only pregnancies either of us had ever had. Both missed miscarriages—the inconceivably cruel kind that trick you into thinking everything is going well even long after they aren’t. This doctor was kind and compassionate. He told me that physically there was nothing wrong with me. I am grateful I wasn't alone this time.
But this time I was more adamant—speaking to whoever I could about getting the tissue tested for abnormalities—desperate for answers. I was given a firm no—again stating that only after three losses (which can be over the course of a woman's entire reproductive life or in a row) would they look deeper.
So here I am, now 37, having lost two pregnancies in a row after seeing a healthy heartbeat at the dating ultrasounds. Both lost nearly to the same day in the pregnancy. With no answers at all. I feel like I am going crazy. And this time it's just before Christmas.
So I went through the process again, feeling like Groundhog Day. The weeklong wait, the (COVID-mandated) solo visit to the Kensington clinic to go through the procedure all alone. The unhelpful chat with the onsite counselor. My situation is clearly not what they typically deal with at this clinic.
No follow-up tests, no reasons. Just nothing.
This time I pressed for a referral to the fertility clinic. We were lucky to have taken the place of a cancellation and were able to get in within eight weeks. That appointment was quick, our doctor told us she would be doing some genetic testing for both of us, some blood tests for me and a sonohysterogram (SHG) to rule out structural abnormalities. She answered the long list of questions I had with matter-of-fact responses but offered no suggestions. I know this is an extremely busy clinic and understand we can't expect her to spend an unlimited amount of time with us. We leave with our requisition forms and renewed uncertainty.
My cycle returned a few weeks after that appointment (I don't know why they tell you two to six weeks is the normal range for your cycle to return after a D&C, it has been way off 100% of the time for me) and I was able to get in for blood work as prescribed—that was in mid-February. They were not able to get me in for the SHG that first cycle and advised us to contact them again for a test the next cycle. So now we are in a waiting game—the doctor told us to keep trying, but I don't think I can go through another loss so am afraid to.
The next month when I contact them to schedule the SHG, they are able to get me in so I look forward to the test. On the day of the test (another one attended solo because COVID) the ultrasound technician (who is mercilessly quite pregnant) spends a few minutes doing a thorough internal scan but doesn't say much. The ultrasound setting at this point is a source of a lot of anxiety for me so I bite back tears. She leaves and brings in the doctor, who completes the SHG. It is a really quick procedure—moderately painful—but she has what she needs in less than a minute. She tells me everything looks good and leaves the room. That's it for that test, I guess.
I realize when I return home that the clinic has not contacted me to book a follow-up appointment as they had noted at the first appointment they would, so I contact the clinic and leave a message. They get back to me and we book the appointment for May 27th (the earliest appointment they have) which is nearly four months after the initial appointment. I ask to be placed on a waitlist.
In the meantime, working with a naturopath to help me find answers, I had a blood test (which I paid for) that revealed the presence of thyroid antibodies, suggesting Hashimotos disease. A condition that could play a part in these devastating losses. But my GP dismissed this as a concern, noting that only once I (almost inevitably) become traditionally hypothyroid would treatment and further investigation be warranted. I decide to bring it up with our doctor at the fertility clinic.
But I received a voicemail from that doctor telling me that all of our results 'looked good' and that she was taking us off her waitlist. No opportunity to speak with her or request to stay on the waitlist to discuss our options and next steps. So, without any answers, and knowing there are still more we could be doing, I watch the days and months fly by as I now very quickly approach 38.
Soon this process will have been taking over our lives for two years, and we are no closer to answers or 'growing our family' than we were when we made the decision to start trying. What we are is two years older and a lot less hopeful.
I know in the grand scheme of fertility journeys that this is not a long time. It feels like forever.
So, Mother’s Day is a bit of a difficult one. I have watched virtually all of my friends start and complete their families over the years, some even while we’ve been on this fertility journey. I am so grateful for my own mother and want to celebrate all of my friends and family who are strong, beautiful mothers—but it's bittersweet.
Instead of little hands to hold and snuggle or milestones to record we have only our loss and time passing that puts us further away from where we both so hoped to be now. The world is an unforgiving place for the unlucky members of the club we're now in. Baby shower invitations roll in, nieces and nephews pass milestones and grow into little people. Feeds that were once filled with images of nights out now almost exclusively dedicated to smiling photos of chubby-legged toddlers and young families whirling through adventure after adventure. And we bury our tears and pain so that we can try (badly, probably) to be there for the people we love.
Each loss has taken a little piece of my soul. Each loss an infant I will never cradle, a little personality I will never get to see develop, a family Christmas photo that won’t be taken or proudly sent. A little face we won't get to study night after night searching for emerging hints of my brown eyes or my husband's red hair. A little family gathered around the dinner table, giggling while the dogs wait for inevitable scraps at the foot of a highchair that isn't in our kitchen. A little family that... just isn't.
It's hard to be hopeful when you're on this journey since so little of it is in your control. When you don't know if you'll ever get to really be someone's Mom, or how many more losses you’ll need to survive—and you feel like you're living life on the outside looking in. And when you're getting the best help that's available, but it isn't enough, and it just isn't getting you anywhere. And throughout all of it you need to show up in your life like nothing's happening. Because pregnancy loss just isn't recognized in any meaningful way, not really.
And on top of it all to have more difficulty getting appointments, not being able to see most health care professionals in person or having to attend big appointments and go through procedures all alone because of COVID—it's only made things that much harder.
My hope is that one day we as a society can treat pregnancy loss with the care it deserves and invest into research that helps shed new light on causes and then one day treatments. Because there's nothing else in the world like having your future child taken from you, repeatedly, for no reason at all and with no explanation.
There's only so many times a heart can break like that.
If you would also like to share your story, please visit here.
It is the AWHF's mission to foster equity in women’s health, close gaps that exist in research today, and connect pathways from lab to life. Show your support for women like Leigh from across Alberta and beyond with a gift to the AWHF.
This story from Leigh Rose from Calgary, posted with her permission, was originally submitted directly to the AWHF via the story submission form, and reposted here on the Royal Alex website. Minor grammatical edits have been made for the sake of clarity and accuracy.