During the first week of December 2019, I was feeling very pre-menstrual. Moody, crampy, bloated, sore. I was sure my period would start any second.
The days kept passing, and I said to my husband, “I thought my period would’ve started by now.”
He gave me a side-eyed glance and, in true Mike Henry fashion, said, “Well, go pee on a stick.”
I was pretty darn sure a pregnancy test would be positive. I know my body, and I knew my period should’ve started. Although we had been trying to conceive, I wasn’t sure I was ready to know the answer.
The next day, which was December 8, I couldn’t stand it any longer, and when Mike got home from work, I blurted out, “I’m going to take a pregnancy test.” I felt like he should be nearby for this occasion even though we both knew it was going to be positive.
And it was.
In a state of shock, I walked downstairs and cautiously announced, “It’s positive.”
“Good! That’s what you wanted, right?” he asked.
“Well, I thought that’s what I wanted,” I said.
I battled with conflicting thoughts for weeks. I did want a fourth baby, but I was also nervous about adding another family member. In hindsight, I spent way too much time dwelling on those concerns, but I’m going to save that part of the story for another blog.
10 weeks, 2 days
That’s how far along I was when I had my first midwifery appointment on January 22.
I had hoped I would be able to hear the baby’s heartbeat with the Doppler, so when she asked if I wanted her to try, I gave an enthusiastic, “Yes!”
She put the gel on the Doppler, then started moving the wand around on my belly.
“I’m not getting the baby’s heartbeat.”
She pressed the Doppler harder onto my belly.
My heartbeat again.
“It’s normal not to hear the heartbeat this early. Do you want me to keep trying?”
“Ummmmm, no, I guess not.”
“This doesn’t mean anything is wrong. There’s about a 50/50 chance of hearing the heartbeat at 10 weeks.”
I tried to think positively. The baby is just too small or not in the right position.
But because I’d had a miscarriage years ago, the words “no heartbeat” were scary. My mind raced with worst-case scenarios. What if there really was no heartbeat?
I had planned to leave that appointment and start announcing our news to family and friends. I even had a list of people to call and text.
Instead, I left my appointment feeling discouraged and thinking, “No way I’m telling people now. Not if I might have to share crushing news later.”
I thought about making an appointment for an ultrasound because I knew that would be able to detect a heartbeat at 10 weeks. (I was seeing a home birth midwife who doesn’t do ultrasounds but will order them with another provider upon request.)
A week or so went by, and I was still feeling very nauseous and exhausted. My lab work had come back normal. I had not experienced any bleeding or cramping.
I knew all those things were good signs. I decided to forgo the ultrasound and trust that everything was OK.
12 weeks, 2 days
Mike came home from work on February 5 and asked, “When are we going to start telling people about the baby?” He was anxious to share the news with his parents and brother, and he suggested we tell the big kids.
That evening, we sat down with Elliot and C.C. and let them know another baby would be joining our family. Elliot’s reaction was typical for him — not overly excited but quietly happy. C.C. was less than thrilled, especially at the prospect of possibly having a sister. She wanted to remain the only girl, so she preferred the new baby be a boy.
I felt relieved that we could finally talk about Baby No. 4 in front of the big kids, but I was still worried that I had not heard a heartbeat.
12 weeks, 3 days
On the morning of February 6, Vincent and I were excited for a playdate at our house. Our friends were set to arrive around 9:30. About 15 minutes before their visit, I went to the bathroom to pee.
I don’t know if it’s because I had been through a miscarriage before, but I checked the toilet paper every time I wiped during pregnancy. Every single time. I was shocked when I saw pink discharge.
“No, no, no, no, no, no,” I cried.
I couldn’t believe what I was seeing. I was in my 12th week. This wasn’t supposed to be happening. I was almost through the danger zone.
I texted my midwife and let her know.
“Have you had any cramping?” she asked.
“No,” I replied.
I knew that pink discharge could mean nothing, but as a pregnancy loss mama, I feared the worst. I reminded her that there had been no heartbeat at the 10-week appointment.
She offered to do a heartbeat check that afternoon. I was relieved she could fit me into her schedule and tried to speak positively to myself, “Remember, the pink discharge could be nothing.”
Then, I remembered the playdate.
“Oh my gosh, April, you have to pull yourself together,” I thought.
The rest of that day, including the playdate, is mostly a blur. I continued my obsessive toilet paper checks at every bathroom break, and, to my surprise, there was never any more pink discharge. No red or brown blood either. Not even a drop.
Looking back, that pink discharge is a mystery to me. In the days before it occurred, I had been treating a yeast infection, so I thought maybe the pink discharge was a result of that. Or perhaps I had bumped my cervix while inserting the cream to treat the infection.
Or maybe it was the tiniest little nudge from a higher power. In hindsight, if it hadn’t been for the pink discharge, I might have carried a dead baby in my uterus for two additional weeks. I wasn’t scheduled to see my midwife again until 14 weeks.
But back to February 6. I arrived at my midwife’s office late that afternoon. I felt nervous but hopeful. She took my blood pressure and asked me some general health questions. I told her that I had been feeling pretty terrible until I hit the 12-week mark. This was consistent with how my previous two pregnancies went. She agreed that it was normal for the nausea and exhaustion to begin fading at 12 weeks.
Finally, the time came for the heartbeat check. I laid back on the table, and she squeezed out the gel. Before she put the Doppler on my belly, she said, “This is not the best Doppler. I have a better one in the car.”
Much like the 10-week appointment, there were lots of swishing noises but no fetal heartbeat.
The midwife didn’t seem too concerned and said, “I’m going to get that other Doppler out of the car.” She returned a few minutes later with a device that, to me, looked exactly the same as the one in her office. I didn’t care, though. If it could detect my baby’s heartbeat, that’s all that mattered.
When this attempt at finding a heartbeat failed, I knew it was bad. It’s possibly a result of my work. I spend a lot of time emailing and talking with midwives. I write blogs and website content for them. No, I’m not a clinician or an expert, but I know more about pregnancy and birth than the average person.
And I know 12 weeks is far enough along to hear a fetal heartbeat with a Doppler. There was some discussion about my dates. Was I sure they were right? We went over the calendar together. I described my cycles before I got a positive pregnancy test. I knew when I ovulated and menstruated. I was certain my dates were correct.
So she gave me some options. 1) Blood draws 48 hours apart to test hCG levels. A stagnant or declining level would indicate miscarriage. 2) Ultrasound at a doctor’s office the next day. Ultrasound can measure the baby in the first trimester and detect a fetal heartbeat as early as six or seven weeks. 3) Emergency room immediately. This would be the quickest choice for a definitive answer, but it would likely mean hours of waiting.
I chose the second. My midwife texted one of her midwife friends who sees patients at a hospital-based practice, and she ordered me an ultrasound for the following day.
As I left my midwife’s office, I tried to be positive. I remembered how stubborn Vincent was in utero. He never liked to reveal his heartbeat. He made the midwife work for it every time.
Maybe this baby just doesn’t like to be still to let us take a listen? Still, I knew the facts. I knew the odds were not in my favor.
12 weeks, 4 days
In the very early morning hours of February 7, I had a dream that my midwife was palpating my belly, as midwives do. She solemnly told me, “This pregnancy is not viable.” (I’m pretty sure palpation is not an accurate way to declare a pregnancy not viable, but it was a dream.)
Then at about 4:30 a.m., I awoke to an eery silence. It’s difficult to describe, but I remember listening to my husband breathing and sensing a strange feeling in the air. Maybe it was the snow that was falling. Or perhaps it was the impending bad news that was about to crush my dreams for the baby in my uterus.
At some point, I fell back to sleep. I woke before my alarm and noticed a message on my phone. Two-hour delay for the older kids. I turned off my alarm and tried to sleep a little while longer. When I heard my 2-year-old calling for me, I grabbed my phone to check the school status. Canceled.
Great. Mike was working. How was I going to go for the ultrasound with three kids in tow? Especially this ultrasound — one that had the potential to deliver terrible news.
As I considered my options, however, I thought, “Elliot’s old enough to stay home by himself for a little while, and I could probably take Vincent with me and have him sit in the stroller.”
It was C.C. I didn’t know how to handle. She knew I was going to an appointment “to see if the baby was dead,” and she actually requested to stay home with Elliot. I didn’t feel comfortable with that, so I texted one of our neighbors and asked if she could stay with their family for a little while. They agreed. This turned out to be one of the biggest blessings of the day. I am so thankful C.C. was not there for the ultrasound.
Despite the snowy conditions, Vincent and I arrived at the doctor’s office on time and sat in the waiting room for only a couple minutes before the ultrasound technician called my name. She guided me into the room and kindly showed me where I could park the stroller.
I wasn’t sure how much my midwife had communicated with the folks working at this doctor’s office, so I went ahead and explained to the ultrasound tech why I was there. She asked if I had any previous ultrasounds during the pregnancy, to which I replied, “No.”
I laid back on the table, and she prepared my belly and the wand. As soon as she placed it on my abdomen, I could see my tiny baby. Way too tiny for 12 weeks. I knew the ultrasound was going to confirm the worst possible news.
She spoke what I already said in my head. “This baby looks smaller than 12 weeks. To get a better look, I’d like do a transvaginal ultrasound. Would that be OK?”
I answered yes. She handed me a sheet, and I went to the bathroom to undress from the waist down. When I returned, she asked me to lie back down and put my feet in stirrups. She explained that she would look at my ovaries first, then the uterus and the baby.
My ovaries must have been OK because no one ever mentioned anything about them. When she pointed the wand at my uterus, she zoomed in on the baby. She estimated the baby’s gestation to be 8 weeks, 6 days. This was obviously bad.
“I’m sorry, I’m not seeing a heartbeat,” she added. As I mentioned above, ultrasound can detect a heartbeat as early as six or seven weeks, so, even if my dates had been wrong, a baby at 8 or 9 weeks would have a visible heartbeat.
That was it. My baby was dead.
I started crying, and the ultrasound technician repeated, “I’m sorry.” She handed me a box of tissues and said she would confer with one of the midwives in the office while I got dressed.
She came back a couple minutes later and asked if I wanted to see one of the midwives there or if I’d like to wait and follow up with my home birth midwife. I knew the drill, but I said, if one of the midwives was available, I would see her. I didn’t want to wait long, though.
She left again, and as I sat crying into the awful, scratchy, doctor’s office tissues, I thought about how this part of the ultrasound technician’s job must feel for her. What a terrible task — to have to deliver this devastating news to moms.
When she returned, she had a nurse with her who would take me to see one of the midwives. The ultrasound technician hugged me and told me again, “I’m so sorry.” I followed the nurse to a patient room, where I waited, again, only a couple minutes.
A young midwife entered, introduced herself and said, “I’m sorry to be meeting you under these circumstances.” I returned the sentiment.
She told me there were three options: 1) Do nothing and wait for “the products” to pass naturally. This could take up to two more weeks, which I found shocking. My baby had already been dead for four weeks. It’s crazy that he or she could continue to stay in my uterus for a total of six weeks. 2) Take a medication that would speed up the process. This can be a good option if waiting sounds too tortuous. 3) Schedule a D&C at the hospital. This is an outpatient procedure, but it does require general anesthesia. It would also mean shuffling schedules and arranging childcare.
At that time, I thought I wanted option 1. I declined the medication but said I might change my mind. I knew I didn’t want a D&C unless it was medically necessary.
The midwife went over signs of infection and reasons to go to the ER. I was impressed by her kind, compassionate care. Unlike when my first miscarriage happened, she didn’t say anything dumb like, “You can try again.” She stuck with “I’m sorry,” which is really the only appropriate response.
I left the appointment and called Mike as soon as I got into the van. He listened as I sobbed nonsensical words into the phone. He told me he loved me, and we hung up. I wiped away the tears as best I could. It wasn’t a long way home, but I did have to drive, and the 2-year-old was in the back seat.
I picked up C.C. from the neighbor’s house, and we went home. After telling Elliot the bad news, I had to feed everybody lunch and get the little one ready for a nap. When Vincent was quiet in his room, Elliot asked me if I wanted to play a board game with him. This was a rarity, and I was surprised at this gesture from my 12-year-old boy.
All I wanted to do was crawl into bed and pretend this nightmare was not happening, but I said yes to the game. I could use the distraction. Soon after we started playing, though, we heard the garage door going up. Mike had left work and come home early — also a rarity. Probably more unusual than the board game request.
The only other thing I remember from that day is getting into bed that night. Mike was already lying down. He flipped onto his back and moved one arm, which I knew was an invitation to snuggle with him. I laid my head on his chest and released a whole bunch of tears. All I could think was, “Why? Why did my baby have to die?”
It was February 10, and Mike was off work. I had decided the previous day that if there hadn’t been any bleeding, I would call the doctor’s office in the morning and request the medicine that would bring on cramping and bleeding. The waiting was, indeed, tortuous.
Despite the excellent care I had received three days prior, I couldn’t believe how difficult it was to get this stupid medication. I called twice and didn’t hear back. I was nervous to take the medication on a day when I would be home by myself with a toddler. That’s why I was anxious to get it on Monday when Mike was home.
I finally heard back from the midwife very late in the afternoon, almost 5 p.m. She apologized for the delay and said she would electronically submit the prescription for misoprostol. It’s a prostaglandin that softens the cervix and prompts the uterus to shed. She walked me through how to use it — it is most effective if placed vaginally, not taken orally.
When I picked up the medication, I wondered what the pharmacist thought. Miscarriage management is actually an off-label use of misoprostol. It’s primarily an ulcer medication, but misoprostol has been well-studied and is considered safe for treating a “missed miscarriage.” This is the term healthcare providers use when a fetus has stopped growing but hasn’t come out of the body yet.
Did the pharmacist know what was I going through simply by looking at the prescription? Did my teary eyes and splotchy face give away why I was picking up this medication, this medication that I desperately didn’t want to need?
That’s how much it cost for eight pills that would release my baby from my uterus.
Mike and I talked about our schedules for the rest of the week, and I decided that I would take the medication the following day. Early afternoon after Vincent went down for his nap. This would give the medicine time to do its job, with the worst of the physical part happening when Mike would be home with me.
13 weeks, 1 day
I am not afraid to admit — playing is not my favorite thing. I love my children, but playing is hard for me. The minutes seem to go by at a snail’s pace.
But on February 11, I actually wanted the morning hours to go by slowly. I dawdled as I made lunch. I took my time as I got Vincent ready for a nap. I was not looking forward to “early afternoon.”
Still, the minutes and hours passed. I found myself alone, panicking as I prepared to place the medication that would allow my baby to escape, even though I never wanted to let go of him or her.
I took four ibuprofen and grabbed a couple tissues. I made sure my book, laptop and headphones were on my nightstand, right next to the bed.
I went to the bathroom. I checked the toilet paper. Still no blood. I washed my hands.
As I sat down on the bed and looked at the bottle of medication, I realized the warning labels read, “Do not take if pregnant” and “Keep out of reach of pregnant women.” How funny, pharmacy. Thank you for that.
My mind started playing tricks on me. What if the ultrasound technician was wrong? What if she was new, and she just didn’t see a heartbeat, even though there was one? Maybe my dates were off?
My rational self knew these thoughts were nonsense. But my heart was breaking all over again, and I was grasping for anything that could mean my baby was still alive.
I put the bottle back on the nightstand. I couldn’t do it.
I sat on the bed, confused and angry. Again, I thought, “Why did my baby have to die?”
I reached for my Bible, but I didn’t know what to read in that moment. This might sound silly, but I remembered a scene from the most recent episode of Grey’s Anatomy. One of the characters had participated in a Jewish ceremony that prepared his dead uncle’s body for burial. During the scene, the nephew recited Psalm 23.
It’s one of the most well-known pieces of scripture, and it’s also the first Bible passage I ever remember hearing as a child. I flipped to it in my Bible and read it. One verse, in particular, calmed me: “Even though I walk through the darkest valley, I will fear no evil; your rod and your staff, they comfort me.”
I prayed more fervently than I had in months. “Please, Lord, don’t leave me alone. Help me know you’re near.” Over and over again, I begged for God to sit with me in my pain.
I was still scared, but I placed four pills, just like the midwife told me to. I laid in bed, giving them at least 30 minutes to absorb.
Just as I laid down, my friend Marina texted me. She knew I had decided to use the medication, but I hadn’t told her when. Her text was absolutely divine intervention. I replied with, “I’m so scared. Please tell me some Christian songs I can listen to right now.”
She sent me the names of several songs, and I played every one of them. It was my darkest valley, but those songs — his rod and his staff — they comforted me.
After all that, it feels anti-climatic to tell you that the first dose of misoprostol didn’t work. I felt a little bit of cramping, but still no bleeding. The instructions said, “If no tissue passes within four hours, repeat dosage.”
By that time, Mike was home. The second dose was much easier to place, mentally and emotionally.
We ate dinner as a family, and then it was time for the 2-year-old to get a bath and go to bed. Most Tuesday evenings, I have an hour and a half to myself while Elliot is at Boy Scouts. I usually go to Starbucks and work on writing.
It had been about an hour since I placed the second dose of misoprostol, and I was feeling some mild cramps. I wasn’t convinced the medication was going to do anything, though, and I wanted to try and keep my weekly alone time.
Before we left, I went to the bathroom. The toilet paper check revealed blood. It was happening. I was actually relieved in that moment because I felt like I could finally start to work through my grief.
I told Mike that I still wanted to take Elliot to Scouts and go to Starbucks. If that changed, I would let him know. He said OK, and Elliot and I left the house.
I dropped off Elliot and drove to the nearby Starbucks only a couple minutes away. I walked in and ordered my drink. While I was waiting for the barista to make my beverage, I felt something shift and knew I needed to go to the bathroom. When I sat on the toilet, it seemed like a gush of fluid came out. I looked down and saw blood and clots in the toilet.
Oh boy, this was a mistake. When I was done in the bathroom, I grabbed my finished drink from the counter and headed to the van. I texted Mike and told him what happened and that I was on my way back. He would have to pick up Elliot from Scouts.
In hindsight, I can’t believe I left the house after taking that second dose of medication. I think I was annoyed that the first dose had done nothing. Because the misoprostol had been slow to produce results in my body, I did not realize how quickly it could work.
I had some cramping as I drove, and I made it home just in time for another gush to fill the toilet. This pattern of cramping, then gushing continued for about the next two hours. It was impossible for me to tell what was coming out. I couldn’t distinguish between clots, tissue and uterine lining. How in the world could I identify if my baby was in the toilet?
It seemed like a lot of blood. A lot of tissue was passing quickly. I used a lot of toilet paper and many pads. I’m sure I flushed my baby. I just don’t know which flush took him or her away.
Today — February 19
I would be 14 weeks, 2 days if my baby were still alive. I would be having a midwifery appointment today if I were still pregnant.
But my baby is not alive, and I’m no longer pregnant.
I don’t have a pretty bow to attach to the end of this story. That’s just not how pregnancy loss works.
Miscarriage is filled with confusion and sadness. Still, I am incredibly thankful for a loving, supportive family and a wonderful circle of friends who have prayed for me, cried with me and sent me notes.
I will never forget this baby I never got to meet. He or she will hold a piece of my heart forever.