Coping with Pregnancy Loss

Over the past year, my husband and I have experienced two late miscarriages. I cannot sufficiently describe the pain, the shame, the guilt, the sense of failure, the desolation of losing a child you were hoping for. We had been trying for nearly a year before I finally conceived successfully. I was happy but anxious. Some of my friends had experienced multiple miscarriages in their first trimesters before having children. I held my breath, waiting to enter the “safe zone” – post 12-week mark. I breathed a sigh of relief when we were finally there and we shared the news with our friends and families, but I did not fully relax. When could one truly feel “safe”? I was also not the kind of person to plan baby showers, reveal my baby’s gender or open a baby registry. I didn’t want to jinx anything. I didn’t want to make a big deal of being pregnant. I was a multi-faceted woman after all, and I was not about to let motherhood or pregnancy define who I was.

Right before the 18^th week mark, I felt a gush of water pour down my legs onto the bedroom carpet while I was folding laundry. I rushed to the toilet as the water continued to pour and saw streaks of blood. I knew something was terribly wrong, but I still held on to hope. I called my husband, Andrew, and he immediately left work to come and find me. As I waited, I called my sister in tears. She tried to comfort me, but I felt myself numbing as I contemplated the possibility of losing my child. It was still only a possibility. At the hospital the news was grim. My baby would not survive and if I did not terminate the pregnancy, I too was at great risk of severe infection. I could hardly look at the ultrasound. I could not bear to look at a child I knew I was going to lose. I made the decision to induce labour. Perhaps the most painful experience I’ve had is giving birth to a baby I would not take home. Initially, Andrew and I wanted to move on quickly, but I’d watched an episode of Outlander (feel free to roll your eyes right here but I swear I’ve only watched a few episodes!) where the main character was told that if she did not hold her still-born baby, she would regret it forever. So we held our baby. I’m not sure how long for. And finally gave it up to the hospital for cremation. I think a part of me still wishes we had taken the ashes home.

The doctors were not clear on what had caused my water to break so early. I had no sign of infection and my cervix looked fine. Was it the snake I had stepped on while hiking a week before? Should I have put salt in the corners of our house when we moved in? Did I bring bad luck onto myself? In those moments of grief, you clutch at straws to find meaning. Andrew and I went on a holiday to try and recover from the pain of our loss, when I suddenly got very sick. I was bleeding excessively and in excruciating pain. We had to drive four hours to the hospital and when we got there, they said I had bits of retained placenta and would have to go into surgery. After the surgery, I was informed that I had a sizeable fibroid in my uterine cavity, which could have caused my water to break early as well as my initial difficulty getting pregnant. I was relieved they had found a possible cause and an operation was scheduled. 

I got pregnant easily after that and we were over the moon. In fact, at 3 weeks, I remember waking up early one morning and feeling an overwhelming sense of joy. Somehow I knew I was pregnant. A few days later I did an early pregnancy test that confirmed my suspicion. I couldn’t contain my joy. I informed my mother immediately. The week in which I had lost my previous pregnancy passed, and the very next day I emailed my colleagues, celebrating the end of an excruciating week. I decided I would have a baby shower and registry. This was going to be a celebrated pregnancy. Right before going to bed that night, my water broke again. I was numb. I went to the hospital expecting the worst. When they checked my baby’s heart rate, it was normal. I was given the option to go home after 48 hours on antibiotics and wait it out. If I made it to 25 weeks or beyond, I would go stay in the hospital and they could resuscitate my baby when it came. I didn’t know this was even a possibility and I cried tears of relief. Up until that moment, I had not even been able to cry. 

The doctor said “expectant management”—watching and waiting—an option I hadn’t been given before because at the time, my baby’s heart rate had dropped below normal. I wondered why I had not been told of this then. Our doctor, a specialist in pre-term birth, gave us a paper she had co-authored on my condition: Preterm Premature Rupture of the Membranes (PPROM). Andrew and I researched everything we could, from medical journal articles to women’s anecdotal stories. This time did not feel like a freak accident, like I had felt with my previous loss. There was a pattern of sorts. I was calmed that information was out there. I was calmed by the ability to develop expectations. For women like me, who suffer more than one loss, the risk of subsequent losses is greater. I went home determined to stay positive. To give this baby’s survival my best efforts. We were overjoyed when I finally felt baby flutters. Friends showed up with kindness and food. My husband’s parents came. My mother flew in with herbs. I decided to minimise activity. I drank litres of water each day. I stopped checking my emails to avoid stress. I believe we did everything in our power. But one morning, nearly 3 weeks later, I woke up with severe nausea and after a bout of vomiting, felt tissue at the entrance of my vagina. Again, Andrew had to come rushing home. Again, I called my sister in great trepidation. Again, we rushed to the hospital. This time we were not alone, but accompanied by our brother and mothers. Again, we got grim news. The baby could not survive and I was at great risk of infection because the umbilical cord was exposed in the vagina. This time I opted for a surgery to empty my uterus. I could not bear to give birth again. We decided to take the ashes home with us. I was consoled by the fact that I had had more time with this baby than before and had developed fond memories along the way.

I have always wanted to share my story so other women going through this, especially those from my country, may not feel alone. But I felt an overwhelming sense of shame. People would think I deserved my fate. In my twenties, I had not imagined myself to be the kind of person who would settle into domesticity. I was always fiercely independent. I was not (and might never be) “a good girl”. I shunned societal expectations on my behaviour. I lived on my terms as much as I could. Nevertheless, I felt pride for myself and my mother when Andrew and I married for a second time in a traditional ceremony in Uganda. I hadn’t needed to follow the rules that constrain female behaviour to achieve some traditionally feminised goals: “marriage and family”. To an extent, definitely greater than my mothers and grandmothers, I could choose the woman I wanted to be, whether I conformed or “misbehaved”.

I have thought a lot about what women in my society endure when they do not fulfil their supposed biological function in marriage. Once you are married everyone immediately expects you to expand your family and the longer you go without expanding it, the more judgmental people become. Even those closest to you. I remember when one of my cousins got married and after years passed by without children, my own family members started mocking his wife and questioning the viability of their marriage. Would those same people sympathise with my situation? Would people think my husband should find another wife? I remember a friend of my sister’s whose current husband would not marry her, even informally, before she had given birth to at least one child. Before an aunt of mine had twins, she suffered a stillbirth. To this day, we have never talked about it as a family. I don’t know what support she received. She certainly didn’t receive any from me. I cannot even begin to grasp her pain or isolation then. A couple of months ago, my cousin shared her experience with difficulty having a second child and how she eventually informally adopted a son. We don’t even talk about adoption when we talk about families. A close friend of my mother’s never had any children and I grew up listening to pitiful remarks about the pitfalls of being childless but never any thoughtful insight into what she had wanted for herself. No one ever wondered if she had tried and failed. If she lived with shame, knowing that the women around her gossiped about her situation without empathy. 

In a society where women are considered “very fertile”, where our mothers appeared to easily have multiple children, the inability to effortlessly bring children into the world can feel debilitating. But now I question even that. Is it really effortless? My own grandmother lost her first four children before she went on to have ten more. We need to talk about the path to motherhood. It is not straightforward. Not for all of us. Some of us will struggle, for years perhaps, before we can expand our families. It is not a given either. My husband and I have had to ask ourselves about the depth of our relationship. Can it survive without children? Can it survive the possibility of years of struggle to finally bring a live healthy child into the world? 

I am developing a Facebook Page (old school I know, but social media is exhausting) that can bring together resources and information for women, particularly those from unsupportive societies like mine, as they cope with infertility, pregnancy loss and child loss. You are not alone. You are not a failure. There are multiple pathways to motherhood.