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The extraordinary pain of an ordinary miscarriage

PERSPECTIVE | ‘It’s not your fault’

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March 11, 2018 at 9:51 a.m. EDT

“It was nothing you did,” the nurse says. “It’s not your fault.”

I am silent. I had not thought it might be. I look again at the image of the baby on the screen. There it is. Sitting up in its dark cave, as if waiting for something, as if on its best behavior.

If I sit straight, it seems to be saying, no one will notice.

I know how it should be, how it should look. This is my second pregnancy. I know the heartbeat should be there, flashing and flashing like a siren. So when the radiologist says that he’s sorry, the baby is dead, I already know. But I carry on staring at the monitor because there is some frail, furled part of me that is hoping there has been a mistake, that the heartbeat might suddenly appear, that the scanning machine might roll further and there it will be. I can’t look away, even when the radiologist starts talking again. I want to burn the image of that tiny, ghost-pale form into my retina. I want to remember it, to honor its existence, however short.

About 1 in 5 pregnancies ends in miscarriage; up to 75 percent of these occur in the first trimester. The risk of pregnancy loss, then, in the first 12 weeks is about 15 percent. About 1 in 100 women experiences recur­rent miscarriages.

We all, I think, know these statistics, or at least have a vague sense of them. We know miscarriage is out there, at our backs, pursuing us, like Andrew Marvell’s wingèd chariot.

Should we tell others about our pregnancies earlier?

It’s why you’re not supposed to tell people you’re preg­nant until you’ve passed the magic 12-week point. But I’ve never understood the blanket secrecy you’re supposed to apply to early pregnancy. Certainly, I’ve never felt the need to broadcast the news far and wide, but it seems that pregnancy at any stage is significant, life-changing enough to warrant telling those closest to you. Even if something as devastating as pregnancy loss happens, wouldn’t you want your close friends, your family to know? Who else would you turn to at such a time? How else do you explain the grief, the stunned pain on your face, the tears?

Because losing a baby, even at a very early stage, is a shock like no other. Intellectually, you know it’s a possibility: As soon as you get the line on a test stick, you look every day for the telltale sign of blood. You tell yourself it might happen; you tell yourself not to build things up, to be sensible, rational, balanced. But your body is singing a different song, a distracting, absorbing, joyous tune: Your blood capacity rises, pulsing along your veins, your appetite hears the call, responds to demand, and you find yourself in the kitchen at midnight, contem­plating grapefruit and halloumi.

Your imagination keeps pace with your teeming body: You picture a girl, a boy, perhaps twins. It will be blond, it will be dark, auburn, curly-haired. It will be tall, it will be petite. It will look like its father, you, its brother, a melange of all three. It will love painting, pole-vaulting, trains, cats, puddles, sandboxes, bikes, sticks, the building of towers. You will take it swimming, you will rake leaves and light bonfires, you will push it along the seafront, you will tuck it into the basket its brother used.

You tell yourself not to be stupid enough to buy anything, but then you pass, in a shop, a knitted rabbit in soft blue wool, with a yellow ribbon. You reverse, you hesitate, you pick it up. Quick, while no one is looking. You picture yourself placing this rabbit inside a crib. Of course, you buy it, handing over the money, hurriedly, furtively. You carry it home, wrap it in tissue and hide it at the bottom of a drawer. When you are alone, you take it out and look at it.

You leaf through name books and think: Sylvie, Astrid, Lachlan, Isaac, Rafael? Who will it be?

One woman’s emotional journey to take charge of her own fertility

When miscarriage happens — and it will happen to you, over the years, several times — the impact is like that of a wrecking ball. Each time you lie on the scanning couch, staring fixedly at the faces of the radiologists as they examine the image on the screen and learn to recognize the expression — a slight falling, a frown, a certain freighted hesitation — and you will know before they say anything that this one hasn’t made it either.

It will be hard, every time, not to listen to the internal accusations of incompetency. Your body has failed at this most natural of functions; you can’t even keep a fetus alive; you are useless; you are deficient as a mother, before you even were a mother.

Don’t listen to those bad fairies, you tell yourself. It was nothing you did.

So, after the terrible moment in the dark of the scan­ning room, you are always taken somewhere else, where you must wait for someone to come and speak with you about “what happens next.” But you know “what happens next.” As you take the stairs down, you feel the notion, the idea of the child leaving you with each step. You feel its fingers loosening, disentangling themselves from yours. Gone is the child with blond or dark or auburn hair; gone is the person they might have been, the children they themselves might have had. Gone is the little brother or sister you pictured for your son. Gone is the knitted rabbit, wrapped and ready in tissue paper, pushed to the back of a cupboard, because you cannot bring yourself to throw it out or give it away. Gone are your plans for and expectations of the next year of your life.

You must adjust to this new picture. You must somehow get past the due date. On that day you will feel the emptiness of your body, your arms, your house. You will watch your body backtrack, unpicking its work: the sickness recedes, your breasts shrink, your abdomen flattens, your appetite disap­pears. You will have the general anesthetic, on the first occa­sion, and the fetus is removed from you while you are unconscious. Whenever it happens again, you admit yourself to the hospital, take the drugs to induce expul­sion, refuse painkillers, because somehow you want the pain, the discomfort, the ache, the searing cramps: It seems important to go through this. Each time, you will insist on having the body of the fetus, on being able to take it home. This always seems to cause consternation. One doctor says you can’t have it because he “needs it.”

You stare at him for a moment, wondering, did he really say that?

“I need it,” you say.

“No, you don’t,” says the doctor, shaking his head.

“But it’s mine,” you mutter, with rising menace, curling your hands into fists.

Your sister gets up from her chair and steps into the corridor with the doctor. You don’t know what she says to him, but she returns with a small, sad, wrapped package and hands it to you.

There is a school of thought out there that expects women to get over a miscarriage as if nothing has happened, to metabolize it quickly and get on with life. It’s just like a bad period, a friend of mine was told, briskly, by her mother-in-law.

To this, I say: Why? Why should we carry on as if it’s nothing out of the ordinary? It is not ordinary to conceive a life and then to lose it; it’s very far from ordinary. These passings should be marked, should be respected, should be given their due. It’s a life, however small. Yes, of course worse things happen every day. But to dismiss a miscarriage as nothing, as some­thing you need to take on the chin and carry on, is to do a disservice to ourselves, to our living children, to those nascent beings that lived only within us, to the person we imagined throughout the short pregnancy, to those ghost children we still carry in our minds, the ones who didn’t make it.

This is an edited except from Maggie O’Farrell’s memoir “I Am, I Am, I Am” (Knopf). O’Farrell is a mother of three and the author of seven novels. She lives in Edinburgh. Find her online at maggieofarrell.com.

This piece originally appeared in The Washington Post.