My Story - The Fourth One (Part 2)

During my final visit with Dr. J, she told me nausea usually improves sometime in the ninth or tenth week of pregnancy. She was right and I was relieved to start feeling better. The pregnancy seemed to be progressing smoothly and I was so excited.

My appointment with Dr. S (my regular OB) occurred when I was 10 weeks 5 days. I was thrilled to be in the double digits and felt like we had reached a major milestone! My appointment was first thing Friday morning and I made it right on time. My husband was running a bit late but was on his way. The nurse called my name and escorted me back to an exam room. She did the preliminary check in with my vitals etc. The nurse then handed me the prenatal packet. This was real and I was excited. Dr. S and his nurse practitioner came in and introduced themselves. Dr. S is the head of general OB at University Hospital. I had heard wonderful things about Dr. S and I was impressed with him right away.

Dr. S decided to do a quick ultrasound in his office. Since I had experienced so many previous miscarriages he wanted to give me some reassurance by seeing the heartbeat again. One of the things that really impressed me about Dr. S is that he connected with me on a human level. He was compassionate. He understood that because of my miscarriage history I needed a little more reassurance than someone who has never experienced pregnancy loss. The clinic where Dr. S saw me had an old ultrasound machine. (This clinic had a new machine on order and had borrowed an old dinosaur from another clinic while they waited for the new one to arrive.) As Dr. S performed the ultrasound he thought he could see the heartbeat. However, because the baby was still quite small and the old dinosaur machine couldn't do an internal ultrasound, he suggested that I head over the hospital to have an ultrasound in the maternal fetal medicine department just to confirm that everything was OK. Dr. S was confident that using the high quality ultrasound at the hospital we would see the heartbeat very quickly. Because everything had been going so well and Dr. S and my husband and I were all convinced everything would be fine, my husband left for work and I headed over to the hospital.

I checked in at the maternal fetal medicine department and waited to be called back. As I sat in the waiting room, I watched a couple come out and announce to their family the results of their gender ultrasound. I was excited to be there in a couple of months myself.

The technician came in and called me back to a room. She had me lie down on the exam table and prepared to do the ultrasound. I watched the large television screen on the wall that was connected to the ultrasound machine. As the technician scrolled over my belly I saw a beautiful side profile of our baby. I was amazed how much the baby had grown and how incredibly clear the picture was. I was savoring the moment. Nothing could have prepared me for what I was about to hear.

As the technician focused on the baby's chest, I couldn't see the rhythmic flickering of the heartbeat. I thought maybe I was missing something. The technician indicated she was having a hard time finding a heartbeat on this little one. She would need to do an internal ultrasound. The technician left me alone for a couple of minutes to get ready for the internal ultrasound.

The technician came back in and began the internal ultrasound. She focused in again on the baby's chest. Still no cardiac motion. She turned on the microphone and listed for the heartbeat. Nothing. The technician turned to me and said, "I'm really sorry." I didn't know what to say in response. I was in complete shock.

The technician left the room and the attending maternal fetal medicine doctor called Dr. S. After informing Dr. S of the results, they patched him in to talk to me.

"Does this mean my baby is dead?" I asked Dr. S in a state of shock, horror and disbelief. Dr. S replied, "Yes Caroline, the baby is dead. I am so sorry." I had been watching the ultrasound and knew there was a problem when I didn't see the strong, rhythmic flicker that had become so familiar with our previous ultrasounds. Even after seeing this ultrasound with my own eyes, I still couldn't believe it. I wanted to scream "No!" I sat there numb as the tears started to roll down my cheek. This was the baby that had been given a 93 - 95% chance of success. This was the baby that had been right on with all of the milestones and was developing perfectly. This was the baby that was healthy. This was the baby I supposed to be able to hold. This was the baby that was supposed to make it. This was the baby that was supposed to be...

Dr. S suggested that my best option would be to have a D&C. Due to the size of the baby and the fact that I hadn't begun to show any signs of miscarriage, he was concerned that miscarrying at home would be quite brutal on me.

I called my husband and through my agony and tears, relayed the horrible news. Neither one of us could believe what I had just been told. The technician returned to the room and told me I could leave when I was ready. I thought to myself, "Where do I go? I just found out my baby is dead." I was in such a state of shock that I was afraid to drive. I pulled what was left of myself together and walked out into the hall. I found a chair and sat down. I called my parents and told them what happened and then I started to cry again. Usually I am quite a private person, but for the first time in my life I didn't care if people saw me crying. I was reeling from the shock and pain.

As I was sitting in the hall, I looked up and noticed Dr. S was coming toward me. He had apparently finished with patients in the other clinic and had come over to the hospital to do rounds. He stopped right away and again expressed his sympathies to me. He then talked strategy and told me they (meaning him, my RE and maternal fetal med) were going to do a "full court press" to figure out why I couldn't stay pregnant. I appreciated his kindness and his willingness to be assertive in finding a solution to our problem. Even though it was a dreadfully hard situation, it helped knowing I had this medical team in our corner.

After speaking with Dr. S, I found my way over to a little chapel around the corner. As I walked in, it was dark except for the light shining through the stained glass at the front of the chapel. The chapel was empty. It was a small room. I sat down and offered one of my most heartfelt prayers as I began to sob. I told God that I knew he had always been there for me and that now, more than ever I needed him to get me through this. I told him that I didn't know how I would do it but that I knew he did. I pleaded for his help and comfort.

After a few minutes of praying and sobbing, I felt like I was finally in a position where it was safe to drive. I walked out of the little chapel and looked down the hall towards the maternal fetal medicine department. I thought about how much life had changed in the two hours since I had walked through the door. I turned to leave and then remembered that I didn't have a picture of the baby. I walked over to the maternal fetal medicine office and asked for a picture of the ultrasound. They were happy to oblige. I'm really glad I have a picture of our baby. The pictures from the hospital were the clearest ultrasound pictures I had and it makes what I went through more tangible somehow.

On my way home I received a call from my husband. His boss, after learning about what happened that day, was very understanding and encouraged him to take the rest of the day off. My husband and I spent the afternoon together and tried to get through a small part of what was facing us.

Over the course of the weekend, we decided that I needed to have one more ultrasound before I had the D&C. I called Dr. J's office on Monday morning. They were wonderful and got me right in. Dr. S had left town for a couple of weeks and I felt like I needed to have Dr. J confirm what I had been told on Friday. Dr. J had been through my two previous miscarriages with me. Somehow I needed to hear the news again from her.

When I met with Dr. J she expressed her sympathy. She conducted an ultrasound and confirmed that the results we received on Friday were correct. Meeting with Dr. J gave me some added comfort and peace about going forward with the D&C.

Since Dr. S was out of town, one of the RE fellows  (Dr. D who had been with Dr. J at my first appointment in June) was scheduled to perform my D&C. Dr. J gave me her full confidence in Dr. D and her ability to perform the D&C.

The next day was the day of my D&C. My husband and I arrived at the hospital at 8:00 a.m. I have a hard time with general anesthesia – it makes me really sick and groggy. Because of this I opted for conscious sedation. I didn't want to sleep through the procedure and in spite of the effects of the sedation didn't allow myself to fall asleep. I emotionally needed to be awake to say goodbye. Going through the D&C was a very difficult experience for me. It seemed to be such a horrible and unnatural way to part with someone that I loved so very much. I hope to never have to do that again.

At the admonition of Dr. S and Dr. J, we requested genetic testing be performed on this baby. We met with Dr. J about three weeks after the D&C and she reviewed the results with us. We learned that I had been pregnant with a genetically normal baby boy. To this day we still don't know why we lost him. I have undergone additional tests but have yet to find specific answers to explain this pregnancy loss. We have since met with the head of maternal fetal medicine (and Dr. J.), and have come up with a game plan for the next pregnancy.

Each of the miscarriages has been hard for me and I have grieved each of them afresh. This last one was particularly traumatic because we had every reason to hope and plan for a healthy pregnancy and baby. It has taken me a long time to find a place for it. It is slowly getting better and I am grateful to be where I am. I don't think there is a day that goes by that I don't think of and miss our baby boy.