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Loss. . . and return

Trigger Warning: pregnancy loss


In early March of 2019, I had my second pregnancy loss, at approximately 10 weeks. We had previously had a heartbeat, albeit weak, at our 8 week ultrasound, and when I returned two weeks later for a follow-up, there was nothing but quiet. It hurt. It felt lonely, even with my husband and my toddler daughter at home. I turned to writing publicly, not something I often do, and it helped me feel less alone (it was only on my private Facebook at the time).


Since becoming a pelvic health therapist, and now with a practice specializing in care for pre-natal and postpartum mamas, I have learned so much about how that loss (and previous loss) physically and emotionally kept the score for quite some time, even after having a successful (though high risk and difficult) subsequent pregnancy and healthy baby. I want to re-tell this story now because in my practice, I meet and work with so many women who have experienced similar loss and loneliness. I want to return the village that came out for me, stretch the circle that holds space for loss or choice.


Because what a strange contradiction - to feel alone in a crowd. Though Medusa Maternal is a very niche offering in the greater scope of occupational therapy for women who are or are becoming mothers, it is also, by design, an offering to women who are not mamas, cannot become mamas, or choose not to be mamas. It is the space in which you can be and feel seen, heard, listened to, held in the support with compassionate care and rehabilitation. It is empathy and understanding for your humanness, your choice, your experience. It is community.


***

March 8, 2019

I remember an image I saw once in an article about pregnancy and (in)fertility. It was a profile silhouette of a woman, with a rounded belly that was hollow, and the outline of a fetus as seen on an ultrasound shaping the curves of her brain. That image sticks with me to this day, but especially burns today: a woman pregnant in theory but not in reality.


Miscarriage is raw, is heartbreaking, it hollows you out and feels like a loss you could have, should have, prevented if only your body didn’t fail what your mind knew to be true, real, solid. It is also “common,” as many medical professionals, friends, loved ones are quick to tell you, meaning well and wanting to normalize what feels so strange and alienating. I am not alone, but I am now only one, and not two, empty now of that which connected me to so many women, to other mamas, to my partner, to my own body. Funny how when pregnant we want to share it all, and yet when suddenly no longer, we want to hide, fold into ourselves and limn the edges of a reality so many women experience and yet we feel we must suffer alone.


I am lucky, privileged, to have support, to have insurance and resources and the health literacy to know that when my insurance initially says they don’t cover “pregnancy removal” I can argue that it is a necessary medical intervention to prevent infection risk, and that what is coded medically as a procedure that is deemed elective will be further explained in the doctor’s notes as truly not my desired choice this time. I am lucky that I do have a choice to intervene, much as I had with my first miscarriage: the choice to allow for the natural progression, a process that was as sudden as it was expected, as gut-wrenching as it was painful, and as traumatizing as it was revealing: of my body’s response to pain and loss. I am luckier still that if my insurance didn’t cover the procedure, I have the means to pay out of pocket. Because while this feels no less physically and emotionally painful, I am comforted by the fact that I don’t have to also worry about compounding factors out of my control.


Because going through this, again, only further solidifies for me that I, that we, would always choose life. The life we want, the life we imagined, the life we created or hope to create, whatever that design may be. I made a different choice once. And again today I have exactly that: a choice not in having loss, but in getting to describe it as such.

But there are not politics in heartbreak. There is emptiness and loneliness, and the intense desire to crawl inside myself and a try to fill that hole, that vacuum left by the tiny being that has left me. My body doesn’t recognize miscarriages, it holds on so tightly, so desperately as though to try to give it staying power, it tells my mind the life is still there, my womb still grows and my body still aches for the being that was and then wasn’t. A little over two weeks ago we saw a heartbeat, a rapid flicker of white light on the ultrasound imaging screen, a measurement dating 5 days behind my flawless knowledge of my own dating of this pregnancy, but no matter, there was a heartbeat, a relief we didn’t have the first time I miscarried. We, as health professionals, went home relieved, not asking the questions we should have when the tech became quiet and later suggested a follow up scan in a short two weeks. Only in happily reviewing the print out of the images, the mottled shapes and misshapes of an early scan, where you project your imagination onto what your future baby will develop to be, did we see the heart rate: 105 where it should have been 130 or more. An interminable wait until the next scan in which I spent my time searching online for the good stories of flukes, of changed outcomes, of happy follow-ups that became healthy babies, allowing myself only brief moments of doubt, continuing my circumscribed diet and pre-natals and hope.


Two nights ago, before the follow-up ultrasound, I held my belly as I fell asleep, its soft, small bulge curled into my arm as though I could hold that baby there, safe, loved and needed, as though my body hadn’t already let it go. I didn’t know that that tiny life passed a couple days after the first ultrasound. I didn’t know. I didn’t know. I didn’t know. How could I have not known? Where was my motherly instinct? Why didn’t my body hold on as long as my heart did? What was corporeal was now only conceptual. I was that image: the empty womb, with the baby shaping only an idea, as though for 2.5 weeks it was imagined, pretend, shifted from body to belief.


There is so much that a miscarriage robs you of, and the sadness can be ugly and faulty and loathsome and selfish. What about the father in all this? What about the women who must endure this after feeling the baby’s movement, after a months instead of weeks, after a due date that is silent? It all matters and it all hurts. I don’t pretend to know someone else’s pain, I only know what is authentic to me and feel a true and profound empathy for what could’ve been worse and is for so many women. I quantify my hurt to try to dampen it, to avoid self pity, to prop myself up on a tenuous wall, where if I can just catch my breath I can steel myself and shake sense into my own head. Because where my womb is empty, my head is full - of self doubt and self loathing, of saying the wrong thing to my partner, of fear of final chances at my age, of failure of my body to hold that heartbeat solid and true. But perhaps loss is loss, whatever the size of it. Loss of family planning, of that which we get a glimmer of and hold onto like it’s the fucking mega millions ticket. Loss that is common, yes, but shared so infrequently, common, yes, but felt so keenly, plaintively by me as I fight to be both alone and not. I want to believe that I am strong because that’s what I should be and am ashamed to not be, and yet I want to fall exquisitely apart, fall to pieces so that I can destroy what failed and rebuild into someone who doesn’t break.


I sat looking outside my backyard window yesterday, and noticed sweet pink blossoms at the tips of some ragged branches on our apricot tree. New life budding in the warmth of a 70-degree early March day. This week is supposed to bring cold weather again, nights near freezing in which that early life may be arrested suddenly, quietly, gently.

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