Well, it has happened again. Miscarriage number three. Only one baby in five pregnancies. Shit.
At the time I wrote about number two, about a month ago, I was already pregnant and didn't know it. Adam and I had been under doctor's orders not to try to conceive again until we got some answers on what might be the problem, but we figured that we'd start using protection after my first cycle. Ooops, we never got that far! I must say, it's quite exciting to get pregnant without really trying. No ovulation predictor kits or loose underwear or basal body temperatures - it seemed miraculous! And maybe because of the surprise and new experience, I somehow convinced myself that this was the one - this one was different. I was sure of it.
To add to my certainty, we had an ultrasound and saw a heartbeat at 7 weeks. Everything looked perfect. The fertility doctor told us to come back in a week for one more ultrasound, just to be sure, before she would refer us to a regular ob-gyn. So at 8 weeks, once again, we found out there was no heartbeat. After my pregnancy in the fall when I went to the 8 week ultrasound alone only to get the bad news with no support, I decided I would never have an ultrasound again without Adam present. I'm glad for that, because I was devastated this time. Although it was still nowhere near as bad as my first pregnancy experience, it was the worst shock of these recent three.
I still didn't completely believe it until we got a second ultrasound that day. And even then, I had moments of disbelief. I mean, mistakes are made sometimes, right? But I've since had a third ultrasound with the same results. I'm now waiting for the inevitable passing. I decided not to get another D&C because, although it would provide certainty and possibly more information about what went wrong, the procedure was more traumatic, mentally and physically, than I had anticipated when I decided to go that route the first time. It also requires Adam and I to be totally useless for at least two days, if not three. And I passed the second miscarriage naturally with no pain or fuss (I didn't know ahead of time with that one) so I'm less frightened of what will happen. Still, the waiting is very difficult.
After number two, when she instructed us to use protection for the time being, the fertility doctor explained, "because the last thing you want is to have another miscarriage." Well, she was wrong. I'm actually glad it happened this way - or maybe I should just say that I have no regrets. We had another shot at a baby. We lost, but we had a shot.
Barring any evidence of a treatable condition, both Adam and I see this as a numbers game. There are still avenues to pursue in diagnosing our troubles, but we've covered all the common things. There are only two things that look suspicious at this point: the MTHFR issue, which is now being treated (but wasn't in time for this pregnancy), and some kind of genetic defect in one of us. If the problem is the former - we're covered. If it's the latter, well, we know we can produce a healthy child because we have one, so it's logical to assume we just need to get lucky. That doesn't mean that there is nothing more we can do. What we are trying to find out (and I haven't been able to pry this information out of the doctor yet) is whether, if it is a recognizable genetic issue, what the treatment options would be. I only know of one, which is IVF and then genetic testing of the embryo before implantation (which is just a numbers game minus the miscarriages). We've already decided that we won't do that. It's too expensive, too stressful, and the success rate is too low. So why bother with further testing if we would take no action on it? I've tried to address this with my doctor twice, and she has intimidated me out of pressing for an answer both times. (I really need to work on my assertiveness skills.) Adam is going to call her next to see what he can find out, and if that doesn't work, it's "Hello, Internet."
Right now, Adam and I agree that we will disregard the doctor's instructions and keep trying immediately, even if we continue on to genetic counseling and whatever might follow that. It's amazing to me that the doctor refuses to discuss this issue with us to understand our values and priorities. (She had the same attitude towards the D&C issue - she recommended that I wait, but as soon as I started asking questions she got defensive and said, "Fine, then have the D&C," but would not directly answer my questions.)
Anyway, the worst of it is over. I only knew I was pregnant for ten days, but they were ten days of joy and it may sound silly, but nothing can take that away. We got pregnant again, and that's something. So many people can't get that far, and having a child already makes a big difference in how I feel about it. Sure, I suffered terribly for the loss, but it is a temporary thing. In fact, this one was particularly difficult, but one week later, I'm practically recovered and ready to move on. To paraphrase Ayn Rand, my focus is not on avoiding pain, but on achieving life. I don't mean the life of the baby we hope to have, but my own life and my own values. This does not mean that I will do anything to have a baby - our position on IVF makes that clear. It doesn't mean that I evade the fact that we might fail. I am perfectly aware of that. It doesn't mean that the pain of miscarriage is repressed or even irrelevant. I fully experienced the pain. I barely got out of bed for five days. On Monday, at my lowest point, I started to wonder when and if this repeated trauma would do permanent damage to my psyche. But by the next day, that feeling had disappeared and I have felt better each day since. I think these experiences are showing me the real meaning of a pain that "only goes down to a certain point." (Ayn Rand, again.) I can't say that I have that level of self-esteem in all areas of my life, but I have it here, and it gives me more confidence in all those other areas. I know that I can and will act to achieve my values.
But I will never again look forward to an ultrasound.