Missing Hope: A Trio of Miscarriages, and What Happened After

I have been afraid most days of my life, which is what anxiety is, and the months of this pregnancy have been the most anxious of my life.

The morning of my second miscarriage, I went shopping for socks. The blood had come early, right when I woke up, and there wasn’t much of it except the smudge it left on the toilet paper, which I had grown accustomed to checking on every trip to the bathroom, like tea leaves or tarot cards—a harbinger from within, a portent of loss. My previous pregnancy had ended at nine weeks, just after my husband and I saw and heard the heartbeat for the first time, but we didn’t find out about it until our thirteen-week appointment, and I had only bled the day before we went in. Mingled with grief and fear that first time around was another emotion: embarrassment. How foolish, to have gotten my hopes up; to have carried a dead thing inside of me for four weeks without my consent, my knowledge. I wouldn’t be betrayed like that again, at the very least. I wouldn’t miss a sign. I wouldn’t allow my hope to outgrow the circumstances. My vigilance paid off that morning, when, in a small bed and breakfast I had retreated to with my mother in the small Northern California fishing village of Mendocino, I saw the brown smudge of blood on the toilet paper, and I knew.

Fishing villages in California have gone one of two ways in the twenty-first century: Although people still fish, the towns have either grown depressed and vacant, or, like Mendocino, reinvented themselves to cater to tourists who need a weekend away. Hence the sock store. Vaguely nauseous, I took a bath that morning, then dressed myself and insisted to my mom that we continue to go about our day; no use driving back to San Francisco to see a doctor when I knew what was happening. It was early December, and every store and restaurant was decorated for the holidays, carols and the smell of cinnamon wafting down Albion Street. The sock store was across the street from our bed and breakfast, so it was our first stop, and I bought a pair of Lando Calrissian socks for my Star Wars-obsessed husband and a pair of patterned tights for my sister. There was a baby section on the back wall, and I looked at it with something like detached curiosity but didn’t dare go near it. I bought a portrait of Abraham Lincoln for my dad to hang in his study at the antique shop next door. Mom and I ate lunch at the bar of the one pub on the street.

That night at dinner, I wanted to order a glass of wine. I wanted to find another way besides words to say it was over. “Maybe wait until tomorrow,” my mom said. “Just in case.” I waited.

I saw the doctor the next day. It was too early to tell whether I would miscarry, she said. She pointed to the screen with one hand while holding the wand in my vagina with the other. “There’s a fetal pole,” she said. “You’re still pregnant.” My husband took a picture of the fetal pole, which was a blurry white circle surrounded by enormous darkness, and texted it to our family thread. “Hope,” he wrote.

That night I bled through several pads, and when we went back to the doctor the following week—a different practitioner than the week before—she asked if I was sure I had been pregnant in the first place. “Did you take a urine test at the hospital?” I told her I hadn’t; just the home pregnancy test. “Huh,” she said. “Well, there’s nothing there now.” Only the enormous darkness remained.

*

How do we begin to hope when hope has wrought crushing disappointment in our lives? Zack and I knew we wanted children. We got married when he was twenty-five and I was twenty-four; we didn’t start trying for nearly six years. We liked our lives without children. We moved and traveled and bought a house, in San Francisco, in this economy, with help from family and his stock options. I wanted our ducks in a row before we pulled the goalie, so I stayed on the pill until we moved into our new home which, with two bedrooms separated by a sliding pocket door, seemed perfectly suited to nursing a newborn child to health and maturity. We were ready—financially, professionally, personally. We got pregnant the first month we tried, without any effort other than the usual involved in having sex. I took the test the morning of my thirty-first birthday and, after seeing it was positive, rinsed it off and placed it on Zack’s pillow as he brought me breakfast in bed.

Were we excited? He was. I felt ambivalent, anxious, and afraid—my typical emotions in the face of threatened change. We told our families right away, our friends not long after. I got sick. We had an ultrasound, saw the heartbeat, cultivated new rituals: Zack would bring me a chocolate protein shake in the morning, and I would take careful sips in bed while watching episodes of The Bachelorette on my laptop. When I started to feel better around eleven weeks in, I figured the timing was normal. I knew about miscarriages, but never thought I would have one. Why would I? There was no family history. I was, if not exactly youthful, also not Advanced Maternal Age—and besides, what did that mean; women get pregnant when they’re forty. I wasn’t convinced I would be a great mother, but I knew Zack would be a wonderful father, and felt like that was sturdy enough for me to lean on for a while.

It was what they call a “missed miscarriage,” one in which the fetus had died but my body had not bothered to let me know. The terminology around miscarriage is terrible, no phrase more so than this one—not only did you mis-carry, as in fail to properly nurture your would-be child into life, but you also missed it. Nice going, lady. You thought you could be a mother? You couldn’t even tell when your child was missing inside your own body. How, then, were you to be trusted with a child who left your body, a child on the outside?

A piece of paper we got at the hospital reassured me that the miscarriage was not my fault, no matter how much sex I had or how much exercise I did. I hadn’t done either of those things since finding out I was pregnant, the nausea precluding most enjoyable activities, so I got the idea that perhaps it was my fault. Perhaps every other woman out there could not be held responsible for her miscarriage, but I could certainly be held responsible for mine. The reasons were abundant: I hadn’t wanted it enough. My initial reaction was not joy, but anxiety. We had waited too long. The doctor who broke the news of the miscarriage to us said as much: “If you were eighteen, this might not have happened, but as you age your risk of chromosomal abnormalities increases.” I didn’t know what to say, so I just nodded and said, “Oh.” Maybe it was due to the protein shakes—not enough nutrition. The sips of beer I had taken from Zack’s glass as I started to feel better. The two glasses of rosé I had at a Yankees game before I knew I was pregnant. Maybe it was punishment. Maybe God didn’t want me to be a mother.

When we got home from that appointment, my husband and I laid on our bed underneath the comforter he had used in college and wailed, and I thought how unfair it was that that bedspread had outlived our child, and some but not all of my hope died, like depleting power in a video game.

*

There was a third miscarriage, after a trip to Turkey and Georgia, and in my anger I held it over Zack’s head, this lost child, because I hadn’t really wanted to try a third time without some kind of medical intervention—except that I had; I had wanted it more than anything, dreamed about how we would tell the story: After two miscarriages, everything had simply worked, probably because we had been on vacation and we were relaxed (stress being the ultimate enemy of pregnancy). We would tell the story of how we conceived in a cave hotel in Cappadocia on a day too windy to go up in the hot air balloons.

That part was true enough, but the end came quickly, and this time without the foretaste of blood, just with depressing calls from the doctor’s office about my hormone levels, which were low and not rising quickly enough to indicate a viable pregnancy. The blood came a few days later. At least with the last two I was spared the discomfort of a “procedure,” which is what they call the removal of the pregnancy and its remains, when they insert a catheter into your body and aspirate what was to have been the person who occupied the room next door.

All around me, in the meantime, pregnancy came seemingly easily and perfectly. My dear friends grew pregnant and round and had beautiful children, who I loved with a new kind of love, born within me despite my losses—the love I could not give to my own child. I went to a baby shower five days after my first miscarriage, and that friend developed pre-eclampsia and had to deliver her baby at thirty-one weeks, and he grew strong and fat but not before several harrowing months had passed.

“It’s weird to know that you are going through the hardest thing you’ve ever gone through,” she said one night while we ate pizza at a restaurant down the road from the hospital where her baby lay in an incubator. “I mean, it’s just strange to be in the middle of it, and know it, and you can’t do anything about it.” Impotence was our shared feeling. We were on different ends of it, but we understood each other. Our husbands understood. They saw us cry and they held us and they cried, too.

After the third miscarriage we met with a specialist who ordered scores of labs and several painful imaging tests, one of which included having a balloon inserted through my cervix, blown up, and ink shot through it to ensure that my fallopian tubes were free of blockages. “This shouldn’t hurt more than a normal period cramp,” the nurse reassured me. Her grandmother had had seven miscarriages before giving birth to her father, something she said perhaps to empathize/perhaps to be kind/perhaps because it was a reflex and she had and said the same to any woman who walked through her door after a miscarriage. It made me trust her, which was a mistake, because that test felt like a thousand period cramps stacked on top of each other and all happening at the same moment. “Good news,” she said cheerfully at the end. “Your tubes are clear.”

Three times I had gotten pregnant on the first try. Three times, my breasts had grown tender and my stomach sour. It didn’t matter. All the tests came back great, great, great. My body worked. My body should have worked. My body didn’t work.

We took the summer off from trying to get pregnant, as one would take the summer off of work, or give up sugar for Lent. We traveled and talked and I tried to write, but became distracted every time I sat down at my computer. “Successful pregnancy after three miscarriages,” I typed into Google what felt like ten times a week. “Clomid for recurrent miscarriage.” “When to do IVF.” “Afraid of never being pregnant.” “Infertility.” My search history was depressing, and I was depressed. I was intimately familiar with the responses to each question on each related forum, and regularly found myself on fertility-related chat rooms based in England and Australia. It was fine, I told myself, as long as I didn’t participate.

Nothing brought me joy, because it is hard to have joy without hope, and I was killing my hope on a daily basis. In my mind, we had already gone down every possible road—medication, intrauterine insemination, in vitro fertilization, adoption, surrogacy—and had met with a dead end every time. Now all there was to do was to settle myself into a happy life without children. We would still try, but we would fail. I knew it.

*

We tried again in September. This time, we had used a medication that helps a person’s eggs to grow ripe, along with a shot that triggered ovulation, and I inserted progesterone suppositories into my vagina twice daily. My breasts grew tender, my stomach sour, my heart surprisingly light. Zack and I went to Mendocino for a weekend, just a few days after the positive test. “I am feeling afraid, of course, but also sort of giddy with some kind of preparation,” I wrote in my journal on the trip. I treasured every wave of nausea. The anxiety medication I had been on for seven years wasn’t in my system any longer; over the summer, my therapist and I had worked out a slow and steady taper. I couldn’t get excited yet, but neither was I convinced that I would miscarry, as I had been previously.

We returned home on a Sunday, and by Monday afternoon I had fallen into a state of near-constant panic. No words, only an invisible, creeping fear that ran along my thighs and into my ears. The week wore on and I grew even more frayed and nauseous, angry at my week-ago self who believed this might work out. On Friday, I suffered an all-day panic attack, alone at home. I couldn’t bring myself to leave the house or change out of my pajamas, so I walked from room to room feeling my heart pounding, staring at my white face in the bathroom mirror, willing an expression to form. I would die, the baby would die, my family would die, my husband would die. Life ends only in death, and why hadn’t I thought of that sooner, before we tried—really tried—to have a child? For extra credit in one of my college political science classes, we could memorize what Thomas Hobbes said about life outside of human society—“solitary, poor, nasty, brutish and short.” My parents traveled for work; my husband traveled for work; my mind went to work obsessively charting how their deaths would play out, how I would be left all alone, how this baby would die inside me and then I would die. Solitary, poor, nasty, brutish, short.

The next day I went to the emergency room and told a man who said his name was “Doctor Lipton, like the tea,” that I had been through a week of near-constant panic attacks, and that I was six weeks pregnant, and they gave me an IV with two milligrams of Ativan and he told me I should strongly consider going back on my anxiety medication. They had an entire warm refrigerator just to heat up blankets and place them on top of cold patients, and my mom kept sneaking more and more of them and piling them on top of me. I felt like myself again. I felt good. I joked with the nurses about my bright yellow vitamin pee. That night, we went to the movies. Thank you, I thought in God’s general direction. It’s over.

Whatever it was had, in fact, only begun. The panic continued, and I couldn’t work through it, couldn’t suck it up and move forward. Every day started at 3:00 or 4:00 a.m., deep in dread, fearing death, mashing out hope whenever it briefly reared its head, emotional whack-a-mole.

They don’t tell you how pregnancy allies your body against sanity, how it makes your heart beat faster—this is true; you are creating a new organ along with a baby and so, in order to increase your blood levels by half, your body makes more blood, which makes your heart pound—and how it makes your breathing shallower; how it makes you feel like a panic attack is always imminent. They don’t tell you about the feelings, the progesterone that can create joy in some women and depression in others. They don’t tell you about the guilt you will feel—how you worked so hard for this pregnancy; how you wanted it so badly; how you were, in fact, depressed without it, and now that you are depressed within it you wonder if you were ever sane. The sickness, they say, will pass, so you wait until twelve weeks, then thirteen, then fourteen, and you find yourself sicker than ever, going back to the hospital for fluids after throwing up, vomiting so profoundly that you pee yourself every time, eating the same brand of Think Thin chocolate brownie protein bar because it is the only thing you can keep in your stomach. Sick is a feeling as much as a state of being, and it makes you feel Victorian in the worst way, like a woman sent to bed for being weak, which is an especially tough blow in a culture where your value is predicated on your professional productivity.

Most of all, they don’t tell you that fear, to reverse a phrase from C. S. Lewis, will feel so like grief, and so you begin to mourn what you have not yet lost, because mourning prematurely is the only way to protect yourself from hope. You steel yourself against strangers who ask when you are due, against diaper commercials and well-meant but too-early baby gifts, against advice from friends about what to do once he’s here. You don’t understand, you think. He will never be here.

*

I have taken Ativan every day of this pregnancy, along with my daily anxiety medication. I have spent hours Googling the effects of Ativan and SSRIs on pregnancy, and I have found every possible opinion on the topic, and the only ones that have stayed with me are the ones that hover like auguries of disaster: Cleft palate, heart defect, increased anxiety in the child, what kind of mother would take that chance, what kind of mother would put her own well-being above her unborn child’s, what kind of monster are you.

I have been sick every day of this pregnancy. The trips to the hospital; the long days of unremarkable nausea; the eating without tasting, without desire. Other women reassure me that this makes life with a newborn easier, because you are so relieved not to be sick that even long nights of screaming and feeding pale in comparison. Perhaps.

I have been afraid most days of my life, which is what anxiety is, and the months of this pregnancy have so far been the most anxious of my life. I cannot see a day when I hold this baby in my arms, even though I can feel him now, and sometimes I smile when he kicks me and I place my hand where his foot just was, and then I can see something of the future—a woman who looks like me; a quiet baby; a rocking chair; a prayer.

Zack and I were watching an episode of Planet Earth recently that showed a bird returning to her nest. The egg she had laid was punctured, oozing yellow yolk down onto the tree below. Her child would not survive. “She knew something was wrong,” the narrator said, “but the desire to incubate was strong.” So she settled in over the broken egg, yolk collecting on her tail, because something inside her body told her she had to, even as something inside her mind told her this wasn’t right. Her baby would never be born, never fly, never coalesce into a thing with feathers. Still, she remained.

People keep saying the same thing to me: It is so worth it. What are they really saying, I wonder? What is “it,” and what is it worth? If it is a baby and it is worth every day of this angst and fear and vomit and self-doubt, then it must be worth a lot, indeed. And I have to believe that, in some part of me, or else I wouldn’t be doing this. Why do we have children? In Spanish, the phrase “to be worth it” is “vale la pena,” or “worth the trouble/pain.” That clarifies things a bit, although I still cannot speak to anything being worth anything, because there is no baby yet; there is only my fear and his occasional kicks. The verb “esperar” in Spanish is another one I think about a lot, because it means both “to wait” and “to hope.” I hate them both, and yet without them, I have nothing.

“I said to my soul, be still, and wait without hope, for hope would be hope for the wrong thing,” T. S. Eliot wrote in “East Coker.” Eliot never gave birth. He doesn’t know.

When Zack and I returned to Mendocino that weekend in September, we spent Saturday morning walking around town after a hike. We bought books and ate pastries in the sun and eventually found ourselves back at the sock shop. He went in, found some more Star Wars socks, and came out with a little brown bag. I couldn’t bring myself to go inside, but I looked in the window. I was six weeks pregnant then. Today, I am thirty-six weeks pregnant. Our baby boy is due June 3.