Trigger Warning: Pregnancy loss, abortion, graphic descriptions, fertility.
If you’re reading this, I certainly hope you started out by reading Part 1 of this blog. It is the back story of how we came to learn that a pregnancy after the birth of our first son, Ben, turned out to be unhealthy and unpromising, to say the least. I also told the story of how we came to make the final decision to terminate the pregnancy.
As soon as the decision was made, we shared the news with our parents. My mother then shared with me something that I didn’t know about our family history. More than 60 years prior, my grandmother had gone through something similar. I always knew that she lost a pregnancy or two, but I never knew that she faced the same gut-wrenching decision that I had to make. Knowing that I had Grana’s support made all the difference to me. I’ll never forget her exact words: “May you and Binda care for each other on the emotional days ahead. You are giving a gift of love as you act on your decision. I honor you both and send my love.”
Amazing! Giving up this baby was a gift of love to the family that I have. With that in mind, I was confident in my decision to discontinue the pregnancy. I was heartbroken and beyond disappointed. But I was no longer confused or doubtful.
I notified my OB/GYN of our decision, as well as the genetic counselor who would help us arrange the next steps. My doctor’s practice doesn’t perform D&E (Dilation & Evacuation) procedures, but they referred me to Johns Hopkins Hospital, who would take excellent care of us. Then we hit another roadblock. Now that the decision was made and we had a plan of action, Johns Hopkins couldn’t get me in for another three weeks. I would be 19 weeks pregnant by the time my D&E date came along.
We waited some more. It was agonizing. We continued to hide the pregnancy as much as possible. We just didn’t want to go down that road. Then I got a call from Hopkins. “We’re sorry, we just got all your insurance information, and your policy won’t cover this procedure here.” Ugh, perfect. We looked into the out-of-pocket costs, but it was clear that if we could find a place to perform the procedure through my insurance, it would be best to go that route. Hopkins referred me to a clinic in Northeast Baltimore County, about 45 minutes from home. “It isn’t glamorous,” they cautioned me, “but they do these procedures all the time and they know what they’re doing.
The place I went to for the procedure was not pretty. It didn’t have money pumped into it the way Hopkins does. But, in hindsight, I’m so glad I ended up there. Hopkins would have done the procedure in their labor & delivery unit, along with all the other healthy babies, and mothers who get to bring their babies home. I was in a place that was dedicated to people who were going through what I was going through… Or so I thought. The place was an abortion clinic. There’s no other way around it. They do abortions all day long. I suspect that 99% of their clientele have unwanted pregnancies. The doctor and his medical assistant seemed to be very confused by my tears during the consultation. The doctor asked, “What’s going on? Are you okay?” He was clueless. I told him I was just emotional because I actually wanted this baby. He continued to look confused, but he proceeded to tell me what to expect for the procedure.
The D&E procedure is a two-day process. Day one is an injection in the abdomen, which stops the baby’s heartbeat. For some reason, this caught me off guard. I wasn’t expecting that I would be leaving the office that day, carrying a baby that was no longer living. Day two would be the medical procedure that included contractions, dilation, and giving birth to the baby while under twilight anesthesia. I would have no recollection of that part of the process.
After he explained the whole process, it was time for the injection. For the medical staff there, it was like putting a dog to sleep. Not fun work, but in a strictly clinical sense it was an injection that stops the heartbeat, just the same. They sent me home with a pill to take the next morning that would induce contractions.
I cried the whole way home. I called my mom to let her know that the baby’s heart had been stopped. Then I called my sister to tell her. We cried together on the phone for the entire duration of my drive. It was a very difficult conversation for her to have, but she knew I needed to process this unthinkable loss, so she graciously let me talk my way through it. I didn’t even consider at the time what an emotional burden that must have been on her, but I am forever grateful that she allowed me that time to grieve on the phone with her.
My sister had the added emotional stress of being pregnant, herself, while this was going on. Her due date was the same day as my procedure, and she confided in me that she felt a massive amount of guilt for having a healthy baby at the same time I was saying goodbye to my not-so-healthy baby. I reassured her that there is nothing for her to feel guilty about, and I wanted her to honor everyone by enjoying her pregnancy and welcoming her baby into the world with positivity and love. I told her that it would have devastated me if something was wrong with her baby too. Knowing that she was having a healthy baby under safe circumstances was the silver lining to the dark cloud hanging over my family.
I finally got home, and Binda was there with his parents and Ben, standing in the driveway. I got out of the car, collapsed into Binda’s chest, and simply said, “They stopped the heartbeat today.” And I burst into tears again. Binda’s mother did the same and gave me a comforting hug.
The next morning, I was instructed to wake up early and take the medication that would gradually induce contractions. Binda drove me to the clinic, and I started to feel the contractions on the way there. I spent the morning in a recliner chair alongside another girl who was having the same procedure that day. We dilated together while we told our respective stories. Hers was very different than mine, but I respect her decision all the same. The meds made us nauseated, so we vomited into buckets while we waited to be dilated enough to birth our half-term babies. We were freezing cold from the IV fluids, so we were curled up under heated blankets while we continued to wait. After not too long, I was ready to go into the other room. I remember nothing of the room, or what happened there, other than feeling an intense pressure on my abdomen as they pushed and pulled to get the baby and placenta out.
The recovery was quick, and within an hour of the procedure, I was ready for Binda to drive me home. My mother was at my house waiting for me. This all happened just in time for her to be able to fly out to be with my sister a couple days later for the birth of her baby.
After a full day, I was feeling strong and almost fully recovered. And then, like salt in a wound, my milk came in. My body thought I had given birth to a premature baby, so it kicked into high gear with providing what my baby needed. It was physically painful and emotionally devastating. My body was making food for a baby who was no longer with me. My breasts were swollen up to my collar bone, and I couldn’t stand the feeling of anything touching them. Even taking a shower was painful. I tried every trick in the book: Sudafed, cabbage leaves, tight sports bra, caffeine. All the things you’re supposed to avoid while trying to produce milk for a baby, I was doing them. Eventually, I needed some relief, so I dug out my hand pump from the basement and expressed a small amount out, being careful not to express enough to signal to my body to make more. I only allowed myself to do that once a day, about 0.5 ounces per side. After about 3 days, everything had dried up and I was feeling much better. All that was left behind was a post-pregnancy body, another twist of the knife. I was so ready to not look pregnant anymore so I could move on with my life. I went on an extreme diet and lost the weight quickly. I was happy and sad at the same time to no longer look like there had ever been a pregnancy.
I am so grateful for the support I received from my partner, our parents, our siblings, and our close friends. Without that support, I would have felt unnecessary guilt and even more despair. I didn’t deserve guilt, because I gave a gift to my family by doing what was best for all of us as a unit. Despite knowing in a very academic way that I made the right decision, there are still days when I wonder about my baby, and I must reassure myself that I did the right thing. My baby had a heartbeat (however weak) and I could feel it moving in my body. We connected, regardless of my best efforts to keep an emotional distance between this baby and me after finding out we might not proceed with this pregnancy.
And then there are the continued reminders of that pregnancy that haunt a mom in this position. The mailing list I signed up for at Motherhood Maternity also added me to a coupon mailing list for Enfamil. A few months after the D&E procedure, on what would have been the due date of the baby, I received a canister of formula in the mail – a generous free sample from Enfamil. It was like the breastmilk all over again. Absolute salt in the wound.
Important to know: Women who experience this kind of loss are just as susceptible to Post-Partum Depression as women who have full-term babies who survive. In fact, it’s possible for the depression in a second-trimester D&E mom to cut even deeper, because it is rooted in self-imposed guilt and “what ifs.” Not only is there self-imposed guilt, but there is also society-induced guilt all around us. From pro-life protesters that fly planes overhead with pictures of half-term aborted babies like mine, to strangers or acquaintances on social media claiming to know more about what is right and wrong than you do, it all weighs heavily on the heart of a mom who decided that the best thing for their family was to no longer continue with a pregnancy. There are always going to be the people who say, “If I were in that situation, I know exactly what I would do, and I know I would keep that baby.” I rest assured that absolutely no one knows how they would react to a heavy situation unless and until they are in it. I wouldn’t wish this decision on my worst enemy. It is not a decision that my partner and I came to lightly, and it is one that we are grateful we never had to make again.
We were blessed with another pregnancy a few months later. I was on pins and needles throughout the entire first trimester of my pregnancy with Alex. Again, we shared the news with only our closest friends and family. We just needed to make it to that 12-week scan and the genetic screening at that time. I went to the same genetic counselor I had gone to with the previous pregnancy, so they knew my history. They were rooting for me. I will never forget the voicemail I received from one of the ladies in their office I had come to know throughout this process, when she called with my test results. It was Friday, at the end of the business day, and I had missed her call. I wouldn’t be able to hear the actual news until Monday morning. Legally, she wasn’t allowed to leave any news, good or bad, on my voicemail. But she made it clear that I had nothing to worry about.
“Hi Rachel, this is Susan from the Center of Maternal Fetal Medicine. It’s Friday at 5:16. I am so sorry you’re not able to pick up and our office is closing. But I wanted to give you some wonderful news that you’ve been anxiously awaiting. I’m not going to leave it on the machine… Our office opens on Monday at 8am, but I want you to know that you should have a FANTASTIC weekend… And that’s all I’m going to say. Okay? I’m so sorry you couldn’t pick up the call, and I saw this JUST came off the fax machine, and I wanted you to have a wonderful weekend. I can’t tell you details, but all I can tell you is have a wonderful weekend, Rachel. Okay? And we’ll talk to you Monday. Have a Wonderful weekend. I have good news to share with you. Take care! I have good news! Talk Monday! Alright, buh-bye!”
I have saved that voicemail on my phone since June, 2019, and I hope to never lose it. I love hearing the excitement in her voice whenever I replay it. I felt like she had a vested interest in this pregnancy going well. That voicemail was the symbol of hope that I needed, and it’s the reassurance that I had a team of people who supported me and knew I did the right thing for my family. In return, I have an amazing family, and we are so blessed. <3