!!!!!*****WORKING DRAFT*****!!!!!
“Anytime” came sooner than I’d imagined. Friday evening as I rode home, I started feeling some cramps. By the time I got to the bathroom, a little blood with a small clot plopped out. I called the health plan consulting nurse, hoping to be told to “lie down and check with us in the morning.” Instead, she said, “You can stay home if you like, but there’s no way to know for sure what is happening or what might be going on without an exam.”
“If I stay here, how would I know if have to come in?”
“If the cramps or bleeding get worse, then you really should,” was the answer.
“Is there anything I can do to stop this?”
“I’m sorry, that’s a question you’d have to ask the doctor.”
After hanging up, I pulled out a couple of books I’d bought that week to support my anticipated journey. In addition to the new version of Our Bodies, Ourselves, on impulse I’d purchased Spiritual Midwifery, thinking it might offer an alternate perspective to the medicalized obstetrics I’d encountered throughout my career. It offered stories of women living on “The Farm”, an evolved post-hippie commune in Tennessee. Attempting independence and self-sufficiency, the author, Ina May Gaskin, had taught herself and others about pregnancy and childbirth. They became midwives to their community’s burgeoning population. Starting with mostly joyful, and sometimes sad stories of births, Ina May then detailed what happens during pregnancy, how to keep yourself safe, what can go wrong, and what to do if it does. I flipped to the short section on “miscarriage”, and learned that “…two out of every ten women will have some spotting in the early months, but only one of them will have a miscarriage.”
Somewhat reassured, I was able to fall asleep, but was awakened by a gooey wet feeling between my legs. Just a smear this time, on the insides of both thighs, but enough to send me searching for Stephanie Seacrist’s business card.
“Sarah, you really should come in. Now. I’ll see you here, take a look, we’ll talk.”
I headed back to Women’s Hospital, the cramps increasing all the way. By the time I limped through the ER doors, I knew more blood was coming out. Stephenie was there to catch me as I staggered towards a gurney, helping me lie down while she said to the nurse at her side, “Set her up in the gyn room, with a sterile speculum and some ring forceps, please.” Looking at me with her eyes, enlarged by her glasses, she asked, “Cramping?”
I moaned affirmatively.
“It’s OK, you’ll be all right…”
“The baby?”
“Let me look, then we can talk, all right?” She gave my hand a squeeze, then helped lift me onto the exam table. After the nurse had removed my pajama bottoms, Stephanie said, “Sarah, you’ll have to put you heels into the stirrups now. I’m going to drop the foot of the bed, then tilt you back a bit.”
She talked me through putting in the speculum, adjusted the light above her shoulder, and asked, “Can you get me some four-by-fours?” The nurse ripped open a package of gauze wipes, and then I heard the “click” of an instrument, while Steph said, “Just cleaning things off here…” and then, a “Plop” as something fell into the stainless steel bucket below the table.
“What was that?” I asked fearfully.
“Oh, some blood, a clot…OK, I see it now,” she said, as I felt a sudden, short cramp which reverberated several times, then passed. “Nurse?” Dr. Seacrist asked as I heard her metal stool swivel while a jar cap was unscrewed, then screwed back on. “OK, Sarah. The bleeding’s all stopped now. Let me just take this out…” And then I was lying with my legs straight again, looking pleadingly at Stephanie Seacrist.
“I’m sorry. I’m so sorry, Sarah.” She took my hand in both of hers, and said, “There was nothing we, nothing you could do.”
My chest tightened, first with a deep sadness, then a sudden resolve, awareness that, whatever had happened in my womb, my life, my future would go on. “Was it…” I managed, gripping her hands firmly.
“There’s really not much there, just the placenta and some unformed tissue. What we call a ‘blighted ovum’.”
“Blighted…” I tried.
“Yes, a lot of conceptions, things don’t go right from the start. The baby never really forms, probably a misfire of the chromosomes coming together improperly. Would you like to see?”
The practical, clinical side of me took over, and nodded. She handed me a small plastic jar, two inches or so in diameter, in which a thumb-sized clump of white feathery material rested beside a grape-sized translucent bag, bulging with fluid, whitish flecks floating inside. I turned it round and round, looking up through the bottom, hoping I could sense a soul. My gaze lingered a minute more, then I handed it back to her, asking, “What happens next?” I asked.
With a half smile, she answered, “Well, in the old days – meaning when I was an intern – we would have done a D&C, scrap off the inside of your uterus, make sure everything is out and the bleeding’s stopped. But now, as long as you’re not bleeding any more – and I don’t think you will – we’ll just watch you here in the ER, and you can go home in a few hours.”
I wondered, Why don’t I feel sadder? Out loud, I said, “Thanks. Thank you.” Business-like, I added, “Can I get dressed now?”
“Of course. The nurse will get you a pad. I’ll come back in a few minutes, OK?” I nodded, trying not to look as she took the jar from my hand, and carried it out with her.
On her return, she sat down heavily on the round, backless stool, and swiveled to look straight at me. “How are you feeling?”
Firmly, I said, “No cramps, all gone. Thanks.” Almost impishly, I continued, “I guess now, I’ll have all my energy available for my orals. So that’s a good thing?”
“Sarah, I sense you’re like me, you’ve always been on top of everything in your life, your direction…but there are some things we can’t, we shouldn’t control.” She paused, “Maybe, given you’re a psychologist, a scientist, I shouldn’t tell you this, but, listen: Deep inside your heart and mind, I know, you’ve lost someone very close and dear to you. You know, better than most, I suspect, that grieving is healthy, something you have to do. Don’t let the name ‘blighted’, or the size fool you. This pregnancy, this baby was – is – very real to you, someone you’ll never get back, who you’ll always carry there inside. When it comes – and it will come – when the sadness comes knocking, please, please let it in.”
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