“Can I have a photo?” I asked the ultrasound technician after she finished the scan.
“Well there’s nothing to see, there’s no embryo. It might be too early.” She answered hesitantly. She had been performing the ultrasound for an hour and I knew I was 8 weeks pregnant, at which point there should be an embryo. “The radiologist will sign your report later today and you can see it online.” The words slammed into me like a bucket of cold water.
Being an ob/gyn myself, I knew this was likely a failed pregnancy. Despite the heat of the August wind, I sat shaking in my car. I cried on the phone to my husband during the entire 30 minute drive to my office. We were caught in a mix of devastation and uncertainty since the ultrasound measurements did not meet the diagnostic criteria yet. I was fully aware that miscarriages are quite common, yet this intellectual preparedness did nothing to soften the emotional reality.
There was no call from my obstetrician that day, even after I left a message. I specifically sought prenatal care for my second pregnancy outside of my institution to keep it private and I was just any other patient. The next day she left me a voicemail to recommend trending my pregnancy hormone, the beta-hCG. I was lucky enough to be able to schedule a second ultrasound at my hospital the following week and my colleague came in to tell me that the gestational sac was measuring two weeks smaller than expected. And my pregnancy hormone was trending down.
The one thing I was certain about was wanting a dilation and curettage procedure. Now I could finally shift into “management” mode with a diagnosis. The relief from the certainty lasted for about a minute. Nevertheless, I tried to focus on the next step.
The hospital where I started my prenatal care had a surgery slot within a few days with a different physician. I spent some time with my son in the morning before my husband and I left for the hospital. I was grateful that everything went smoothly, but the situation felt surreal. My body felt empty. I had only known I was pregnant for five weeks, but it felt like such a loss.
At my postoperative visit two weeks later, the ob/gyn who performed the procedure asked, “Did you feel pregnant?” I was so taken aback by that question. I had been so tired that I had to nap every weekend while my son played with his dad. My appetite bounced back and forth. Of course I felt pregnant. Now, over a year later, I still wonder why she asked that question.
Over the next couple of months, the raw ache gradually transformed into a memory, and I began to go entire days without thinking about the loss. There was nothing else to do besides wait for time to pass. However, the experience remained a part of me moving forward. Now, writing this 34 weeks pregnant with my second son, people often ask me what number pregnancy this is and I want to say third. Even though it didn’t last for nine months and never took the shape of a baby, it left a permanent mark in my life.
Not only do we not talk about miscarriage enough in society, but we often don’t list it as a pregnancy. I won’t disclose it in a casual conversation to avoid a whole story about it or prevent others from feeling sorry for me. But I wish I could include it as a fact without dwelling on it. I am no longer sad about the loss, but I don’t want to pretend it didn’t happen.
Perhaps if sharing these experiences was more common, doctors wouldn’t ask women if they “felt pregnant” when the pregnancy didn’t work out. Perhaps the question came from a place of curiosity or misunderstanding. As doctors, we often treat conditions that we have not personally experienced. We have studied them and can explain them to others, but education only goes so far. Sometimes the less said the better.
Anna Zelivianskaia is a minimally invasive gynecologic surgeon at Endeavor Health in Chicago, Illinois. She is passionate about advancing women's health through individual care, research, and writing.
Animation by April Brust
