Suboptimal: A Little, Common Story


This will be a long post, but it’s a little story. Little, and very common.

Last year, I had a miscarriage.

For a full thirty-two years of my life, I didn’t think I’d ever write those words. Why would I need to? Miscarriages were things that happened to other people. Not to me.

Last year, when I was thirty-three, I still didn’t think I’d ever write those words – albeit, for a different reason. By then, the statement was excruciatingly true. But I couldn’t bear the pain of admitting it in public. And I thought I never would.

I’m now thirty-four years old. I’ve had time to understand my little, common story. How it happened. What it meant, if anything.

In the summer of 2017, my partner Rich and I decided that we were “not not trying” for a baby. I’d vaguely heard somewhere that it took about a year for a woman in her early thirties to conceive, so I assumed that I wouldn’t need to think about it much for a while.

Well, almost immediately, I missed a period. That had never happened before – and I’d been off the pill for almost a year, so I knew it wasn’t my body adjusting to the hormonal change. So I took a pregnancy test. Negative. Right-o, I thought, just a false alarm.

A few weeks later, when I missed another period, I took another pregnancy test. Negative, again. Okay, I thought – something strange is going on here. But I had a lot going on in my life, and I’d been conditioned to think of pregnancy tests as gospel truth. I ignored the contradiction, and assumed I wasn’t pregnant. Life carried on.

By the time I missed a third period (still getting negative pregnancy tests), I was baffled enough to go to my GP. He gave me a form for a blood test. It was difficult for me to get to the hospital at that stage (I lived in York but worked in Cardiff, and I was in the car for 12-14 hours every week, on top of the hours demanded by my job as a lecturer and researcher). So, incredible though it sounds, it took me another couple of weeks to get the test done.

Before the results could come back, I started to feel a strange ‘hot stretching’, as I put it to myself, in my stomach. A sort of pulsating, or thrumming. A note of enlivenment. This worried me enough to take yet another shop-bought pregnancy test, while I waited for the bloods – probably the fifth or sixth I’d taken since August. This time, it was positive. Pregnant, it said. 1-2 weeks. The blood test results, when they came back, confirmed the result.

Well. There it was, then.

We felt what I imagine most people feel when they see that symbol. Joy, shock, terror, giddiness. But we felt something else, too. Confusion.

If I’d last had my period over three months ago, but the pregnancy test said I was only a week or two pregnant – what was going on? I had no symptoms yet, aside from those gentle ructions in my stomach. No sickness, no breast tenderness, no needing to pee. How could I be both 1-2 weeks pregnant and 13-14?

My GP shared my concerns. He fast-tracked me for a scan at our local hospital, which we were able to attend a week later.

In that intervening week, I did my usual drive down to Cardiff, and had a busy time teaching. I managed to catch a vicious cold, and on the drive back to York I started to feel very, very ill. But I smiled through it. We were having the scan when I got back. I’d know, at least, how far I was along. I’d be able to start making plans.

Here’s the thing. In that just-over-a-week of knowing that I was pregnant, our capacity for parenthood had grown like the beanstalk from the magic beans. We’d started to text each other possible baby names, and discuss the coin toss that would determine whether my surname or Rich’s got handed down to posterity. We’d started to talk about nurseries and schools, and laugh at our breakneck acceleration into middle age. There’s a picture of me from that week, taken by Rich, where I am smiling so broadly that my face looks as if it’s coming apart, like some sort of split bean.

We’d been tipped over a brink. We’d gone from thinking of ourselves as kids to thinking of ourselves as kid-havers. It happened with such speed, and such smoothness, and such a feeling of giddy delight.

That’s what made what happened next all the more devastating.

When we went for the scan, it was immediately obvious that something was wrong. The sonographer, consulting with his colleague, said, as if we weren’t there, “If it’s there, it’s very small.” “That could be something,” his colleague replied uncertainly, pointing to the screen – which I couldn’t see, because they hadn’t displayed the image on the visible monitor. I didn’t realize, at the time, how significant that was.

They asked me to go and have blood tests to track what was happening with my hCG levels. Off we went.

We waited, and the nurse took my blood. We waited, and the doctor said my hCG levels were not rising as fast as they should.

A word floated in the air. The word was suboptimal.

I did it all, that long Friday afternoon, with a smile clapped to my face, wiping my streaming nose, suppressing coughs, explaining to anyone who would listen that it was a bit of a funny situation, I could be 3 or 14 weeks, nobody could say. How funny!

Finally, when we were summoned back from the waiting room for what felt like the millionth time, the doctor pronounced that word. My pregnancy, it seemed, was suboptimal. It could be ectopic – the embryo implanted in the fallopian tube. Or could be that the chromosones had just mushed the wrong way. Or it could be other things, or none of them. Nobody could tell me. All I could do, the doctor said, with an apologetic air, was go home and wait it out, and come back for another blood test the following week.

Rich held my hand as we walked out of the hospital, towards the car. “It could be fine,” he said. “It could be fine!” I agreed.

But when we got in the car, and I was safely strapped in the passenger seat, I put my head in my hands and bawled.

A few days later, I started bleeding. My first emotion was overwhelming relief.

Relief? Yes, relief.  The word suboptimal had been haunting me since the moment it was pronounced. The pregnancy was less than best, yet still I carried it. Since the sonographer’s first words, I had known, on a level I can’t explain, that there was only death there inside me, acting like life. I was just waiting for it to leave.

And so, when it did, I was pleased.

I rang the early pregnancy unit, and asked if they wanted me to come in. No, a receptionist told me – not unless I was in unusual pain. There was nothing they could do, and anyway, I was due back for a follow-up next week.

When I got off the phone, Rich said quietly, “You’ve been moved to another list, haven’t you?” He didn’t seem relieved.

My wonderful GP said “I’m sorry. It’s a terrible thing.” He asked me a few questions, and then – perhaps because he was familiar with my thirteen-year history of depression – signed me off work for three weeks. I’d never taken sick leave before, and I felt okay, and three weeks seemed like a lot to me. But he was adamant – and thank god he was – that I’d need it.

The first week was sort of okay. I bled, and cramped, and didn’t feel great. But I was stoic, and smug about my own stoicism. I could see it for what it was: an unfortunate medical condition, nothing more.

Pro-choice since adolescence, I had never, for one moment, believed the clump of cells in me to be a person. Life, as far as I was concerned, went on.

The second week, I fell to pieces.

The thing that dissolved me into little bits was the realization that nobody would ever be able to tell me why it happened. Not the GP, not the sonographer, not the specialist we saw when we went for the scan to confirm that I had miscarried. Nobody would ever explain to me why I missed three periods without my hormone levels rising. Why, when they did rise, they didn’t rise quickly enough. Whether I had some form of life-to-be, or life-that-was, inside me for two weeks or four months.

I had been moved to another list. The case was closed. Kind and sympathetic though all those people might be as individuals, when I looked for answers I got one big institutional shrug. And the words, “It’s very common.” More about those later.

When I say I fell to pieces, I mean that it felt as if my brain had come apart. Whatever held it together had dissolved, and now bits of Sophie were floating around like dust mites. There was a bit here, that felt annoyed, and guilty, that I couldn’t work. A bit there, that didn’t realise I wasn’t still pregnant, and was deciding my favourite name for a girl. There was a bit that was worried that this had damaged us, Rich and I, somehow. There was a bit that hated my body, the traitor, that had for years tricked me into thinking that it was a perfectly good body. There were a million other pieces of me, past and present, living alongside each other. But these pieces wouldn’t work together, like a good brain should.

I lay in bed, or sat on the sofa, or went for long walks across the meadows near our house. That was the most I could do.

Everywhere the bits of me went, they saw toddlers. If you’d asked, before all this, how often I saw a toddler, I’d have said, Oh, maybe once a week? Now, I swear, it was twenty a day. I couldn’t leave the house without them assailing what-used-to-be-me. Like zombies in a B-movie, they clustered around the windows.

Rich said, “I hate the word miscarriage.” One part of me knew what he meant, and was grateful for it. Another part thought it was a fair word. An accurate term. After all, I’d done it wrong. I’d carried mis.

I had nightmares. About Rich leaving me, because now I was worse than useless. About a particularly nasty ex telling me, Your tits looked better when you were pregnant. About people I loved being butchered and dismembered, into small pink bloodless parcels. If I managed to hold it together during the day, I paid for it at night.

Gradually, a couple of weeks later, the pieces of my brain started to come back together. But they re-joined in an ugly, unwieldy way. You could see the sutures.

I was angry about everything. I was angry at myself, for being such a stupid emotional woman. I was angry at the happy people with babies. I was angry at the oblivious people, who wouldn’t ever know what this was like. I was angry at the medical professionals who had shrugged their shoulders and told me it was very common.

All my life, I’d been a workaholic – but suddenly I didn’t care, at all, any more, about my work. It was pointless, stupid, and vain. Next to what had happened to me, it meant nothing. And yet, if anyone had said to me, Yes, having a baby is a more meaningful experience than your work, I’d have punched them in the face.

In this condition, my sick leave expired, I went back to work in Cardiff. On the drive down, I stopped at my parents’ overnight to break up the journey. My mum insisted on loading me up with packed lunches for the week: sandwiches, slices of quiche, bits of fruit. She wrapped every item in about eighteen layers of cling film. As if by over-wrapping them, she could over-wrap me. Keep me safe from knocks.

Being back at work, being away from Rich, being expected to perform like a normal person – it was all hard. I’d told only a few necessary people in order to get my sick leave signed off, but it quickly became apparent that other people knew, even though I hadn’t told them.

Some people were kind. They clearly wanted to support me, even if they didn’t quite know how. Others were thoughtless. They didn’t scruple to let me know how inconvenient my absence had been. One person, I’m sorry to say, was actively cruel. She seemed to delight in making my life as hard as possible. She drew attention, whenever possible, to my sick leave and the circumstances behind it. Usually, I’d have resisted her, fired back, made a real fuss. I couldn’t. I just took it, like a punch bag leaking its stuffing.

My memories of those weeks back at work are blurred. I hardly slept at all. If I try to picture myself then, I’m walking through the corridors as quickly as possible, shoulders hunched, looking at my phone, trying not to speak to anyone.

Finally, the semester came to an end and we broke up for Christmas. It was a great relief in one way. In another, it made things harder. My milestone had passed. I was still here, with my anger, and a new year was coming. What now?

Over the Christmas break, I started to think about the words, It’s very common. I had always vaguely known, on some level, that one in three pregnancies end in miscarriage. One in four women, roughly, experience one. I’d known this but I’d never really known it, if you see what I mean. Only one friend had ever told me of her own miscarriage. Where were the others?

I started to really think about it. One in four. One quarter. Four of your female-bodied friends, sitting in a pub? One of them has had something like this happen to them. Or they will. Maybe it’s happening right now.

Without really knowing why, I started to tell my friends what had happened to me. And immediately, my world changed a little.

Me too. Us too. We had the same thing happen. One by one, the stories came.

They’d never said. I’d never known. All along, there had been this great seam of suffering, underlying what I thought of as normal life.

I wrote in my diary at that time, The last few weeks have been the greatest lesson in empathy I’ve ever known.

I started googling accounts of miscarriage, on the Miscarriage Association website and elsewhere. The seam grew deeper, and wider.

Most of the confessional pieces online were more dramatic than mine. They were second-trimester or third-trimester foetuses – real almost-babies, not my stupid little Schroedinger’s embryo. Or there were two or three or four losses, all compounding one another in a messy palimpsest of grief. Or it happened after a costly and gruelling course of IVF. They’ve got it worse than me, I thought.

But there was the odd account that I thought of as a little, common story like my own, and was more precious to me for that littleness and that commonness. I was pregnant, for a little while. Then I wasn’t. I don’t know what happened.

I hadn’t even been ‘trying’ / I didn’t even want it / I don’t even believe it was a person.

 So why have I fallen apart?

 Why did I fall apart?

I wrote this to a kind friend, who had sent me a care package from the USA:

I’ve gone from the person I was comfortable being, to a mum-to-be, to a woman who has a serious problem and might or might not have a viable pregnancy, to a woman who had miscarried, back to the person I was at the beginning – but different somehow. All in just a few weeks. It makes my head spin.

 I don’t believe that what I had inside me was a person. But I’m still grieving, and I can’t quite figure out what for. It sounds strange, but I think it might be for the former Mes. The Me who had never been pregnant, and the Me who was pregnant for the first time. Because I can never be those Mes again.

More succinctly, I wrote to another friend:

I will always be a bit sadder, and a bit shitter.

These aren’t inspirational words, I know. They’re harsh, ugly words. And yet, writing them helped. It was writing things like this, and hearing or reading the accounts of others, that eventually helped me to get better.

Not to recover, mind. I will never again be the person I was. That person’s gone. There’s no point in trying to recover her.

But I’m better than I was.

I’m different. My plates have shifted.

In this post, I don’t intend to cover What Happened Next. I’m only really comfortable with talking about the inside of my uterus with the buffer of a little time and space.

There are many other things I could say, about the year 2018. About the process of “trying”. About what it was like to see the words ‘Pregnant: 1-2 weeks” again. About seeing the cursed, cruel blood on toilet paper. About despair. About relief. About learning to hope like a grown-up. About all the rest of it.

But that’s for another time. If at all.

I’m better than I was.

I am not glad I had a miscarriage. I wish, with all my heart, that it had never happened. But even the worst things can, in certain lights, look positive. And you might as well try to glimpse them in those lights as frequently as you can.

So, let’s give it a go.

I’m healthier than I was. I no longer think I’m invincible – that my body is a machine that can move indefinitely and omnipotently, powered by my force of will. I will never know why my pregnancy was suboptimal. I will certainly try not to blame myself. But I will be kinder to my body than I was. Just on the offchance that doing so might help me avoid being suboptimal in the future.

I love Rich more, and better, than I used to. There are always bits of your partner that you’ve not yet had the opportunity to see, aren’t there? And in many ways, it would be better never to see them – who wouldn’t want to live a life together free of suffering? But if you have to see those bits, then there’s a consolation prize. Afterwards, you can love that person more. You can love them better.

Perhaps I’m not the best judge of this, but I think I’m a nicer person than I used to be. I certainly understand suffering better. If I can’t comprehend why somebody is so miserable or prickly about a circumstance I don’t relate to, I no longer assume that the problem is with them rather than my own ability to relate.

I understand that life has many dimensions. I’ve stepped off the treadmill that I’d been on for many years – one that measured my happiness almost solely in terms of professional success. Yes, I still care about that stuff. But less than I used to. The idea of happiness has re-formed itself, like the beads in a kaleidoscope. Sometimes, things need to come apart in order to find their best shape.

I understand the power of stories. I always thought I did. But not like this.

This was a long post, but it’s a little story. Little, and very common.

I’m not sharing it to try to start any sort of a #movement, or change behaviours, or anything like that. I’m sharing it for just two reasons.

The first is that, for me, it’s a sort of healing.

The second is that the internet’s the archive of that seam of suffering that I discovered when I started to talk to my friends. I want my story to be here, in case someone needs it.

If this has happened for you – if you’ve heard the word suboptimal – if you’re in pieces, and that’s more than just a metaphor – know that you’re very far from alone.

We may be suboptimal. Our pregnancies may be less-than-best.

But best is a big ask.

For now, let’s aim for better.

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