Motherhood and Miscarriage

May 17, 2017

What was meant to be an exciting experience, hearing my baby’s beating heart for the first time during my eleventh week of pregnancy, ended in shock and dismay. I will never forget the doctor’s clinical words and the look on his face: “I am sorry, but we cannot find a heartbeat. You have unfortunately miscarried. We will need to schedule a procedure to remove the fetus from your uterus.” He then made a quick exit from the room, leaving the nurse to help me pull myself together. Thinking this would be a routine pre-natal check-up, I had gone to the doctor on my own and was left searching for my car in the parking lot, alone and dazed, within 15 minutes of receiving the news.

 

I had confirmed my pregnancy at seven weeks, watching the ultrasound screen as the little lima bean shaped nugget that would be my second child blipped at a steady clip. Four weeks later at my follow up visit, the blip was gone. The little lima bean I had already grown to love was still there, but the hope of eventual delivery and lovely life had vanished. After the medical explanations were given (of which there weren’t any really), and the reality sunk in, I checked in at the hospital a few days later for a D&C to rid my womb of the remaining tissue, and with it any hopes I had developed for the child I had once expected.

 

Until having a miscarriage, few realize how common it is. As many as 25 % of known pregnancies end in miscarriage. It could even be twice that number given many may happen before a woman even knows she is pregnant. My doctor explained that this is nature’s way of managing a myriad of issues or problems that may exist (like chromosomal abnormalities). He reassured me that there was no concern that I had caused the miscarriage in any way – that it could not have been the result of stress or anything else I might have done. As a recent PhD graduate who was working full-time at a research institute and actively searching for an academic position, I was, of course, (wrongly) concerned that my busy life was just too much for the growing fetus to bear. But the doctor insisted that miscarriages are, quite simply, very normal, and that because I had already carried a child to term and gave birth, I had no reason to worry. He noted that I was only 32 years old and would have many more opportunities to have another baby. He was both right, and wrong.

 

Nearly a year later, after landing a tenure-track position at a state university, I became pregnant again. That pregnancy also ended in miscarriage and resulted in another D&C. Six months later, another pregnancy and another D&C. After the third miscarriage, my physician suggested that I undergo a series of tests to determine whether I might be struggling with any physical anomalies or hormonal irregularities that could be causing repeat pregnancy loss. After much blood work and what seemed like countless examinations, I was cleared again to attempt conception, and if it happened, I would be treated with additional hormone injections to enhance the odds of fetal survival. Despite such efforts, however, that pregnancy also failed. I was broken, and so was my marriage.

 

After a time of recovery – physically, mentally and emotionally – I married again. My second husband, who had not had children, and I were both in our mid to late 30s and we were eager to have a baby. He was happy to be a step-father to my daughter, who remained unaware of my fertility issues, but we definitely wanted to have another child. He was aware of my previous miscarriages and supported me through the medical process while I continued to visit with specialists in search of answers to my puzzling fertility situation. I eventually learned that I had endometriosis and adenomyosis. I underwent an extensive laparoscopy surgery to address the endometriosis, and endured a chemically induced menopause for six months to firm up my uterine tissue and address the adenomyosis. I was then given the green light and became pregnant fairly quickly, but it didn’t last. As my husband and I were pushing toward 40, we decided to undergo in-vitro fertilization to try and control the implantation of the strongest embryos. The three that survived the fertilization process and were inserted into my uterus didn’t grow, which was also a disappointment (and an expensive one at that). I surprisingly became pregnant three months after the failed IVF attempt, and shortly thereafter I suffered my sixth and final miscarriage.

 

In the end, we were never able to solve this puzzle – nothing really explained why I had one child and then my body couldn’t do it again. Nothing really explained why we would see a fetal heartbeat (the little lima bean blip) at around 6-7 weeks every time, but by week 9, 10 or 11 the flicker of potential life was gone. The fetal tissue had been tested for abnormalities after miscarriages 4, 5 and 6 – and only the 5th pregnancy actually showed a chromosomal problem. For the other two, the test results were perfectly normal. As difficult as it was to endure the physical and emotional pain of six pregnancies and six miscarriages, the lack of answers was perhaps as or more difficult to accept.

 

For ten years, all throughout my probationary period as an assistant professor and into my early years after tenure, I suffered through these difficult experiences, just as many other working women do. Throughout that time, I continued to teach my classes, travel abroad to conduct research, attend professional conferences, mentor students, and engage in departmental, college and university service – and all the while I silently struggled. I took hormone shots while on the road, attended departmental meetings in between receiving the news of a miscarriage and having a D&C, taught class after crying in the car the entire way there and then again, all the way home. No time was taken off, reports of my medical issues weren’t filed, and the information wasn’t shared beyond a few close friends and family members. And as the miscarriages mounted in number, I confided in even fewer people. I was so tired of being the bearer of bad news.

 

More or less, I engaged in a self-imposed isolation that wasn’t obvious to anyone at work (or at home either, as I had a small child to care for as well). This exceptionally personal experience just didn’t seem to belong in an academic environment given the higher education workplace isn’t especially welcoming to such intimate, human situations. Other academic women have felt similarly – noting the awkward nature of these kinds of conversations.

 

Moreover, all of my supervisors and most of my colleagues were, of course, men. I felt uncomfortable talking about the issue with them, and I was convinced (at the time) they would have felt uneasy hearing about my persistent fertility woes. If I were to reveal my struggles, I wasn’t sure how I would then be treated, especially during the delicate time before obtaining tenure.

 

In addition to the intense physical toll, emotional anguish and mental frustration I experienced from multiple miscarriages, the financial stress of managing the medical bills while also paying for student loans and, of course, daily life with a small child added to the pressure. For too many years I carried around a sense of failure that was the result of a culture of secrecy surrounding miscarriage. The humiliation and disappointment associated with having a miscarriage is real, and when you multiply that by six, the pain runs even deeper. And yet everyone around you continues living their lives, as they should, but this reality makes you feel even worse – as wrong as that may be. Watching others become parents, and perhaps their young children welcome home their siblings, was difficult – and it felt shameful that these joyous experiences brought, for me, jealously and pain. This was particularly pronounced after my daughter was old enough to ask why she was an only child – why she was the only kid in her class that didn’t have brothers or sisters. I was often screaming this same question in my head – WHY?!

 

Eventually, the issue of why I had multiple miscarriages was no longer the right question to ask. It was simply my reality. But I still have to ask why I would feel as if I couldn’t, or shouldn’t, be more open about my experiences – why I didn’t feel comfortable asking for leave from work without worrying about repercussions – why I felt like I had to power through in order to avoid any appearance of weakness in my academic environment. Much has been discussed about the impact of having a child on the upward advancement of female faculty, as well as the impact of waiting until academic positions are more secure and then struggling to have a baby. These effects are indeed all too true. As a mother and a professor, I experienced the difficulties of academic motherhood too. But the “miscarriage penalty,” as Jessica Winegar puts it in her recent column in the Chronicle of Higher Education, is one that is less visible, and yet just as troubling.

 

Fertility issues for women in higher education, in general – pregnancy, childbirth, pregnancy loss, and infertility – are all likely to impact a woman’s academic (or any) career. So, it’s time to talk about it. Let’s find solutions to the multitude of concerns surrounding the issue. The first step is to fight the urge to remain silent. Looking back, I really wish I hadn’t kept these struggles to myself. We must work together to remove any real or perceived workplace barriers that prevent these much needed discussions. Ensuring that there are more women at senior academic levels – or perhaps any member of the faculty that would be known or even designated as a go to person for these kinds of personal problems – may be one way to address these concerns. Perhaps if I had had a more advanced female faculty member or administrator to go to, I wouldn’t have felt the need to remain silent. Whatever the solutions may be, we should find them.

 

Having recently celebrated Mother’s Day, I know I am most fortunate for the amazing daughter I have. But we should remember those whose pain is even more prominent on the day we recognize moms – those who would love to be mothers, but can’t be – and those who have been expectant mothers and have experienced pregnancy loss. Let’s also celebrate those who mother in other ways – developing connections with women who are like their mothers, or like their children. While I have experienced the joy of motherhood and am fortunate to have a wonderful mother, many of us may not. Most importantly, let’s dedicate ourselves to being more open and understanding of our various motherly experiences and perspectives. We owe it to ourselves and to the future women of the academy – whether they are faculty, staff or students – to end this culture of silence about fertility.

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