Miscarriage Support 
People often comment on the age gap between my two children. Simon is eight. Zoe is 3 months old. “You left it a long time” they may say. In the years before Zoe came along people would ask if I was going to have more kids. “Did you only want one?” I have been asked. Sometimes it has been hard to reply to these people. The story behind our quest to have a second child is a long one, thankfully with a happy ending. Zoe’s birth was a dream come true, and in retrospect, it is amazing to us that Simon came along so easily.
Simon was born in 1991. I had an easy pregnancy. I maintained good health and continued working right up to just before he was due with no problems. His birth was a bit traumatic – the cord prolapsed (became trapped between his head and my cervix). Simon was delivered by emergency Caesarean nearly three weeks early. I had great faith in those looking after me and the baby and I never presumed anything could go wrong. Sure enough despite the scary start Simon was a good weight and very healthy. It was not until some time later I realised that his life had been at considerable risk by the prolapsed cord. I have however always remained grateful that I had that innocent first pregnancy with him. What was to happen to us over the next few years would remove all trace of the innocent presumption of first time parents that nothing could possibly go wrong.
We wanted to have another baby when Simon was about three. As my pregnancy with Simon had happened so easily we presumed everything would go according to plan. We started trying in July 1993 and I had a positive pregnancy test in October. However I miscarried very early. I was philosophical – many women I knew had suffered miscarriages and had gone on to have babies. In May 1994 I had another positive test – but immediately things did not seem to be going well. I had sporadic bleeding and some pain. After some blood tests and a scan an ectopic pregnancy was diagnosed and I was rushed off for laparoscopic surgery and a D and C. This miscarriage was a bit more shocking and certainly more painful and difficult to recover from. We still felt very confident that everything would come right, and sure enough, by August I was pregnant again. This time everything seemed to go OK. My doctor was confident and so was I. I felt the baby move early on and got big very quickly. Simon came with us for the scan – we had decided to find out what sex the baby was. Simon wanted a little brother, and we discovered that was exactly what he was getting. We were all very excited. Simon nicknamed the baby “Pum pum”. I continued to get big and tired.
When I was about 31 weeks pregnant we travelled to Hastings to see my husband’s grandmother who was dying of cancer. It was a very hot weekend and the baby did not seem to be moving much. I was a bit worried about him but when we got back to Auckland I went to the doctor and all seemed to be fine. However by the next weekend I was worried again. There were hardly any movements and I felt (but did not want to believe) something was very wrong. The next day I went to my doctor first thing in the morning. She could not find a heartbeat and sent me to the hospital to go on a monitor. They could not find a heartbeat either. Finally I went to have a scan – by then Peter had arrived from work in response to a panicked call from me. The scan confirmed our worst nightmare. “There is nothing going on in there – no heartbeat” were the words the doctor used. Our baby had died.
The next few days were terrible. I was admitted to hospital and they attempted to induce the birth, carefully due to the fact I had had a previous Caesarean. However my body was reluctant to go into labour. Eventually after nearly 4 days with very little progress we made the decision to have a Caesarean section. We needed to get our family back together. Simon was with his auntie and family and was missing us. Peter’s grandmother in Hastings was getting much worse and other family members needed to be with her, and I was physically and mentally exhausted. Once the decision was made things happened very quickly.
Our second son was finally born at 5.30pm on 10 February 1995, silently. We named him Kieran. We held him and kept him with us all the next night. Peter’s grandmother died a few days later. She was a wonderful woman and I always say that somewhere she is holding her ninth great-grandchild and looking after him for us. When Peter’s parents got back from her funeral we had a little funeral for Kieran. Simon cried and cuddled me for so long. I felt (and still do feel) so lucky to have him, and so sad that he did not have the brother he wanted. He helped fill the emptiness I felt and gave me a focus during that difficult time.
After Kieran died we waited for a while before trying again. There was no reason that could be found for Kieran’s death, which in some ways was frustrating, but on the other hand at least no serious problem had been identified that could recur in a subsequent pregnancy. We felt sure that we would have another baby, but the thought of being pregnant was very frightening. It seemed a lot to risk – we knew we could not bear the pain of losing another baby. I joined my local Sands (Stillbirth and Newborn Death Support) Group and met parents who had similar, yet unique, stories of grief and loss of a baby. This support was invaluable, especially in the difficult months after Kieran’s death when many people around me seemed to have forgotten my baby, or seemed to think I would have “got over it” by now. Within a couple of years I started to help run this group and became involved in Sands nationally for a time.
In the meantime my mother was diagnosed with lung cancer, and given only months to live. I really wanted to her to see her next grandchild, and was pleased to be pregnant again in February 1996, a year after we had lost little Kieran. I was seeing a specialist and having regular scans. Everything went wrong at 10 weeks – suddenly no heartbeat. I still felt so pregnant – it was so unfair. More surgery followed, and tests revealed that this time a chromosome disorder had caused the miscarriage. Further tests showed that there was no genetic problems with me or Peter. We resolved to continue – after all we had had one baby already, we knew we could do it.
The rest of the year was spent taking care of Mum – she was in and out of hospital and the hospice. Despite her illness it was a valuable year for both of us – we talked about all sorts of things and got closer than we had since I was a child. Before she died, in November 1996, I assured her we would have another child. We talked a little bit about adoption. I am an only child and my mother would have always liked to have had more children. She could understand my feelings better than many other women.
Simon also started school that year. I was working part-time so I could be around before and after school. I watched the other parents with their children – everyone seemed to have more than one. I was envious even though I felt I should be happy with just one – after all I was a member of the “mummy” club, wasn’t I? Many people would give anything to have just one child. I well appreciated that as I had friends struggling with fertility problems – it made my quest for another baby seem somewhat selfish in comparison.
A couple of months after Mum died I found out I was pregnant again, but I miscarried straight away. I was pregnant again, for the seventh time, a couple of months later. My specialist suggested HCG (pregnancy hormone) injections to help sustain the pregnancy. However after about a week of treatment I miscarried again. The next suggestion was that I attend the Recurrent Miscarriage Clinic at National Womens’ Hospital. I went on a waiting list to be seen and in July 1997 I visited them for the first time.
The clinic is run by lovely supportive people and they have a very high success rate with the women who go through the clinic – about 80% go on to have babies. They have strict rules they advise you to abide by (as much as you can). These basically involve avoiding all kinds of stress – that means no work, no driving, no weddings, funerals, large family gatherings, no sex, no hot baths, no housework – the list goes on. While these things in themselves do not cause miscarriage, most of the women who go through the clinic do seem to have fragile pregnancies – therefore the main bit of advice is “go home and put your feet up and grow a baby”. I had a lot of tests but initially they could not find anything in particular wrong with me. While this was frustrating it also put me in a category of “likely to succeed” as I did not appear to have any serious problem.
In November 1997 I became pregnant again. I was very optimistic – after all I was under the care of the clinic and I was sure that with their help I could succeed. I told my boss that I had to be off work for the next few weeks. The family was told – we were going to need lots of support. I was having regular blood tests to monitor the HCG levels – the level of pregnancy hormone should rise steadily in the first few weeks of pregnancy. If it fails to do so you can tell that the pregnancy is going to fail. Waiting for the blood test results was always very stressful. In the sixth week of the pregnancy I phoned for my test results only to hear that the HCG level had failed to rise enough. Although I had no bleeding or pain, this pregnancy was going to fail. Despite the fact the miscarriage was very early, I found it very hard to deal with – I had been so determined it would work this time. I remember taking Simon to his Numberworks class that day and sitting in the car outside crying with frustration. What more could I do? Everyone who had been told about my pregnancy had to be told about yet another miscarriage. I returned to work feeling slightly foolish. However the clinic staff were very encouraging. Many woman had more miscarriages under their care – it was not time to give up yet.
Another test was arranged – an endometrial biopsy. This was to ascertain if the lining of my womb was sufficiently thick at the critical time of my cycle for the fertilised egg to implant and start to grow. This test was done by inserting a very thin tube through the cervix into the womb and removing a tiny section of the endometrium. It was slightly uncomfortable but bearable. The result indicated that I did have an endometrial insufficiency which was likely to be the cause of the early miscarriages I had suffered. The treatment would be HCG injections and progesterone suppositories once I next became pregnant. These can help to sustain the pregnancy. It was a relief to find there was a reason for at least some of the miscarriages, but I knew I faced more intervention if I was to become pregnant again – which I did immediately, to my surprise.
I embarked on a course of HCG and progesterone and had blood tests every three days. Bleeding started early on but this often happens with recurrent miscarriers, and the blood tests results were OK – although not rising quite as steeply as they should. After a couple of uncertain weeks (which felt more like months) I started to have bad pain. Having already had an ectopic pregnancy there was some risk to me of another one so it was off to hospital at midnight on a Saturday. After several hours I was admitted and sent to a ward. The next morning I was scanned and an ectopic pregnancy was confirmed. I was given an injection of a drug called methotrexate which is starting to be used as an alternative to surgery in cases of ectopic pregnancy. It basically dissolves the pregnancy cells from the fallopian tubes. It seemed like a good bet to me as I really did not want yet more surgery under general anaesthetic. However after nine days the pain was back and worse. I took myself back to hospital on a Monday morning. They were very busy and I eventually had a scan at 2pm, which confirmed that the pregnancy was still developing in my fallopian tube, which fortunately had not yet ruptured. I was trundled off in a wheelchair and the surgery I had so hoped to avoid was arranged for that evening.
The next day the doctors were pleased to inform me the fallopian tube had been saved and I should be able to get pregnant again. They could do some tests on me in a few weeks to confirm this. I was almost disappointed to hear this – I was at the stage I wanted all the responsibility taken away from me. I wanted to hear that I could no longer get pregnant, or that I should not get pregnant. I would then grieve for my lost fertility and just get on with life. I tallied up the number of months I had been pregnant in recent years – it was a total of over two years with nine separate pregnancies. On top of that I had spent many more months trying to get pregnant. My surgery tally was two Caesareans, two laparoscopies, three D and Cs’. I had had five general anaesthetics in less than seven years. I had endured countless blood tests, HCG injections, scans and other tests. I had one living child and I should count my blessings and stop putting myself and my family through all this. I knew Peter felt it was time to stop. He was more than happy with Simon and felt so helpless when things went wrong. I talked to the doctor in charge of the Recurrent Miscarriage Clinic. She was very sympathetic. She explained that what had just happened to me was regarded as a serious incident. While they would continue to treat me as long as I wanted to keep trying, she had to advise me that with my history there was little they could do from a medical point of view. Too many different things had gone wrong with my pregnancies. Looking at the whole picture I was unlikely to succeed. However the decision was still mine.
I must emphasise that all through our years of trying to have another child we did not let our lives be consumed by the process. We have a great son and supportive family and many friends. Although we often talk about Kieran and he will always have a place in our family, I always thought it would be a further tragedy to let Kieran’s death and my miscarriages impact too much on Simon’s childhood. I did not want him to have memories of a sad and desperate mother. Over the years we had great holidays, enjoyed Simon’s milestones – the three of us became a tight little unit and had a lot of fun together. We almost came to believe that adding another person, a baby, to the family, would disrupt the life we had made for ourselves….yet still we all still held a little hope that one day it might happen. Simon never stopped talking about “when we have another baby” and was always suggesting names for the imagined family member. I explained to him that it may not happen, that we are not very good at making babies. After the last ectopic pregnancy Simon (then nearly seven) wanted to know what was wrong with me, as I had been hospitalised twice in a fortnight. He was really sad – he cried and told me to keep trying because he wants a brother or sister so much. I know we are very lucky to have him (as people keep telling us) but what some do not realise is that he was affected too – he grieves for the baby brother he never got play with and he never gave up hope that he would be a big brother one day.
The other option we had explored earlier that year was adoption. Although I knew very few children are adopted in New Zealand these days we thought we should find out what was involved. We filled out all the forms and went through the preliminary steps. We met with a CYPFS social worker and attended a day long seminar. I even wrote a profile about our family – this is the information that is given to birth parents to help them decide who they want to adopt their baby. At this stage we stalled the process before attending the next required seminar as I had received notification of my first appointment with the Recurrent Miscarriage Clinic. Peter was ambivalent about adoption in any case. I left it as something we could come back to at some stage. When we attended the first seminar I was so impressed by all the potential adoptive parents who were there – it seemed to me they would all be excellent parents. I can only hope some of them have succeeded in adopting a child or children, or perhaps even having one of their own.
After the ectopic pregnancy our babymaking plans went on hold. I considered having a tubal ligation. On the other hand I felt I had got pregnant too soon after the endometrial biopsy and that I should give it one more shot – maybe the tenth time lucky if I did everything right. Peter and I talked about it but he was reluctant and I did not need too much convincing that we should give it a rest. We took ourselves off to Fiji and had a fantastic family holiday. Towards the end of the year we arranged a holiday in the Bay of Islands and looked forward to Christmas with the family and a summer of barbeques with friends and boogie-boarding with Simon. We booked an overseas trip to visit family members in the US and UK. Life seemed sweet. Then a week before Christmas I found out I was pregnant.
It had long ago got to the stage that being pregnant was no cause for celebration. Past history showed that was not the important bit. Surviving the next few weeks and then subsequent months was the real test. However this time I had conflicting feelings. First, the pregnancy felt different from recent ones. I felt as if my hormones were in overdrive – very sick, tired and overwhelmingly pregnant. I thought this was a good sign. However I could not ignore my past history. I knew I should phone the Recurrent Miscarriage Clinic and get myself along to see them. I waited a few days, not even telling Peter my news. The timing was so bad. I did not want to spoil Christmas and (foolishly) I was sure that telling him would do precisely that. I did a lot of thinking. I realised that I could not face the stress of repeated blood tests, the constant scrutiny and concern of medical staff, family, friends and workmates. If I could not have a baby on my terms I did not want to go through with this. After Christmas I finally told Peter my news. He hugged me tight and asked why I had not told him sooner. I explained how I was feeling and we agreed I would go and see the specialist obstetrician we had seen previously.
The decision not to return to the clinic was a big one for me. However I had decided that for me giving up work and making huge changes to our lives would be more stressful to me than not doing these things. Also telling everyone at this early stage was something I wanted to avoid. I had taken on board a lot of what I had found out at the clinic, but I adapted it to suit my needs. I explained a lot of this to our specialist. My first scan showed all was as it should be, and a second one two weeks later showed a heartbeat. It was suggested I take a low dose of aspirin to improve blood flow between me and the foetus and this I did. We had a pleasant holiday up north except I could hardly face food, especially come dinner time. Barbeques were out the question as the smell turned my stomach. I did not mind.
When I reached twelve weeks we told family members, we cancelled our travel plans, and I told my boss but not the rest of my workmates. Simon greeted the news with tempered enthusiasm – it was still a big “if” for all of us. He talked about his future as a brother always adding the comment “if this baby does not die”. I felt sorry that this was his reality, but it was also this way for us. We could not just relax and take the arrival of the baby for granted. For a long time being pregnant was just a state I was in, it did not necessarily mean a live baby to have and keep. I told other workmates when it became hard to conceal the obvious. I dressed in slimming trousers and loose tops – no tent-like dresses this time. I could not face too many people noticing and commenting on my bulge. Such small-talk seemed to presume that all would go well and I did not want to discuss how many children I had or past history. As time went on I got better at coping with the comments and questions – people mean well and of course want everything to turn out for the best. Most people I knew would assure me all would be fine this time – but how did they know that? My SANDs friends who had been through subsequent pregnancies understood the stress of worrying about something going wrong. They knew there were no guarantees.
I had extra appointments with the specialist throughout the pregnancy. At all the early appointments I had scans, and most of the later ones. This I found very reassuring – seeing the baby’s heart beating was a beautiful sight. However I decided against any other tests – at 34 I was not yet very high risk and I did not want amniocentesis because of the increased risk of miscarriage. Also the thought of finding out something was wrong with the baby and having to make a difficult decision was beyond me. It seemed like having the baby was an enormous leap of faith in itself – I would just have to hope for the best.
Week after week the pregnancy progressed. Time seemed to crawl by. I remained very healthy – no bleeding, no pain, good weight gain, blood pressure normal, good movements from the baby. I finished work when I was 7 months pregnant. I felt as if I was doing the right thing being at home resting but time dragged even more. I would spend hours lying around willing the baby to move and would worry when she went to sleep and I felt no movements for a while. Eventually I allowed myself to buy some baby clothes and get a few things ready. For so long it had felt like tempting fate to do so, but I was beginning to believe we really would have this baby.
On 4 August, when I was 37 and a half weeks pregnant, I went for my routine appointment. I had been feeling very anxious as I thought the baby had moved down a bit. Having already had two caesareans, I also had to have this baby by casearean and this was booked for 12 August. I was anxious not to go into labour as I did not want the cord to prolapse as it had with Simon. This was probably unlikely but I managed to worry about every little thing. I did not trust my body to keep this baby safe. I expressed my fears to the doctor and he said he would see if we could bring the delivery forward. I went home to await a phone call. When his assistant rang me at about 2.30 that afternoon her first comment was “I hope you have packed your bag – he will do you tonight”. I was booked in for seven that evening. I felt an enormous sense of relief as well as a massive attack of nerves. It was really happening – this time tomorrow I would have a baby to hold.
We arrived at the hospital at 5.30pm as instructed after leaving one very excited boy with his grandparents. I was shown to a room in delivery suite and a midwife prepared me for surgery. However at that stage we found out that the operating theatres were very busy with acute cases. We were hopeful that the baby would be delivered that night, but it was a case of wait and see. We took my bags upstairs to the ward and spent the next few hours sitting around – it felt like being in labour without the pain. Finally at 10pm we were told that a theatre was free at 10.30. I was rushed off and made ready. Lying in that operating theatre was incredibly nervewracking. The memories of the last sad time I had undergone this procedure came flooding back.
Little Zoe Margaret Attwood was born at 10.47pm. She emerged yelling loudly – what a beautiful sound. She weighed 3160 grams (6 pounds 14 oz) and was 49 cm long. She was pronounced in perfect health and given to her proud dad to cuddle. What a feeling! She was very like her brother Simon – perfect little round head, beautiful big eyes, a rosebud mouth. Peter could not stop smiling and neither could our specialist. Simon had a similar reaction when met his sister for the first time the next morning. He declared it to be the best day of his life.
We spent three nights in hospital and most of the time I felt very calm and greatly relieved. Although it had been 8 years since I last had a new baby to care for I found all the skills coming back. I was much less emotional than I had expected. It was not until we were coming home in the car with Zoe, Simon and I all sitting together in the back, that the tears started. I wept with happiness – this was a moment I had longed for. Taking a healthy beautiful baby home from the hospital was something that had been denied to us four years previously and it and it made it extra special this time round. I could not believe that our dreams had come true.
At the time of writing this Zoe is three months old. She has fitted into our family like she was always supposed to be here. Simon adores her. He does not understand why she is seems so much more beautiful than any other babies he sees. “It is because she is our baby” I tell him. It feels so good to say this “…our baby”. She gives meaning to everything we went through over the past six years. I do not know why all went right this time but in retrospect I had an excellent pregnancy in physical terms. Mentally it was probably about the most stressful thing I will ever do. I so believed that I would have another baby. The fact that several different things had gone wrong with my previous pregnancies made me difficult to treat. What was needed was careful management of the pregnancy and a large measure of good luck. It was truly a case of “tenth time lucky”. We had several names we had shortlisted for our baby girl. Finding it hard to decide we consulted Simon. He chose Zoe as his sister’s name and could not have chosen more appropriately. The name “Zoe” means”life”.
