Approximately 1 in 4 pregnancies in New Zealand (NZ) end in miscarriage. As a woman who has suffered a miscarriage (ectopic pregnancy) and found the support, both formal and informal during this time, to be lacking, I wished to research this socially and culturally placed experience in order to offer policy solutions in order to improve upon the support offered in New Zealand. I am currently a post-graduate Sociology student at the University of Auckland, and as a recipient of one of the Health Research Council summer studentship scholarships I was able to conduct my research entitled ‘Improving Miscarriage Support in New Zealand’ over a three month period. My miscarriage story is told in brief below, and while this for me, despite my uncertainty of carrying the pregnancy to term (prior to knowledge that I was to miscarry) was a traumatic and emotional experience, I think it is also necessary to note that while for most, miscarriage can be both a physically and emotionally traumatic event – for some it is not. The emotional loss felt by the women and her partner will depend on the identity and importance they have given to the foetus, and not all foetuses will be created in the minds of the parents as a baby.
My miscarriage occured in March 2005. At the time I was in a short term relationship with a man who has now become one of my best friends, our miscarriage being one of the things that ties us together in the understanding of an event that others seem often unwilling or unable to discuss.
When we found out we were pregnant we had mixed emotions as to whether we wished to carry the pregnancy to term, adopt the baby out, or have an abortion. Since we considered abortion, it was necessary for me to meet with a counsellor (at Capital Coast Health – the hospital in Wellington) and have an ultra-sound. The day I met with the counsellor at the hospital I had had some spotting, and told her, that I wasn’t sure if I was still even pregnant. She told me that spotting was normal and that I had nothing to worry about. After talking with her I was as unsure as ever as to how I wanted to proceed with our pregnancy. I was in no financial position to support a child, however I knew of others who had little financial support and seemed to get by okay regardless. In addition, at 24, I felt there was more out there in the world for me to see and I worried about the travel opportunities I would miss out on. I decided if I were to abort that I would need to make this life lost count for something.
A week after my visit to the counsellor I went for my first ultra-sound at which no foetus1 was visible. I was told that this happens sometimes if the foetus is still too young to be seen. I was told to return to my G.P for blood tests to confirm our pregnancy and track its progress and if I felt any pain to go to the hospital. Over the next few days I had blood tests done (every second day) to measure my pregnancy hormone levels. These I was told were increasing but not at the expected rate and therefore was told that there may be a problem. During this time, one night, I felt a slight pain in the lower side of my abdomen and had a friend take me to the emergency department of Capital Coast Health. I told the woman at the reception that I was pregnant, that there may be complications with the pregnancy, and that I was feeling some throbbing. She told me that I could wait, what would be around 4 hours she suspected, to see a doctor, but that there was probably nothing wrong and that I could go home instead if I wished and take a panadol. Not wanting to wait with it being late at night, having work the following morning, and not knowing at that time that I may have an ectopic pregnancy, I went home.
A couple of days later, I went back for my second ultrasound at which time the foetus was visible, but outside of my womb. (I will use the term foetus throughout my story as I find it difficult, as a result of the minimilisation and medicalisation of my experience, to call the foetus a baby.) I was told by the technician that the foetus was in the wrong place and she would call an ambulance (as we had no car) to take me to the hospital. I for some reason, shock(?), or perhaps uncertainty of the situation declined the ambulance and took a bus with my partner. My charts were sent to the hospital and on arrival I was met and another ultra-sound performed. The doctor confirmed that I had an ectopic pregnancy and that an operation would be needed to remove the foetus. My memory of what further information I was given about the surgery is hazy, but I carry a strong recollection of, and I guess disgust and anger at, the comment my (reasonably young) doctor made prior to leaving the room – he told me flippantly that he was excited to perform the surgery as he had only done a couple before.
Following this I was transported to a room – I’m not sure where in the hospital, to wait a few hours as the water I had consumed for the ultrasound needed to deplete before they could perform my operation. The details surrounding this next period are a little jumbled, I remember some forms, one of which I was to write what I wished done with the foetus after the operation – I ticked the box for cremation and return of the remains (whether I did this before or after the surgery I can’t recall). I was also able to put a name for the foetus on this form – I called her Aroha.
The operation itself was traumatic. I had never had an operation before and felt incredibly scared while being prepped for surgery. I recall mumbling something to the doctor about ensuring that I received a vegan meal the next day – which seems comical now I guess, but in hindsight during my confusion was probably my way of feeling like I had some kind of control or decision making power in the whole process. When I entered the operating room I felt fear like I had never experienced before. I remember asking for reassurance that everything would be okay, being told that it would, and then counting backwards as they put me under.
I have no idea how long the surgery took. The next thing I remember is waking up feeling pretty spacey (as a result of the morphine I guess I was on) in the middle of the night and calling out for my partners hand, holding it seemed to be the only way I thought I could feel safe. When I woke up the next morning I was weak, and in pain. I needed to use the bathroom and was helped by my partner to get to it. I can’t remember what my thoughts must have been when I saw the incision marks, stitches and yellowed skin (stained from the operation). But when I looked in the mirror, I had incredible puffy eyes – the kind you have when you cry all night. I later asked my doctor about this and was told I had cried a lot during my surgery. I always found this strange (and interesting), the sadness I must have felt while completely unconscious – almost a bodily despair.
Doctors and nurses checked in on me throughout that morning, only one asking me how I was doing in reference to my emotional well being – not physical. She was older and I appreciated this immensely. Early that afternoon I was checked out, given a prescription for painkillers and a Wellington Miscarriage Support Group Pamphlet. My mother had driven with her new partner down to Wellington from the Hawkes Bay to see me, and I left with them, and my partner. Being that she wasn’t often in Wellington she thought we might like to go to lunch with my Aunty who lived in the city. I being completely confused about what I was feeling, either emotionally or physically, agreed to go along. We had not told my Aunty what had just happened to me, she has reasonably strong catholic views and it was thought that she would frown on the event, so instead we said I was just a little unwell. I felt shocked by this whole lunch experience, between pretending I was only a little ill, to being surrounded by my mother’s new partner, and a room full of strangers at a café. Trying to hold back my tears I remember requesting that we leave and was taken home.
I spent the next week there, with not enough energy to leave the house (a problem further exacerbated by living up a hill). The first three of four days were physically the most painful I had ever experienced. I craved the time rolling by so that I could take my next set of painkillers. The blood and tissue which I passed both in the shower and while using the bathroom was heavy, and coupled with the pain, made me fear that perhaps there was something wrong. I called the hospital and was told that it was normal. I spent these days mostly by myself, with a couple of friends stopping by in the afternoon, they tried to be supportive, but the best thing they offered was some respite from focusing on my bodily pains and some humour from their days going ons.
I had been given a medical note excusing me from work for 5 days but as I had only been working for the organisation I was employed by for 3 months I was not entitled to any sick leave. My partner was also unable to take any leave, bereavement or otherwise, so he tried to work, but came down with an ear infection – caused by the stress of the event. I remember this frustrating me as I felt I needed him to work so that he could partially (financially) support me during my time off. I didn’t realise at the time, how much of a toll our miscarriage had taken on him too.
Ten days later (not the 5 I was given a medical certificate for), I was physically able to return to work – which required standing all day. I did not spend any real amount of time grieving, nor, while I considered it, did I contact the local miscarriage group – in part because I figured that those who attended were probably older and had planned their pregnancy, and I doubted the legitimacy of my grief, firstly because I had been unsure of keeping the baby, and secondly because the experience had felt emotionally minimised by the hospital staff, and even my mother. I instead threw myself back into my work, and six weeks later was offered a role in the Philippines and I embarked on the travels I feared I would be unable to take if I had gone through with the pregnancy. When considering an abortion, I had told myself that if that were to be my choice, then I would have to make the life lost worth it, and I felt the same after my miscarriage. I traveled and lived in a multitude of cities and countries over the following year from Manila to San Francisco. During this time I developed a phobia of flying which I still have and I have since read that phobias, such as flying, can be associated with the miscarriage experience, lack of control of this experience, and the close experience of death and realisation of the impermanence of life.
I still mourn for my loss and am particularly emotional both around the anniversary of my time of my loss – March 17, and what I expect would have been my due date. Further to this, while I (mostly) practice safe sex with my partner, every month I still fear being pregnant and carrying an ectopic pregnancy. This fear manifests itself physically and I feel slight pains in my abdomen – on the side with my remaining fallopian tube.
Since my miscarriage I have completed a degree in Sociology, and when I heard of the Health Research Council Summer Scholarship decided to apply to research and write my report ‘Improving Miscarriage Support in New Zealand’ so that I may attempt to help the many others who have or will share in the miscarriage experience. While ectopic pregnancies are uncommon, the lack of support I received during my miscarriage seems to be unfortunately too common- from the insensitive care I was given at the hospital, the lack of, or uncertainty by my family on how to offer me support and my unwillingness to feel deserving of outside support, through to the financial difficulties I faced from the lack of contractual obligation for paid leave by my employer.
I thus hope that my report, along with the experiences and stories collated, along with the signatures collected and other submissions made by Miscarriage Support Auckland Inc. to the Maternity Action Plan are able to make a difference. To hark back to the cry of feminists during the 60’s and 70’s, ‘the personal is political’, and this submission made by Miscarriage Support Auckland Inc., shows that the miscarriage experience is definitely so.
Sarah Thompson