An account of a natural miscarriage at home
Diagnosed with a missed miscarriage, Pavla opted to miscarry naturally at home. She shares her experience here.
Were there things I wish I knew before it happened? That I wish others had told me? I think most of all, I wish someone told me not to be afraid of the pain.
I thought I was lucky when I had next to no symptoms during my first pregnancy. If anything, I had slightly bigger and fuller breasts. No nausea, just a healthy appetite, a new aversion to chocolate, and a big thirst for kefir.
It was around the seventh or eighth week that I began to worry my breasts didn’t feel as full anymore. My husband wasn’t worried at all and did his best to encourage me to relax. Each day that passed without any serious sign of anything being wrong – no spotting, no cramping – we pulled up an online miscarriage risk calculator, and watched our chance of miscarriage go down, waiting for our 12th week scan and the opportunity to share our news with the world.
Still, the worry was there. And after we looked at our less than 5% chance of miscarrying on the first day of the 11th week, after my husband went to work, after I had a glass of kefir with my breakfast, I went to the bathroom and saw the faintest brown-red tinge on the tissue paper. “Argh, I knew it,” I thought, sighing out loud. “This was too good to be true.”
Aware that spotting can be normal in pregnancy, we went in for a scan at local urgent care the next morning to make sure. The technician told us that the baby was measuring at seven weeks, and not much else. She said they didn’t try and find the heartbeat at this stage. I saw a little bean on the screen wiggling about, thinking that it must be moving and so it must be ok. But if it was measuring three weeks behind, surely that must be bad? “The measurements don’t always add up”, the technician said.
We saw an ob-gyn about an hour later. I was weighed at first, and my blood pressure was taken – it was normal. Then the ob-gyn greeted us. “I’m so sorry, you’re having a miscarriage,” was her first sentence. “There was no heartbeat,” was her second. “I’m so sorry, I feel so bad telling you this when we’ve just met.” My husband gripped my hand, but I felt a strange wave of relief. The grief would come later, but for now, the uncertainty, the worry was gone. My worst fear was confirmed, and so removed.
We were given three options – a D&C at the hospital, pills to start contractions at home, or a wait and see approach and an eventual natural miscarriage at home. We asked if there could be some mistake. She said she was happy for us to have another scan, but with the baby measuring as big as seven weeks, and no heartbeat, and with me already at ten weeks, the diagnosis was certain.
I knew I wanted to wait and miscarry naturally, let my body do what it was intended to in this situation. It took another week. Some days I would see that tinge of brown-red on the tissue, some days I wouldn’t. We managed to go away on a pre-planned weekend to Vermont to see the fall foliage, and nothing happened. I looked up stories from other women about what miscarriage was really like, stories like this one, and they helped me feel prepared. Then on Tuesday, 9th October, as I ran to the bathroom at college, where I was taking classes, I saw blood. “It’s happening, I think”, I told my husband over the phone. I got in my car, and drove the 50 minutes or so home.
The cramping started while I was still driving. I didn’t yet know it was the first minor contractions. They would come and go, like bad period pains, but a little more intense, more noticeable. I passed the car journey by singing along to children’s songs I remembered from when I was little. Somehow, the singing helped, it was soothing.
It was about 4pm when I got home, where I located super absorbent pads I had once bought by mistake when on a trip abroad and never used before. My husband got back from work at around 6pm. The contractions were still manageable, and just made me pause and hold my belly when they happened, from time to time. We had dinner, and watched Agatha Christie’s Miss Marple. I was lying down on the sofa, and when a contraction would come, I would sit up, or turn over, and let it pass, while I took a couple of deep breaths.
At around 9pm we got ready to go to bed, and that’s when the contractions became more intense. It was around then, that I realized they really were contractions, like the ones I read about in an attempt to get an early handle on preparing for birth. I asked my husband to bring me snacks – apple slices and peanut butter, and a glass of water with honey and salt – I felt like I was about to go through a lot of pain and the snacks and “energy” water would help prevent me from fainting. As I learned later, any attempt to eat or drink would just make me feel nauseated.
Just as he brought the snacks in, it really started. One intense contraction after another. Each time it would happen, my abdomen seized, and huge wave of pain took hold of me. I would completely lose control, as my body would take over. I would either kneel, resting my bottom on the soles of my feet, my hands placed on my thighs, or I would stand, and bend forward, leaning against the wall, or the bed. It was too painful to lie down. I would take deep breaths, and increasingly, I would scream – I suppose another way of taking deep breaths – and no matter how much I worried about the neighbors, I couldn’t suppress it. Then, the pain would subside, and I could rest for a few minutes, talk, and be normal. Then, I would go to the bathroom, when an avalanche of blood and clots would pass into the toilet, and then stop. Sometimes it wasn’t even that much blood, just clots and tissue. I would flush, instinctively, with relief. Then I would return to bed, and it would start all over again.
I asked my husband to start timing the contractions, and over the next few hours, they went from being 6-8 minutes apart and lasting about a minute, to being 2 – 4 minutes apart and lasting about two minutes. By 4.30am, they were running into each other at about two minutes long.
By 4.30am, after several hours of contractions, which were now on top of each other, with just seconds of rest in-between, I felt increasingly physically exhausted and like I was going to faint. I tried to drink the water and eat the apple slices, but I also felt increasingly nauseated. At some point towards the morning, I was on the floor, screaming and crying. Up to that point I thought I was handling it ok. I was in a sort of zone, and while I was screaming and writhing and in pain, I felt strangely fine and calm mentally. The words like “screaming” and “writhing” sound much worse than they felt, even if they are accurate. It’s a feeling like a part of you is being pulled apart, but the rest of you is totally fine.
Perhaps it’s not dissimilar to extreme sporting activity, like a marathon, which is painful, but during which you otherwise feel healthy. In some way, you feel excited and engaged – it is an activity, and each contraction is an onslaught, a wave of something to be resisted, requiring all your strength. But still, by the end, that feeling gave way to desperate exhaustion and an insurmountable desire for an end – any end. I was on the floor, saying weakly to my husband – “I don’t think I can do this anymore”. The contractions now seemed almost continuous, and I wasn’t getting enough rest between them. I felt like it all had to end somehow – with a trip to the hospital, death, fainting or something.
Then, just like that, I began to feel dizzy and nauseated, the room began to smell, I stumbled to the bathroom and vomited. I immediately felt better and went back to bed to lie down. The contractions eased, and I fell asleep. I think it was starting to get light, so it must have been around 5 am.. I learned later, that before managed hospital births became the norm, most women delivered over the course of the night.”
When I woke up it was both easier and harder. Easier, because the contractions were now less intense, but harder, because I think the adrenaline-inducing intensity of it all was gone, and I was no longer in a zone, just in pain, and handling it as best as I could. This was when I took some Ibuprofen – it had no effect. I fell asleep again at some point, and when I woke up it was late morning, and I felt much better. Elated even. Whether it was adrenaline again or a different kind of a hormone rush, I actually felt very happy – I was very proud of what I had been able to do, and glad it was over, and that I was recovering – it felt like I’d be back to normal in no time.
I was given a kit before it all started to collect the tissue for testing. I read a blog about how to use a sieve to catch it on the toilet, or to let tissue pass on a waterproof blanket. I wasn’t able to do either in the moment. I thought I passed a sizeable piece of tissue early on – maybe that was the embryo. And I passed big red tissue with a sort of a torn cord attached to it later on, which I thought was the placenta. Could have been either or neither, I have no idea. It wasn’t pretty, but it wasn’t gruesome, the instinct to flush was overriding any others. I never saw anything that resembled a baby, which I think would have perhaps been more traumatic, but perhaps also in a way reassuring.
Once my initial elation passed, the pain settled at a manageable level, and I had period-like bleeding for six more days, although it was getting progressively lighter. Those days were the toughest, as the immediate concerns of surviving and recovering gave way to an inescapable sense of loss that felt so decisive and permanent. As luck would have it Meghan Markle and Amy Schumer announced their pregnancies right around then, as did two of our close friends. They all had a similar due date in April/ May of next year. As their dream continued and they celebrated with the world, my dream had ended. Try as I might, and consumed by guilt, I couldn’t be happy for them. Not yet.
Spotting carried on and off for another ten days, and throughout those days I sometimes had a yellow-ish discharge, which made me concerned about an infection, but as I had no other symptoms or fever, I waited and it disappeared on its own. Slowly, with utmost will, the anger and grief became manageable, and a small trickle of hope appeared – hope that we’ll be able to get pregnant a second time, and with a different ending. My husband and I became intimate again nine days after the miscarriage, and although in retrospect it seems a little soon, it really helped me feel close to him and to feel normal and attractive again.
Pregnancy tests were still positive for another fourteen days, then became negative. I had consistently higher temperatures like I usually do in the luteal phase from the twenty-first day, which suggests that I may have ovulated during the first cycle after the miscarriage, but I can’t be sure.
Looking back on the experience, it was both excruciating, and somehow not at all. It’s hard to describe, because when you write down words like “excruciating,” “most intense pain I’ve ever experienced,” “I thought I might die,” and so on, they are both accurate, but at the same time give a completely wrong impression, because although the pain is intense, it is not scary pain, not the kind of pain that feels unhealthy, like an injury or illness. It’s more like the kind of pain when you’ve exhausted all your strength while exercising and can’t catch your breath. Your body takes over, you get into a sort of physiological trance, and you know it’s going to be ok, but that your body is going to need to work extra hard right now.
My mum said that right after she first gave birth, she was sure she would not have any more children, because it was so painful, but that just a few minutes later she wanted to do it all over again as soon as possible. And that’s kind of how I felt. Never have I wanted to get pregnant so urgently and so readily, as I did in the days after I miscarried – an ordeal, but one that leaves you in awe of the female body. I felt like I had done something I was built to do, and even though it ended so sadly, I was so happy that I was alive and able to do my job, as it were. An exhausting, excruciating job, but nevertheless a job that was meant for me, and that I really wanted to do.
Were there things I wish I knew before it happened? That I wish others had told me? I think most of all, I wish someone told me not to be afraid of the pain. We are told so much about how painful pregnancy and birth are and how we can avoid that pain, but my experience was that the pain had a function, that it helped my body take care of me. I wouldn’t change that for the world, and I can say that naturally miscarrying at home is something I would definitely do again. Of course it’s different for everyone, and perhaps I got lucky this time in that there were no complications. All I can say is that women’s bodies are wondrous things, and that it is possible to have a positive experience without avoiding the pain.
I wish too, that I knew that language is limiting, and that describing pain can make it sound worse than it makes you feel at the time. On another hand, I wish I knew that birth-like contractions were a real possibility, and to prepare for a mini-birth that can last several hours, and a recovery period of a few days. Too much literature described miscarriage as “period-like cramping,” which in my case it wasn’t.
And I suppose I wish that miscarriage had been less of a taboo subject. I had to cancel a few things in the two days around the miscarriage, and in most cases it seemed inappropriate to tell someone it was because of a miscarriage, so I said that I was “sick.” And that’s not quite right. It made me question the wisdom of holding back information about a pregnancy for the first twelve weeks, and to imagine instead a world, where women could share their pregnancies earlier, and their miscarriages if need be, with less stress because of the taboo and pressure of it all.
Then, it may be easier for pregnant women to negotiate time off work when needed, and to support each other at a time that can feel so sad and isolating. And I think it would help the wider population – male and female, with and without children – understand the long and often fraught process that goes into forming and growing families.
I would say there were three things that helped me get through the miscarriage the most: the first was reliance on my own body to do its thing, the second was the immediate support of my husband while it was happening, and the third was wider community support from those with whom I shared the experience – my teacher at college, who told me about her own miscarriage, other moms and hopeful moms on an online forum I go to, and a few friends – both male and female, who had kids and who were amazingly sympathetic, and who helped me see that this too shall pass, and that one day I too, will be happy again.
So for anyone waiting to miscarry and unsure what to do, here is my practical advice:
1 – get lots of night-time super-extra absorbent pads
2 – make sure you’re close to a toilet
3 – don’t worry too much about collecting tissue because it’s really difficult
4 – trust in your body, and breathe, scream and move as it tells you
5 – expect it to happen overnight once you first start bleeding, and cancel everything for two or three days after that
And here is my emotional advice:
1 – make sure your partner, if possible, is at your beck and call
2 – tell whomever you trust, because their sympathy will help you
3 – know that you will be happy and feel at peace when it’s done
4 – know that you will then come down, and feel terribly sad
5 – but above all, remember that one day, you too, will be happy again.