It took precisely two window-shopping rounds of a Taiwanese food court to reach breaking point. Eyes glazed over and with a sluggish gait, the first lap was an unenthusiastic attempt at surveying the dinner options. Round two carried with it a ‘choose something and get out of here' sense of self-determination, that although hurried in intention, still seemed to proceed in slow-mo.
Ordinarily I would have loved the comings and goings of a bustling foreign food hall during the dinner rush, quietly observing the culinary habits of a nation and actively staking out local favourites. Tonight the only thing that got me out of our Airbnb rental and trying to be invisible among the constant buzz of chatter and screeching of chair legs against the linoleum floor, was the image of the detestable array of plastic waste that would no doubt accompany any take-out option.
I caught the urge to spontaneously erupt into tears, and with painful swallows pushed the feeling down my throat to sit on my heavy heart, adding to the weightiness that allowed forward movement only through deliberate shuffles, while the energy of the food court whipped by blurred and muffled.
Two laps in and not even a vague shortlist of dinner contenders had formed. Finally I relinquished myself to the overwhelm and leaned on my husband to make the decision for the both of us.
With an order placed and food court buzzer in hand, scouting out vacant square footage in the dining area felt like another lap I wasn't motivated to make. It felt fortunate when we witnessed the familiar and distinctive “getting ready to go” ritual of final phone and bag checks, and the slight yet audible jiggle of an iced drink cup to check for last dregs, followed by a mostly air-filled suck of a straw for good measure.
Strategically positioning ourselves within swooping distance of the table, we were the first to lay claim to the newly vacated space, cramming ourselves onto the end of the bench, we were able to make room for 1.5 people into two. The buzzer started vibrating and during my husband's brief trip to grab our food, I had to politely decline two separate diners who were ready to scoot up next to a stranger if it meant a slither of real estate upon which to balance their tray.
We sat in silence as we ate. I brought the fork up to my mouth in a repeated action that was nothing more than a necessary motion that preceded the immediate goal of crawling back into bed.
It had been hours now since I had discovered the bleeding in a chain restaurant bathroom. The hope that this could be some standard first trimester spotting felt distant and was undoubtedly fading.
A woman who was now sitting opposite us turned around with a scornful expression. Someone had accidentally brushed past one of the shopping bags she had lined up at the end of the row, taking up space that could have comfortably seated two other people in the busy evening rush. Scowling and staring at the “offender”, scoffing and tisking, she never let the scorn off her face the entire meal, after which she promptly got up and left all her garbage from a vendor outside the food court strewn haphazardly over the table and encouraged her two teenaged daughters to do the same.
Back at the apartment, my energy extended only to staring at a TV screen and making increasingly frequent visits to the bathroom. It seemed I had been far too optimistic when I had purchased sanitary products for a light flow on our way home from the day's sightseeing that had been abruptly halted from the moment I exited that bathroom over a late lunch and tearily blubbered, “I'm bleeding” to my husband, who knew exactly what I was fearing.
Overnight my body was somehow tuned into this and had me bolting upright several times throughout the night to go to the bathroom. When I got up at around 4am, the bleeding had subsided significantly and there was this moment when I tried to imagine this ending with a doctor's assurance that this was the kind of bleeding that is common for some women to experience during early pregnancy.
A little while later, my eyes shot open. As I made my way to the bathroom, I already knew that the 4am reprieve had only been short-lived. That slow shuffle to the bathroom as I cradled my stomach with my hands, felt like a long, knowing march toward heartbreak. Like when you feel bad news is coming and you're hanging in that moment between that internal knowing and those words actually passing someone's lips.
When I finally reached the bathroom, there was absolutely no doubt in my mind that our baby was gone. The hope that I had clung to just hours earlier having now drifted out of reach. I sat there, crying so hard that I was making no sound. Eventually I ended up on the bathroom floor, head resting on my knees, feeling a debilitating sense of grief and anxiety, while staring at the cold, white tiles as if I was void of any emotion at all.
When I emerged from the bathroom, my husband awoke and asked if I was OK. I just shook my head and the tears came again. He shot up in quick understanding and held me as I started involuntarily rocking back and forth on the sofa and the emotions cascaded over my body.
It wasn't supposed to be like this
Our trip to Taiwan for our 10th wedding anniversary had promised to be a highlight of the year. Two weeks of low-key exploration, amazing night market food and perhaps even a few beach days before heading into Tokyo's winter.
Added to my excitement was the fact that I was expecting our first child and planned to tell my husband on our wedding anniversary, four days into our trip. It was a secret that had been hard to keep, but the timing felt too perfect to burst out with the news beforehand, especially now that I had made it to just a mere few days' away from our anniversary date. Little did I know that once I did tell him, this time to share in the happy news together would be limited to just over a week.
We were now at the end of our trip and scheduled to fly back home to Japan the next day. But instead of exploring Taipei and enjoying our final full day of our holiday, we were now in the emergency room.
The emergency room
The triage doctor didn't know the word ‘miscarriage', but living in a country where I'm constantly working to communicate, I was already prepared with a translation of the term on my phone, pulled up after the word 'emergency room' that we'd used to communicate with the taxi driver.
There were a number of different translations including ones that were more along the lines of ‘miscarriage of justice' but I guessed that the first entry was the one I was looking for, since it had the character for “flush” in it. I recognized it as it's a character that is also used in Japanese. My hunch was confirmed when their follow-up question was, “Are you pregnant?”
After taking down information about my symptoms, and personal details, including my blood type, height and weight, and checking when I was scheduled to depart Taiwan, they added a wristband to my attire and I was admitted. I was seen by a doctor who recommended I have blood taken and then a sonogram in gynecology.
The battle for blood
Let it be known that I absolutely loathe blood tests. Nine times out of ten it's a huge problem getting blood out of my tiny, uncooperative veins. Two nurses were attending to me and neither could get blood out of the crook of my inner arm. They kept moving the needle around inside me until they had spanned a full 180 degrees. They looked at each other puzzled, and eventually gave up, looking to the top of my hand for better real estate. One, two, three, pain. Pushing and reinserting, swiveling, readjusting, and still we were no closer to drawing the vials they needed.
I hadn't been looking any of this time. Instead, I tried to close my eyes and breathe. The stings kept coming as they continued trying to draw blood. My mind started wandering and somehow jumped to the worst places, like them telling my husband I hadn't made it and him returning to our Airbnb without me.
The next thing I knew my eyes were half open and everything was this odd muted yellow, alarms were going off from the machines beside me and half a dozen doctors and nurses in scrubs rushed around me, yelling in Chinese. A hospital bed came rushing in at great speed and the metal bar was quickly pushed down on the side closest to me, among more urgent calls.
I didn't need to understand Chinese to feel the sudden change in tone. At this moment, I find it hard to put into words just how scared I was. I honestly felt that my life was in danger and all I could think of was my husband in that waiting room. Was this really going to be the end of my story? Petrified and alone in a foreign Taiwanese hospital with pregnancy complications. Of all the amazing places I had been, all the adventures I had taken, all the things that people always told me were “too dangerous,” was it going to come down to the one thing that people had been telling me to do my whole life?
I could feel the surge of adrenaline, which helped me suddenly move towards the bed as the nurse hurriedly grabbed me and tried to lift me onto it. I was on and then made to turn around as it seemed they wanted my legs on the head of the bed so that they could be elevated. I was pushed only a matter of meters, right up into the adjacent wall where I was promptly attached to various monitors and the quest to get that needle to take continued.
Everyone around me tried. They had tourniquets around both my arms and several medical personnel were flicking my veins up and down. In my peripheral vision, I could see that the staff kept rotating on the stool beside me, as each one tried a different point and failed. They had just tried the side of my wrist, at a painful point over the bone, and were starting to inspect my ankles when a doctor who had been called in was able to draw blood from the original crook in my arm and get an IV in. I was asked for my name. I answered. Then suddenly the doctor said, “It's over now. You can relax.” I nodded.
The doctor who I had seen earlier was also called and encouraged me to relax. “I'll try,” I told him. The nurse beside me said that was, “blah blah blah blah dystopia.” Well, that's all I could make out and maybe even that last word wasn't right. “What's that?” I managed to mumble. “It's hard to explain.” She thought for a few moments. “Basically what just happened was out of shock or fear, and usually once you have your legs up, you start to feel better.”
I was told that I was being moved to another part of the hospital. I was given a bed number, which was attached to my bed railing and I was moved into the hallway. I turned to the nurse and asked her if she could find my husband for me. Unable to locate him, I knew that she was probably making the assumption that my husband was Caucasian. I explained in the simplest way I knew how, “He looks Chinese but isn't Chinese.” She peered over again. “With sunglasses?” she asked. “Yes, that's him.”
Despite my previous explanation, soon she was at the head of my bed speaking Chinese to my husband who is used to being spoken to in all manner of local languages on our travels, thanks to an appearance that can apparently pass for a variety of different ethnicities. “You don't speak Chinese?” Switching to English, “She has to rest here for a while.”
After a little time had passed, the original doctor came by to see if I could walk, then I was escorted round the corner to gynecology, with my IV bag in hand, as instructed. The gynecologist seemed instantly unimpressed. “Where's your IV stand?” “We weren't given one,” I responded. “Well, you need one.” My husband was sent away to go track down a stand. Later, we'd be able to see the comedy in him being taken to a back storage cupboard to retrieve one and passing patients who were all carrying their own IV bags, too. “Guess they weren't given one either.”
My husband came back just in time for the intravaginal sonogram, divided from me by a curtain. The doctor unceremoniously started the sonogram, pushing from side to side, and I remembered thinking how painful and uncomfortable it was. I was looking straight ahead until she made me look at the screen. “Look. Look at this. Your uterus is empty. There's nothing here. You've had a complete abortion.” She removed the device and told me to get dressed. “You can try again from your next period.” That was it. Matter-of-fact and emotionless. How I yearned for just a fraction of kindness in her voice, for her to show the tiniest amount of recognition of the emotional pain, for just those two small words, “I'm sorry.”
The next day
By the following morning, the bleeding had increased considerably. It had now reached far beyond any period that I had ever had and I started to get a little scared.
While there wasn't evidence of it, the Taiwanese doctor had said they hadn't been able to rule out ectopic pregnancy (when a fertilised egg implants itself outside the womb, usually in one of the fallopian tubes, making the pregnancy nonviable and potentially causing life-threatening complications) and I was concerned that the bleeding was getting worse, rather than better with time.
On the metro to the airport I told my husband that I was considering taking the medicine I had been given to stop the bleeding sooner. While I originally intended not to take it and just let things happen in their own time (and I was reassured that in either case it was fine to wait until my scheduled appointment on Wednesday to be re-examined in Tokyo), I didn't want to have to deal with the bathroom every 30 minutes on the flight. Plus the doctor had strongly recommended taking it anyway to alleviate my symptoms. So I decided to start the course of treatment right then and there in the hope that it might make the journey back home a little more comfortable.
We arrived at the airport, checked in and sat down to quickly eat our lunch boxes we had gotten in town. During the second half of my lunch, I could already feel my body was rejecting food, like it was the last thing it wanted, even though I had felt hungry not too long earlier.
My back and abdomen were starting to hurt and I wanted nothing more than to just stay where we were, but we still had to return the Wi-Fi router in the arrivals hall and then make our way through security. I was now needing to purposefully breathe through the pain.
The security lines were incredibly long and they seemed to be trialling some new automatic immigration system, whereby people with children went one way and people without children went another. Everyone was confused in the non-child lane because it asked you to slide in your passport and then put your index fingers on the panel for scanning, but apparently they wanted us to skip the passport step and only do the finger scanning. Immigration agents were coming by to each person one-by-one to explain this and it all seemed to take twice as long as a manual system.
I had already started tearing up from the emotion of the past 48 hours and the pain and anxiety of not knowing what was happening with my body, as we quickly tried to bundle the items we took out for the security inspection back into our carry-ons.
Now with the delay at immigration we were cutting it fine for our flight, and our LCC was departing from one of the farthest gates. The last thing I wanted to do at this moment was rush, but I booked it and we made it to the gate with two minutes to spare.
On the airplane
On the plane, I had to face the reality of returning home without our most precious cargo of all. The pain had grown to an intensity that I had not experienced in my life and the bleeding was now at unparalleled levels. I was in agony.
Annoyingly after rushing to make the flight, the plane sat on the tarmac as we waited for three Japanese passengers whose seats were in the row in front of us. Some time later, they sauntered on laughing hysterically at how they had held up the flight and then proceeded to spend the flight drinking and reacting so obnoxiously to each others' immature banter that the woman in front of me kept repeatedly banging up against the back of her seat in her fits of laughter.
For the first half of the flight, it was a battle with incredible pain, the constant banging on my knees from the seat in front and trying not to panic. It was like waves of pain that came one after the other, after the other. Somehow, finally, I had dozed off to sleep and when I woke, the pain had dissipated.
Am I cut out for childbirth?
Back in Tokyo, I continued to take the medicine as prescribed, three times a day. The next morning after taking the medication, I again had the same horrendous pain and the bleeding was just as bad, if not worse, than the day before.
I couldn't understand why it hurt so much and I kept feeling the urge to push. I sat hunched over on the toilet with my head rested on the wall in heartbroken and confused despair, and I started to think that the pain was directly linked with the medication.
The pain had been so severe that I started questioning whether I was cut-out for the physical duress of childbirth. I had always considered myself to have a relatively high tolerance for pain. But if I was struggling to handle this, how on earth would I be able to cope with the physical pain of labour?
I started Googling how miscarriage pain compares to labour pain. I delved into forums of women before me who had experienced a miscarriage and questioned the very same thing. I know that getting medical information from the Internet is not always the soundest advice, but I wasn't on an uninformed quest to self-diagnose – I already knew that I had miscarried – and I wasn't looking for a definitive answer to my query as I knew that it would be different for everyone.
But reading stories from other women who had experienced pregnancy and pregnancy loss, far from sending me down an Internet spiral of despair or “worse case scenario” panic, was the exact kind of reading and sense of female camaraderie I needed as I lay in bed trying to comprehend it all.
I honestly went into the search expecting to find what I thought I knew to be true, what I had been conditioned to believe to be true. That of course labour pain was going to be a million times worse than the physical pain of a miscarriage. I mean, who was I kidding to hope that they could be even remotely similar?
That's what we see in mainstream media all the time. In movies and TV shows, we see labour as the gruelling physical process of a pregnancy and miscarriage depicted almost purely as an emotional one. Something goes wrong with the pregnancy, the woman goes to a doctor, is told the unfortunate news and now she's sad. Cue to said woman being brought a cup of tea at home and grieving. There is virtually no mention of what your body goes through physically during a miscarriage and just how long that physical process can take.
What your body goes through during a miscarriage
Once a miscarriage starts, it usually takes about 1-2 weeks to complete. Just like a full-term labour, this can happen faster than average for some women and much longer than average for others.
Physical symptoms usually include heavy bleeding and cramping, and as I found out can also include contractions and dilation of the cervix, just like in labour, yet this is often glossed over or not even mentioned, which I'll get to in a little bit.
There are various types of miscarriage and pregnancy loss, and the recommended treatment will depend on what type of pregnancy loss you are experiencing, how far along you are in the pregnancy and what is in the best interests of your health and possible future pregnancies.
Some women experience a spontaneous miscarriage with immediate or near immediate physical symptoms, and others may have a ‘missed miscarriage' in which the baby has died and stayed in the uterus, and physical symptoms of a miscarriage are delayed. In such cases, the fact that the baby has stopped developing is often only detected during a routine scan or when physical symptoms arise later on.
Deciding on what to do next brings its own stresses. Some women prefer to allow nature to take its course and wait for physical symptoms to start (or continue if they have already started), a process that may take days or weeks, and others choose to have the contents of the uterus medically removed in order to expedite what is already a traumatic experience, or because it is medically recommended to do so.
There are two kinds of procedures – a D&C (dilation and curettage) used in first-trimester miscarriage and D&E (dilation and evacuation) used in later-term miscarriages. Both D&Cs and D&Es involve dilating the cervix and clearing the uterus of pregnancy tissue.
Doctors will usually honour the wishes of the mother either route if it will not endanger her health, but even women who choose to try to miscarry without surgical intervention as their first choice, may end up needing one of these procedures to successfully complete a miscarriage.
In my Internet search, I was amazed to read that many who had experienced a miscarriage(s) and a successful pregnancy (or several successful pregnancies) said that their miscarriage(s) physically hurt at least equally to full-term labour, if not more, and in some cases “a lot more.”
Some said that they felt it physically hurt the same or a little less than their labour(s), but because of the emotion attached to a miscarriage, they felt that the experience was “much worse.”
Many of those women said that although labour was excruciating, they believed that knowing the pain was going to result in meeting their baby at the end, helped them keep working through the physical duress of labour.
In their miscarriages, they described the complete and utter despair of knowing that working through the contractions was “all for nothing” and the heartbreak of passing the gestational sac and their unborn baby, more often than not, alone over a toilet bowl.
Others said that in their experience the pain was not as great as the final stages of their full-term labours, but there was quite a lot of consensus that the pain of miscarriage contractions was similar to the early and middle stages of labour. Interestingly, a number of women across a variety of sources said that if they compared their miscarriages to their successful pregnancies, they would rate the pain as being equivalent to 6cm dilated. I found the specificity of that observation quite interesting.
Lots of women described their miscarriage contractions, not as multiple contractions, but as one long contraction with no breaks in between. In this sense, they said it can feel like the final stages of labour, when the contractions are so close together that they are basically “on top of one another.”
The pain is generally concentrated in the back and lower abdomen rather than in the back and stretching right across the belly because in the earlier stages of pregnancy the embryo/fetus and pregnancy tissue that your body is trying to expel is obviously not taking up as much space.
This all made complete sense to me. I was instantly taken back to the airplane the day before and the waves and waves of pain that didn't stop, how the pain was so bad I couldn't speak, the strange oscillating movement in my back, a feeling I had never felt before, and the pain in my lower abdomen. The latter I had been feeling at tolerable levels since the bleeding began, but intensified significantly after I started taking the medication on the way to the airport.
So, I was actually having contractions?
I sat in bed completely astonished reading this. None of the doctors or nurses at the hospital in Taiwan mentioned anything about these potential symptoms. I was told that I would likely bleed for about one week and that I may experience some cramping. They explained it as a “heavy period.” Nobody mentioned about contractions and labour-like level pain.
What didn't add up for me about my experience and what I read from other women was the huge physical relief many described after passing the gestational sac and the embryo/fetus. They described the pain almost immediately dissipating and the bleeding stopping, too, or at least soon after.
I was confused.
I had passed the gestational sac early Sunday morning before going to the hospital in Taiwan. I'd had a sonogram and the doctor said that the gestational sac was indeed gone from my uterus. She had declared it a ‘complete abortion.'
It was now Tuesday afternoon and the bleeding had become worse, not better, and I was having these intense bouts of pain that lasted 1-3 hours at a time, seemingly these long contractions that everyone was discussing. If there was “nothing in my uterus at all” like the doctor in Taiwan said, and if the medication was to “stop the bleeding,” why was I continuing to have these symptoms?
Putting the pieces together back in Tokyo
The next day, we went to see the OB in Tokyo as scheduled.
It was the day I had been so looking forward to just a few short days earlier. It was the day we'd get to see our baby on the monitor for the first time, and with my husband finally clued in on the news, we could get excited about it together. I couldn't wait to get the photos and the DVD from the sonogram, and for everything to start feeling “real.”
Instead, I was now in the waiting room writing notes on my consultation sheet to inform the doctor that although I had made the appointment for pregnancy, I had since miscarried, or should I say ‘was miscarrying'.
The form, which was also for women going to the clinic for non-pregnancy gynecological check-ups, took me much longer to fill out than it should have, each simple question prompting me to pause and leaving me unsure what to write. “Have you ever been pregnant before?” Well, no, not before this time. But now that my first pregnancy had ended in miscarriage it was technically, yes. I guess I should just write ‘no' though? I ended up skipping the box answers and just writing, “This was my first time to be pregnant” as an addendum to my previous explanation about the miscarriage.
When I walked into the consultation room, the doctor had clearly read my notes already because after introducing herself she skipped all other questions and simply asked, “Are you still bleeding now?” “Yes,” I confirmed. “I'll need to do an intravaginal sonography to take a closer look.”
On the monitor, instead of seeing our developing baby, we saw my uterus void of the gestational sac. This wasn't a surprise, just a painful repeat of what happened in Taiwan. However, it was far from “empty” as the doctor in Taipei had described, the Japanese OB pointing out a large blood clot and remaining tissue.
This was now a full three days since I was in the emergency room in Taipei and, without trying to be too TMI, in that time I had passed blood clot after blood clot, along with tissue. If there was still pregnancy tissue remaining now, after three days of the heaviest bleeding of my life, how on earth did the Taiwanese doctor conclude that my miscarriage was complete?
“If you continue to bleed ‘this much' I might need to do a D&C to extract the remaining tissue.” “Under anesthesia, of course,” she added. “Let's wait one week and make a decision then.” Back in the consultation area, the doctor said she was going to prescribe more medication, asking me how many tablets I still had left from Taiwan.
While she was doing her paperwork, I had the chance to confirm what these tablets actually do, since the answer I had gotten from the Taiwanese doctor did not seem to align at all with my actual experience, and of the forums I had read most women didn't mention about medication or the precise names of anything they had been prescribed.
“They're a contraction-inducing medication. This is a very important process for your body to go through after a miscarriage.” “We use the exact same medication in Japan so I'm going to prescribe you another 7 days' worth.”
All the pieces of the puzzle were clicking together. What I had read from other women the day before about having contractions when miscarrying, and my own personal observations of the sharp increase in pain being connected to the medication. Of course, I can't say that I was 100% surprised based on my previous day's reading. I'd already substantiated that contractions were definitely part of the miscarriage process for many women out there, but I still hadn't been able to conclude anything for certain about the link to the medication.
Until now, these were just general observations I talked to and texted my husband about, and I didn't have full-scale contraction episodes every single time of the three times a day I had to take it, which further added to the confusion about my hypothesis.
So when the Japanese doctor told me outright the purpose of this medication, it was as if a feeling of utter disbelief washed over me, that increased in intensity over the seconds in which those words came out of her mouth and the realization that what I had been told in Taiwan was in fact not the full picture, sank in.
While technically true, saying that the medication “stopped the bleeding earlier” instead of “causing contractions” and even heavier bleeding in order to hopefully expedite your body's natural process and hence completing the miscarriage sooner than if you didn't take the medication at all, was indeed a very important distinction to make.
What people don't understand about miscarriage
What I've learned about miscarriage is that although common, it's rarely talked about openly and because of this there are a lot of misconceptions about it.
While I don't claim to speak for every woman and every miscarriage experience, this is what I learned during mine and what I wish people knew about it.
You don't just go from being pregnant to not pregnant
What people often fail to understand about miscarriage is that you don't suddenly go from being pregnant to not pregnant simply because something has gone wrong with the pregnancy, you still have to birth your unborn child one way or another.
Sure, you don't have to push a full-term baby out, but your body needs to “go through the motions” of labour in order to clear the uterus of pregnancy tissue, whether that's achieved through natural means or is medically assisted.
And your body can still think it's pregnant for a little while, even when you're not anymore. The urine tests I had to take at my follow-up appointments in Japan still brought back a positive pregnancy result more than a week later. It can take some time for those hCG hormones (produced in pregnancy by the placenta after implantation) to drop to reflect a non-pregnant state.
Miscarrying is more than an emotional experience
Most people understand that there is an emotional side to miscarrying (which is probably why most people avoid bringing it up if they know someone has experienced one).
But there is virtually no mention of what your body goes through physically during a miscarriage and just how long that physical process can take.
Which takes us to the next point.
Yep, as I personally discovered, symptoms can range from bleeding to cramping to full-on labour pains – including contractions, dilation of the cervix and the urge to push… Yet we're simply told to go home and deal with our “heavy period” – the preferred term medical practitioners like to use for what happens during and while you complete your miscarriage.
In my case, I had contractions for a week after I started the medication, each one lasting from between 1-3 hours (yes, hours!) without break, until my uterus was clear of the blood clots and pregnancy tissue, and this was after I had already passed the gestational sac.
Yet many of these symptoms are glossed over or not even mentioned at all, even by medical professionals charged with your care.
Like many others, I had to discover I was having contractions on my own
Like many others before me, I had to scour Internet forums to find out about the contractions because any discussion of them was notably absent from my ER visit, as well as my follow-up clinic visits.
I read one woman's account in which she said she asked the hospital staff point blank about why she wasn't told about the contractions, to which they simply replied, “We didn't want to scare you!” Let me tell you, nothing is scarier than randomly experiencing “labour” out-of-the-blue.
The “heavy period” euphemism isn't helpful
Here's the thing, medical practitioners:
As women, we are no strangers to seeing blood. We have to be crimson warriors every few weeks and/or deal with managing our cycle for decades of our lives. The grief of losing a child aside, you're unlikely to scare us with the physicality of vaginal bleeding. No matter what your usual flow or menstrual symptoms, we get it. We understand periods.
Bleeding from a miscarriage may or may not be heavier than you experience on your usual period, you may have intense cramping that you may or may not already experience on your usual period, but you're still just describing it as another kind of period.
Glossing over miscarriage as a “heavy period” and omitting other common potential symptoms like contractions is not only not helpful, especially when you send women away with medication that is to induce that very process, it's downright irresponsible.
On the airplane, I had nowhere to go. There was no place for a private moment. I couldn't exactly lock myself in a tiny and dirty bathroom cubicle for the entire flight, and who would want to. I could barely move in my seat, let alone get into any position that might help me cope with the pain. I tried to breathe and not draw attention to myself, as I fought back the tears.
Not only was I still trying to deal with the shock of losing our baby, now I had no idea what was happening to my body physically. Why was it hurting so much? Was I experiencing some kind of complication? Why wasn't the medication helping at all?
Sure, knowing about what was happening to my body wouldn't have stopped the pain, but it would have made a world of difference to my entire emotional and mental state. I wouldn't have been caught off guard by it. I wouldn't have worried the entire flight and thereafter that I was descending into some kind of medical emergency.
If I had known that these were contractions, my high levels of pain would have been explained, my mind would have known what was happening, no matter how unpleasant, and I would have been able to focus on working through a pain that I knew was normal to be having right now.
While I never expected that the bleeding or pain would suddenly stop, I also didn't think that the medication would escalate my symptoms. Worse case scenario, I thought it wouldn't (immediately) do anything (or at all) and I'd have to get through the flight with my existing level of discomfort. I thought I was making an informed choice about my health.
If I had understood the process, I could have postponed starting the medication until I was home in Tokyo and laboured in the privacy of my own home and bathroom.
That's not to mention that a “heavy period” can also downplay the totality of the miscarriage experience for many women, with those around them thinking it's “not that bad” because, don't we go through a version of this every month anyway?
It's time to acknowledge that not every woman having a miscarriage will encounter mild physical symptoms, and it's time to be upfront about it.
You're walking around with an invisible condition
Back in Tokyo, with contractions coming at me at varying times and with varying levels of intensity, and knowing that the medication I needed to take three times a day to complete my miscarriage was actively inducing them, meant that I was forced to take the rest of the week off. I felt guilty about it, especially as I had taken the two weeks prior off for our trip, but there was no way I was able to work on a set schedule or function in any professional setting.
One of the hardest parts was knowing “how to be” in society for a while after that. Being asked about Taiwan and everyone saying how lucky I was to take the trip, and then because I had suddenly taken the extra week off people asking “What happened?” multiple times a day.
On the way home from the Japanese doctor's office, I only had a 30-minute train ride to get through but the contractions had started again. I ended up having to get off the train 10 minutes in.
During the total of 5 minutes I was in one of the bathroom stalls (I know because I made it on the very next train service), a woman make a loud 'tisk' and then said “Nagai” in an irritated voice. This simply means “long.” In this context, “Ugh. They are taking so long.”
She banged on the toilet door quite aggressively, as if she was using her fists rather than her knuckles. The only thing I could think to reply was “Sumimasen.” “I'm sorry.” To which she snarkily resumed her conversation with her friend. “Oh, so there is someone in there. Just taking their sweet time.”
This is perhaps one of the more unassumingly difficult parts of a miscarriage and I'm sure people with invisible conditions get it all the time. Others simply assuming you're doing something selfish or to inconvenience others when using public facilities. Even in my hurried need, I had checked that this bathroom had more than one toilet stall, so despite getting agitated that she couldn't go into one immediately, she and her friend were not still waiting in line when I exited. In fact, no one was.
I felt like I wanted to walk around with a sign that said, “Please give me a moment. Just trying to miscarry over here.” Maybe then people would give me a break and not make me feel worse than I already did about needing an extra couple of minutes here or there, or allowing me to sit on public transportation.
Your reaction to someone's miscarriage is important
And this comes to perhaps the biggest problem – that miscarriage, despite occurring in 1 out of every 4 pregnancies – is still shrouded in secrecy and shame. I'm not saying that every woman has to shout it from the rooftops. I believe that everyone has the right to deal with their pregnancy loss in a way that works for them, and I completely understand that some people do that by not speaking about it or not speaking about it for a long time.
But we, as society, need to get a hell of a lot better at reacting to it when women (and their partners) do speak up about their loss(es). Like the doctor in Taiwan, the Japanese doctor also didn't think it necessary to express any kind of sympathy, only matter-of-factly stating the situation from a medical standpoint. Apart from a couple of understanding messages of support from friends (to which I hold so dear), overwhelmingly the other people I had selectively shared the news with preferred it wasn't mentioned at all and the words I so desperately longed to hear – simply “I'm sorry” – didn't pass their lips.
At best, they got visibly uncomfortable or just didn't respond, and the worst reaction I got was a look of utter disgust followed by an, “Ewwww, why are you even telling me this?” This is coming from someone I have known for a long time, is a parent themselves and has shared many of their personal topics with me over the years. It wasn't long before I stopped telling people entirely and dealt with my grief in silence.
The grief doesn't just “go away”
The emotional pain doesn't “disappear” once the miscarriage is complete, you just learn how to carry it in ways that help you carry on. You're simply left with a due date that never happened and no one ever acknowledging it, and a fear of history repeating itself.
Now that I am in my second pregnancy and even though I have reached full-term and am now waiting for our baby's arrival, I can tell you that even when you are so far along that many consider it “safe”, the anxiety never fully leaves you.
Every time you go to the bathroom or feel a slight cramp. Every time the doctor or midwife puts the doppler on your stomach and they don't hear the heartbeat right away. When you may be close to delivery but there's always the chance of late-term pregnancy loss, of some complication before, during or after the birth, then of Sudden Infant Death. You feel just one medical practitioner's sentence away from the worst of news. Everything being fine in one moment until it isn't.
Don't get me wrong, we are elated and incredibly grateful about this second chance at a successful pregnancy and we are putting all our energies behind a positive outcome. But this happiness, as joyous as it is, doesn't take away from the previous loss, and it's important to acknowledge that, and talk about it. Even if other people don't want to hear it.
I always knew there was a time for me to speak up about this, even when I had decided not to continue sharing the news in my personal circles. It was a matter of choosing where to place my energies and when.
Now I'm ready to share my story and I hope others are willing to listen to many others like it. Because women are silently grieving all around you and I for one expect more than an ‘Ewwww'.