The Products of Conception by Alyssa Craig
“I think, There is death inside me”
A missed miscarriage is when embryonic death has occurred but there is not any expulsion of the embryo. It is not known why this occurs. Signs of this would be a loss of pregnancy symptoms and the absence of fetal heart tones found on an ultrasound.
-americanpregnancy.org
Everything starts to snowball Afterward, when I’m sitting in the bad-news room and she has returned for the 3rd time to see if we’ve made a decision. Where Ernie hands me a tissue and strokes the back of my hand with his thumb. Where he tucks me into his shoulder and says nothing.
Last night I had a terrible dream where I bled all over the place and no one would help me. I shook my slicked hands, pleading to everyone who passed by. I woke up sweating and panicked, groping around in the sheets. There wasn’t any blood.
This morning I had to pee the minute we stepped into the big brick building, but we were running late. I focused on that rather than seeing what I knew, what must have been plain on the screen in the examination room, if you knew what to look for.
After, I was able to relieve myself. An expressionless woman led us to a small room in the back of the office furnished with two plush leather chairs and a large, darkly-stained desk supporting only a jar of hard candy, a fleshy-pink begonia and a box of tissues.
I sighed. “This is a bad-news room.”
Ernie squeezed my hand. “You don’t know that.”
But I did know it.
It took forever for the doctor to come in with her thick manila folder and sit down across from us at the big desk. “I’m so sorry,” she crooned in an accent I couldn’t quite place. I didn’t hear her other words. They were clinical, but her expression was not.
When she left the bad-news room I realized I was clutching Ernie’s arm, white knuckled and shaking, unable keep the tears in my eyes. “What the fuck,” I whispered.
She came back once because she forgot we were there and then again to suggest an exit strategy.
And now here we are, sitting across the desk from her, spiraling. At first I refuse. I cannot make this decision. I am not ready.
“Right now it’s an elective procedure,” she assures us. “It’s just that most people would rather get it over with.”
At home Ernie plays piano for a while and then pours himself a scotch. I call into work for tomorrow and the next day. I need to think. I have a few glasses of wine because I can now. Before bed I don’t take Crinone, my “daily dose of hope.” I won’t miss it. Instead I look at the box before sliding it under the bed, to be ignored with the dust of years spent too lazy to move the bed and vacuum.
If you’re an aspiring mother, you may need help fulfilling your dream. When you need hope, support, and convenience, there’s CRINONE®. Containing the natural female hormone progesterone, CRINONE® helps your body achieve and maintain pregnancy, so you can look forward to life’s next steps.
+ + +
I spend the next day in bed while Ernie argues with the lawnmower. I have moments when I picture a small creature, distorted and dormant. Other times I picture my grandmother’s face when I saw her in the emergency room, blank-staring and slack-jawed, a line of spittle bridging the gap between her lips.
I think, There is death inside me. I want to claw it out.
I wake up in the middle of the night with my heart pounding and feeling like I’ve misplaced something important but I can’t remember what it is. I reach over and clutch Ernie’s cold pillow.
I get out of bed the next morning famished and feel like vomiting all day. I want this to be over. I am afraid of what will happen if my body catches on and deconstructs our project on its own. The doctor explained the possibilities, that the longer I dally the worse it will be when it does happen. I’ve been through that before. I know what it’s like, only this time it’s gone on for longer. Every day I wait will mean more pain, more blood. I am terrified.
+ + +
A few days later the doctor calls to see how I am doing and if I’ve made a decision. I tell her I’m ready to go through with it, but I don’t want it to be “voluntary.”
She says the only way it isn’t voluntary is if it’s an emergency. “Are you bleeding at all? Are you having any pain?”
“No,” I say.
She gives me a phone number and tells me to call on Tuesday. She tells me to lie. “Don’t eat anything after breakfast. When you call, tell them you are having pain,” she says. “Tell them you bled a little bit. I will fit you in.”
I am torn. I don’t want an elective procedure, but I don’t want to lie either. I don’t understand why there are no options to make this less painful than it is. I don’t understand why there is no right thing to do.
“Just see how you feel. You can always not call,” Ernie says when I ask him about it.
But I know that I’ll call. We’re going to a wedding on Cape Cod in a few weeks and I want to be able to dance. It’s completely selfish and I am glad; I want to be able to hate myself for being so totally, unabashedly selfish.
+ + +
Tuesday comes and I feel numb. I go to work at 7:00 and stare blankly at my computer. At 8:15 I have a bowl of oatmeal with brown sugar and raisins and a cup of British Breakfast tea. At 8:45 I call the number and leave a message. I say I’m having some pain and that there was blood this morning when I got up. The phone on my desk keeps ringing but it’s never the office calling back. By eleven I am ravenous and queasy. My head throbs. I can’t keep up with my work. I close my office door and turn off the lights. I rest my head on the desk.
At 12:15 the call finally comes. “Be here by 1:30,” the voice says. “Don’t eat anything.”
Twenty minutes later I leave the office, plastic smile plastered on my face. “I have a doctor’s appointment. I’ll be back in a little while,” I lie.
I go home. I change into jeans and a t-shirt. When Ernie pulls up I get into his car. He drives the scenic way, along the river. We hold hands and don’t say much.
When we get to the hospital it occurs to me that I have no idea where to go. A young nurse greets us at the door and walks us to a cubicle. A short-haired, animated woman sits there, tapping her pen on the desk and looking at her computer as though it were a question mark. She is surrounded by thank-you cards and photos of children. A clear vase of calla lilies sits on the corner of her desk.
We sit in front of her on hard plastic chairs. She takes my information down and looks at my driver’s license and insurance card. She asks the reason for my visit. Her expression changes when I tell her why we’re here. She says kind things. She’s had practice. She places a band with my name and information on my right wrist.
We walk around the corner and down the hall to an elevator. We descend three floors and when we emerge it feels like we are deep underground. What is done down here is kept hidden. Down here I cannot be judged.
A nurse greets us and has us sit in a waiting area. There aren’t enough beds. “The doctor is running a little behind; there are a lot of births happening today.”
I think about how unfair it is that my departure is delayed by their arrivals. I watch a soap opera on the waiting room television for about an hour. I notice that one of the actors is a girl I went to high school with. She’s on a yacht and in some sort of peril. She runs across the deck to the rail, cups her hands around her mouth and calls out, brow crinkled in worry. She is alone on the boat and no one can hear her shouts.
Finally they call my name. We rise and follow a nurse to a murky blue room with a peeling forget-me-not border. There is a stretcher, a small table and a green vinyl armchair. I change into a gown and get under the covers. The nurse comes back and asks questions.
“Have you ever been under anesthesia before?”
“No.”
“Number of pregnancies?”
“Two.”
“Number of living children?”
“None.”
I cannot look her in the eye.
After she leaves another nurse comes in and introduces herself to me. She is awkward and spits when she talks. She isn’t sure what to say to me, whether she should make jokes or keep quiet. She decides on jokes. I wish she would shut up.
She needs to set up my IV and I make the mistake of looking at the needle. It’s bigger than I was expecting. I gasp a little and look away.
“I’m sorry,” she says. “I’ll just do this real quick.”
She ties off my right bicep with a blue tourniquet and flicks my forearm. I have bad veins.
“Hmm,” she says. She swabs the crook of my elbow with an alcohol wipe.
I look at the floor and hold Ernie’s hand. “Squeeze as hard as you need to,” he says.
The needle jabs and rolls under my skin. She can’t find the vein. I suck my breath in through my teeth.
“I’m sorry, sweetheart,” she spits on my arm. “I’m going to try again.”
She moves down my arm, swabbing and stabbing. Hot tears roll down my face. I can feel Ernie’s skin under my nails.
“I don’t want to do this,” I say.
“I know,” he soothes.
“I’m going to have to try the other arm,” she sprays, pulling the needle out for the third time and releasing the tourniquet. I am bruised and bleeding. I am covered in gauze and paper tape.
“I don’t want to do this,” I say again and sob. He strokes my hair. I am his pet.
“I changed my mind. I want to go home,” I cry. They both ignore me. I am the muted actress on the abandoned yacht. “I just want to go home.”
The nurse gathers her things and leaves without uttering a word or inserting my IV.
A few minutes later I stop crying. A different nurse comes in and inserts the IV, fast and painless, into the crook of my left elbow. She hangs saline and leaves, saying they will be in for me soon, once the doctor’s last patient has finished giving birth.
We sit in relative silence for a few hours. There’s no television to distract us and not much else to talk about. We play hangman on the back of a Walmart receipt with a golf pencil Ernie finds in his pocket. He adds facial expressions to the hung man when I guess all the wrong letters. Ernie laughs.
I don’t tell him that I have the coda from “Hang on to Your Life” echoing in my head. It used to scare me when I was a kid: Burt Cummings’ drawn out, spoken word psalm. It has stalked me through every moment I have been faced with demise.
They gaped upon me with their mouths,
as a ravening and a roaring lion.
I am poured out like water,
and all my bones are out of joint;
my heart is like wax; it is melted in the midst of my bowels.
My strength is dried up like a potsherd;
and my tongue cleaveth to my jaws;
and thou hast brought me into the dust of death.
+ + +
A while later a woman in scrubs knocks on the door. “We’re ready for you,” she says. She tucks my hair gently into a net.
I kiss Ernie goodbye and tell him, “I’ll see you soon.”
He says, “I love you.”
I hope he will have something to eat. I hope he will have someone to talk to.
The woman in scrubs wheels me around the corner and down a long hallway. She backs me into a white room with a metal table and bright lights. The doctor is waiting there with two men. They are all gowned and masked. They are speaking with their eyes and hands.
I slide from the stretcher to the table.
“How are you feeling?” she asks me.
“Scared,” I tell her.
“The worst is almost over,” she says. She introduces the two men: the anesthesiologist and her surgical assistant. I picture the assistant saying “scalpel” as he hands the doctor tools over my unconscious body. An oxygen mask goes over my face. Someone spreads my legs and slides them into long, warm leggings.
“These are kind of great,” I giggle. I am overcome by giddiness, by the absurdness of the situation. I don’t know what else to do so I keep laughing.
“Scoot your backside to the bottom of the table,” I am instructed and I comply.
Velcro straps are placed around my wrists, pinning my arms to the table. A large, white blanket is laid over my entire body. I start to taste plastic in the back of my mouth. Styrofoam. Band-Aids.
“Something tastes bad,” I say, my voice muffled by the mask.
“That’s the medicine. In a minute or two you’ll be asleep,” says the anesthesiologist from somewhere behind me.
“Where should we send her, Tahiti?” the doctor asks, placing my feet into stirrups.
“Tahiti is nice this time of year,” say the anesthesiologist.
“I’m still awake,” I say. My heart pounds. This isn’t working.
“In less than 60 seconds you won’t be, so start thinking about your happy place,” says the doctor. She lifts the blanket, exposing my lower half.
Sixty seconds, I think. Yeah, right.
And everything fades.
+ + +
There are few images and sensations. I’m moved to the right. I look next to me and see a bed-pad soaked with brown blood. I feel warmth tuck around me and something is shoved up between my legs. I hear the squeak of the wheels on the gurney as I am transported somewhere else. The hair net is gone. The oxygen mask is gone. It must be over. I’m too tired to decide if I feel different or not.
For a while I lay there. I hear the repetitive, jarring beep of what sounds like an alarm clock. When I reach to hit snooze I realize I’m tethered by an IV and monitor leads. I remember where I am and put my arm down. I repeat this pattern every 30-60 seconds. Every few minutes my blood pressure is taken. The cuff squeezes my arm and my fingers tingle.
I’m moving again. I’m back in the room where Ernie is sitting in the plastic chair, rubbing his palms on his jeans. He stands and smiles when he sees me, but the smile does not travel to his eyes.
In my mind he asks how I feel and I tell him “empty.”
In reality he kisses my forehead and says, “I missed you.”
A nurse who does not spit comes in and says I can go home as soon as I can eat something and go to the bathroom. I eat a graham cracker and drink some apple juice. About fifteen minutes later I pee. With help I change back into my clothes and the new nurse removes the IV and gives me my discharge instructions. No work for 24 hours. No intimacy for 6 weeks. No swimming. No lifting, pushing, pulling. Hydrocodone every 6-8 hours as needed.
A wheelchair arrives and she takes me back up to the surface and out into the world. It is a different place now. The sun dips into the horizon, leaving stripes of orange and pink in the clouds. The air is thinner. Ernie pulls the car up and I get in.
I feel okay, but I’m really not. We go to CVS and pick up my prescription. Ernie asks if I’m hungry and I say yes. I must have fish fry. We look for a Long John Silvers. Each one we find has closed already, so we just go home. It’s 9:15. I go to bed.
The next morning I wake up around 10:00. Ernie is at work and I am completely alone. No one else knows what I have done. I’m groggy and have a headache. I head down stairs and drink water from the faucet, out of my cupped hands. I want coffee and get out my favorite mug, but my fingers don’t work right and I drop it. It shatters into 9,000 pieces. I walk across them to get the broom and sweep them up, then spend 20 minutes picking ceramic shards out of my foot.
I give up on the coffee. I curl up on the couch and watch reruns of My So-Called Life. It reminds me that when the guy you like sleeps with your best friend people will feel sorry for you. They don’t understand other kinds of heartache. They fear it; they fear you. They are afraid your sadness is contagious, a disease they might catch. They will go to great lengths to avoid looking you in the eye.
On Thursday I go back to work. I’m still exhausted. I spend a few hours trying to catch up on what I’ve missed. Every time I walk pain shoots through my abdomen. I take my temperature and it’s 101.7. I call the doctor and leave a message.
Someone from the office calls back around lunch time. A fever could mean infection so they want me to come in. When I go I have to sit for a long time in the waiting room. Swollen women and their partners come in and out with copies of ultrasounds and smiles on their faces.
My abdomen is burning up. The doctor is pretty sure it’s not an infection but gives me a prescription for an antibiotic—just in case— and a note to stay home from work the rest of the week.
When I get home I feel a gush and find bright red blood in my underwear. I’m tired and I ache in every way I can imagine. My breasts hurt. I’m still nauseous. The fever comes and goes and I take a hydro before bed. I verbalize my thoughts on the pervasiveness of the letter K. There’s Circle K, Big K, Kmart, Special K. I called my great-grandma Nanny K. Isn’t that weird? K is short for OK, alright, copasetic. When I fall asleep I do not dream.
+ + +
One day and two weeks later the doctor calls with results. Nothing was found and so there are no answers for us, no reasons why this had to happen the way it did. My blood work is fine. My organs are fine. There were no defects found in the products of conception. Those words, cold and sterile, make me want to reach through the phone and punch her. But I don’t have any better words to describe what it is I’ve lost.
Fuck you, I think. “Thank you for letting me know,” I say instead.
On Saturday we go to that wedding and we dance. I press against Ernie’s suit coat and he sips a Dark and Stormy over my shoulder as we rock back and forth, like a dinghy on roughening seas. I have moments when I forget, but mostly I just feel sad. I feel guilt. I have no idea what Ernie feels; he won’t tell me.
New research finds that couples who have experienced miscarriage or stillbirth are more likely to break up even years after the loss than couples whose pregnancy ended with the birth of a child. For miscarriage, or pregnancy loss prior to 20 weeks, the likelihood of breaking up is 22% higher than for couples who have a successful pregnancy. The rate of splitting up peaks between 18 months and three years afterward, before falling back to rates similar to that of other couples.
"At a time you would think you would be able to help each other, we were going totally separate directions…I was grieving. He was moving on."
-Wendy Becker, qtd. in USA Today
+ + +