Published on April 23rd, 2020 | by Cass Lewis0
Pregnancy and Loss in the Time of Coronavirus
Just as the coronavirus outbreak began in New York, I started experiencing flu-like symptoms. But I’d been pregnant enough times to recognize the specific type of nausea I was experiencing—I was queasy yet starving all at once. A home pregnancy test quickly confirmed that I was indeed pregnant again.
My husband and I were giddy. In the face of the approaching coronapocalypse we’d found something to be hopeful about. We hadn’t been trying that cycle, even though our five-year-old daughter had been relentlessly asking us to please make a baby (she was under the impression the process was similar to a modeling clay kit, in which you roll various colors into certain shapes and smoosh them together until suddenly it resembles something recognizable).
Before this pregnancy, we’d had five losses over three and a half years.
The first loss happened at 10 and a half weeks. There was no heartbeat when I went in for an ultrasound. I was told that I’d have to undergo a surgical procedure known as D&E (dilation and evacuation) to remove the remains. My OB never mentioned the option of waiting for nature to run its course or the medicine I could have taken, called Misoprostol, which would send my body into labor and help push out the tissue. At the time, I was shocked and devastated by the stillness on the monitor. Later I tortured myself: I should have asked more questions. Why does it always feel like, no matter what, it’s always the mother’s fault?
The next morning, before I was put under, my last thought was: Why are there so many people in the operating room? It was a teaching hospital, something that I usually support and have even, during other types of visits, consented to being part of the learning experience. But I didn’t understand that I was being someone’s lesson in this time of grief and vulnerability. I did not voice my objection in time. The surgery was botched, and I can’t help but wonder if it’s because I was put in novice hands.
Afterwards, I experienced profuse bleeding and excruciating pain, which were repeatedly dismissed by my doctor’s office until I ended up in the ER, where the medical staff explained the surgery had not been completed properly. They gave me Misoprostol and monitored my bleeding until I stabilized.
All of the options—surgery, waiting, or taking Misoprostol—come with risks, and the mother should be able to make an informed decision. A benefit of surgery, and the one thing that was done correctly during my procedure, was gaining an understanding of why the first loss occurred. An examination of fetal tissue revealed the loss was due to a chromosomal abnormality called Trisomy 13, which can randomly happen in any pregnancy. I also learned that it would have been a boy.
Two more pregnancies, and subsequent losses, later, my new doctor suggested that perhaps scar tissue from the botched surgery was preventing a strong enough implantation. But the only way I could be tested and treated for scarring was to be referred to a fertility specialist, which would not be covered by my barely basic insurance coverage. The costs for a specialist felt out of the equation. We were still paying off our debt to the hospital for our first loss, which I had to appeal twice and describe the loss and medical procedure repeatedly in detail to pencil-pushers with no medical background over a period of nine months before the insurance company finally agreed to pay what they were supposed to all along. Each time I received another bill or insurance statement, my stomach felt like it had fallen into my shoes. I had to relive the loss over and over again.
So, we kept trying without treatment and kept losing.
The morning we found out that I was pregnant again, when we discovered I was experiencing the first trimester for the seventh time, we were on our way to New York to help an artist friend move her paintings from her apartment in Brooklyn. She’d lived in the apartment for 15 years and had been priced out when her landlord sold the building. She was now being displaced and trying to cope.
Travel restrictions had not yet been implemented. It was the last weekend we could get away with denial. Everyone was talking about the coronavirus and worried about exposure, tapping elbows, but we continued on with our plans as though we weren’t about to enter into an unprecedented pandemic. I was careful not to lift too many things and entertained our daughter while the others did most of the work.
The next day, I traveled by myself via Amtrak to Washington, DC, to honor a family member who’d won an award for public service. There weren’t many people around and the train station was eerily empty.
I’d considered canceling my weekend obligations, but what could I have said? If I said I was under the weather, everyone would think it was coronavirus. If I revealed I was pregnant, knowing that it would likely end in loss, I would just be setting everyone, including myself, up for disappointment. So, I kept my pregnancy to myself and continued with our plans, but I was extra cautious about washing my hands and staying away from close talkers.
In hindsight, some weeks into isolation, I know we all seem foolish for not shutting ourselves in earlier, yet I’m glad I got to see my family and friends. Seeing them gave me the strength to face what my husband and I knew would probably end up happening a week and a half later when the spotting began.
Most movies portray losses as a woman getting her period at an inconvenient time. But in reality, pregnancy loss—and I prefer the term “loss” to “miscarriage,” since “miscarriage” sounds to me like it implies the fault belongs to the mother who somehow carried the embryo or fetus wrong, like “mistakes were made”—is more painful, gruesome, and more drawn out than a period, sometimes lasting weeks.
I was depressed when the bleeding started, and my plummeting HCG levels confirmed that I was in the process of losing the pregnancy. It is a familiar sadness, now, like that familiarity of the initial nausea. But for the first time in all this sequence of loss, I was also relieved. In the back of my mind, I couldn’t help but wonder what it would be like if the pandemic continues and months from now, what might happen if some complication or premature labor forced me to an already overwhelmed hospital. Would I be turned away? Or, would someone else in need of medical attention be turned away because I took their place?
Perhaps I’m just looking for a coping mechanism to get through this loss, our sixth and hopefully final, to get past it and to the potential of hoping again. I know that if I was still pregnant, I’d be worried for many different reasons, now, about myself and the baby. Also, I’m not going to miss the morning routine of shoving saltines into my mouth the moment I open my eyes, if you can even get saltines, or having to empty my bladder every hour, with all public restrooms closed. Maybe I’ll be able to finally stop craving tandoori chicken during a time when restaurants are mostly shuttered (and when I still don’t know how to cook anything beyond pasta and steamed vegetables). My breasts will stop feeling like they’ve been replaced by hot iron weights. When I have a migraine, I’ll no longer have to tough it out without prescription medicine. And I can start drinking coffee again.
Since schools are closed, my daughter and I no longer have to put ourselves through the frenzied morning rush. I still wake up early so I can work before she rises, but now we enjoy a leisurely morning together, reading books, practicing her writing and math skills. At lunch, we watch videos of children’s book author Mo Willems sharing drawing techniques. In the afternoons, we put puzzles together, learn piano, build imaginary towns, create characters, and play board games.
I may never be able to give my daughter a sibling. But in this time we are together, I find myself more present with her. She is my focus. She is proof of what is possible. Being around her inspires a sense of purpose. As she is learning how to read and ask questions of the world, I’m learning how to be a more attentive mother. Each day, our connection grows stronger. The past five and a half years vanished too quickly, much of that time swallowed by grief. Right now, life has been interrupted, placed on pause, allowing a new opportunity to relish the person she has become.