The next chapter

We started “trying again” as soon as we could after the disaster of the miscarriage. We had become pregnant the first month we tried last time so surely it would be fast again this time right? I remember typing into Google “chances of two miscarriages in a row”. The stats were in our favour so I thought well if we can get pregnant again then surely we can’t have any more miscarriages. It’s meant to be rare, having more than one in a row. By month four of trying I was totally obsessed. Ovulation tests, cervical mucous checks, back pain, headaches, two or three different apps tracking things and the monthly panic attack which were progressively getting worse. Every announcement of everyone else having children was devastating. The looming deadline of my niece being born was ever pressing. Pregnant women for me were getting harder and harder to be around. I remember thinking why do they deserve it and I don’t? We are building a house for our children, we are researching and watching our friends, we are babysitting and picking up all the habits and development of everyone else’s children, so why can’t we have ours? It was getting all encompassing and we decided it was time to book a trip and have a really good reset.

Travel is my number one hobby. I love researching everything I can do, learning about history, culture, art and seeing new things. I find it helps me understand people and then I can see things from different perspectives. It throws so many challenges as you and you have to rise to them or else you are stuck, not safe or heaven forbid, you miss out on something. It’s an amazing way of leaving your life at home behind and becoming a nobody somewhere else rather than the constant grind of daily life at home. I have to make so many decisions in my job that sometimes I get decisioned out and need to just go with it for a bit. Travel also helps with knowledge in pub quizzes which I’m rather partial to. We decided we wanted a long haul flight but only one and we wanted to take ideally less than two weeks off work. We are both self employed and holidays have the double whammy of the cost of the holiday plus no annual leave pay. We looked at flights from New Zealand (which are never cheap and always take a long time) and decided on Japan. We both hadn’t been before and we really like Japanese food (in NZ anyway). We thought it was a good mix of culture, history and cuisine. We also watch a lot of documentaries on the Second World War so Hiroshima was a draw for us. I haven’t done much of Asia. I went to India for a month during my final year of university and it really wasn’t my thing. A bit too dirty, corrupt, smelly and full of mystery food that might make you sick. Japan seemed like a good starting point as I feel like I’m missing out a large part of the world in my travel history because I started Asia with hard travel before I had done any travel. I’m a lot more experienced now and I feel I would enjoy it more and have less culture shock than the first time. Everything was booked and we were excited to be going. It didn’t happen.

We found out I was pregnant three weeks before we were due to fly out. I remember thinking I will get the dating scan to make sure everything is fine and then as long as my midwife gave us the all clear we could still go. When she called we talked about being careful of food especially seafood as part of the safe pregnancy diet and I asked if I could still go on the rollercoasters at Legoland and Disneyland like we had planned. She said it was fine in the first trimester (now knowing what I’m like in the first trimester going on a rollercoaster at 7-8 weeks pregnant seems so silly, vomit central!). I took a digital pregnancy test the Monday before we were due to fly out and it said 1-2 weeks pregnant. That was my first indication something was wrong. I remember thinking that’s weird, it should say 2-3 or 3 plus weeks. I wondered if it was a chemical pregnancy and our scan on Wednesday would show nothing and it was all just a dream / nightmare again. When we went in for our scan there was nothing there. Well, nothing in my uterus. The lovely sonographer who we have ended up seeing a few times over the last few years said she would have a look around. What she found was known as the “ball of crap” firmly stuck in my left fallopian tube. Ectopic pregnancy. I remember thinking, seriously? We were then referred to our local hospital and my midwife messaged to say “well shit”. We were referred up to the gynaecological assessment unit with thankfully a short wait. One thing I have to say is they really need to address waiting rooms in these situations. Half of the waiting room was losing babies while the other half had their babies there and were having assessments post birth. The last thing you want to be around when your “baby” is dead or dying is either a perfectly healthy pregnant women or a newborn baby. In Australia they now have legislation to separate people. We should be doing this everywhere. It just adds to the trauma.

When you have an ectopic pregnancy it is considered to be a medical emergency. If a fallopian tube “blows” then a woman can lose an incredible amount of blood and death is a real possibility although these days the mortality rate is coming down but it remains the most common cause of first trimester maternal death globally. I got put in a room with a young doctor and a rather large IV line in my arm just in case they needed quick venous access. In case it blew in other words. The registrar came and examined me for bleeding and any abdominal pain and deemed that I was stable. They then took bloods. Lots of them. And then we waited. And waited. We waited until almost 9pm until the consultant came and saw us to say the blood hormone levels were low and I appeared stable therefore we would try “conservative management”, also known as do nothing. They would repeat the blood tests in two days to see if the hormone levels were coming down and if they were then they would keep checking until it was back to zero. We asked about Japan and the doctor said oh no, you can’t fly. We went home with a medical “do not travel” and cancelled our holiday which was meant to make us feel better. The next day I woke up to blood and a sore left shoulder. The symptoms they told us to be careful about. We called the hospital who advised us to return and they would do more testing. I can’t remember much of that day. I was nil by mouth in case I needed emergency surgery and we spent 7 hours waiting for blood test results. I remember there was a stupid picture on the wall of my room that had an oriental looking teapot on it and I remember thinking well that’s ugly. My amazing husband sat there playing on his phone sitting on an ever increasingly uncomfortable chair while I got a bed. When the doctors finally came in we were laughing. My husband had just said “imagine if after all this we finally have a kid and they’re a cunt and we don’t like them”. The doctors advised us the hormone levels had gone up and we now needed to consider treatment options. Our options were 1) methotrexate – a highly potent drug that essentially depletes folic acid levels and I describe it as “dissolving the baby” or 2) surgery – removing the fallopian tube and whatever was in it. I remember being really upset about losing the tube. I had become pregnant twice off the left side. That side has always had issues. It’s the ovary that just keeps fighting. It’s been stuck to my pelvic wall three times, its had a precancerous cyst removed from it and its been cut in half and is still alive and clearly kicking. When I got upset one of the lovely older nurses explained to me that just because you’re missing the fallopian tube, it doesn’t meant the ovary becomes redundant. The tubes move to capture whichever egg is being released and it doesn’t have to be the tube associated with that side that captures the egg. Um what? The diagrams always show the tubes firmly attached to one ovary and one side of the uterus. Mind blown! We chose the methotrexate. In hindsight surgery may have been the better option but we were steered towards medical management and I personally don’t think there were any good options so we chose the lesser of two evils. Imagine if the right tube was stuffed and the left one was gone. I remember my husband trying to ask questions and advocate for me but the doctors weren’t really having a bar of it. I know they see a lot of abusive relationships but it also good to realise when someone is advocating rather than being controlling. I hadn’t eaten properly for two days, I was stressed and considered unwell. I needed someone to help me make a decision who knew me and I felt like we didn’t really get that support. After choosing the methotrexate we were then told the hospital pharmacy was closed for the night and we needed to come back in the morning. We haven’t accessed public hospital care much but we found the nurses were great, the doctors were overworked and often quite junior with the top layer of consultants being too thin and due to all of this, incredibly inefficient. We were also told that if we went for the surgical route I would be put on the elective surgery list for the following week meaning any incoming traumas would take precedence. So much for a medical emergency. The system really is quite strangled. If you are dying, its great. If you aren’t dying then it falls down.

I still don’t know if the methotrexate was the right choice. Did it work? Yes. Did I have side effects? Yes. Methotrexate is an interesting drug. They give it to you as a jab in the bum which sounds simple enough. What isn’t simple is that it can only be given by a nurse who is past childbearing age and for the first 48 hours you need to consider all of your bodily fluids to be toxic to anyone else. I had to ideally have my own bathroom, double flush toilet paper and double bag any sanitary products or tissues I used. This all sounds fine but what you don’t think of is that when you have an ectopic pregnancy and for me my second loss in a row, you cry a lot. My tears were toxic. This meant that cuddles when I was crying weren’t allowed. Even from my husband. And there were tears alright. I remember vividly him going out for a morning of work and sitting on the floor of the lounge crying hysterically. I don’t remember ever crying that hard and I don’t think I have since. Two in a row was just too much. One good thing that did come from the methotrexate was that we had a forced break. We had a three month period where we weren’t allowed to try because it would result in a foetus with severe birth defects and we would be losing another baby. Even at the time, those three months felt like a blessing. It gave us time to process what had happened, time to find ourselves as a couple again and maybe even the chance to go away although it would be kept local this time. We had no more worrying about cycles, trying windows, periods and symptoms of them and trying to predict whether or not it was on its way or not. We were tired. Our mental health was shot. Unlike the miscarriage though, the “ball of crap” had never been a thing. We weren’t attached to it like we were the last one. It was easier. The hard part was what the methotrexate did to me. That was the hard part of this one and it makes me question my choices. It also reminded me that at that time, we had two choices, both were poor and both had drawbacks. I remember thinking while I was in my mess on the lounge floor that I didn’t want anything. I didn’t want the house we were building, I didn’t want plane tickets, I didn’t want nice things. I just wanted a child. One of my own. One that was as least a little bit like me. And right now, for the second time, it was literally going down the toilet.