I’ve known for many years that I have Polycystic Ovarian Syndrome (PCOS), so we headed into marriage knowing that getting pregnant could be a challenge. Neither of us expected we would get pregnant on our honeymoon but, just over a month after we returned home, I found I was visiting the bathroom several times an hour and my boobs felt like they might explode. “Do you think I need to take a test?” I half-joked to my husband, and couldn’t quite believe it to be reality when the test told us that we were, in fact, pregnant. In that moment we became parents, with hopes and dreams and plans for our future that were no longer a theory, no longer some far-off thing that might happen “one day.”
Our first pregnancy was short lived and just two short months after we tied the knot we experienced the heartache of miscarriage. The Early Pregnancy Unit (EPU) confirmed what was already obvious, our baby was no longer. There was nothing tangible left from that pregnancy, the test we had taken was digital and the battery died; there were no scan pictures. The only trace of our little Grace was the change I felt in my body, the hole I felt in my heart.
Three and a half long years passed as we tried to navigate life as newlyweds while carrying the heavy weight of loss and the pain of infertility that saw many negative pregnancy tests. In those years I lost myself and had to fight hard to claw back some sort of sense of being.
We had our first appointment with the fertility clinic two years after we lost Grace, and another 8 months down the line we began treatment with letrozole to induce ovulation. On 4th December 2018, during our fifth round of letrozole, I was in a car crash that was legally my fault. I was hit in the driver’s-side door by a truck as I pulled out from a junction and the first thought that came to mind when I realised that I was conscious was, “the baby!” I was embarrassed by my response because it was still too early to test and any little pregnancy would still be floating through my fallopian tube.
But, sure enough, just 11 days later we finally saw those two pink lines that we had waited so long for. We were over the moon and the two weeks that followed were filled with cautious joy. On one hand we were fully invested and sure that this was our time, but on the other hand we were filled with anxiety due to our previous loss and the reality of how long it had taken us to get here – what if we lost this one too?
Christmas Eve brought with it some bleeding and we found ourselves with an appointment booked at the EPU for Boxing Day. The same EPU where we learned our first pregnancy had ended in miscarriage. But the bleeding seemed to stop on Christmas Day, so we were back to being hopeful that this was, indeed, our time and that by next Christmas we would have a 4-month-old baby in our arms.
I found arriving back at the EPU extremely triggering and could feel my heart beating out of my chest. We were seen in the same room and by the same midwife who had confirmed the loss of our first pregnancy. In spite of our hope, I half expected loss, but never for a moment had I expected to hear the words, “It looks like your pregnancy is ectopic.” The next few days became a blur of driving back and forth to the hospital for blood tests and scans. They wanted to monitor whether the pregnancy was still developing, if not then there was the possibility that we could pursue expectant management, which is sometimes called watchful waiting (and basically means being carefully monitored while the pregnancy dissolves itself). It felt such a contradiction that we should be hoping for that outcome when everything in me wanted to hear that the pregnancy was developing. However, a developing pregnancy implanted in a fallopian tube can’t survive and, left untreated, puts the mother at risk of death too.
Our baby was fighting hard and still growing so we had to take the awful step to end the pregnancy. We had two options: medical management or surgical. Medical management, involving injections of methotrexate to starve the pregnancy of folate and cause it to dissolve, can save the fallopian tube but can be a drawn-out process and can still result in the tube rupturing. For lots of reasons, we felt more comfortable opting for surgical management and on 28th December 2018 my right fallopian tube containing our precious pregnancy was removed.
Along with the usual consent forms – which, by the way, are terrifying with all their talk of the potential worst-case scenarios – we had to agree to what would happen to our little one when they removed my tube. We were given two options: the NHS would deal with cremation (the minimum acceptable standard according to Scottish legislation) or we could opt-out of NHS-organised cremation and make private arrangements. I remember at the time feeling like I had no idea what the latter would involve and with such a short amount of time to consider our options we agreed to the NHS seeing to things. Those are about the only details I can remember being given about what would happen to the wee one after surgery.
I left the hospital two days later with empty arms and a scarred belly not knowing where my very tiny baby was or when they would be laid to rest. I fought the whispers in my head that told me I was over-reacting. We were “only” about 6 weeks or so, but my husband had seen our pregnancy on the screen and we had a test with two pink lines in my bedside drawer. This pregnancy had been tangible and I had a desperate need to know where our little one was and what was going to happen to them. It took me over a month to pluck up the courage to start asking questions, always having to fight the urge to apologise for needing to know and often playing down the enormity of how important those details were to me. It then took over a month to get concrete answers. It took a whole lot of persistence and many phone calls with the gynaecology ward, the EPU, pathology and the mortuary but I finally got a date and a place for our little one’s cremation which took place nearly 12 weeks after my surgery.
For a baby at just 6 weeks gestation, cremation is shared with other tiny babies. It’s not possible for parents to attend these shared cremations but we have a date to remember and a place where we know the collective ashes will have been scattered. We still haven’t visited but the peace that those details brought to my heart allowed me to start to move forward.
We named this wee one Hope because, while the outcome was filled with sorrow, the pregnancy restored hope to us which had been lost for many years.
There are still many unanswered questions, like whether the car accident was to blame for Hope not being able to get to my uterus, but I have found that the concrete details that I fought for – the pathology report, the date of cremation, where Hope’s ashes were scattered – have helped to ease the burden of the unknowns. We will never have a concrete answer on the cause of ectopic or whether the airbag that went off in my seat caused a bleed in my tube, but we will hold on to the tangible things that we have. In that sense it has been easier to carry the loss of Hope than it was with Grace. I would encourage parents who experience early loss to pursue the concrete answers that they can, and not to listen to the whispers (or indeed comments from others) about “it having been so early” that cause us to play down the significance of the loss we have suffered.
Grace and Hope are a huge part of our story, of our family and of who we are. They will always be remembered by us and the concrete, tangible details that we have been able to glean have helped us enormously in being able to do that.