My Ectopic Pregnancy
Below is the story of my ectopic pregnancy. I wrote this in order to help me process the events I went through, and to encourage others to advocate for their care. Lastly, I hope to encourage dialogue about pregnancy loss as it is often something women don't talk about which results in others feeling even more alone when they experience it.
After our first pregnancy took us quite by surprise, we tried to plan our second pregnancy more strategically. I work for a school district and timing a pregnancy is the only way to achieve some paid maternity leave! While we realized we only had so much control in the matter, we hoped for a late-spring baby in order for me to spend the summer at home. We began trying in August of 2015 and by the end of September 2015, we had a positive pregnancy test! Our baby was due May 27, 2016. Several good friends of mine had recently gone through miscarriages. While I didn’t want to get my hopes up, I thought to myself, “it can’t happen to me”, as if I was some kind of fertility ninja. About 10 days after the positive test, I began to have some spotting. I instantly knew something was wrong. I contacted those same good friends and asked how much time took place between a little spotting and heavier bleeding. We prayed and went to bed hopeful, but I couldn’t shake the feeling that something wasn't right .
The next day we headed to Austin to celebrate our anniversary. I called my midwife office and asked them if I needed to come in. They told me that if I was having a miscarriage, it would be fine to pass everything at home, as long as I wasn’t losing too much blood too quickly. By that afternoon, my bleeding had increased and everything seemed to be consistent with what my friends had described. I figured, if I was going to have a miscarriage, I may as well have a “destination miscarriage” and wrap my head around it away from our usual routine.
We returned from our trip and told our close family and friends our sad news. I bled for about one week. I decided to keep the 8-week appointment I had already scheduled when we got our positive test. The midwife felt like my uterus was small and that likely the miscarriage had passed. However, they were still getting a positive pregnancy test. The nurse said, “Maybe this is another pregnancy”, trying to be hopeful. I knew it wasn’t. In fact, I thought I had already gotten another period, but couldn’t tell if it was just the rest of the miscarriage working its way out. Standard procedure after miscarriage is to do back to back blood draws to confirm that your HCG levels are dropping down to zero. I gave blood that day and returned a week later to give another sample. Then, I waited. After about a week had passed, I had a missed call from my midwife office but no voicemail. I thought it was odd but assured myself that if I was in any real danger, surely they would contact me again. After more than a week had passed and I still hadn’t gotten any results, I contacted them. I spoke with a different midwife who informed me that my HCG levels hadn’t dropped, they had actually increased. She wasn’t sure the reason for the rise and told me I needed to come in for more blood work and an ultrasound.
On November 10, 2015, I went in for my ultrasound. I was expecting that at worse, there was some leftover tissue from the pregnancy and I would need a D&C. When the tech did the ultrasound, she let me know my uterus was empty. She scanned over my left ovary and said that everything looked good. She scanned over my right ovary and suddenly got quiet. She then told me she was seeing an “area” she didn’t like near my right ovary. I prodded her for more information, but she couldn’t tell me anything. I was sent to an exam room to wait (and try to keep my toddler from picking up the speculums out of the bucket). The midwife came in and told me I had an “ectopic pregnancy” in my right fallopian tube. She told me I needed to call someone right away to pick up my son and that I would be transferred to care of an OB in the practice. I was sent to a different floor to be admitted to the hospital in case I needed surgery that day. I called my husband in tears and told him to hurry. They rushed blood work and an OB came and met with us. Because I had gone nearly 11 weeks with the ectopic, it had actually started to shrink on its own. My HCG levels at 9 weeks were in the 6000s and on this day they were in the 2000s. My low HCG level qualified me for a shot of “methotrexate” to encourage the cells to shrink. It was less invasive than surgery, kept the fallopian tube intact, and was what the OB recommended. During this consultation I realized that I would have to wean my then 16-month old son. We asked the OB if we could go home to have time to wean my son and pray. She was hesitant, but felt like it would be okay as long as we came back in 48 hours. We went home, we prayed, and we changed up our routine to keep my son from being too upset about the weaning process. The challenging thing about weaning a toddler is that they are old enough to ask for milk and yet too young to understand why you would tell them no.
We returned to the OB’s office on November 12th. She wanted a different tech to repeat my scans to verify the ectopic. When the scans were repeated, the OB and tech agreed that what was showing up on the scans could not be verified as an ectopic. It had appeared to shrink and was measuring smaller (by several mm’s). Based on the scans and my lack of symptoms (other than continued spotting), I was sent home with the instructions to return for weekly blood draws. If at any point my HCG levels were not dropping nicely, we would need to do a round of methotrexate. In addition, I was told to contact them if I had any abdominal cramping or discomfort. We were so thankful that I could continue to nurse my son and that we had waited before pursuing treatment. We truly believed (and still do) that God had healed me, at least for the time being. The rest of November was a bit of a blur of weekly trips for blood draws. I continued working, always slightly nervous that something may happen while I was working with students. On several occasions, I had strange cramping and called the nurses line at the hospital. Both times I described what I was feeling (uncomfortable but not excruciating pain) and was told that I didn’t need to come in to the hospital. Each week we waited anxiously for my HCG results. By the end of November, we high-fived in the kitchen when we read that my levels were now in the 200s. We had almost put this whole mess behind us.
On Saturday, December 5th, 2015, we returned home from a fun family day. We had chopped down our very first fresh Christmas tree from a farm. We were excited to start decorating it after our son went to bed. My husband left to get us dinner and pick up some hot chocolate while I got Titus in bed. I was tired from a busy day but otherwise felt really good. I was rocking my son in his room when I suddenly felt a sharp cramp in my abdomen. It felt like digestive cramps or gas pain. I tried to adjust how I was sitting to see if it would help. From this point, the details get a little blurry. I think I knew subconsciously that something was wrong. I put Titus in his crib, took about two steps, and then felt my legs buckle underneath me. When I woke up, I was laying on my back in my son’s room, staring at the ceiling fan. I could hear him crying but it felt like I was in a dream and I couldn’t get to him. I realized I had passed out but I couldn’t seem to move. After catching my breath a bit, I crawled on my back out of my son’s room and managed to pick up my phone off of our kitchen table. I called Andy and said “something is wrong, I passed out, I can’t move”. He got off the phone with me and called 911. Moments later, I realized I was going to throw up. I couldn’t move and did not want to choke. I turned my head as far as I could to the side and threw up in my hair. Andy came home a few minutes later and found me on the floor, laying in my own vomit. This may be the sexiest part of our marriage thus far. Close competition to the time we both got food poisoning from dove he shot but that’s a story for another time.
EMS arrived and transferred me to the ambulance. I asked them to take me to the hospital where my doctor was, but it didn’t have an ER (only antepartum and L&D units) so they took me to another hospital nearby. Once I was admitted to the ER, I told the doctor my history and that I was currently being monitored for an ectopic pregnancy. I was asked if I had eaten enough that day and if I was dehydrated. I probably hadn’t had enough water, but most moms probably don’t drink enough water, right? I explained that I had never passed out and that the way I passed out was a very different feeling from when you get up too fast and get dizzy. I also explained I was having pain in my neck and shoulders (I now know this is called referred pain). Despite the abdominal pain I was currently in, the doctor did not feel anything was wrong with me. She said it was likely just dehydration and she would be sending me home. I then said “so, you’re not even going to do an ultrasound?”. She told me that it wouldn’t show anything because my HCG levels were so low. We went back and forth some and she finally said she would “okay” the ultrasound purely to give me peace of mind. After spending time with a precious gem of an ultrasound tech (who was really willing to listen to me), my scans showed blood in my abdomen. The doctor assured me it could just be a period but that I would need to be kept for observation. I immediately asked for a transfer to my hospital. We were told we would be paying for my ambulance ride to get there and we were totally okay with that.
By the time I was transferred around 4am, my shoulder pain was excruciating. It felt like continuous muscle spasms. I was so exhausted but every time I was close to falling asleep, the pain would startle me. My sweet husband would massage and squeeze my shoulders when it got to be too much. Upon arriving at my hospital, I was greeted by a sweet doctor who gathered all of my history. He took the time to listen and assured me they would find the source of the problem. Blood work and scans were repeated. Nurses came in and asked for my wedding ring and earrings. Then, a surgeon came in and informed me that my blood levels were dangerously low, I was bleeding internally and that surgery would need to be done to find the source of the bleeding. I was given two bags of blood before the surgery. While operating, the surgeon found that my right fallopian tube had ruptured because of the ectopic. My right tube was removed at the point of damage and a liter of blood was taken from my abdomen. They also did a D&C. My initial reaction from the experience was that I was so thankful. Thankful we had gotten transferred and thankful the whole ordeal was finally over. I had walked around with moderate levels of anxiety for the past month, and this surgery meant that it was really, finally, done.
The first few weeks of recovery were challenging. I wasn’t allowed to lift my son and he was at the age where he wanted to be carried around the house all the time. I didn’t have the energy I wanted to have in order to take care of him. Our family and friends rallied around us during this time and cleaned our apartment, decorated for Christmas, brought meals, and came over to lift Titus in and out of his crib. The love that was expressed in tangible ways during this time is something I will always remember.
Looking back on everything, it’s easy to think “why didn’t we just get the treatment to begin with?”. Or “why didn’t I insist something was wrong with me before the rupture?”. I am at peace knowing that we made the best decisions we could at the time, with the information we had. My situation was unique in that most ectopic pregnancies are caught early on and are caught because of a rupture. My OB had never had a situation like mine where the pregnancy was seemingly going away on its own. As someone who is more natural-minded, I wanted to approach treatment with caution. Although this is not a trial I would choose to go through, I have learned so much and have a new appreciation for the more medical side of obstetrics. Only you can know your body and advocate for yourself, and I better know how to do that. While God didn’t take away my ectopic completely, I have no doubt he gave us the wisdom in the midst of a scary situation to make helpful (and possibly live-saving) decisions about my care.
I’m now writing this in March of 2016. We have been cleared to “start trying again” when we are ready. My body is healed. I still get sad sometimes when close friends discuss their pregnancies. This isn’t because I’m not happy for them, but because I wish I got to do the pregnancy thing with them like I did with my first. Our “due date” will come in the next few months and I have no doubt it will be a hard day for me. We walk forward with hope, knowing that we are undeserving of good gifts, but praying that we would be blessed with another child. I have a new compassion for women who have experienced pregnancy loss. If you know someone who has experienced loss, I would encourage you to avoid clichés and platitudes. Tell them you are sorry for their loss and just listen. Don’t try to figure out the “why”. Just be there.