Miscarriage is no new phenomenon, but the way we talk about it has changed over recent decades. No longer shrouded in the level of silence or shame it once was, it’s a well-known – though sad – statistic that around 1 in 4 pregnancies will end in miscarriage.
Yet, despite the increased chatter around how common it is, the actual mechanics of miscarriage are still kept largely under wraps, discoverable only by the rude shock of experiencing one personally. There’s an entire book and movie franchise built on what to expect when you’re expecting, but knowing what to expect during pregnancy loss is much harder to nail down. It’s not as simple as one minute you’re pregnant and the next you’re not, so what’s missing from the conversation?
Like her previous pregnancies, this one came with severe nausea. So intense was her first trimester vomiting that it burst a blood vessel in her oesophagus and landed her in hospital.
“I was projectile vomiting and everything was covered in blood,” she recalls. “It was like a horror story, like I’d been shot.”
Nicola was discharged from hospital after treatment but returned the following day for her scheduled eight-week pregnancy scan. She was surprised, though, to find that this time, it wasn’t just her and her doctor in the room.
“(The doctor) was testing a new machine that someone was trying to sell the hospital, so there was a sales lady in the room showing the doctor how to use it,” she says.
This became particularly uncomfortable when an internal scan provided bad news.
“It got really awkward. The doctor told me there was no baby – it was just the sac and the pregnancy hormones,” Nicola says. “I was being told that it was not a viable pregnancy, and I just remember this woman trying to sell the machine.”
It was in that context that Nicola was prescribed medication to end the pregnancy, and given the option of waiting for it to pass naturally or to schedule a dilation and curettage (D&C) procedure.
“I had all this stuff the doctor had already given me for the pregnancy in my bag, like a prescription for anti- nausea medication, and information about the next round of tests I needed to do, but by the end of the appointment, I was being handed new prescriptions to end it,” she says. “I just wanted to get the procedure done as quickly as possible. I felt like crap, I was exhausted, and I just wanted to move on.”
The D&C was scheduled for the following morning, but it wasn’t until she got home that Nicola realised that she hadn’t been provided with any detail on how to prepare for it. By 9pm that evening, she called the obstetrician. She was told that the details had been sent to her via email.
“I was like, are you serious? I’d just had a miscarriage and it was the evening before this procedure. I wasn’t looking at my emails.”
Nicola was advised to take the medication at midnight, so she set an alarm and followed instructions.
“I really didn’t know anything about it, though,” she says. “I knew it was something to stop the pregnancy and help the D&C process, but I wasn’t given any further instructions or told what to expect.”
Soon after taking the medication and returning to bed, Nicola was woken by strong cramps and bleeding.
“I was literally dripping in blood. I couldn’t walk and I had to put towels under me,” she says. “No-one had told me to prepare for this.”
Thinking her body was miscarrying naturally, Nicola rang the doctor at 6am on the morning of the scheduled D&C procedure, only to be told that these were expected symptoms of the drugs she had been prescribed. The procedure would still go ahead.
“I was dropped at the hospital wearing two pairs of pants, three pairs of undies, some pads and a towel,” she says. “And I was trailing blood. I could see that I
was dripping blood at the hospital day surgery ward.
“My grey towel was turning red, and I was just waiting there by myself.”
Eventually, after requesting to be fast-tracked, Nicola was moved to a shared room.
“The nurses were pretty nice and I was finally given the right pads, but I didn’t have a change of clothes,” she says. “No-one had told me what to expect, so I didn’t think that I’d need them.
“After the procedure, I couldn’t leave because I was so dizzy from losing so much blood, and I could hardly walk.”
The recovery was no less challenging, with Nicola caring for her two young children at home while her husband had to work. She was in pain, struggled to move, and continued to feel unwell for several days. Her doctor called the following week to check in, but several days of phone tag ensued and a conversation never eventuated.
“It just petered out and we never actually spoke,” she says. “I think I was meant to go back for a review, but I never did. It was just over, that was it.”
For Nicola, the experience was more physically traumatic than it was emotional. She was astounded by how little detail was provided to help her prepare for the process, and by the apparent gaps in the medical system that caused her to feel vulnerable and uninformed.
Nicola’s experience highlights the ongoing lack of awareness about the reality of miscarriage, and the failure of the medical system and society at large to provide real support to women going through this deeply personal experience. That this is the story of just one of those 1 in 4 pregnancies indicates that the “chin up” rhetoric simply won’t cut it anymore. Expecting women to work out pregnancy loss in their own vacuum is unfair at best, and neglect at worst. For Nicola, the story only began at the first sign of miscarriage, and its impact carries on still.
“If a midwife had called me to talk me through the process and tell me how to prepare, this could have been a completely different experience,” she says. “I wish someone had told me to pack a spare change of clothes, buy maternity pads, put a towel down on the bed, and that I would probably need some help afterwards due to not feeling well for a few days.
“But I was made to feel like it was just routine and there was nothing to prepare for.
“I didn’t know it was going to be so intense, and I still have no idea if what happened to me was normal.”
*name changed for confidentiality
For more honest experiences, hear Hayley share her account of egg collection and an endometriosis diagnosis here.