How to Have a Miscarriage

Lie silently in a white room, the wand of the ultrasound moving inside you. The seconds lurch forward; try to stop them, understanding that each additional wordless moment is bringing the news with more certainty. Sense death in the doctor’s silence, the knowledge rising in your chest as shallow, desperate breaths, while the wand presses into your vagina, searching. Focus on restraining the scream rising inside you, on matching the doctor’s muteness. He is not finding what he’s looking for, and you know that the body inside yours is as silent as the white room.

Minutes later, back on the sidewalk, squint as if the sun is attacking your eyes. Force yourself to walk around the block with your husband. Everything is the same, but everything is different. There will be no happy news at Christmas now, no Independence Day birth. The anticipated rhythm of the year has been erased. No new baby will keep you at home all summer. Your mind is consumed with these logistics. The alternative is to consider the baby who will never exist.

All the movies have misled you. Your miscarriage doesn’t just happen one evening at dinner, and you excuse yourself, and it’s embarrassing, and that’s it. Your miscarriage has not even started yet, may not start for weeks. All the available options sound bad to you: wait for it to start naturally, get a procedure to remove the tissue, or take medication to make the miscarriage start. For now, you are still pregnant, still deep in your first trimester. The empty gestational sac is still growing, still producing more and more hormones, and you feel sicker every day, unable to stand for long without lying down, too nauseous to eat. In five days you lose five pounds. On Thanksgiving morning you nap from nine to eleven. Limp in bed, you feel useless, disgusting, weak, beset by all the grueling, consuming, whole-body effects of a pregnancy. But you have no baby.

Force yourself out of bed. You’re not going to waste all this time for no reason. If you had a baby you would deserve to rest, but you don’t have a baby. So get yourself up and help chop the potatoes. Your hands are clumsy on the knife, your arms heavy with effort. The air is thick like jelly, each movement requiring extra force. Give up and lie on the couch. Stare at the white ceiling. Does this experience contain even a single redeeming quality? You can’t think of one. The doctor assured you that there was nothing you could have done, but you have a hunch, deep down, that you caused this. Go back up to the bedroom, so no one sees you cry.

At first you thought you’d prefer a natural course, but not anymore, not after nine weeks. How long will you be sick because of your nonviable pregnancy? Because of your dead baby? You refer to it differently, depending on how dramatic you feel. But whatever you call it, your position is now clear: 

Fuck this. 

Get it out. 

The procedure is scheduled. It will be a Manual Uterine Aspiration, a common procedure, you learn. You had no idea that many miscarriages require medical intervention. You have lived a full thirty-five years as a woman, and you find your lack of knowledge on the subject embarrassing.

You thought you would be asleep, but here you are in the surgical suite, awake and alarmingly lucid, your husband beside you in full-body scrubs and a hairnet. On your back again, your legs propped up and apart again, you wish desperately to be rendered unconscious. But that kind of drug isn’t coming. The speculum stretches open your vagina. Watch a three-foot long needle approach your cervix, and then the local anesthesia enters your flesh like an electric shock. Terrified, you feel suddenly unable to breathe, as if the world is fading. The doctor compared this anesthesia to what you experience at the dentist. The words slur in your mouth as you try to tell him it’s in your whole body. “It’s okay. It’s normal,” he says, but you seem to hear his response from under water, and you’re certain that this is not normal.

Things have already moved on, you realize, as you feel scraping in your uterus and a fast suction sound, like the final slurp of an ICEE drink. Watch, horrified, as the doctor removes from inside your body a tube filled with bloody flesh. Feel stunned that you are here, now, seeing this. Softly, kindly, the nurse says, “That’s one,” and you wonder what number she is counting to.

Slide straight from first trimester nausea into postpartum depression. You can eat now, but you can’t feel joy. This will never end, you think, as you lie in bed again with the curtains drawn, angry at everyone, everywhere, who has ever gotten pregnant. Desperate to move past this, you are grateful only that the dead growing thing is no longer inside you. Cling to this fact — it is no longer getting worse. Remember with a shock of horror that the uterine extraction you had is now difficult to get in many states. Long to scream at the people responsible, Don’t make this any harder for us.

You are lucky, you got the medical care you needed. The healing has begun, even if you can’t feel it yet. This single consolation drags you through the ensuing days of hopelessness: the cramps that wake you in the night; the hours with a heating pad; the weeks of bleeding; the residual fights with your husband about nothing and everything; the barren, gray holiday season, its colorful lights illuminating your sadness in a harsh glare. Slowly, slowly, start to notice moments of peace: walking in the park under a canopy of eucalyptus, methodically chopping carrots on the butcher block, arranging red tulips in the dining room so they catch the January sun. 

You can’t imagine trying again, risking this whole thing again. 

But you know you will.