Two years ago, five words broke my world. “I’m sorry, there’s no heartbeat,” the sonographer said, while I stared at my baby on the monitor, blindsided what I had just been told. I was eight weeks pregnant and although my baby was small, it was very real, very longed for and loved. To lose it was devastating.
I had gone to the scan on my own – my husband was in New York directing a play and I was due to fly there the next day. The scan had just been for reassurance – I’d had no reason to worry, I felt fine, I’d had no pain or blood. “You’ve had what is called a ‘missed miscarriage’,” the sonographer continued, then closed the curtain so I could get dressed again.
A missed miscarriage – also known as a delayed or a silent miscarriage – is when a baby has died in the womb but the mother hasn’t had any symptoms. It is ‘missed’ because the body still believes it is pregnant, and it is mostly detected during an ultrasound – often at the 12-week scan when expectant parents are filled with hope and excitement. “Any type of miscarriage can cause shock and anxiety, but a missed miscarriage can be particularly difficult because of the lack of symptoms,” says Tommy’s midwifery manager Kate Marsh.
To add to the distress, it turns out a missed miscarriage must be managed. “You’ll need to decide what to do next,” the sonographer had said, listing options that I could barely take in at the time. You can either wait to see if it happens naturally; take pills that force your cervix to open and your uterus to contract thereby pushing out its contents; or have an operation to remove what is there. Waiting naturally could take days or weeks.
Currently, due to the pandemic, hospital restrictions on surgery mean that many women face waiting for a missed miscarriage to progress by itself, or will take medication to speed up the process at home, but if other management options haven’t worked then surgical would still be provided.
I staggered out of the clinic and headed to Regent’s Park, where I FaceTimed my husband from a bench. I didn’t care about how loudly I howled or how many concerned faces stared at me. To be nearly 4,000 miles apart and experiencing this was unbearable. I was desperate to be with him, so after getting the sign-off to fly, I travelled to New York the next day.
I expected the miscarriage to happen naturally there, but it didn’t. For three weeks, I was away on ‘holiday’ with a baby no longer alive still inside me. How are you supposed to act in that situation? I did not know. But my emotions were intense and volatile. There was profound and painful sadness, followed by guilt when I tried to forget about it. And then when I was overwhelmed by tears, I’d question whether I was being overly sensitive to grieve something so small.
A few days from what would have been my 12th week of pregnancy – and still no single drop of blood to show I’d lost the baby – I went into hospital for an operation under local anaesthetic called a manual vacuum aspiration (MVA), which involved a suction device emptying out my womb. While it was uncomfortable, I was relieved to finally feel something physical, and an hour later I was discharged. Unfortunately though, while around 95% of surgeries are successful, mine wasn’t – and a few weeks later, after still getting a positive result on a pregnancy test, I had to have it again.
In nearly three months, I’d been pregnant, then not pregnant, I’d spent weeks waiting for a miscarriage, then had to have an operation. Twice. Why had this happened to me?
No one knew for sure. Like most female-focused areas of research, miscarriage is under-funded. But according to Tommy’s, who opened the UK’s first dedicated centre in 2016, missed miscarriage and other types of loss early in pregnancy are usually due to chromosomal abnormalities, or problems with the placenta, but researchers are still exploring this. There is often very little you can do to prevent it.
“One in four women experience miscarriage, yet the myth persists that ‘these things just happen’ and it’s not worth investigating; we refuse to accept this,” says Tommy’s CEO Jane Brewin. “Besides the physical harm, miscarriage can have serious psychological and emotional consequences. It’s vital that we find better ways to care for everyone going through miscarriage, while science continues to unpick how we can stop it from happening.”
The emotional impact cannot be downplayed. Despite increased awareness, miscarriage is still a taboo for many. But in this silence breeds loneliness and shame, which is damaging women’s lives. Losing a baby in early pregnancy has been linked to anxiety and depression, and a recent UK study suggest one in six women will experience long-term symptoms of post-traumatic stress.
“Miscarriage can be devastating. It’s important to recognise what you’re going through and allow time to grieve,” says Marsh. “Talking can help – whether that’s with online communities, midwives and other health professionals, your loved ones – or if you’re more private, document thoughts and feelings in a journal. Others create a physical memory such as planting a tree, having a special candle to light, or making a memory box. Reach out for support, and remember healthcare professionals and organisations like Tommy’s are here to help too.”
My story has a happy ending. After the storm of loss, I got my rainbow baby. I know how lucky I am. But while the joy of my son is infinite, the pain of that loss cannot be forgotten. That was my first pregnancy. Nothing can change that. And now, as I think about growing my family, I have fears for what could happen again.
Being open about women’s experiences matters. So even if it helps just one person, I’ll keep talking about it. Miscarriages may be silent, but we don’t have to be.
For advice and support on pregnancy, pregnancy complications or baby loss, visit tommys.org or speak to your GP.