I remember just a month after my second ectopic pregnancy I saw a little notice in the newspaper. It was notifying people that there would be walk of remembrance for those who had lost babies through miscarriage, ectopic pregnancy, stillbirth or infant death. I stared at that little group of words for a long time. I felt so validated to see ectopic pregnancy given its own acknowledgement as something different from miscarriage. It is a pain and a struggle all its own. While it shares many traits with the grieving process of miscarriages (and at their root they are both the loss of a child), ectopic pregnancies have some uniquenesses, too.
An ectopic pregnancy is a pregnancy that occurs outside the uterus. Most commonly it occurs in a fallopian tube. There is often no clear reason why the embryo implanted in an inhospitable environment and there may be no early indications that this pregnancy is anything unusual. But once that baby has implanted outside of the uterus, his days are numbered. We currently have no way to transplant those embryos into the uterus and if they continue to grow in a fallopian tube, the tube may rupture which may impair future fertility or even cause internal bleeding leading to death of the mother. It can be a very frightening experience.
So for the woman looking for some camaraderie in this difficult journey or for those of you who want to better empathize with a friend who has suffered an ectopic pregnancy, here are some things to know:
The pain is incredible: And I’m talking about the physical pain. I couldn’t straighten up or walk during the worst of the pain. I can’t really describe the pain, but it doesn’t feel like cramping the way you might expect a miscarriage would. It was just like a sharp lump of pain and nothing could fix it. I also was so wanting to protect my unborn child that I didn’t want to take anything for pain. My second ectopic pregnancy I ended up collapsing on the ER floor before somebody put me on a gurney in a hallway while I waited to see a doctor. This is a pretty traumatic way to be initiated into losing your baby.
The disappointment is intense: In my experience, ectopics can be kind of tricky to diagnose. Sometimes hormone levels don’t rise as they should, which tips off your doctor. But sometimes they do rise exactly as they should. Sometimes the baby can be clearly seen in an ultrasound and you can tell it’s in the wrong place. But sometimes you can’t really see the baby at all. Eventually it becomes clear, but for awhile you may be in this limbo where nobody will tell you exactly what’s going on. As the mother of that child, you hold on to hope until the last possible moment. Even when they tell you your baby has implanted in the wrong place, you want to imagine that your child can beat the odds and continue to grow, or magically roll into a better position. What you most want is total clarity, but it seems like a hard thing to get. And all of the sudden nobody cares about your baby anymore and they’re talking to you about the signs that you might be in danger from internal bleeding. It’s hard to really take in that information when you’re trying to understand how you went so quickly from being a pregnant woman to being a woman carrying a dead child who is now in danger herself.
The questions are haunting: Is this baby alive or dead? Is there any hope? What can we do? Why did this happen? Did I somehow cause this? Can’t we move the baby? Is the procedure to deal with an ectopic pregnancy essentially an abortion? All these questions are complicated by the quick timeline required by an ectopic pregnancy. To avoid rupturing a fallopian tube (which along with impairing your fertility could also kill you) decisions have to be made quickly. Doctors know how to deal competently with removing ectopic pregnancies, but I don’t think they always know how to explain it to you, allow you a moment to grieve and help you feel empowered in the decision making process all in the timeframe that feels safe to them. If you don’t get your questions answered, they may stick with you for a long time and can complicate your grief.
The guilt is unexpected: I felt guilty because my body failed me. I felt guilty because we had infertility issues (which can correlate with a higher risk of ectopics). I felt guilty because we did fertility treatments to get pregnant (although I also had an ectopic pregnancy with an spontaneous pregnancy). I felt guilty because I had previously had surgery which may have increased my risk. I felt guilty because I chose to have my child surgically removed from my body (in one situation) and chemically removed (in another situation). Even though we were reassured that there was not a living child still in my body, I agonized about if we were doing the right thing to end the pregnancy.
The ramifications are longterm: It is a double whammy to lose a baby and then realize you are now at a higher risk to lose another baby in the exact same way. The surgery I went through may have left scar tissue that contributed to the next ectopic pregnancy I had. My future positive pregnancy test results were met with fear instead of joy as I felt a correlation between pregnancy and painful loss. We were told if we had multiple ectopic pregnancies, the best thing to do would be to remove the faulty tube, which was a sad thought.
God is bigger than your fallopian tube: I’m not going to say that every infertile woman will eventually give birth. That absolutely isn’t true and I think false hope is incredibly damaging. With that being said, statistically speaking, a lot of women who at one time struggle with infertility will eventually have a biological child. For us, that took ten years and three pregnancies. But I want to take you to that moment in the doctor’s office when they were looking for the location of our baby at his early ultrasound. The first thing the ultrasound tech did was look to see which ovary I had ovulated from. She could tell I had ovulated from my right ovary. . . and it felt like the beginning of the end. Both of my ectopic pregnancies had happened in my right tube. My doctor had said if we had a third tubal pregnancy, he would surgically remove the tube to avoid that happening again. I began to mentally prepare for that reality. But that’s not what happened. God choose to do a miracle in not only providing conception and a proper implantation, but doing it through the damaged tube. I struggle with having hope. I’m not very good at being hopeful, but I am learning that God is not constrained by my lack of hope or a doctor’s bleak prognosis.