Memoir — From the June 2015 issue

Surviving a Failed Pregnancy

The medical ordeal no one wants to talk about

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For eight weeks, the pregnancy seemed normal. I was thirty-six, and thus supposedly at a higher risk for everything, but I’d had no spotting, no unusual pain. I learned that something might be wrong at my first prenatal appointment, even though that, too, started normally. The blood-pressure test and the queries about inheritable disorders went fine. Then the ultrasound took too long; the technician slid into silence. She admitted that she couldn’t find a gestational sac in my uterus: “I’m sure it’s okay. But I’m going to get the doctor to double-check.” She meant to sound reassuring, but I was not reassured. If this woman — who spent her days studying gray screens for early signs of gestation — could not see my pregnancy, what were the chances that anyone else would?

My doctor is so calm that he can appear drowsy, but he walked into the room looking alert. He said he thought my pregnancy might be ectopic. That would mean the fertilized egg had implanted outside my uterus, most likely in one of my fallopian tubes, a location that doomed the pregnancy and endangered my life. He searched the screen for several minutes, but found only a suspicious ring near a fallopian tube. I lay on my back as he explained this, naked below the waist except for a stiff paper blanket, the probe from the transvaginal ultrasound machine still resting inside me. My unease unfurled into a bright flag of dread.

Illustration by Leigh Wells

Illustration by Leigh Wells

No medical wizardry can relocate a misplaced embryo. Left unchecked, the embryo will expand until it rips open the fallopian tube and triggers a wave of internal bleeding. For most of history, ectopic pregnancy was almost always fatal, and ruptures remain a serious concern today. A woman whose fallopian tube bursts might arrive at the emergency room with two liters of blood pooled in her abdomen; the entire human body contains about five. In the United States, early detection means that fewer than five women die for every 10,000 ectopic pregnancies, but even so, ectopic pregnancy is the leading cause of first-trimester deaths.

On that first afternoon in my doctor’s office, the diagnosis remained uncertain. Although an empty womb on an ultrasound might seem definitive, there was a chance that the gestational sac couldn’t be seen because the pregnancy wasn’t as far along as I thought. That theory rested on the premise that I had forgotten the date of my last period, which seemed unlikely. Still, the doctor ordered blood work to check. The tests would measure fluctuations of the “pregnancy hormone” — human chorionic gonadotropin (hCG) — the same hormone that triggers a positive on over-the-counter pregnancy tests. My hCG would be tested again forty-eight hours later and the two levels compared. In a healthy pregnancy, hCG numbers double every two days or so. A more modest increase would indicate an ectopic pregnancy.

In the interim, I had to be vigilant for signs of rupture. If I suddenly started to bleed, or buckled over with nausea, or grew dizzy from plummeting blood pressure, then I was supposed to go to the emergency room. “You need to tell me if you have any abdominal pain,” my doctor said. “Especially if it’s sharp.” I told him yes, of course I would call a doctor if I had shooting pains in my abdomen. “You’d be surprised,” he said. He asked whether I had any questions, but I’d lost my analytic abilities. My appointment ended, and I went home to wait.

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is an assistant professor at the University of Mississippi’s Meek School of Journalism and New Media. Her most recent article for Harper’s Magazine, “Long Division,” appeared in the June 2013 issue.

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