A Little Death and A Lot of Grief

 “A short list of what died that day: my daughter, me, my dreams, her future, all my gods, my laughter, the cabbage I covered my engorged breasts with, and this part of my stomach where I keep her sadness.” -Sarah Agaton Howes in “Lessons from Dying”

I thought I knew what it was. 

I didn’t know what miscarriage was. 

Wasn’t it just a heavy period in the privacy of your home, maybe before you got too attached to the little one growing inside you?

I knew the stats, memorized them when I got pregnant with Teddy.

20% chance of the pregnancy ending within the first 6 weeks. 

10% between 6 and 12 weeks. 

5% after the first trimester. 

I learned new stats this time around. 

1-3% of pregnancies end in the second trimester.

1-2% result in stillbirths (after 24 weeks).

These stats are, of course, raw data, without accounting for race, socioeconomic status, or previous health conditions. Among Black and Indigenous individuals, these rates are much higher, as well as among those experiencing poverty or underlying health conditions (and apparently wealthy Black women are at an increased risk?!). The stats also didn’t tell me that gestation age at the time of miscarriage isn’t a definitive measurement of the extent of grief one feels.

On January 23, 2023, I went in for a regular prenatal appointment by myself--the first in my second trimester at just under 16 weeks. My doctor took out her stethoscope to listen for our baby’s heartbeat, and then took out a travel ultrasound to try to listen. I sat patiently and rather unconcerned, wondering what I would eat for lunch. She asked if we could go to the ultrasound room and I followed her, somehow still not expecting anything was wrong. Even as the ultrasound technician took measurements of my baby, I remember thinking--wow she’s only measuring at 15 weeks. She’ll be smaller than Teddy was.

The doctor made eye contact with the ultrasound technician, and then she took my hand and told me my baby had no heartbeat. 

The daughter I had ached for. 

No heartbeat. 

The child I spent months yearning for, willing my postpartum period to return earlier than it did (breastfeeding delayed it for a year) and peeing on dozens of sticks in the meantime just in case I’d ovulated before my period.

No heartbeat. 

My summer sunshine baby, who fit into so many personal and professional plans I had--one who would be just under two years younger than Teddy but only one grade.

No heartbeat. 

I didn’t know about missed miscarriages. That you could show up at a doctor visit only to find out you’d been carrying around death for days (weeks for some people). 

I didn’t know the same procedures that reproductive rights advocates rallied for made both miscarriages and abortions safer--that D&Cs and D&Es were common surgeries for miscarriages during the first two trimesters, that in the first trimester you’d want access to (hopefully both) mifepristone and misoprostol if you wanted to safely pass the pregnancy at home. 

The doctor explained to me that losing a baby in the second trimester meant it wasn't safe for me to deliver her at home or wait for my body for deliver her--I could either be induced and deliver her at the Bloomington hospital, or schedule to go up to Indianapolis for a D&E (more invasive than a D&C and requires more medicinal training). Wanting to see my baby--the brief life I had grown--I told her I wanted to be induced. She held me while I cried and told me I could stay as long as I needed in that ultrasound room.

From there, I called Dallin in between sobs to tell him our little girl didn’t have a heartbeat and I’d need to be induced that week. I texted my parents, who unfortunately had just left on a cruise for the entire week. My sister-in-law Becca called the hospital for me that afternoon to schedule the induction for Wednesday. I’d wanted time to process, to arrange childcare, to teach my class one more time while pregnant. 

But was I pregnant? What do you call someone carrying death in their womb? 

For five days, I’d been walking around with my dead child tied to me, but my body hadn’t told me. My body had let her die and then hidden the evidence. 

That was another barrier I quickly ran up against. Had our baby died without having lived? Surely, she had existed--and for me continues to exist. The lack of words to discuss pregnancy loss was something I had not expected. It was not part of the stats I had memorized.

Waiting two and half days before returning to the hospital turned out to be too long. I had trouble sleeping, unsettled by knowing I had lost my daughter without having had the physical confirmation of her separating from my body. I tried to continue life as best I could, attending meetings and teaching but mostly weeping. I read so many blogs and articles on second trimester loss, including this account so beautifully and sorrowfully written titled Delivering Death.

The first night I’d ever spent apart from Teddy was spent in labor for his dead sister. My friend Abby stayed the night at our house with him while Dallin, Becca, and I drove to hospital, did a lot of waiting, and I was vaginally induced around 9:30pm. 

When I was pregnant with Teddy, I met Melissa Larimer at Flora Massage, who specializes in prenatal and postpartum care (she also had doula training in the past). I texted her on Tuesday to tell her about my miscarriage and she offered to come be at the hospital with me at the beginning of the labor. She also helped prepare me via text for what to expect from the labor and delivery of a 16 week gestational old baby. Melissa’s support was one of many gifts people offered me over the course of these hellish weeks. 

I rested/dozed fitfully until around 2am, when I was given more induction medication orally.  I then listened to a podcast until 3am when my contractions started to get more intense. I asked for pain medication, which made me feel pretty incognizant and somehow resulted in me telling my generous sister-in-law--who spent the night on the hospital floor to be with us--that I wanted to punch her in the face. 

At 5am, the pain medication had worn off and my contractions were fairly intense. I was not physically or emotionally prepared for this kind of labor, labor I had not anticipated for many more months. As the contractions intensified and I yelled out in pain, I asked for (demanded?) an epidural. By the time it was ready, the intensity had passed. The doctor on call checked my cervix and said I was only 1 cm dilated, so it would probably still be a while. 

With an insane urge to pee after her inspection, I delivered our tiny Sara a few minutes later.

Dallin and I both held Sara in the smallest of blankets. Her features were ambiguous and body soft, but her fingers were perfectly formed, her toes individualized. We spent two hours with her, trying to remember the time we’d had with her (a trip to Utah, playing volleyball, lots of movies while lying on the couch) and mourning her loss from our lives, the child we’d never get to raise. The hospital graciously made us a memory bag for her, a teddy bear that mirrored her body’s size, hand and footprints, her measurements, and a few other mementos.

Sara’s delivery was not the end of our stay. We waited and waited and waited for my placenta to come on its own. Teddy got special permission to visit us in the hospital because he was still breastfeeding, and that was the only part of our stay that didn’t terribly suck. He is too young to understand much of anything, so the hospital was simply a new place to briefly explore. After 10 hours, my placenta still hadn’t come and so the doctor recommended a D&C. Much to my delight after having not truly slept in two days, I went under general anesthesia for the short surgery--but not before being warned there was a good chance I might need a blood transfusion (which is always nice to hear) and a very small chance my uterus could be punctured. Everything went well though and I was so relieved to be done with the whole physical process when we left the hospital at 9:30pm Thursday evening. 

The medical staff didn’t have any explanation for this miscarriage--there were no genetic abnormalities, no malformations of her body or organs that would have made her incompatible for life, my placenta was normal. Sometimes shit just happens. Stats don’t keep you safe.

Because I had a C-section for Teddy’s birth, I was given two IVs that left large bruises on my arms. Ugly bruises that lasted for three weeks, but because they reminded me that this had really happened, I wore them like a prize. A physical manifestation of the trauma on my body and soul from the miscarriage. I struggled to be grateful for my postpartum body, the one which  had betrayed me (after multiple miscarriages, Sarah Agaton Howes referred to her body as “the deathtrap”). I bled for a week and my milk supply increased. My tiny baby bump remained, but there was no baby. My hormones raged. I tested high on depression on my postpartum screening--but how do you differentiate depression from grief? 

I am not sure I have ever felt so emotionally and physically drained after that week. I spent the following weeks engrossed in articles, poetry, and books about miscarriage, my favorites being Unexpecting: Real Talk on Pregnancy Loss by Rachel Lewis by and What God is Honored Here edited by Shannon Gibney & Kao Kalia Yang. I wish I’d read Kate White’s Your Guide to Miscarriage and Pregnancy Loss before I’d had a miscarriage, but I didn’t have a strong impetus to do so without experiencing a miscarriage myself.

I’ve continued living life while (mostly) quietly but also sometimes ugly and loudly grieving Sara. The first two weeks of the miscarriage, I didn’t want to talk about any of it with anyone outside my family. Now, I find myself wanting to be asked about Sara and her birth. I’ve had more social anxiety, knowing dead babies don’t make for pleasant conversation but also having all of my recent experiences influenced by this loss. I know death makes others sad and it’s impossible to know if and how to bring it up to someone--not only because it’s awkward but also because everyone processes their losses differently and there is no wrong way to mourn. But the grief is there. 

Through all of this, I am genuinely happy for my friends (and strangers) who are pregnant or have newborns. I am, yes, often jealous of the new life you’ve grown and sometimes sad or angry about my own loss but SO GRATEFUL you’re growing/grew life as well because I am also absolutely terrified on your behalf. I will never again have the ignorant bliss of my first uneventful pregnancy with Teddy, not ever seriously wondering if I would lose him. The stats were in my favor, so why consider the other possibilities? It is an absolute miracle that we keep choosing to make and birth babies when there are so many things that can go wrong. Things stats don’t give you specifics on. 

I’m not really on a quest to “normalize” miscarriage, but I do want to normalize talking about pregnancy loss. I hadn’t heard stories of second trimester loss outside my own mother’s until I had my own. In what could have been an overwhelming lonely experience, I had so many people reach out to tell their own stories of loss--losses that changed them forever. We received flowers, food, and items to help us memorialize Sara’s part in our family and I have been deeply touched by people from many parts of my life.

This is what miscarriage can look like. 

I thought I knew who God was in my teens and early twenties. I spent many years of my life thinking God wanted me to be unhappy, that my plans were made to be destroyed. I trusted that God’s plans were better than mine, but I sure did hate that those plans included canceled trips, fraught breakups, sickness, death, injury, and unsuccessful applications. The emotional labor of working out details of my life often felt squandered.

I let that vision of God die and have shifted faith to a more concealed but also more compassionate God. One who is just as grieved when we experience loss, when our plans fall through, when our hearts break. This God wants my plans to work out. Does this mean I believe in a helpless God? If so, it’s better than believing in a God of Death, one who is all-controlling and wants us to suffer in order to learn something.

Maybe I don’t know God that well, but I think I felt Her tender hand holding mine as I delivered death, sensing that She knew what it was like to feel this kind of helplessness. Have I humanized God too much through this imagination?  

I don’t want a God who destroys, I want a God who weeps (“In Her Arms” by Paige Payne”)

Grief is love.

“My heart has depth I am certain grief gifted me.” --Sarah Agaton Howes in “Lessons from Dying”