Ectopic Pregnancies: What to Know and How to Recover
I discovered I was pregnant in November of 2007, which immediately gave me the idea for the perfect Christmas gift for my husband. I went out and bought a pair of baby booties and wrapped them while trying to figure out ways to keep the secret of my pregnancy for the next six weeks. I could think of nothing better than watching Troy open the booties and learn he'd be a dad again. He'd jump for joy! And our little family of four would celebrate the upcoming new addition. Maybe the boys would get a sister. It'd be the best Christmas and new year ever.
Two weeks later, I was at work and started cramping in my lower abdomen. Doubled over in pain in my office, I called my doctor and asked to be seen. Even though I wasn't far along, I knew something wasn't quite right. The nurse told me that some cramping and groin pain is normal and to call her back if I experienced any bleeding. In the middle of the night, the cramping became so severe that I woke up my husband, told him I was pregnant, and that something was wrong. So much for the Christmas gift of all Christmas gifts.
We went to the doctor the next day and began the first day of a 6-week endeavor to try and save the pregnancy.
I wasn't far enough along for the doctors to see anything on an ultrasound or to hear a heartbeat. We had good news and bad news. The good news was that my pregnancy hormone levels were increasing daily. The disturbing signs, what potentially could be the bad news, were that I was cramping and had started spotting. The doctor suspected an ectopic pregnancy.
The Basic Facts of Ectopic Pregnancies
I had never heard of ectopic pregnancies (or maybe I had and didn't pay attention). If you're at all like I was (and don't know), here's the basics:
- An ectopic pregnancy happens when the egg implants outside the uterine lining. In my case, it implanted in my Fallopian Tube. P.S.: This happens in 1% of pregnancies.
- Ectopic pregnancies, if not treated, can result in death most commonly due to internal hemorrhaging.
- The good news is that early diagnosis and treatment resolve the majority of ectopic pregnancies. The technical term is tubal abortion and the treatment is a medication commonly used for chemotherapy called Methotrexate.
- The decision to wait it out or to end the pregnancy can be a confusing one. And this is where the story goes totally atypical and got incredibly difficult.
If you're anything like me, you find words like internal hemorrhaging, abortion, and chemotherapy a little scary and nothing short of overwhelming. I found myself asking, "Do I take the risk of bleeding to death to give this baby a shot at life? Or, do I end a pregnancy that wouldn't be viable anyway and ensure my health and safety?" All sorts of health, safety, values-based, and other issues surfaced and what seemed like a simple issue to begin with, all of a sudden felt weighty and one I was ill-equipped to make on my own.
What further complicated my decision-making process was when my doctor said he couldn't be 100% sure the pregnancy wouldn't be viable. That, coupled with the fact that my pregnancy hormone levels were increasing, caused serious doubt for me. "What if I ended the pregnancy unnecessarily?" I thought. That thought alone was enough to make up my mind to wait a little longer.
During the wait, I should have stayed in bed. But, not being super wise, I went to my accountant's office. The ride over was painful. My cramping increased significantly. I immediately went into the bathroom upon arrival and in addition to the loss of a lot of blood, lost large pieces of tissue. I about passed out, thinking my insides were falling out. I called the nurse, who said that I was probably having a miscarriage. She instructed me to take the tissue from the toilet, wrap it in paper towel, and bring it to the doctor's office. Gross! I about threw up, but reached my hand into the toilet and gathered the biggest piece and took it into the office. At least a miscarriage would be better than me having to make a decision to have a tubal abortion, I thought.
Once the hard part of passing the tissue and retrieving it was over, we headed to the doctor's office. A few days later, I learned that I had passed my uterine lining and that it was void of fetal tissue. This confirmed that I was having an ectopic pregnancy and while we didn't know where the egg had implanted itself at the time, I felt better about making the decision to end the pregnancy. We discussed options and Methotrexate seemed like the best choice.
But the egg was stubborn.
I took a dose of Methotrexate but not before somehow missing the news of all of the potential side effects: nausea, fever, fatigue, dizziness, among others. And I experienced them all. What I did not experience, however, was the reason I took it in the first place... to resolve the ectopic pregnancy. Nope! My pregnancy hormone levels kept increasing. I was a mess emotionally. I had the beginnnings of a baby inside of me that didn't want to go. Logically, I knew it wasn't a baby yet and I knew the pregnancy wouldn't be viable, but it felt as if it was real and as if it were hanging on for dear life and while I was trying to be very practical and not get emotional, it was simply impossible. I was trying to grieve losing a baby I hadn't, and that didn't seem to want to be, lost.
My doctor gave me a second dose of Methotrexate right before Christmas. I struggled through the holidays, pregnant and cramping. I just wanted to move on. I waited for the Methotrexate to take effect. I could always try and have another baby, right? And I had two beautiful boys to be grateful for in the event that couldn't ever happen, I kept telling myself.
And then, on January 7, 2008, after two doses of Methotrexate and six weeks from my first doctor's visit, I developed all the signs of a ruptured Fallopian Tube and Troy drove me to the ER, where they performed a vaginal ultrasound, saw nothing amiss, hopped me up on pain pills, and sent me home against my wishes. I begged them to keep me for observation. If there's anything I've learned in my nearly 40 years, it was that I know my body. And, when I suspect something of being amiss, it is definitely worth looking into. But, my begging went unheeded and I ended up at home and experienced one of the longest, sleepless nights of my life.
The next morning, I called my nurse and asked to please be seen again. I knew something was wrong. She said to come in in a couple of days, that since the ultrasound hadn't shown anything, that I just needed to give my body time to process the Methotrexate. I started crying and asked if they'd please see me. She said yes. And I replied, "Will you have a massage therapist on hand? My shoulders are killing me. I have severe pain in them." I laughed as I said it and she got serious and told me to please get to the office as soon as possible.
Severe shoulder pain is one sign of internal bleeding. And as it turns out, my Fallopian Tube had ruptured, but not in the typical way, because typical would not be par for the course with me. Instead, a small tear developed and blood was drop by drop making its way into my abdomen. When I went into the ER the night before, not enough blood had pooled to show on the vaginal ultrasound. But five hours later, when I got a second vaginal ultrasound, the sight was alarming enough that the doctor picked me up, put me in a wheelchair, and ran me into the OR, where they were ready with blood transfusions and for him to operate on me. I was at once angry at the ER for sending me home when I told them that something was wrong and to keep me for observation and grateful my nurse went against protocol and decided to have me come in that day, saving my life.
The recovery wasn't easy. But after 24 staples in my abdomen, a 4-day hospital stay (in the maternity ward no less... talk about emotional), and six weeks in bed, I was able to walk like normal and start to process the grief of losing a baby.
Tips for Recovering From the Loss of a Pregnancy
While every woman is different, here are some recovery tips I found useful:
- Move through all the emotions you feel: anger, sadness, frustration, or others. Don't tell yourself you shouldn't feel a specific emotion or that you should get over it within a certain time frame. Just feel it, process it, and let yourself grieve, recognizing it is part of the recovery process.
- Give yourself a break. Taking time off from housework, professional work, and even scaling back on your personal obligations will help you make time to go through the grieving process, to recover physically, and to get the energy you need when you step back into life as you knew it.
- Let others help you. Don't turn away help with housework, meals, child care, help with your job, or anything else. The people that step in to help will be your biggest support system in helping you get through this rough time.
- Talk it out. Whether you speak with family, friends, a therapist or all of the above, talk it out.
- Write it out. I wrote over 100 pages in my journal during the six weeks I was in bed recovering. Not everyone is a journal-a-holic like I am and some aren't as slow to heal as I was. If writing helps you process, regardless of how many pages you write or how much time you have, do it! I found it to be one of the most beneficial ways of processing my experience.
- Keep on top of your doctor's visits. Physical health is as important as emotional health. Paying attention to both in the recovery process will get you a clean bill of health much more quickly.
The thing that helped the most was being able to take maternity leave and spend uninterrupted time with my two beautiful boys. It’s four years later and after such a scary experience and a subsequent miscarriage, we are still a family of four. I’m grateful for the family I have and that I was able to make it through the ectopic pregnancy alive.
Featured image courtesy of Flickr.
Have you experienced an ectopic pregnancy? What was most helpful for you in your recovery?