mercoledì, ottobre 19, 2016

Oversharing, on purpose

A person who's very close to me and who I love very much and who had been trying very, very hard to have a baby for many years just miscarried. She had made it to where I made it last year, and my miscarriage was detected the same way hers just was - 12 week scan, whoops sorry, I know you still feel pregnant, but there's no more baby there, diagnosis missed abortion.

But since she's in Australia, they just let her body get rid of it itself, instead of the curettage my gynecologist immediately packed me off to here. It's the second time I've heard that being standard in Australia, that they wait for the mother's body to do it itself when there's a missed abortion around that time, or at least that they don't rush to book in the curettage and the result is the mother's body doing it itself. And there's a rationale behind that. It makes uterine scarring a little less likely than it would be if you got a curettage from a doctor who wasn't competent, and I guess Australia is a pretty litigious society where the general assumption is that people aren't competent (and frankly, in the short time we were there, I did meet a fair few incompetent doctors).

And as the F-word cynically pointed out, it's probably cheaper on average to not intervene, which would make non-intervention more likely in a public health system like Oz, and an intervention more likely in an insurance-based system like the one here.

But - damn. It makes me realise - I had a really good miscarriage. Once you're on the level of discussing something as awful as miscarrying, that seems like an absurd or even offensive thing to believe. But there are good and bad ways of dying and there are good and bad ways of miscarrying, and maybe if we talked about both things a little bit more we'd be better at them.

 So. Here's me. 

Losing my baby was really emotional terrible. The physical process of the loss was NOT terrible. The missed abortion was picked up in the morning, and I spent that afternoon being upset at home and then processing through all the requisite checks and interviews at the nearest hospital. Because of the hours I spent being upset at home, there wasn't time to have the curettage the same day as the detection. But I was seen quickly by the gynecologists, who were kind and sympathetic, and gave me the choice of whether or not to watch the screen while they were checking the fetus for any unexpected signs of life. I went back to the hospital the morning after the missed abortion was detected for the curettage. All through this process, all I felt was pregnant. Still sick in the mornings, still tired, still that general physical sensation of the first trimester - and that's it. I lay in bed for a couple of hours waiting for the initial drugs to start the sloughing process while I thought about what had happened and said goodbye to the poor little body inside me, and then I went under sedation like I was slipping into some satin sheets. I woke up fantastically refreshed as my system flooded itself with whatever hormones you get flooded with when you're not pregnant anymore. I wasn't euphoric or anything, but I was in a really terrific physical mood, like when you've had a big sleep after an active day and you want to eat a couple of steaks for breakfast.

That's it. It took me a long time to not be terribly sad all the time, and I still am some of the time, and I'll always be more fearful and sad than I was before losing the baby. And I don't know what different emotional states I'd be dealing with if I didn't already have a living child, and if I didn't manage to get and stay pregnant again soon after the miscarriage. And I think I'll probably lose my mind permanently if anything happens to the baby I'm carrying now, which is almost full-term.

But as far as my physical experience of miscarriage goes, what happened above was it. I didn't even see any blood, except for a tiny bit after taking the sloughing drugs and before going into the operating theatre. I contrast that with what my friends in Australia told me about their experiences with nature being allowed to take its course after the missed abortion was detected at the 12 week scan. It hurt, terribly. It hemorrhaged, awfully. I think ultimately both of them ended up spending a lot more time in hospital than the eight-odd hours I was in for my checks, interview, and curettage, so if there is a money-factor in this sort of decision-making, it was a pretty false economy (though they were seen to mostly by nurses while I was seen to by nurses, an anaesthetist, and some gynecologists so the staff/specialist spend was certainly higher). And the process, in both their cases, lasted a week or more.

Do women who face this understand there are other choices that are or aren't being made for them? I'm sure they don't. I didn't. I was resentful when I researched it afterward that I'd been packed off for a curettage without any other option being presented, because I was scared of scarring and risks for future pregnancies. But then hearing how things went for my Australian friends . . . they certainly got scarred, if not physically; the whole process was simply much, much more traumatic for them, so much so that I can't understand their experiences, even though our tragedies were all the same. 

These are things we need to be able to talk about, as women. Not just because miscarriage is shitty and it helps to talk about shitty things or whatever the fuck, but because it's a matter of agency. Of control of our own bodies. I don't know why things are different here from Australia, but I'm pretty fucking sure it's not because of what women want here versus what they want in Australia.

1 commento:

aglaiketstirk ha detto...

Yip. But you and I don't know of a world that's designed around a woman's needs or best interests.
Sexual health and reproduction is just another area where our lack of power screams patriarchy.
And it gets no better whether you're at the beginning of that - or the end.
Services here are not 'woman-centric' or designed to meet our needs. Our fucking bodies are a fucking mystery - even to us. From the shape and size and extent of our clitoris to how or why we orgasm to the chemical constituents of breast milk - it's all theory, prejudice and the source of jokes and discrimination.
We cry? Oh well, that's our hormones. We scream or are angry? Oh well, that's our hormones. We are hysterical. We are irrational. We are the symbol of chaos. The centre of sin.
Jeez.
I'm sorry about your friend and I am so sorry about your own miscarriage. Life can be full of such cruel shit.

My own miscarriage came at the 4 month mark. My 3rd pregnancy.
I expelled what was clearly the amniotic sac - and contacted my doctor. I was sent for a D&C anyway. I was 28, had two kids already and was trying to finish another degree - the pregnancy wasn't planned but it wasn't unplanned either. I felt ambivalent about it - and about its end. The fact that I had no period after the D&C because I was immediately pregnant again, probably indicates that I cared more about the ending of that 3rd baby than I admitted to myself or anyone else.
But I'd grown up with a permanently miscarrying mother. I witnessed her final stillbirth (7 months) - can still see the blood. I suspect I am desensitised to miscarriage. In many ways it was normalised for me just by virtue of early experience.

I hope your current antenatal care is high quality.
Thinking of you and your friend. x