*If you’ve experienced pregnancy loss this post may be triggering for you so please proceed with caution.*
Not in a million years did I think I’d be writing this post. For one, I’ve never had a desire to document my pregnancy experience or share any of mine and C’s family planning choices with anyone besides the two of us. And secondly, I never thought pregnancy loss would happen to me.
It’s true. Despite pregnancy loss being so common, you just don’t expect it to happen to you. It makes the whole experience feel so surreal and quite honestly, I’m still trying to process it.
But I’d like to believe that some kind of purpose can be derived from this experience and/or at the very least could help one of you feel a little less alone. Because that’s how the last month of my life has felt. So, incredibly, alone.
I’ve spent countless hours on reddit message boards reading about ectopic pregnancies and women’s various experiences with them hoping to find someone who shared something in common with me. I desperately googled “ectopic pregnancy” only to find pages of clinical websites listing off risk factors that didn’t apply to me and stats and outcomes that made my heart sink. I wanted to hear from a real person going through this. Not a statistic.
At one point during this journey (or saga!) I went down a rabbit hole of trying to hear a first person account of a D&C (more on that in a bit) and found a blogger who willingly opened up about her experience and shared not just the events but slso her emotional experience with the D&C. It helped me to mentally prepare for my own D&C and also reminded me that whenever this season of my life was done I would want to be just as helpful as she was for me.
So here I am sharing what the last month of my life has entailed. This has been going on in the midst of a pandemic, raging wildfires and poor air quality on the West Coast, racial injustice protests and in my case, a not-so-fun hacking of The Healthy Maven which took my entire business down for 5 days. So yeah, this month has sucked. But I’m feeling ready to talk about it and hopefully help continue processing what has happened to my body.
Finding Out I’m Pregnant
The title of this post gave away the ultimate outcome of this pregnancy: ectopic. However it took 10 days before we were able to confirm this. So I’m going to tell our story from the beginning. Let’s flash back to August 12, 2020.
A week and a half prior I had had my period which was nothing out of the ordinary. I am incredibly fortunate to have a regular, manageable period. It’s pretty consistently 28-29 days, with the first day being the heaviest and the most painful. Typically it will last another 4 days of light spotting and then I’m done.
However, a week after my period *should* have been finished I was still spotting and cramping. I found this unusual and thought I’d just connect with my OBGYN to be safe. We chatted (pandemic-style) over the phone and she suggested I come in for some testing and that if I had a pregnancy test at home I should use it. I kind of scoffed at the idea because I’d just had my period and thought that unless immaculate conception had occurred there was a 0% chance I was pregnant. But I rushed out to CVS anyway and picked up a pregnancy test.
Not an ounce of me expected it to say positive but much to our surprise the word “pregnant” appeared on the test and C and I were absolutely shocked. We were so happy but also knew that things weren’t adding up so we shouldn’t get too excited. I messaged my doctor and she cautiously congratulated us but also told me I’d need to come in for extra testing that afternoon.
I went in and had blood work to confirm my Hcg levels and also have an ultrasound. My Hcg levels were at 1024 and the ultrasound could not find anything on the screen (in my uterus or elsewhere). I was told I’d need to come back in 48 hours to test my Hcg again and see if it had doubled as well as have another ultrasound.
That first 48 hours of waiting was excruciating. This was the only time C and I held onto the belief that this could still be a normal pregnancy. If what I thought was my period in late July actually wasn’t my period, then I would still be in early pregnancy (5ish weeks) and there was a chance I was too early for anything to be seen on the screen. But we still had no confirmation so we just had to wait.
I went back to the doctor on Friday 48 hours later and had my Hcg tested again and another ultrasound. My Hcg had doubled to 2131, which was a healthy trajectory but again they could not see anything on the ultrasound. I was sent down to radiology for another ultrasound to confirm but they also didn’t see anything. Because I wasn’t in any pain and I was otherwise stable my doctor suggested we do another 48 wait and test.
I went back 48 hours later and while my Hcg hadn’t doubled it had increased more than 50% which was still indicative of a healthy pregnancy. The new metrics for when you’d expect to at least see a gestational sac on an ultrasound is an Hcg around 3500 and mine was at 3214. Because I was still below the threshold and this was a desired pregnancy, we decided to wait another 48 hours.
Guys, I am not a patient person. While I’d begun to suspect this was not going to end well, the waiting periods were driving me nuts. We also were in the middle of a massive heat wave with no A/C, smoke advisories from fires and my body starting to show it’s first signs of pregnancy (extreme bloating, aching legs and painful breasts). I was not in a great mood, to say the least.
48 hours later we did another round of testing and again my numbers didn’t double but went up in a still healthy range to 4900 and still we couldn’t see ANYTHING on an ultrasound. I was officially diagnosed with a “pregnancy of unknown location”. It will likely be the strangest diagnosis I will ever receive in my life. Turns out I was pregnant, they just couldn’t find out where.
If you don’t know anything about an ectopic pregnancy, it’s basically a pregnancy that develops outside of your uterus. A healthy and viable pregnancy can only develop in your uterus. If it develops elsewhere it is not a viable pregnancy. 2% of all pregnancies are ectopic (very rare) and 98% of them happen in a fallopian tube. At this point I was in the 2% of the 2% in that my ectopic could not be found. But it was time to start making decisions and moving forward…
And for those wondering, what I *thought* was my period a week and half a prior ended up being heavy implantation bleeding which happened to occur on the exact day I expected my period. So it was just bad luck and also meant I was at 6 weeks pregnant based off my LMP. Okay moving on…
Because my pregnancy could not be found on ultrasound, we had to do a D&C to confirm it was not in my uterus. If you’ve never heard of a D&C, it’s a dilation and curettage procedure to remove tissue from inside your uterus. Sadly, most women come to learn about a D&C if they’ve experienced a miscarriage. Though there are a couple ways to miscarry, a D&C is the most invasive but also the fastest and most confirmed option.
I did not receive a D&C because I had miscarried. I received a D&C because they needed to extract tissue from my uterus to confirm there was no pregnancy tissue in there. It would help us confirm my pregnancy was ectopic if no pregnancy tissue could be found.
Now I don’t want to scare anyone with this and I know every woman has their own experience with pregnancy loss but by a landslide my D&C was the most painful thing I have ever experienced. Some women are put under general anaesthesia for the procedure (which I would have 100% done) but due to the pandemic and wanting to avoid the hospital as well as the fact that they didn’t expect to find much in my uterus they suggested local anaesthetic and pain meds instead of being put under.
Now at this point we’re 9 days after the initial pregnancy positive. C drove me to the hospital but sadly had to wait in the car. I was probably there for a total of 1.5 hours. I was given pain meds and anxiety meds and told to wait 15 minutes before the procedure would begin. I’m not going to lie, having to do the whole procedure alone totally sucked. I was skeptical that only waiting 15 minutes for the meds to kick in would work but I was also desperate to get out of the clinic and back to C. I just wanted the whole thing to be over.
In hindsight I should have insisted we waited longer for the pain meds to kick in. In the end the pain meds didn’t work and the local anaesthesia also didn’t work (even though they gave me double the dose). My doctor had told me that the procedure would most likely feel like heavy cramps but I have truly never felt anything like this in my entire life. I lay there crying (I’m not much of a crier- it takes a lot to get the flood works going!) while it felt like she was stabbing my insides with a knife. I asked her if this was what heavy cramping feels like and she said it shouldn’t be too painful. When I told her it felt like she was stabbing me she just kept apologizing and tried to move as quickly as she could.
When it was done I just lay on the table sobbing. I somehow picked myself up and walked myself to the pharmacy to get my pain meds and then met C at the car. By the time I got home all of the pain and anxiety meds had kicked in and I passed out for a few hours.
I still to this day don’t know why it was so painful. Most of what I read and what the doctor had told me indicated it shouldn’t have been. So I guess I’ll pose this to you: If you had a D&C, what was your experience like?
Treating the Ectopic: Methotrexate
We had to wait 24 hours for the results from pathology to confirm or deny pregnancy tissue in my uterus. When the results came in they didn’t surprise anyone: no pregnancy tissue in my uterus. I had a confirmed diagnosis of an ectopic or in my case a pregnancy of unknown location (a rare type of ectopic).
Most women discover they have an ectopic pregnancy because it ruptures. This is typically a very painful experience that can be life-threatening if left untreated. In my case, I was stable so no surgical intervention was necessary. If you catch the ectopic before it ruptures the usual course of treatment is to treat with a drug called Methotrexate.
Methotrexate is a chemo drug that is injected into your bloodstream to help your body break down and absorb the pregnancy. Methotrexate is a folate antagonist which means it depletes your body of all folate which is essential for growing a healthy baby. It’s why doctors encourage you to take prenatal vitamins with folate before and during pregnancy.
In my case I’d need a shot (or 2 in the bum!) of methotrexate and need to follow a low folate diet. Guys, folate is in everything healthy aka all veggies. So following a folate-free diet really wasn’t fun for me. I was also told I shouldn’t drink because my liver was in overdrive and that I’d have to eliminate all exercise, heavy lifting or strenuous activity in case it still ruptured. Because here’s the thing about ectopic pregnancies: even if you’re treated with methotrexate, you’re still at risk of rupture until your Hcg levels drop to zero which typically takes around 4-6 weeks.
So I was on bed rest which honestly wouldn’t have been so bad if we weren’t trapped inside because the smoke was so bad outside.
I’m pretty fortunate in that my methotrexate reaction wasn’t too terrible. The first 48 hours were the worst with a low grade nausea and a weird metallic taste in my mouth, which I’m told is very common for chemo drugs. About 4 days after the shot I had some heavier cramping but nothing too painful.
The protocol with methotrexate is a 4 and 7 day follow-up and then 1 week follow-ups thereafter. 4 days after the shot it’s typical to see Hcg levels rise (mine did and hit 10,295) but then if they fall by at least 15% on day 7 from day 4 you know it’s working. Luckily mine fell 20% on day 7 which meant I didn’t need to get another methotrexate shot. At that point I was on bed rest, following a low-folate diet and just hoping for the best.
Obviously my preference would have been for the methotrexate to be effective and a few weeks later start feeling somewhat more normal. But you can’t always get your way. 13 days after my initial methotrexate shot and 6 days after my levels had dropped 15%, I felt a sharp pain in my belly. I was told to look out for sharp pains that are hard to breathe through or a feeling of needing to faint or dizziness. I was on the phone with my friend Meg, literally laying in bed doing nothing when it suddenly came on.
It was painful but I was able to breathe through it and talk with Meg for another 20 minutes. At first I thought I might be having a bad gas pain? I just really didn’t want it to be a rupture.
But after hanging up I ran to the bathroom and trying to pass a 1 and 2 was so painful I knew it must have ruptured. I called C from the upstairs bathroom and told him I thought my ectopic had ruptured but I wasn’t sure. Either way we knew we needed to rush to the ER just in case.
Ectopics are the leading cause of maternal mortality in the first trimester. If you don’t know you have one you could confuse it with some other kind of pain or put off dealing with it. But when an ectopic ruptures it releases blood into your abdomen which can cause you to go into toxic shock. So you need to get treated ASAP if you have one.
We hopped into the car to head to the ER and I called my clinic along the way. Pro-tip: if you know your ectopic has ruptured, have your clinic call the ER to inform them of your case and that you’re coming in. C pulled up to the ER and having to say goodbye and hobble my way into the hospital was awful. Not having partners be a part of this process is really, really difficult.
Thankfully they expected me and I was whisked into the hospital immediately and given an ultrasound and pain meds right away. The ultrasound showed free fluid (I.e. blood) which indicated that my ectopic had ruptured. What’s crazy is that at this point they STILL couldn’t see the pregnancy. They suspected it was in one of my fallopian tubes but they couldn’t be sure until I had surgery.
Which leads me to the next event in this saga: emergency surgery.
If your ectopic pregnancy has ruptured there is only one option – surgery. Thankfully, I was a good candidate for laparoscopic surgery, which is less invasive and leaves only 3 small scars. The on-call OBGYN (I’ve now met 6 of 8 doctors in the practice!) had me call C on speakerphone so she could explain the procedure and what we might expect. I was going to be put under general anaesthesia and they would make 3 small holes (1 through my belly button) and look around for the rupture to remove the pregnancy. Even though we couldn’t see it on ultrasound, there was a good chance it was in one of my fallopian tubes and based on bleeding it was likely the left one. While she said she’d try to preserve the tube if it was in there, I’m also at much higher risk for another ectopic if we leave a damaged tube inside of me.
Based on what little information I could gather in that moment I gave her consent to remove the tube if it looked in rough shape and couldn’t be repaired. Then I demanded Ativan (lol) and let them wheel me up to pre-op.
At this point I don’t remember much. The morphine and Ativan had kicked in and everything became a blur. The last thing I remember was the anesthesiologist saying “this will feel like a glass of wine” and me responding “haven’t had one of those in a while!” and then I was asleep.
When I woke up I was pretty freaked out. It was late at night (11:00 PM) and I was the only person in this big post-op room. C couldn’t be there and I could make out two women sitting at a desk. From what I’ve been told, I started to panic pretty intensely and was yelling for Ativan. I’m glad that my subconscious knew how to treat my anxiety lol…although it’s somewhat ironic because up until that point I’d only taken Ativan 3 times in my life and one of those times was just before the surgery.
The nurses helped me get dressed and then wheeled me out to the parking lot where C was waiting for me. He took me home and helped me get into bed and take my meds. My mouth was so dry that I kept insisting on spoonfuls of coconut oil?! Honestly it’s all a blur.
When I came to, C told me they had found the pregnancy in my left fallopian tube and that it had grown to an inch (3 cm) and had damaged my tube. The had to remove my left fallopian tube along with the pregnancy and removed half a litre of blood from my abdomen. My Hcg levels had dropped pretty substantially to 3451 (from 8250 the week before) but in spite of this it still ruptured. It’s all just so crazy. That’s what I have to say about that.
The Recovery – Physical + Mental/Emotional
I’m breaking down the recovery into physical and mental/emotional because both have looked very different.
The first 48 hours after surgery were the worst. I couldn’t walk, I had no appetite and C literally had to do everything for me. One thing I’ve learned about laparoscopic surgery is that it’s common to have intense shoulder pain even though the surgery was done on the abdomen. In order for them to see around they inject you with CO2 which then gets trapped in your body and oftentimes makes its way up to your shoulders. For the first 48 hours after surgery my shoulders hurt SO much. Rolling side to side was painful and i’m not a great back sleeper so none of it was ideal.
Then the pain dissipated and I was able to walk again. Within a week I was hiking up in Tahoe (albeit pretty short hikes) and felt *mostly* like myself again.
The one annoying thing that has remained (we’re a little over a month out and 2 weeks from surgery) is a terrible rash I developed on my hip bones. I’ve come to discover that NO ONE talks about this, but it’s actually quite common to develop an allergic reaction to the mesh underwear that give you at the hospital. I was bleeding quite a bit after the surgery so I went home in mesh undies and a giant pad and a few extras of each. I changed them each day and while I had no issue for the first 5 days I started to become itchy after. I then developed a rash on the outside of my hips and abdomen. THIS HAS SUCKED. Seriously, it’s just been another thing I haven’t wanted to deal with. But between cortisone cream, ibuprofen and anti-histamines it’s much less itchy now and starting to go down. So fair warning, you may react to the hospital mesh underwear: anyone else?!
Otherwise I am starting to feel like I’m getting my body back. I’m cleared to exercise indoors in a few days which is a godsend since the AQI makes it impossible to do anything outside. It will likely be weeks or maybe months before I get my period back. It’s all just waiting game now.
I think this piece is going to take much longer than the physical recovery. I’ve come to terms with what has happened but I’m also still in shock that this all went down. Like I said, I had zero idea this would happen to me. I think I was more emotionally prepared for miscarriage when it come to pregnancy loss but not an ectopic pregnancy.
Part of what makes it so hard to accept is that I didn’t fit any of the risk factors. I’m not over 35, I don’t have endometriosis, I don’t have a history of STIs or Pelvic Inflammatory Disease. I’m just really unlucky. And sometimes that’s the hardest piece to accept.
I think for many women their pregnancy loss is followed by a deep sense of grief. I do feel this but not for a baby I never had. I don’t feel like I have an angel or rainbow baby. This pregnancy never felt like a “real” pregnancy or something I could allow myself to dream or be excited about. My grief is more for my body and everything it has been through and lost. I’m also sad that my first experience with pregnancy has been filled with so much fear which I suspect will continue whenever C and I decide to try again in the future.
But weirdly I’m also filled with a deep sense of gratitude. While I would never wish this experience on anyone, I am very changed in the way I few pregnancy and having children and this perspective I wouldn’t change for the world.
I completely understand why some women struggling with pregnancy loss and infertility feel overwhelmed with jealousy and other emotions when they learn someone in their life is pregnant. I don’t feel jealous in any way but I do feel a deep urge to shake them and let them know what a FREAKING MIRACLE it is. I want women who don’t struggle with pregnancy or fertility to understand how freaking lucky they are. I want them to feel it deep in their bones and know that they just as easily could have been me.
But my therapist likes to remind me that I don’t know everyone’s story and a lot of people don’t talk about loss so I probably shouldn’t judge so harshly 😉
Other than that I’m doing my best to take care of my mental health, snuggling the pups and watching a lot of TV. I’m trying to be gentle with myself and be patient with my healing. Sharing this post with you guys is part of that process.
My current uniform: C’s basketball shorts because everything else rubs my hips and makes my rash itchy ugh!
* * * * *
So now I’m in this club I never wanted to be a part of but especially the ectopic pregnancy club which has so few members. I wish I had more women to talk to about this. So far I’ve had friends tell me about a friend of a friend or a step sister who went through this experience but no one who I know personally. My hope with sharing this post is not only to help me heal from my experience but also to connect with other women who have gone through it too.
On top of a pandemic and everything happening in the world, I’ve just felt super isolated. I’m SO grateful to our friends and family who we’ve told and have been unbelievably supportive and generous but I’d love to hear from any of you who have been through something similar.
Years ago when I got shingles (on my face!) I shared about that experience here on the blog. 2.5 years later and that post still gets daily comments from people who are currently struggling with shingles and it brings me so much peace of mind to know that my story can help support others as they navigate their own.
Ectopic pregnancies are even more rare so maybe it’s wishful thinking but if you resonate with any of this I’d love to hear from you. Maybe we can all support each other in this undesired club.
Sending you all lots of love! -D
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