Story #88 - Emilie, Bromsgrove (ENGLAND) - Successful IVF, Fertility, Expat, Miscarriage, Dissociation, Mental Health, Elective Cesarean Section & Postpartum Anxiety
I was born in Thetford Mines, Québec, but I grew up in Abitibi, between Rouyn and Val d'Or.
I left my home fourteen years ago. I stayed five years in Norvege, first as a student, then as a translator of Scandinavian languages. To complete my degree, I went to England for a couple of years, and I met my husband. We decided to move back to Montréal to see if we could make it work there, but jobs were scarce in our fields, and we ultimately decided to go back to England.
I was 29 when we began to think about having children. We tried for one month, and my periods came, but late, at 40 days. My pregnancy test was negative, so I thought that, had I been pregnant, it probably ended in a chemical miscarriage. One week later, we were in a cabin in Wales when I felt excruciating pain, as if someone had stabbed me in the lower abdomen. I blamed it on the food, but I couldn't sit in the car as we drove back home the day after.
I went to the doctor, thinking it was something unrelated. They took my blood, confirmed I was pregnant, and told me to pack a bag and go to the hospital because it could be serious, like an ectopic pregnancy. But when I got there, the doctor, who was about 30, told me it was probably "just" a miscarriage. I knew ectopic pregnancies were incredibly painful, and you couldn't walk, move, or talk. Because I could do all of the above, she gave me Tylenol and sent me back home. She told me, "Come back in two weeks: we'll do an ultrasound to confirm there is no retained product from the miscarriage."
The following morning, someone from the hospital called. They probably realized there had been a fuck with my care and told me to come back for an ultrasound as soon as possible. It turns out the reason why I couldn't sit was that my abdomen was filled with blood, and I was hemorrhaging.
I lost my left fallopian tube due to this ectopic pregnancy. At the time, I felt it was only a freak accident. I thought, "It'll only happen once. I could have died, but I didn't. It'll be fine." I was super hopeful.
We got lucky because two months after, I got pregnant with who would become my daughter.
Her birth ended with an emergency c-section. I know that it can be a traumatic event for some people, but it wasn't for me. I was 42 weeks and they had induced me. Here, they insert a tampon with medicine to start the contractions. It worked well for a while, but then stopped. I kept telling them that the nurse had put the tampon too far and it had gotten "lost" in the uterus, but they didn't believe me. They said I probably lost it going to the bathroom. Eventually, the baby's heart decelerated, so we decided to do a c-section. Indeed, they found the tampon inside—it had slipped in because the cervix was wide open.
Tampon aside, we got lucky because there was meconium in my waters and the baby was in distress.
In a way, I think the whole experience wasn't as traumatic because we had just gone through so much worse. She was alive and I was fine; it's all that mattered.
I had trouble breastfeeding, but my anxiety was nothing compared to what I had gone through during my pregnancy. My mom came at 40 weeks, but baby didn't come until 42. It was fine. We spent two weeks together, then one more after my daughter was born.
Overall, I felt supported by the system, although there's so much pressure to breastfeed. You "have" to do it, even if it's hard. My personal take on the situation is that the Department of Public Health puts a lot of pressure on new moms, but without the means to make sure they succeed. I'd just had a c-section, but the closest breastfeeding clinic was 40 minutes away. I'm pretty sure she had a lip-tie, but couldn't drive because of the surgery, and a newborn in a taxi isn't the greatest idea. If you want to make people feel bad about breastfeeding, you've got to make sure there are resources in place to support them. By the time I was able to see someone, four weeks had passed, and she'd learned to feed on her own.
Like many families, we decided we wanted our kids two years apart, so we started trying a bit after our daughter turned two. In November 2016, I got pregnant again. This time, it was a pregnancy of unknown location*. My test was positive, but we couldn't find the fetus, so there was no way to get it out through surgery. This bout was rough because I had to wait for my body to catch up on the fact that this pregnancy wasn't viable and expulse it on its own. I had to get my blood drawn every other day. Sometimes my betas would go up, as if the baby was growing.
We think it might have been another ectopic pregnancy in the c-section or the tube's scars. I had to take methotrexate, a chemotherapy drug used to treat cancer that also causes miscarriage.
Cancers are the same as embryos: they are heaps of cells that multiply quickly. The chemo med targets and destroys them.
I was reluctant at first because of the side-effects. I had a three-year-old at home, and I was scared. Ultimately, I took it, and I didn't feel so bad. I mean, it's terrible, but not as much as I thought it'd be.
What sucks with the methotrexate is that you have to wait three to four months before trying to get pregnant again. Otherwise, there's a higher risk of deformation and it can be dangerous for your health.
In July, I was lucky and got pregnant on our first try after the PUL. But unfortunately, this one resulted in a "missed" miscarriage at ten weeks. I was nervous, but my care involved many ultrasounds based on what had happened to me before. We had one at six weeks, then another one at ten, but I already had the feeling something was wrong. When I went in, they told me the baby had been dead for two weeks.
Everyone who goes through a miscarriage is taken by surprised, but I was in shock. I thought I'd gone through enough with the ectopic pregnancy, as if there is only so much a person is supposed to go through in her life. But I tried to get back on my feet and settled into solution mode. I didn't want to wait for my body to reject the fetus, so I elected to do a D&C.
In November 2017, I got pregnant again naturally. I thought that this pregnancy would be fine. I had three cycles of blood tests to make sure everything was okay. And it was. I thought, "Great! This one will stick!"
But two weeks later, I felt the stab again. Not as bad as the first time, but I knew. I went to to the hospital (a different one than for my first,) and that time, they believed me because of my history. They discovered the baby was indeed in my right tube, but it hadn't burst yet. They gave me a choice between the drug or surgery, which would mean losing my other—and last—tube. I chose the medicine, but it didn't work, and I had to have the surgery anyway.
I'd lost both my tubes, so then what?
Bizarrely, I had this belief that I was doing fine. My problems were mechanical after all, and could be figured out.
But I wasn't fine. Throughout the course of four years, I had five pregnancies and only one live baby.
Back in July, after my missed miscarriage, I had called my primary care physician because I wasn't doing so well. On top of all the problems we had keeping our babies, I had complications with one of my surgeries. I ended up with an open wound on my belly with my daughter because I developed an abscess and had to let it drain. I was 12 weeks pregnant with her then. I remember during the call telling him I had intrusive thoughts and my anxiety was through the roof. What would be next? Stillbirth?
My doctor sent my history to a mental health clinic. They called me a month later and asked me to come up for triage so they can figure out which services would be appropriate. My brain wouldn't stop spinning. I kept focusing on all the things that could go wrong. The nurse there told me that they would care for me, but there was a one-year waitlist to see a therapist.
One year. Things change in one year!
So we put my mental health on the ice and decided to try IVF in the meantime.
The health care system here is the same as in Quebec: everything is free, so all the care and services are stretched to the max. I would have like to start SSRIs, but IVF clinics won't take you if you're on them, despite strong evidence that it doesn't interfere with the pregnancy. Heroin addicts can get pregnant, but you can't be on ANY medicine if you want to do IVF.
I experienced a lot of dissociation during this time. I was living my life the way you watch TV: as if it wasn't really mine.
Despite all this, I was hopeful that IVF would work. After all, you don't need your tubes for that, just your ovaries. But they were tired. In theory, removing the tubes shouldn't affect your ovaries, but everything is connected over there, and my egg supply was very low.
I saw the doctor often and tried to talk to him about my problems and worries, but he's a gynecologist, not a therapist. For two years, I'd think I'd hit rock bottom, but the ground kept opening beneath my feet over and over again.
The miscarriage, PUC, second ectopic pregnancy, then IVF. Rock bottom? Nope! Low ovarian supply. The clinic told us we should start considering egg donors. I wasn't sure I wanted to head into that direction. I was lost, nervous, traumatized; I don't think I was in a good mental state to make that kind of decision.
We decided to move forward with my own eggs first. We didn't have anything to lose except money. NHS only covers fertility treatments if you don't have any children. Since we already had a daughter, it was out of pocket.
I started the injections with the maximal dosage for the drugs. I thought, "Go big or go home. We can't say we didn't try." At the retrieval appointment, they only got 3 eggs. Usually, with the maximum dose, it's 15 or 18. Usually, they will throw these away and ask you to wait for another cycle, but we didn't have that kind of luxury. We collected them and decided to implant one of the three.
It was the right decision: that egg is currently sleeping in the room next door.
As happy as I was that it had worked, as anxious and shocked I felt. We had gone through two years of "everything good that happened will be followed by heartbreaks."
During the entirety of my pregnancy, I was convinced something bad was going to happen.
We did ALL the tests, even the ones that weren't necessary. I wanted to control as many variables as possible. At night, I would go sleep making up scenarios about how I would tell my parents there were chromosomal abnormalities, and I had to abort. I believed these stories helped me prepare for the worse, but instead, they put me in a constant state of stress and anxiety.
This was when I began to (finally) see a therapist. We did CBT and I was telling her, "Your thing isn't working! This is bullshit!" Telling my brain to rationalize and focus on one thought at a time is not possible when you're still dealing with overwhelming trauma. I was too deep into it.
I would google every little thing although it's always—always—a bad idea. Every time I'd get an answer, another one, more pressing, more stressful, would pop up. For example, I had too much amniotic fluid at the end of my pregnancy. I was like, "I knew it! Something terrible is about to happen." In the end, it was nothing, but I spent the last four weeks of my pregnancy being sure they'd missed something during the ultrasound and my baby would die.
I would see my therapist every three weeks, and she'd tell me, "Think positive, it will go well, it's nothing!" Right... So when the baby ended up being transversed, which is extremely dangerous because it means the cord can come out first and then you and/or the baby can die, I went to see her and said, "SEE! I told you." She didn't know what to say.
I had an elective c-section because I didn't trust that the baby would be fine. He ended up flipping and being breech anyway, so it all worked out, and I headed to the OR a little bit more at peace.
After his birth, my anxiety decreased, but I was left with the lingering trauma of the past years. I still have difficulties with that. I'm someone who always thinks the worse is going to happen. If you'd tell me tomorrow that my son has cancer, I wouldn't be surprised. I am forever waiting for the other shoe to drop.
I know I need help, but these days, with COVID, it's even harder to see someone. I can measure how taxing these few years have been physically, mentally, and emotionally. Although I am lucky to have two healthy children and a successful IVF story, something's broken in my brain. If only I could reconnect what's missing, I feel I could live a happy life.
My fears are mostly directed towards my children. Every day I'm sure my daughter will get hit by a car or my son will get ill. The sequels run deep.
Before COVID, I wondered if I was going through premenopause, so I did some tests. Everything came back negative except for my cortisol level, which was high. The doctors told me I was too stressed. They said, "You should try yoga."
I had told myself that if everything came back normal, physically speaking, I would invest in therapy. But then COVID happened. It's a stressful situation. We are lucky to have a safe cocoon at home, but we worry about our families.
And once again, my mental health is put on ice until further notice.
I can talk to my husband about it because he was also affected by the roller coaster. He supports me well, but can't truly grasp the complexity of it all. To be fair, I don't talk about it often. It drains me when I do, and then I lose patience. I know that I have to do something about it to lower my anxiety. I know this is what it takes to induce positive changes in my life.
I'm scared. And it's so hard. One of the reasons I reached out is because telling you my story is a form of therapy. When you read your own story, written by someone else, it helps make sense of your life. And right now, I'll take every bit of hope.
*Pregnancy of unknown location (PUL) is when the pregnancy test is positive, but there are no signs of intrauterine pregnancy or an extrauterine pregnancy via transvaginal ultrasonography.