Part 19: Goodbyes

"What should we do for the service?" the woman asked her husband. She wondered if he thought it strange that she wanted a service in the first place. Her husband seemed okay with it, so she didn't worry too much about it. As they discussed the details, the woman made some notes.

"This looks good!" she said smiling. "It will be a wonderful service." 

Just then a faint emotion stirred within her and began to crescendo. Before she knew it tears were filling her eyes and she started to sniffle. At last an audible cry emerged.

The woman's husband took her in his arms and comforted her. "Just let it out," he said in a warm voice.

While she had cried different times over the past couple weeks, it had been about other things—the stress, her condition, the long road ahead. This was the first cry in awhile that actually grieved the loss of her pregnancy, yet it felt just as fresh as the first time and emotionally it was just as hard.

The cool Sunday morning air filled her lungs as she made her way to the backyard where she found her husband standing by the small spruce tree. Sunshine settled upon the tiny hole beneath the lower branches he had dug just moments before in preparation to receive the package she held in her hand wrapped in a white napkin.

Together they stood looking down at the site, the wind blowing and the sound of passing cars traveling along the nearby country road resonating in the distance. They began to sing:

How great is our God.
Sing with me, how great is our God.
And all will see how great, how great is our God.

She placed the tiny package into the small hole. After each shared a few words, the husband closed in a prayer.

“Dear Lord, we thank you for the gift of each other and for this pregnancy. Even though it wasn't a baby, it was still special. We pray for healing in the months ahead—spiritually, emotionally, and physically—so that someday we can try again and be blessed with a baby.”

With a small spade they took turns covering the newly filled space with a mixture of soil and wood chips. Every spade-full finalized reality. Dreams of starting a family, caring for a baby of their own, passing on the many things they wish to teach, and enjoying God's gift of a new person had been postponed. They offered up one more moment of silence, then turned and together walked away.

Part 18: The Delivery

It was just like any other Saturday morning. She awoke at her normal time while her husband lay sleeping under the mound of covers. He would be there till at least 9:30 a.m., to the detriment of the woman, of course. An early morning chat with her husband over coffee was her Saturday morning dream, a dream, unfortunately, crushed every week. Alternatively, she knew his dream was to sleep in, and somehow she worked up the weekly discipline to restrain herself from harassing him awake before the allotted time...most Saturdays, anyway.

Her first stop was the bathroom.

Ummm...that was weird.

The woman had passed clots before, and large ones at that, but this did not feel like a clot. Peering into the toilet she saw a dark shadow resting at the bottom. Curiosity got the best of her and she fished it out.

Upon further examination, the woman determined that what she had in her possession was indeed the mass from inside her uterus. It measured a little over 3.5 cm in length, just like what the doctor explained from her ultrasound a week and a half earlier.

She hurried to the bedroom.

"Honey," she whispered nudging her husband hoping he wouldn’t mind too much. "I think I just passed the tissue."

Looking at her with tired eyes he acknowledged the situation and lovingly rolled out of bed to take a look.

"Yeah, that definitely looks different than a clot," he confirmed, still a bit groggy.

They deliberated the meaning of it all, wondering, perhaps, if it was a good sign for things to come. Little did they know it would mark the end to two and a half months of the woman's bleeding. They questioned what to do with the the tiny mass. After a few moments of silence, the woman replied saying, "I think I'd like to have a funeral."

Part 11: Conversation with God

“What are you doing, God? How could you let this happen? And why me? There are so many women with unwanted pregnancies, but I wanted this, Lord! You know I want to be a mother! I have been waiting so long to start trying for a family and now I’m going to have to wait an indefinite amount of time longer! I have been planning and preparing as much as I possibly could for the last 3 1/2 years!”

My dear child, in your heart you plan your course, but I determine your steps.

“Well, my course was a pretty good one, God. We paid off all our debts but the house. I stopped taking birth control for six months to make sure there wouldn’t be any interference when we started trying. My husband finally came around without me nagging, which was nothing short of a miracle, and after three months of trying we finally got pregnant. We were all set. Our basement would be all finished by the time the baby arrived. Nine months and it would have been fine. But, no. You took it all away before anything even began. From the very moment of conception this was hosed and You knew this would happen before I was even born! Thanks for the warning!”

I love you, my child. I know the plans I have for you—plans for good and not for disaster, to give you a future and a hope. I cause everything to work together for good. In time, you will see.

“Well, it certainly doesn’t feel very hopeful right now. And logically I don’t see anything good about the fact that this whole thing keeps getting worse and worse. I could handle a miscarriage. I could handle getting surgery. But I can’t handle this never ending unknown of what is going on inside my body. I have absolutely no control over this. It’s just too much!”

Without Me, you can do nothing, my child. Come to me. You are weary and carry heavy burdens. Give Me your burdens. I will take care of you and give you rest.

“I’m scared, Lord. What if this gets even worse? What if these cells are spreading? What if I get cancer? What if I can never conceive again?”

Be strong, my child. Do not be afraid or discouraged. I am with you. Do not worry. Come to Me with your needs and My peace which exceeds anything you can understand will guard your heart and mind as you live in Christ Jesus. I will never leave you nor forsake you. Trust in Me.

“I'm sorry, Lord. I know You care. I know You love me. I believe You’re in control and that You will take care of me through all of this. Forgive me for my unbelief. Even though I cannot see exactly what You’re doing and I certainly don’t understand it all, I will trust You, Lord. Please give me faith to trust You more. Take my worries, my cares, and my life. Use it for Your glory. I need You so much. ”

Part 9: Perspective

“Well, at least we know that it wasn’t really a baby,” said the husband.

She wanted to resent him for the comment, but the woman knew that he was only trying to help. Biologically speaking, she knew he was right. The pathology report came back diagnosing them with a complete molar pregnancy, which meant that her egg had no genetic material inside so when it was fertilized, only the DNA from her husband was present. Had it been a partial mole, as the doctors originally suspected, at least they would have both created a little life, abnormal as it may have been.

The woman found herself grieving all over again. First it was the little life that never got to be. Now it was the little life that never was.

“But, it’s kind of like we lost a baby, right? I mean, didn’t you think about what it would be like to be a dad or what you wanted to name it?” she asked.

“Of course,” he said.

“And this whole time we’ve thought it was a baby, so we still lost a baby,” she insisted all the while trying to convince herself.

As she pondered the situation, her mind wandered off to the “what-ifs.” The cells in complete molar pregnancy could become invasive, spreading to other parts of the body, including the brain. They could even develop into choriocarcinoma, the malignant cancerous form of the disease. Twenty percent of women with complete moles experienced a recurrence of cell growth after their D&Cs. She tried to block these thoughts out of her mind, but no matter how many times she swept them away, they always found a way back in.

A few days later, the woman went in for some blood tests. It had been a week since her surgery. Now began the weekly blood draws where the doctor monitored her HCG (pregnancy hormone) levels. If things were progressing as they should, the levels should be dropping. Once the levels hit zero, she would begin the six month long wait to ensure they stayed that way. If they remained at zero, she would then get the clearance from her doctor to begin trying again. She could picture that day in her mind. I hope I get good news today, she thought.

Later that afternoon she received the call from her doctor with the results. Her levels were down to 15,000, a 255,000 point drop from the week before! She could hardly believe it—good news two weeks in a row. The light at the end of the tunnel was a little bit closer and shined a little bit brighter. Things were definitely on the up and up.

Part 6: Snowstorm

His emotionless eyes said it all. The doctor glided the ultrasound wand over the woman’s belly as he gazed intently at the screen. Though she didn’t know what he saw, she knew what he didn’t see. There was no baby. If there were to be, this would have been the time for it to show up on the monitor and he would have said something right away. He would have smiled. Instead, his face was somber. It screamed amidst the silence: There is no baby.

If there is no baby, then what is it? How could I be feeling all these symptoms and there be no baby? she wondered.

Finally, the doctor spoke up. “I still don’t see a fetus. What I do see is a little more concerning. This ‘snowstorm’ appearance indicates to me something along the lines of what is called a hydatidiform mole or molar pregnancy, but we will need to get a clearer ultrasound taken to be sure.”

“Hide-a-didda-pole what?” she asked.

“Hydatidiform mole.  It is when there is a genetic abnormality starting at conception...”

The woman drowned out the rest of his explanation as her mind wandered off on a tangent. Abnormal. There was that word again. Since the beginning none of this had been normal. She had to wait three married years before getting the opportunity to start trying for pregnancy. She had started bleeding 6 weeks into her pregnancy and it still hadn’t stopped yet. They never saw anything normal on the ultrasound. Her miscarriage did not happen normally. The only normal thing about this whole experience is that everything was abnormal.

“…cancer…”

Did he just say something about cancer? she thought. Apparently certain forms of this disorder could turn into cancer. Great. Even better.

The next ultrasound couldn’t come soon enough. She knew the drill for these vaginal ultrasounds by now. Not pleasant by any means, but if it meant better answers, it was certainly worth it.

The ultrasound confirmed the doctor’s suspicion. “This is definitely a molar pregnancy,” he said. “It happens in about one of every thousand pregnancies.What I don’t know is what kind. There are two possible types: complete and partial. Based on the ultrasounds we’ve seen, I would suspect you’re suffering from a partial, which has fewer risks involved.”

"Just out of curiosity," the woman began, "how often do you see this here?" The medical institution where she was receiving her care was well-known. Perhaps this happens a lot here, she thought.

The doctor replied, "We see this maybe once a quarter."

Wow. I guess not very often.

He continued, "But this condition has been around long enough that we know exactly how to treat it."

He referred them to a surgical gynecologist who would be able to give them more details. They set up an appointment for early that afternoon and made their way over to the next waiting room.

Part 5: Nothing

Day one: nothing.

Day two: nothing.

Day three: nothing.

“It’s okay to go now, little one,” the woman said aloud to her stomach. “I understand. We will see you again someday.” With a quiver in her voice she sang the baby’s first and last lullaby:

Glory baby you slipped away as fast as we could say baby…baby.

You were growing, what happened dear?

You disappeared on us baby…baby.

Heaven will hold you before we do

Heaven will keep you safe until we’re home with you…

Until we’re home with you…

Week one: nothing.

The doctor said two weeks. I guess I’ll wait a little longer, the woman thought.

By this point she began experiencing more distinct pregnancy symptoms. Brushing her teeth in the morning became pointless because each time she finished up, the toothpaste would make her gag, initiating an instantaneous reaction. She was grateful the toilet was only two feet away. Her body also got into the “after work” rhythm, forcing her to run to the bathroom as soon as she pulled into the garage. One time driving home, it came a little early. Thankfully a cup from a fast food drink sat empty in one of her cup holders.

Week two: nothing.

I’m still bleeding so I’ll just wait a little bit longer, she thought to herself. Perhaps it will finally happen this week.

After three weeks of nothing, the woman was finally convinced that nothing was happening. “There must be something still in there if I keep experiencing this morning sickness,” she said to her husband. “Maybe we do have a baby after all.”

“I don’t know what else could explain all this,” the husband replied.

For the first time in five weeks she worked up the courage to go back to the pregnancy website tracker to see how far along she was: eleven weeks. According to the article, she would soon be out of her first trimester and the morning sickness would soon subside. She scheduled another appointment and a glimmer of hope stirred in the back of their minds.

Part 4: Something Normal

“I believe what I’m seeing here is the sac and this would be the fetal pole,” the ultrasound technologist reported, as he zoomed in to show the couple a closer look. “But this does not look normal to me. Considering you are eight weeks along, it should have been much bigger by now.”

The couple then moved to another room to discuss the situation with the doctor. While they waited, a spirit of relief calmed them.

 “Well, at least they finally found something,” the woman said to her husband. “I don’t mind being told I’m abnormal as long as there is something normal in there somewhere!”

The doctor finally arrived. He explained to them that it was indeed a miscarriage and that he believed that the bleeding she was experiencing was caused by a detachment of the placenta form the uterine wall. He discussed with them the options available to deal with the miscarriage. The couple decided to forego intervention methods and let it happen naturally.

“How long do you anticipate until this miscarriage will occur?” the woman asked.

“Based on the amount of blood in your uterus, I would imagine it would happen in the next few days,” the doctor replied. “Be sure to make an appointment after it happens so we can make sure you’re okay.”

“If it doesn’t happen as you say, how long should we wait before seeing you again?” the husband asked.

“If in two weeks you still haven’t miscarried, come back in,” the doctor said.

The couple left, and as they drove back home the woman could not help but relive the car ride from two weeks prior. Another dose of bad news, she thought. This is really happening. This pregnancy did not work out.

She grieved.

Fears about the miscarriage plagued her mind. How bad will it hurt? What if it happens while I’m at work? How do I move past this? She sent up a prayer for strength and courage to make it few the next few days, resting in the peace that followed.

Part 3: Emotional Gymnastics

It was the day of the woman’s second ultrasound. Her hypochondriac tendencies nearly drove her mad the week before, but today was the day where she and her husband would finally be able to get some closure.

“I can say with certainty that this is definitely not an ectopic pregnancy,” the doctor reported after viewing the latest ultrasound scans.

Relief swept over the couple.

The doctor continued, “While your hormone levels did double like normal this past week, based on your ultrasound we believe that they will soon be on the decline, as there is no visible fetus present. You are going through a miscarriage, which should happen at any time. We want you to get another blood test just to be sure these levels are trending downward.”

“So, I should expect to see that the hormone levels have gone down from last time?” she asked.

“Yes,” he confirmed. “Someone will call you with the results once they are in.”

The woman and her husband made their way down to the lab services. The short elevator ride gave her time to reflect on the news. Well, at least we know what’s going on, she thought. This will soon be over and we can try again. The unknowns of miscarriage scared her and the loss of the little life inside grieved her, but she was hopeful that one day there would be new life, redemption to glory over the sorrow.

The phlebotomist rubbed the woman’s arm with alcohol and she turned her head.

“Don’t worry. It’s not you. I just don’t like needles,” the woman said and breathed deeply. In a matter of seconds it was all over and she headed out the door with her husband.

For the remainder of the day, the woman sat at her work desk trying to focus, but all she could think about getting the call with her test results. She waited an hour. She waited two…three…four. Finally, the day was over and she had still not received a call. Impatience getting the best of her, she called the off-hours nurse line to get the answer.

“Looking good!” the nurse said excitedly. “The levels have doubled from last time.”

“Um…that’s interesting,” she replied, puzzled. “I was told they were supposed to be going down since I am having a miscarriage.”

“Oh, dear! I’m so sorry!” exclaimed the nurse, noticeably embarrassed. “I didn’t look at your history first. I’m so sorry. You’re right. It’s been five days since your last draw, not two.”

“That’s okay. I just want to know what that means, since the doctor said they were supposed to be going down.”

“Well, you’ll have to check back with your doctor about that,” the nurse replied, and the two of them hung up.

A call to the doctor’s office the next day began with confirmation of the prior day’s blood test results, but unexpectedly followed with a request to come in again for yet another ultrasound for the following week. The woman wasn’t sure what to make of this, considering the fact the doctor had told her the day before that she would not come in again until after the miscarriage delivered. Sadness. Hope. Despair. Possibility. The emotional gymnastics were starting to wear on her, but she did not want to give up on her baby if her baby wasn’t ready to give up on her.

 Perhaps I am still pregnant, she thought. Maybe they were wrong.

Part 2: Puzzles

“What do you mean I puzzle you?” the woman asked, cold and uncomfortable on the exam table. She was six weeks along and had been bleeding slightly over the last three days. The prior five minutes of poking and prodding amidst silence was bad enough, but “You puzzle me” being the first statement out of the ultrasound technician’s mouth did not offer any reassurance.

The technician responded, “I’m not seeing anything that resembles a fetal sac. This does not look normal,” and she left the room to get a second opinion from a doctor.

Humming from the ultrasound equipment resonated through the room while disbelief resonated in the hearts of the woman and her husband. Anticipation for a more detailed explanation rose within her. The additional five minutes of waiting felt like an eternity.

She turned to her husband, “This cannot be good.”

Finally, the doctor entered the room. Through his British accent, he matter-of-factly explained how the woman was either dealing with an ectopic pregnancy or a normal miscarriage. He wanted to get some blood tests in order to track her hormone levels to determine which one of the two was the culprit. He requested that she return in a week for a follow-up ultrasound.

The woman left the clinic devastated. Anger, disappointment, sadness, anxiety, and fear wrestled with each other to get their fair share of attention. Unable to bridle them all, she sat in the passenger side front seat and wept as her husband drove her back to work.

“Why is this happening? It wasn’t supposed to be this way!” she cried, pleading to God through her tears for some divine explanation.

There was nothing more she could do for the next week but wait and wonder. Either there was an embryo attached somewhere it shouldn’t be, which could threaten the woman’s very life, or the little life that had been there never made it very far and was gearing up for miscarriage.