October is infertility and infant loss month. It seemed like the perfect time to share the story of my ectopic pregnancy and how I was made to feel defective as a result. Luckily for us, it had a happy end. However
The year before Peter and I married we had faced two significant losses in short succession: his father and my grandfather. I had moved from Brussels and we had moved in together. A lost piece of paper meant I won and lost a job in short succession. My grandfather’s funeral and one of my best friend’s weddings had taken me to Australia. Life was hectic and laden with emotion.
That is why we decided together that we would wait a year after our wedding before trying to have children.
At time, I was using the Implanon contraceptive implant. When I was in Australia the following Christmas, I had it removed so that we could start our family planning.
We anticipated that it might take a few months for my body to adjust and were not really worried. We had started using the fertility test sticks (you know, the ones that are like a pregnancy test, but tell you which days you are most fertile). These are supposed to tell you the right ‘time’ to try. Our results were very mixed.
I had various symptoms of polycystic ovaries. In fact, I went to see
The other ovary was “probably just hiding behind my intestines,” because she couldn’t find it. We would find out the reason for the symptoms and the hiding ovary during our subsequent road to Miss M.
A fateful weekend in Warsaw
In June, Peter and I spent a wonderful weekend in Warsaw for the 40th birthday of a very special friend. It’s a great city to visit if you get a chance. Whether it was the vodka or the unclear fertility test, we had no idea that we had fallen pregnant.
The first indication that something was wrong
Fast-forward about 7 weeks and I had a dull pain in my ‘nether regions’. Ten years earlier, I had had a kidney infection. This felt like a mild version of the kidney infection. I took some ibuprofen, drank a lot of water and tea and used a hot water bottle. Hopefully, that would get me through the day.
If it got worse, I would go to the doctor. Of
Three days later and I woke up in incredible pain. I could hardly stand up and the pain robbed me of my breath. The pain was focused
I was also lucky that my doctor asked if I could be pregnant. She wanted to ensure that any treatment would not harm the child. We had been trying, but that it was too early in this cycle to tell.
After a painful ultrasound, temperature and blood pressure checks, etc., the doctor referred me to the emergency department of one of the local hospitals.
Hours without a diagnosis in the ER
It felt like forever. I spent the next 3 hours with various doctors prodding at my stomach and causing excruciating pain. Most of the time, I wanted to throw up (something I generally cannot do, but that is a whole other story). Numerous blood tests and attempts to get a line in left me feeling like a pincushion.
Finally, stumped, one of the doctors reread the notes from my GP. Noting the remark about a possible pregnancy, she decided to have my blood tested.
I was pregnant. The pain made me almost delirious, but I was pregnant. Our attempt had borne fruit. The joy was immediate, even though it is difficult to feel joy when you are in so much pain.
We had almost no time to even get used to the news when we received the next blow. I was pregnant, about 7 weeks along. However, it was an ectopic pregnancy that had ruptured and it would not survive. Neither would if I wasn’t operated on immediately.
Before I knew it, I was being prepped for surgery. The surgeon was on his way
Scar tissue left from my trachea-oesophageal fistula (TOF) operation and the uncertainties about what difficulties that might cause meant that I had the hospital’s head surgeon operating on me at 8 p.m. on a Friday evening. I’m sure he had other plans.
According to statistics, approximately 1 in 90 pregnancies in the UK are ectopic pregnancies. Mine was a one in 850 pregnancies.
- Methotrexate is used to treat more than 70% of ectopic pregnancies. This drug is used in cancer treatment and causes pregnancy cells to stop developing.
- Where the foetus has a heartbeat or, like in my case, where the fallopian tube has ruptured, an operation is necessary.
- A rupture occurs in less than 10% of ectopic pregnancies.
- Untreated, a rupture can result in death.
The result of the surgery
The operation went as well as can be expected. It turned out that the blood resulting from the rupture had pooled near my gall bladder, putting pressure on it. This explained why the pain was on my right side, rather than on the left in my groin where the damaged fallopian tube was.
During the operation – in hindsight, luckily – the surgeon also discovered another key piece of information. It instantly made sense of our fertility test results and my PCOS scan. However, hi delivery of the information left much to be desired.
Hearing the news
There is a saying that most surgeons are great at dealing with anaesthetised patients, but awful at communicating with those patients.
“If we wanted to try and have a child, our only option was IVF.”
That was how the doctor broke the news to me. Blunt. Tactless. No thought for the child we had lost.
The ectopic pregnancy had ripped a hole took up more than 50% of my fallopian tube. While the fallopian tube was still there, it was unsafe to ‘use’ for a pregnancy.
While removing the blood from around my gall bladder he also located my right ovary, nowhere near where it should be. Apparently, I have no fallopian tube on my right side. I was born without one.
The doctor suggested that this was caused by whatever had also caused the trachea-oesophageal fistula. Somehow, I should have already known this.
The delivery sent all the wrong messages
I was defective, or at least that was how I was made to feel. Our attempts at falling pregnant had only had a 50% chance of success because my right ovary was unable to contribute. Now the left side was almost useless. There was no safe way to get pregnant without intervention and without risking the fertilised egg getting ‘lost’ in the hole. This was
Worse, because of its misplacement, my right ovary was useless for IVF. This significantly reduced our chances of success. Did you also know that women who have had an ectopic pregnancy are nearly ten times more likely to have another one, even using IVF?
No time to get to know our child
Unlike most women who miscarry (of which there are far too many), I had not yet known that I was pregnant. I had almost no time to become attached to my child. That does not mean that I did not keenly feel the loss.
At the same time, my body was crashing with sudden hormone fluctuations. This was coupled with the news that I had also lost the ability to conceive a child naturally, something that I had not even considered when I first received the diagnosis.
I was left to tell Peter, regurgitating what I had understood from my still groggy and shocked state. He was stoic, I knew he would be, but he was hurting too. In one move, we had received news that could put an end to our plans to expand our family.
I had managed to lose our baby and now there was a very real chance that we would not be able to have any other children. Our infertility was all my fault. Peter did not blame me at all – he was just happy that I had survived – but I was blaming myself.
What you’re not told
I didn’t know at the time that it is not yet medically possible to save a pregnancy that has implanted in the fallopian tubes. The moment that happened, it was in unviable pregnancy. It had to be terminated either naturally, through medication or, in my case, by surgical intervention. Without intervention, my life was in danger.
Google, and mobile phones, do not work in hospital emergency wards.
Society’s view of ectopic pregnancies
Most people do not seem to even know what an ectopic pregnancy is.
To me, it felt like our society views and deals with an ectopic pregnancy as a procedure, and not a pregnancy that has been lost. Here, doctors don’t generally suggest counselling to help you deal with the loss. Instead, the fact that you have had an ectopic pregnancy just makes you eligible for IVF. In my case, because I had not known that I was pregnant, I was made to feel like I was not entitled to grieve the loss of our child.
Just a tip: if you know someone who has just lost a child, and possibly their chance to have a child, it is NOT the time to mention adoption or other ‘ways’ to have children.
I was defective
Two of the ladies snored. The final bed was occupied by a young woman (my age) had just lost her baby. She and her partner had tried various complicated, painful and unsuccessful rounds of IVF. This was what we had to look forward to?
I was still suffering from the effects of the anaesthetic and trying to come to terms with being pregnant and losing the baby all at once. I was in a fog. The doctor came to see me
Casually, he opened the discussion with words that basically told me that I was defective. In fact, with only one fallopian tube I was defective before the operation and was even more so now as a result of the rupture.
It was as if the doctor had assumed that I had already been told the bad news and it didn’t need sugar coating or tact. I was left speechless (which rarely happens to me) and reeling. Now had to explain to Peter why our only chance for a child was IVF.
It was a relief to go home
Later that day, I was discharged with some basic painkillers and a promise to visit my OB-GYN for a check-up and to remove stitches.
Over the next three weeks, you could find me on the couch or lying on the cold tile floor. After all, it was mid-August in a 3rd floor, non-air-conditioned apartment. Most times my face was splotchy from crying. I tried not to let Peter see my splotchy face because I knew he was hurting too.
Like a normal
IVF made the feelings of deficiency worse
We decided that we would try IVF and spent the enforced break researching our options. The feelings of my own body betraying me did not improve with IVF. Instead, it made them even more acute.
Peter has private health insurance, while I have public insurance. In Germany, Peter’s private insurance would have paid for all of our fertility treatments had any of the ‘fault’ been with him. If his sperm count had been low or if his sperm had been sluggish, his fertility would be a contributing factor and his insurance would have covered all costs.
In our case, our fertility issue lay solely with my fallopian tubes, or lack thereof. As a result, my public insurance was responsible for covering the doctors and medical bills for our fertility treatment.
Unfortunately, public insurance only covers 50% + EUR 200 of the costs of the fertility treatment. These include hormone injections, blood tests, doctor’s visits and procedures. The system, therefore, reinforced the fact that I was defective and made us pay – literally – for it.
All’s well that ends well?
Fortunately, our story has a happy ending. Almost exactly one year to the day after my operation, I gave birth to a healthy baby girl, our own little rainbow baby.
No matter what anyone says, I will never forget my first pregnancy, the pain of a ruptured ectopic pregnancy or the feelings of loss and defectiveness that I felt as a result.