What Mindset helps you manage Miscarriage that Doesn't go as planned? Kristen's Story, Part II

Today I finish my conversation with Kristen.

This week we hear about:
* two challenging miscarriages
* drugs for miscarriage versus D and C procedure
* Insights on how to think about the miscarriages
* Her current pregnancy

 We pick up where we left off. Kristen is talking about getting pregnant a 4th time, around 9 months after the last birth, and how this time things don't go well...

Must Watch video with Elizabeth Banks from the American Heart Association
https://www.youtube.com/watch?v=_JI487DlgTA

References for Oocyte Aging
https://www.medicalnewstoday.com/articles/how-many-eggs-does-a-woman-have#puberty

https://pmc.ncbi.nlm.nih.gov/articles/PMC10080932/

Transcript

Paulette  0:00  
Music. Welcome to what you didn't expect in fertility, pregnancy and birth, how we think and feel about this enormous transition often lives in the gap between what we expected and what we actually experienced. This gap exists in part because of how we tend to talk about and portray these events on all kinds of media in a one dimensional way, everything was amazing, but it's more often the case that there are beautiful things that happen and at the same time, really challenging things that happen. This show shares true experiences, both the easy parts and the difficult parts, and how we manage what we didn't expect, the intense things that can happen in the course of this transition. Can impact how you see yourself, how you see your partner and how you parent. The better we understand what happened to us, the better we can manage all the things that follow. I'm your host, Paulette Kamenecka. I'm a writer and an economist and the mother of two girls, and I met many, many challenges in this process, none of which I expected. Today I finished my conversation with Kristin. Last week, we talked about the weight of the infertility challenges that gave way to three easy pregnancies and births, and this week, we hear about two challenging miscarriages with some insights on how she might have done it differently and her current situation. We pick up where we left off. Kristin is talking about getting pregnant a fourth time around nine months after the last birth, and how this time things didn't go well.

That's between the third one in the for the next one that turns out to be a miscarriage. Are you? You're trying to have four kids? Yes, yep. Okay, and is it this? Another? Is it nine months between the third one in the Yeah,

Kristen  1:51  
yeah, same, same timeline. No, no. Concerns for me, miscarriage isn't, isn't even on my mind. So you don't get confirmation until eight weeks, you know? So eight weeks comes, we go to the appointments and they're like, there's no heartbeat. And that was just a blow. It was very devastating and unexpected, because I've had, I had such easy pregnancies, so it was just kind of a shock and it and not to mention, miscarrying the baby wasn't easy either. So, you know, they they prescribed me the the medication. And there's just a lot of, there's a lot of appointments, a lot of procedures, a lot of it's very invasive, I would say, you know, because at that point the ultrasounds are all done vaginally, so it's just a lot of probing when there's nothing good you know, there's no good news. So, you know, I took the medication, which was terrible. I hated that whole experience, and it didn't

Paulette  2:50  
work. Even like it, because it made you sick. Or what did you like?

Kristen  2:55  
The whole thing is a terrible experience. So, yeah, it made me feel awful. The whole experience of forcing a miscarriage. You know, was very uncomfortable. It's just not a very pleasant experience.

Paulette  3:08  
You're saying uncomfortable physically and emotionally,

Kristen  3:10  
physically, emotionally, yeah, and then, and then to find out that it didn't work. So then I was prescribed it again didn't

Paulette  3:17  
work. Means that it's not getting your uterus to contract to the

Kristen  3:21  
fetus was still inside of me, so the pregnancy didn't come out. Yeah, so then they did it again. Same thing, you know, just horrible. It's not a fun thing to go through, and then I'm also heartbroken at the same time. It didn't work the second time. So then and at this at this point, you know, I was trying to avoid a DNC because then that just felt extra invasive. But at this point, you know, I'd already done the medication twice. It wasn't working. They're calling me and repeatedly for ultrasound after ultrasound after ultrasound, it's still there. So then finally they're like, we recommend you having a DNC, which is what I was trying to avoid, no the whole entire time. So that's what we ended up doing eventually. So the third, third time was charm with the DNC, I'm

Paulette  4:11  
so sorry you went through that just the shock of it not working out, and then

Kristen  4:17  
it's forcing your body to go through the contractions. I was very sick, and not to mention it drained me of all of my energy. And I had three little kids, you know. So it was really hard on my body, physically, on top of everything I was going through emotionally, so 100% and

Paulette  4:38  
I want to put aginal Ultrasound as a top one or two things that are to be avoided, right? And it's not like it's something, something terrible, but it does feel invasive, and it's not comfortable,

Kristen  4:48  
yeah, not comfortable. Super invasive. You know, we put up with it for that first ultrasound because there's something, there's something, you know, to be celebrated in there, but any other reason there, you know, it's just, it's not, it's not a pleasant experience. So,

Paulette  5:05  
yeah, so that that sounds hard. And did you learn anything from that experience that I don't know you want to share with someone who's going through it?

Kristen  5:12  
It was one of those things where I knew that it wasn't my fault, because I was every pregnancy, I felt I was learning more and more about my body and my babies, and they were just very important to me. I didn't question anything that I did wrong. And I think that's what is so hard for women when we experience pregnancy loss, is that you want to find you want to know why, and there is no reason why, other than there was something wrong, there was something wrong with the fetus that wasn't able to grow, and there's nothing that we could have done about it. So there was nothing I could have done about it, to to make it to have made it better.

Paulette  5:54  
Oh, it's totally out of your control. And I think the number one cause of miscarriage is genetic anomaly. And I interviewed a doctor not that long ago who was actually looking at people with repeated miscarriage, yeah. And he was saying, just to give a sense of how complicated the process is, he was saying, they think there's some chemical conversation between the lining of your uterus and an embryo, the ball of sperm and egg, and that sometimes in people with repeated miscarriage, the lining of your uterus is supposed to be able to tell whether a pregnancy will be successful or not. But sometimes that conversation doesn't go the way it's supposed to, yeah, and an embryo that will not be successful in plants and like but so how much control do you have over the chemistry of your uterine lining?

Kristen  6:48  
Right? Exactly. Not much. And it was, it was just, you're super frustrating for me, because it felt like my body didn't want to let go of it.

Paulette  6:59  
This is often referred to as incomplete miscarriage. I looked far and wide for explanation of why we think that happens, what communication is supposed to happen between the uterus and the embryo or fetus, and why sometimes does this fail to happen? And I couldn't find anything. All I essentially did find was quote, We don't know why this happens, which is not the same as we don't know why miscarriage happens. That's a whole other issue, which was

Kristen  7:25  
also heartbreaking too. So it was like, there was not the communication going on between my body and the fetus of what was going on. So it was just, it was really hard for me. And so then I learned, like, that's when I was like, I'm never doing the medication again. Like that's that's definitely off the books. I'm not doing that again, for sure.

Paulette  7:48  
I can see why people are not at all attracted to the DNC, because that feels more like a choice in some way. Although I have had that procedure myself, and I guess in my case, they knock you out for it, at least. So it's not, yeah,

Kristen  8:00  
they do, I mean, but it just felt so much more. It just felt to me, like so much more. I don't know, I don't know how to explain it. It just felt scary. I think it just felt really scary to

Paulette  8:14  
me. It is scary, and in this situation where you don't have much agency, you can't control what your body's doing and what's going on making that decision feels like you're making a choice when

Unknown Speaker  8:25  
you're grieving at the same time,

Paulette  8:28  
even though the choice has already been made. Yes, your body has made that choice. Yes, but, but I could totally see how it would be very uncomfortable to have to do that after the medicine, although useful to learn, no more medicine for you. Yeah, no more medicine. And so it sounds like you recovered from that, because we get pregnant again. What's the time gap

Kristen  8:51  
got pregnant again a year later, and my sister was pregnant the same time we were due we had the same due date. So very celebratory, super exciting. I was a little I was a little worried, because I just experienced miscarriage. But then I was also like, what are the chances of me having two in a row? So I'm constantly googling miscarriages. Percentages my age. You know, my age is also a factor, because I'm also now in my 40s, so I'm very I'm cautiously excited, but still excited because I didn't, I didn't consider, I didn't think that I would have two miscarriages throughout, and then it turned out at same thing at my eight week appointment, no heartbeat. So it was, it was hard, but I'd also already like I had learned. I had learned a lot. I had started taking care of my body, so I work. I had been able to work through a lot of the pain, and I'm more healthy. I had an outlet. I was going to a gym. I was crying a lot at the gym, to be honest, so I had an outlet that was something that I had already had in place. So I was able to to heal from it emotionally a little better. But then, because of my previous miscarriage experience, I decided to just see what happened if I let my body do what it was going to do naturally, just let the miscarriage happen, which was turned out to be another mistake. So I I ended up traveling back to New Hampshire to see my family, because I was like, I need to be with my family right now. My uncle had just, my uncle had actually just passed away too, so there was a funeral, and I just, I just felt like, for me, I wanted to be back home with my sister, celebrate her pregnancy with her, you know, and just be with family. And I'm so, I don't because I didn't experience the miscarriage naturally. I figured I could travel cross country for some reason and everything would be okay. Luckily, everything was okay. I made it back to Denver before everything started happening. But the thought of it, that it could have happened when I when I was out of state, is what's scary. But I ended up in the ER. I ended up losing half of my blood. They ended up needing to do a blood transfusion. My husband thought I was going to die, and they ended up doing the DNC anyways. So just super scary, unnecessary situations. Wait, wait, wait, so I

Paulette  11:39  
feel like, I feel like we're blaming Kristen here, which I'm not on board with that. Let me just be upfront about that you're imagining your body's gonna handle it naturally, which is a fair assumption, because what happens? Did the doctor tell you you can't travel?

Kristen  11:52  
No, no, they told me I could travel. I'm just glad that everything like day that I needed to go the ER, I'm glad I was home and I was my husband was here with me, versus being on an island. I was actually on an island, on a lake in New Hampshire. So I feel like it could have, it could have gone very wrong. It could have been a lot harder.

Paulette  12:13  
I agree. I agree like that's impossible to foresee. So you get home from you get home from the trip, and then what brings you to the ER,

Kristen  12:22  
I was hemorrhaging, just hemorrhaging. I I started just bleeding super heavily, huge blood clots. There was a blood trail all through my house because I was trying to get from get to the bathroom. So I left this huge, disgusting blood trail, and I was just on the floor, hemorrhaging. I couldn't get off the toilet. So it was between, like, laying on the floor because I was in so much pain, and then sitting on the toilet to try not to continue making such a huge mess. And then

Paulette  12:50  
someone has someone called 911, like, how

Kristen  12:53  
did I call? I called the doctor, I called the nurses to see, like, what I should do? Like, is this normal? You know, I don't know if this is normal. There's a lot of blood, you know, it's like, it's, it's so hard to know. And as women, we put up with a lot before we ask for,

Paulette  13:14  
let me pause you there for one second. I'm going to include a link to the ad campaign from the American Heart Association that maybe you've seen it before. It's a couple years old, Elizabeth Banks is having a heart attack in our house while she's tending to the kids morning routine and trying to clean up before the EMTs arrive. Clearly, what you are describing is a well established way of being that we should all unlearn as quickly as possible. Have you seen the it was like a it was like an ad for women with heart attacks. Essentially, the bar is so high for us to ask for help, right? And we, and we don't necessarily know how much blood is the the bars you

the bar is so high for us to ask for help, right? And we, and we don't necessarily know how much blood is the right amount of blood, and that's and that's hard to communicate, because it always looks like a lot. It always, yeah, it's blood, yeah, so and I and so were you just going about your day, and then all of a sudden you started? No, this

Kristen  14:29  
happened in the morning. So I got up, I got it. This was all like first thing in the morning. So I got up, you know, I'm in the bathroom that the kids are up. Um, my husband had already left for work, you know. So when I'm at this point, I'm calling the nurses, I'm trying to figure out, and when I told them that I was starting to feel lightheaded, that's when they were like, We think you should go to the ER. And I was like, Okay. And so then I tried getting hold of my husband, and I couldn't, because he was on a job site. So once I finally got hold of him, he shot home. He's like, I need to get you there. Now, I was like, they recommend me going. I was like, but I'm still being super wishy washy about it. He's like, We're going now before you lose consciousness. Because I was losing consciousness at this point, by the time he got to the house. So I was losing consciousness. He got me there with all the kids, and even still, he brings me in in a wheelchair, and we tell the ER team what's happening, and they still just kind of push me aside because I'm sitting there and I'm not making a lot of noise, I'm not complaining. And it got to the point where I passed out, and one of the doctors started yelling, I guess, I guess one of the doctors started yelling at the nurses that were checking everyone in because they didn't push me through. Immediately, she was like, She's literally losing consciousness. But because I didn't make a big enough deal, it's so it's so hard, you know? It's like, yeah, so that was another to do. So they couldn't find a vein. Like my husband, he's like, I thought you were dead. He saw me just like, unconscious on a table, you know, covered, covered in blood. You know, they can't. They can't get a needle in my arm because, like, my veins are gone. Blood pressure is too low, so they, yeah, it was terrible. So, so, and then, when, then they put me, they and then it was actually super hard, because they, they did the DNC anyways, where I delivered all my babies. You know, it was just, it was just really hard being in the labor and delivery after losing another baby. So just it was heartbreaking, and that's when my husband was like, I can't do this anymore. I can't lose you, because what am I supposed to do without you? So so we made the decision that we were done, and

Paulette  16:56  
I'm not I'm not done taking care of Kristen from unbelievably difficult experience, so hard or not, and this is not your fault. I would say that it's like a social issue where women are encouraged not to hold up their hand I need help, which is insane and unfair and and for the people in the hospital not to notice that you needed help. And for right, terrifying and, I mean, I guess the good news is you don't really recognize it in the moment, because you're so out of it, because you've lost a lot of life. Yeah, well, I can imagine that your husband is brandished with this memory, yeah, of how close you guys came. And, like,

Kristen  17:38  
yeah. I mean, how close it was, not only that, but just the traumatizing my three little kids are there at the hospital with us. You know, it's just the whole thing was extremely terrifying for everybody. It's so

Paulette  17:53  
scary, and it is, and I will cut this.

Kristen  18:02  
I The whole thing was extremely terrifying for everybody. It's

Paulette  18:08  
so scary, and

it's so scary. My first pregnancy was kind of a disaster, and as it seemed to be crashing, the doctors put me in labor and delivery to be seen part but both of my pregnancies were just flat out disasters. Yeah, and I halfway through the pregnancy, they put me in labor and delivery because where else are they going to put me? It's so hard to be in that space if that's not where you belong in that moment. Yeah, right, like it's just or maybe more accurately, you do belong there, because labor and delivery floors contain all kinds of outcomes, some joyous, some tragic, but it's not why you want to be there, and in the past, it's not why you were there. And you know, I delivered in my my daughter is whisked off to surgery, and I go up to labor and delivery. So I totally get how challenging that is to be in that space, when you're so Sorry You went through that that.

Unknown Speaker  19:26  
Yeah, I'm so I

Paulette  19:47  
yeah, I'm so sorry you went through that. That is a lot.

Kristen  19:50  
It was a lot. It was a lot. And so, like I said after that, it was so painful on so many levels that I was like, I was okay with us just being happy with what we have, you know. I was like, we have, we have, we have so much wide chance losing so, so, yeah, so we decided that we were done, and we were, you know, and especially after my youngest turn two, and, you know, I'm coming out of that fog that you're in when you're in it for so long. And I was in it for so long that I was starting to feel like me again. You know, we're starting to plan trips as a family again, you know, because the kids are older and yeah, and I just purge all the baby stuff, get rid of everything, and then I found out I was pregnant

Paulette  20:47  
again. Congratulations. How far along are we?

Unknown Speaker  20:51  
I am almost 24 Wow, almost six months.

Paulette  20:56  
Wow. How does this one feel?

Kristen  20:59  
This one has been terrifying. So physically, I feel great. I I feel like my body was definitely ready, but it's been, and it was been so hard for me emotionally. But my doctor team has been amazing. They literally let me come in like every every other week, every two weeks, to check, to make sure everything's good. It's because I have so much stress, so much anxiety and so much worry. It took me a really long time to feel excited about it. So that

Paulette  21:31  
seems totally fair. And is there some distinction, like the miscarriages that you had were in a period where the miscarriage rates super high. So I said the rate was high, and I thought it was about 30% that's the quoted statistic that I see often, but I found this article published in a peer reviewed journal, so it's not like I found this article in the back of the door in a public restroom, and the article suggests that 30% more accurately describes the rate of pregnancies that translates to a baby. I will include links to this article in the show notes. Yeah, and the hemorrhage, to me makes sense to the degree that this is your body's way of trying to clean out a pregnancy that's not going to progress. So it's not like some weird response to so does once you get past the first trimester, does that give you any breathing room?

Kristen  22:22  
I didn't quite start feeling better. I'm feeling good about it until I could feel her move. So being able to feel her move has given me a lot of peace of mind. And then having the 20 week the anatomy scan was also, you know, because I am 44 so I'm older, you know, there's a lot of high, much, much higher chances of having something wrong, you know, like some having, like, Down syndrome, and then I'm like, Jesus have all its arms and legs, you know. So it's just I was super so having that 20 week appointments gave me a lot of peace of mind, and now that I can feel her kicking regularly. That also helps tremendously. So that

Paulette  23:04  
is awesome. That is awesome. And it is, I do appreciate that this body that you're inhabiting, which for a while, would not let you get pregnant. That's not an issue. Yeah, no.

Kristen  23:19  
So, and it was like, I said, it's, this is a miracle, because we, you know, to be candid. We, we, I think they had sex once, and I'm not tracking my cycle. You know, he's not, you know, we're pulling out. You know, I'm not on birth control, but we're doing what we do at this point in my life and his life, we're like, we're doing the best we can to avoid having children, but here we are. So it's, it's a miracle. It's a miracle baby for sure. So it

Paulette  23:51  
is that's very exciting. And I have to say, in my family, right? There's four kids on the third or fourth, there's a gap. Yeah, she's the best one, yeah. So cover the ears of your other children. But I'm very excited. Do we find out the sex?

Unknown Speaker  24:06  
It's a girl. So all girls

Paulette  24:09  
so fun. Oh, my God, that is a house of fun. It is.

Kristen  24:12  
It is. And I thought for sure. I was like, because I got rid of all my stuff, I was like, maybe this is a boy, because it makes sense for me that I have to, if I have to rebuy everything, if I'm rebuying it for a boy, but, no, it's a girl. But that's all right, we know what to do with girls.

Paulette  24:29  
You're gonna have to fight. You're gonna have to use hand me downs from the circle, whatever your circle is. Yes,

Kristen  24:34  
exactly. And that's what I've been doing. I've been, I've been making sure that anyone I know that has little girls that I get their hand me down. So,

Paulette  24:43  
so now you are, in many ways, a pro, because you experienced the width and breadth of all these things. Are you doing anything differently in this pregnancy than the other three?

Kristen  24:54  
No, no, we're we're scheduled. We're scheduled to for an induction so that you know, same thing. Don't want to have her on the side of the road. But yeah, nothing different. I'd like to involve the kids, if, if they can be around. It's something I'm still trying to figure out. It's like if they're going to be able to be there, but because it's planned, and because I know it happens fast, it would be fun if they can be involved, and somehow, so, you know, that's the only thing different. Is actually, with the third one, with Reagan, my husband didn't even stay in the hospital. I was like, just go home. You know, we've got two kids at home. Just go home, be with them. So, you know, he's we'll probably do the same thing. I'll just be like, you can be there and then leave. We're fine here at the hospital. So

Paulette  25:39  
are you doing anything like, I eat green smoothies or I,

Kristen  25:43  
no, I'm working. I'm, I'm, I'm active, but I'm not doing anything different, really. So I'm just keeping, I mean, I've got three kids I'm chasing after. So yes, oh

Paulette  25:54  
my god, totally active, yes. And people can't see because it's audio, but Kristen looks glowing and gorgeous. So you look like you're doing. Well,

Kristen  26:03  
yeah, I am. Yeah, it's been, it's actually been the easiest pregnancy since my first one. So I think, you know, my, my pelvic floor and my uterus was really tired for the second and third I had some time. You know my, my youngest will be four. Well, she'll be turning four right after I deliver, so I've had a nice break, which I didn't have with my other three. So I think my body is, you know, my body's happy. So

Paulette  26:32  
that is awesome. And I do think that your story is inspirational for people who are having trouble getting pregnant.

Kristen  26:39  
Yeah, it's, it's, there's just so much uncertainty and surprises, and it's just like, you never, you never know. And it's just even, I still, I'm not sure how I'm pregnant, but it happened, you know? It's just like, miracles do happen, you know. So even when you've already written them off and moved on, you know, they still happen. So absolutely

Paulette  27:07  
amazing. And is, I know that you've had five seconds to have a thought for yourself, but is there, is there anything you would do differently in the early pregnancies or for this one?

Kristen  27:21  
I don't think so. I don't think there's anything I would do differently. To be honest, I've had, you know, I feel like I've been very lucky other than other I mean, even though I've had some super terrible experiences, I feel very, I feel like I've been very lucky so with everything. So,

Paulette  27:41  
yeah, I agree. Well, I will keep fingers firmly crossed. Thank you, and 1000 congratulations. You look fantastic, and yours is a really inspiring story that you have been so successful despite those early hurdles and 4% chance, like 4% on a random Tuesday?

Kristen  28:01  
I don't know, yeah, I know. And not just that, but there's so much stress about women having babies by a certain age, you know. And I, I honestly, truly feel like having pregnancies later in life. Just is easier on your your soul, you know? I don't know I didn't have babies when I was young, but I know for me, mentally and physically, and I just feel like there was no reason for me to rush. And I'm glad that things happened on the timeline that they did. You know, I've This is my fourth geriatric as they call it, geriatric pregnancy, and

Paulette  28:38  
allegedly, according to the internet, doctors now call it a pregnancy with someone of, quote, advanced maternal age, and the advanced age really only refers to the eggs in the ovaries. The primary factor affecting fertility with age is egg quantity and quality. You've probably heard these numbers before, but a female fetus in utero typically has six to 7 million eggs at 20 weeks of gestation, that number drops to one to 2 million at birth, when puberty begins, around age 12 or 13, a female usually has between 300,500 1000 eggs. So unlike other cells in the body, you're born with a limited set that declines over time. Quality also declines with age, and scientists think that oocytes age relatively rapidly due to their unique biological characteristics, including the fact that they are highly susceptible to a variety of cellular stressors like inflammation, environmental toxins and stress. I've had

Kristen  29:38  
very healthy babies and pregnancies, and you know, they've all turned out great, great kids, and you know my husband and I are in a place in our lives where we can deal with the chaos of it you know so I

Paulette  29:54  
do think there's a lot to be said for emotional maturity and my first one I was 32, and because i.

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