Monday, October 24, 2016

The naked, bestial creature

I have a picture of my face that I really like. It's the picture I use for my work email, my official online presence, my public profiles. I like this picture because I look truly, truly happy. I am joyful and glowing and five weeks pregnant. This picture was taken a couple days before miscarriage number four. Which wasn't even a proper miscarriage and doesn't 'count' medically because I only had a positive pregnancy test and not an ultrasound confirmation of pregnancy. Chemical pregnancies are very early miscarriages which happen in the first four to five weeks of pregnancy and are very common. My unprofessional Google research tells me that as many as half of pregnancies can end before the first week. 

Sometimes I am confused when I speak with doctors. Have I had three miscarriages or five? What about the miscarriage at six weeks? Too late and painful to be considered a chemical pregnancy, too early to matter much at all medically. To me, the chemical pregnancies count. All of my pregnancies count. The two miscarriages I had at 7 and 11 weeks respectively count more because I saw an ultrasound of the embryo. The last one counts the most because it could have killed me. I saw the heartbeat, a tiny flickering like a little flame, beating cells that legitimatized my state of being and provided a solid medical diagnosis. Sometimes I remember that frantic little beat, trying to stay alive against the odds. My last discharge papers from the hospital read: You have had a miscarriage. Diagnosis: embryonic demise. Translation: 'There is no heartbeat'.

In the last 12 months I have been pregnant as many weeks as I was not. But my quest for a baby has certainly left me without a child. Each loss is different. I have found that a simple and common human affliction can strip me of dignity, leave me confused and disoriented, and push my resources beyond the threshold with which I can effectively cope. I am no longer myself, I am a version of myself in a state of repeated pregnancy loss. The symptoms have been referred pain, headaches, nausea, and emotional unpredictability. I did not cry at the hospital. I did not cry when I got home from the hospital or in the days that followed. But things which make me happy, like spending time with my two beautiful nieces, can days later leave me awash with sadness and rage in the most inappropriate venue at the worst time.

I expected the fifth would be like the first, a huge crushing wave of tears but that flood never comes. I stopped crying after the second. Because I got tougher. I am now a new, shiny hard surface which does not crack or break. All the excess weight has fallen off my body. I'm still soft, but I'm almost a stranger to myself. Whose thinner arms are these? Certainly I am a little bit dissociated from myself. Being destroyed has made me nearly indestructible. This new perspective on life has left me a vast capacity for empathy and a greater understand of the human condition. But I cannot talk about my fifth miscarriage without also talking about the abortion which followed number five (having seen two of the three embryos I lost, I can't think of them as true babies, they were at most strange tiny little spheres of potential human beings that I counted one by one). 

My abortion was the worst part of my fifth miscarriage, and wrapped up in it is the state of healthcare and women's rights in my country. When I left the hospital with my miscarriage diagnosis I was in the process of losing a pregnancy. Sometimes, if one is lucky, like I was lucky with number two, a miscarriage happens all at once. If one is unlucky, as I was unlucky with number five, a miscarriage may drag on for weeks or months while a body tries to rid itself of an nonviable pregnancy. I found out that the pregnancy tissue can continue to grow even after the embryo is gone, even when the body is fighting to rid itself of this dangerous condition which can lead to infection and without proper medical treatment, even death.

Because I didn't have health insurance and wasn't willing to pay over $20,000 for a D&C in the hospital, I ended up in a desperate search for an alternative provider for women's healthcare. The ultrasound at the hospital, performed after I left work in the middle of the day and drove in a daze to the ER, cost $1,066. Over a week later, an appointment made a month prior for my 12 week checkup ended up becoming my followup appointment for my miscarriage. The doctor drew blood and strongly cautioned me against trying to wait it out. My pregnancy hormone levels were still too high, indicating a serious complication. I was already anemic and now threatened with the exorbitant costs of blood transfusions and emergency surgery if I didn't agree to a D&C that would leave me in more debt than all my student loans.

The next day, after a terse and terrible conversation with the hospital billing department I called Planned Parenthood. I've only had a few moments in my life where I felt as desperate as I did then. It was my lunch break at work and I could barely speak because my throat was so tight. Thankfully the person I spoke to was absolutely wonderful. They called the clinic and spoke with the doctor to see if they could perform a D&E in place of a D&C, they made an appointment the next day at the nearest clinic, they explained the cost ($475) and even offered me financial aid which I declined.

On the day I walked into Planned Parenthood I was physically unwell and emotionally removed. I had lost a fair amount of blood in the two weeks since a nurse practitioner had steeled herself and told me that there was no more hope. I could tell it took a toll for her to deliver that news. 'You'll be ok, you're tough. You've been through this before.' she told me. I couldn't tell if she said it for my benefit or hers or just because there was nothing else to say. My body was caught in a hellish limbo of pregnant but not pregnant. I almost cried when we drove past the protestors holding up a three foot sign with a picture of a 10 week embryo. It was a graphic depiction of everything I had lost, so many times. As I walked for the door a woman across the street yelled at me to stop and save my baby. A part of me wanted to tell her she had no empathy, no understanding and no imagination for the suffering of others. A bigger part of me couldn't even articulate the parts of rage when I looked at her. My driver tried to comfort me by telling me my 'baby' was already dead. 'That's not why I'm angry.' I said.

Inside planned parenthood I had to fill out a number of forms requesting an abortion. I had to go through counseling and education on birth control, preventing pregnancy and domestic violence. My counselor told me I was the only person to sit in her office who was actively trying to get pregnant. I was mortified when I suddenly started to cry and could not stop. During my ultrasound the young technician exclaimed 'Oh my god!' and told me I really, really needed a D&C immediately. She turned the screen towards me so I could see the gestational sac, still growing and now measuring at 12 weeks, some days. It was another affirmation that this was really happening and every step I had taken had been absolutely necessary. Without Planned Parenthood I would have been saddled with a huge debt for a procedure I could not forego or postpone. For another hour I sat with six other women in a tiny inner waiting room. Some of them were crying in the quiet way that women cry when they are trying to hide their sadness. The irony of the situation was so overwhelming I wanted it to be funny but I cried along with them instead. I couldn't stop picturing in my mind what a real newborn would have looked like, held in my arms.  

I do not judge those women, I do not think what they did was wrong. I still believe that no one should be forced to carry an unwanted pregnancy. My desire for a child has nothing to do with the decisions others make for themselves. I know firsthand how taxing and dangerous pregnancy can be. We all have desperate times, desperate situations. The last thing I said for the sake of the recorder in the operating room before the anesthesia kicked in was answering the doctor's question, 'For the record, this was a pregnancy you desired, correct?' My answer was, 'yes, very much'. The next thing I knew, two hours had passed and I was waking up in recovery. 

A friend asked me if I get excited anymore when I get pregnant and the answer is 'yes, but'. My excitement is tempered with caution. For me a positive pregnancy test means next to nothing. An ultrasound guarantees nothing. I could not have predicted that a sixty day gap in ten solid years of health insurance would have resulted as it did. I thought that pregnancy was the one. I thought that because I saw that tiny beating heart we were going to make it. Only one of us did. My perseverance, my optimism, my faith and my hope have slowly become insidious. I thought I was a force of nature that could take on anything the world brought my way. It turned out I hadn't actually considered what the worst was. This wasn't even close to the worst thing that could have happened. 

Possibly the absolutely most important thing that I can tell anyone who actually this whole story is that I am one of the lucky ones. I wake up every day thankful. To be bitter would be to take for granted the things I do have. My experience was horrific, but I am educated, employed, married, and financially stable. I have a large support network. I have good credit. I'm in my thirties, not twenties or teens. I could have afforded a D&C if I had no other choice. I was able to cover my hospital bills out of pocket. I can seek support when I need it. In less than a week I will have health insurance and I plan to never ever be without it again.

I can imagine that this situation, or any situation like it, might have been a thousand times worse if I didn't have the resources and advantages I had. I don't know why those others women were at Planned Parenthood that day, but I do know that we make the best decisions of the options available to us. I can't impress on people enough the absolute necessity for women's healthcare providers like Planned Parenthood. They save lives.

And I will leave you with that.

In the Desert 
 
In the desert
I saw a creature, naked, bestial,
Who, squatting upon the ground,
Held his heart in his hands,
And ate of it.
I said, “Is it good, friend?”
“It is bitter—bitter,” he answered;

“But I like it
“Because it is bitter,
“And because it is my heart.”

-Stephen Crane