In the moment of miscarriage

By Nicole Piasecki

I’m eight weeks pregnant and on the exam table at the fertility clinic, a condom-covered ultrasound probe inside my vagina. A nurse dims the lights so I can see my uterus encircling the embryo on the black and white screen mounted on the wall. I expect to see a flickering heart on the screen, a tiny vibrant firefly. And for the doctor to say everything looks great, just as he had done, smiling, two weeks before.

As the doctor moves the probe from side to side, I stare at the screen, waiting. Too long of a silence envelopes the room.

“I’m not finding the embryo’s heartbeat,” he finally announces.

I wait for him to say: Oh there it is. But he doesn’t.

It feels like a marble dropping into my narrow throat, and my stomach turning over and over, and my head floating off of my neck, and my eyes observing myself from above. I’m confused, unable to accept any version of this story that deviates from my certain plan of holding my baby in my arms in the warmth of summer, long nights in the nursery feeding and snuggling, rocking her back to sleep with the windows open, the curtains lifting with the wind’s breath. I was naïve to have already selected the perfect baby name, to have decided on a glider and ottoman for the nursery, to have started writing letters in a Moleskine journal—telling my daughter how much she is loved and wanted.

Could the heartbeat just be too quiet to hear?

“I’m sorry,” the doctor says. “It looks like the embryo has stopped growing.”

He removes the probe with its tiny camera embedded in the tip, then drops the condom and his wadded latex gloves into the red biohazard container. The used ultrasound wand goes into a disinfectant machine on the far wall. Then the doctor turns to wash his hands at a sink on the other side of the small room.

I remove my feet from the stirrups and slide myself back to sit up on the exam table. I cover my legs with the thin white sheet. The tissue paper crackles beneath me. I cry quietly into my open palms. The nurse offers a box of tissues and I take one without looking up or making eye contact.

I hadn’t experienced any signs or symptoms of a miscarriage: not a twinge of pain, not a drop of blood. It didn’t make sense that a life could have ended silently inside me, while I was busy going about my daily routine: teaching, exercising, reading poems and essays, stirring simple recipes on the stovetop.      

The doctor prints the ultrasound photo of the dead embryo from the machine. He tears it from the printer tape and holds it in his hand. I can’t take my eyes off of this black and white image on curling paper hanging by the doctor’s side.

The doctor stands across from me and explains the options for vacating a uterus:

1) Office dilation and curettage with oral painkillers. He can’t promise I won’t feel anything.

2) Hospital dilation and curettage with general anesthesia. He says this will guarantee that I will not feel anything.

3) Stop taking progesterone supplement. Wait.

I can’t imagine spreading my legs and letting doctors make quick work of this loss. I can’t imagine allowing them to scrape my uterus or to tidily vacuum my dream away.

The doctor asks if I need a few minutes to decide. I know immediately that I will wait for my body to let go.

Also, I am in denial. I want to make sure his prognosis is accurate.

I point to the doctor’s hand and ask if I can have the ultrasound photograph. The doctor hesitates. He says he must take it to his office to record some measurements, but he agrees to bring it back to me. I pull on my jeans and sweater and wait in the small exam room. The doctor does not return, and I do not not have the strength to ask again for the photograph before leaving the office.

In the coming days, I brace for what will happen next. I cancel my appointments. I wear thick maxi pads. I check too often for the faintest hint of blood on the pad or toilet paper. I listen for sharp pains or the tiniest cramps, but still, there are no signs. I weep suddenly when I imagine the dark space of my womb encircling a small lifeless creature that I couldn’t save.

Two days after the appointment, I find a hand-addressed business envelope in my mailbox that holds a single ultrasound photograph. The picture is resting in the folds of a blank, white piece of paper. I hold the black-and-white square gently by the outermost borders and look closely at the center—a cloudy, white embryo in a tear-shaped black pocket. I affix the picture to the side of the refrigerator using a small, circular magnet.

Seven days later, the undeniable deluge begins. I run to the upstairs bathroom and watch the lining of my uterus fall into the bottom of the toilet bowl like dark ink separating in water. I try not to look too closely, in fear of what I might see and always remember: something that resembles the picture of the life slipping through me.

The ninth day of bleeding happens to fall on Christmas. The physical pain peaks with the strengthening contractions, and I abandon the kitchen right in the middle of preparing a breakfast quiche. I replace another saturated maxi pad and sit on the toilet while my body rains. It feels as if my heart is falling down, down, down with the fluid, as if the contractions are heaving, haunting sobs.

When I find the will to stand, I walk to the closet and change into baggy pajamas, and then curl myself around an old down pillow in bed. My body sinks into the memory foam mattress topper. The furnace kicks on and off in intervals. A train warns of its approach. I close my eyes and try to sleep, but my mind is frantically working to revise the narrative of the rest of my life.

Nicole Piasecki teaches undergraduate writing and rhetoric at the University of Colorado Denver. Her writing has appeared in Word Riot, Shadowbox Magazine, Gertrude Press, CLAS Statement, and other pedagogical publications.

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