“All was fine until I started to have really bad cramps at around 5 weeks. Little did I know I was soon to experience a silent miscarriage …“
I was and am happily married for more than a year. We had been living together for a few years. We knew that we were ready for kids and so we both did all necessary check-ups, focused on living a healthy lifestyle, and also excluded unhealthy habits from our life. Then we decided we were ready to try for a baby.
Prior to this time, I had a very stressful time at work, I was quite emotional and was sent to see a psychiatrist. After some months, sessions and antidepressants, I started to feel better. A couple of months later I stopped taking antidepressants and found out I was pregnant.
I was happy, shocked, confused…I felt all possible emotions, but we both truly wanted this. I soon realized that as a foreigner living in another country, I had so little information about where to go, where to find a good doctor, where to get advice, where to buy basic things that a pregnant woman needs, and most importantly – who to ask about all these queries. However, I was lucky to be in a W2W group, where I received unlimited support, advice, as well as all contacts that I needed.
Everything was going fine until I started to have really bad cramps at around 5 weeks.
I visited my gynaecologist and was prescribed Duphaston. However no heartbeat was detected, possibly due to it being still very early into the pregnancy, but I was reassured that the pregnancy itself looked good and healthy. After a few days with tablets, the cramps became mild and eventually disappeared.
When I was around 7 weeks, I started to have some brown spotting.
I panicked and went to the nearest private hospital, where I was told that everything was looking good, and a heartbeat of my baby was detected. I can’t explain the feelings I experienced at that moment, but it was a moment of reassurance and amazement for sure. As doctors said, spotting can happen at any time during the pregnancy and this so this was normal. However, it was also mentioned, that my baby was smaller than I thought; I was dated to 6+5, not 7 weeks.
After that, my next regular check-up was scheduled in two weeks time. When I went there with my husband, I was very happy!
We could not wait to see our baby on screen. But that feeling of happiness was cut short when my gynaecologist told me that she could not detect a heartbeat. Could I have experienced a silent miscarriage and not realise it?
I think the truth was for some time I had known that something may have gone wrong. I could feel that my cravings had disappeared, my nausea had gotten better and overall I felt better too, but I knew that pregnancy symptoms could come and go, I didn’t really want to admit that something was wrong, or the possibility of a silent miscarriage.
After this I went to Mater Dei emergency; they confirmed that there was no heartbeat and that 99% I had experienced the so-called silent miscarriage also known as a missed miscarriage. My body simply did not know that my pregnancy had stopped, probably just as my mind had done. I remember that I left the ultrasound room and I simply could not stop crying.
When I calmed down a little bit and saw a doctor after that, she explained to me that they needed to wait another 10 days to be sure it was indeed a silent miscarriage before they give me three options: expectant management (to wait all to happen naturally), medical management (a tablet will be inserted inside my vagina) and surgery. I was also told that the miscarriage could happen at any time. I was given a brochure with some general information about miscarriages, and a cup where I could collect the remaining of my baby if the miscarriage was to start at home. I was then sent home.
The worst thing of all was to wait, not knowing when, how and if it were to start. I think I read everything I could find online about silent miscarriage but that was not enough. There was simply not enough information.
I spoke to my friends in another country and realized that almost everyone had had miscarriages! That was a shock! Why was there this little information if so many women had experienced miscarriages in life? I needed some reassurance, some examples, some stories, to know that everything was going to be well eventually, and most importantly, what to expect exactly.
On the internet I found miscarriages stories from the UK and other countries, where a different health system and approach were evident.
Those 10 days of waiting were the longest days in my life. I experienced nausea, had an upset stomach, a temperature of 37-37.2C, mild cramps, but no bleeding and no strong pain either. My anxiety was over the roof. I spoke with the Gynae at Mater Dei and they told me that in order to be accepted by them, I needed to have a fever (over 37.5C) or to start bleeding. As I had neither of this, I patiently (not really) was waiting for my appointment day.
On Monday (a day before my appointment), I went for a Covid-19 swab. The next day I went to Mater Dei with a bag in case I needed to stay overnight.
When I arrived at the hospital, the doctors sent me for an ultrasound where they confirmed once more that I was experiencing a silent miscarriage and that my body was simply denying that the pregnancy had stopped.
The sent me for a blood samples and then to the gynaecologist, who explained my next options. They told me that the tablets were to be inserted inside me so the miscarriage process would start. At that time in that room I could not ask any questions as I was crying. I tried to stay calm, but tears simply did not stop even for a second. I was sad, confused, angry and terrified. I appreciated that the doctors and nurses were all very supportive, and a particular doctor promised to see me later so I could ask any questions I may have had, as she clearly saw I was not able to speak at that time.
Eventually I settled into a hospital room, got some food, and my doctor came back to answer all my questions. She explained to me that the usual process was to insert tablets inside my vagina that would start the miscarriage process. If the miscarriage would not start in 6 hours, they will insert another tablet and if this does not work, then a third and last tablet would be used. In case a third tablet didn’t work, or I were to have any complications, they would then send me for surgery, a procedure that would be quick, easy, but like all surgeries it carried a small risk.
I got my first (and in my case last) dose (2 tablets) inside me. The process of inserting them was not painful, but it was a little bit uncomfortable. In about 20-30 minutes, I felt cramps coming on, first mild then with each minute they became more and more intense. At first I asked for some painkillers. The nurse gave me some paracetamol that unfortunately did not work, I asked for something stronger, and they gave me a codeine tablet that did not work either.
I was in agony, I had my worst period pain ever.
Here I should say that my periods had always been very painful, but up until the start of the pregnancy I had managed to control them with hormone pills (Jasmin), This pain was exactly as the pain I used to have before that. I usually used to develop diarrhoea on my first day of my periods and I fainted from pain. But at that moment all happened at once.
I begged for something stronger to help me with pain, but when the doctor arrived to see me and to decide what painkillers to give me, I could not meet him as I was stuck in the toilet with diarrhoea. By the time I left the toilet, the doctor had left to see another patient. I hardly remember anything from that time until he came back again. I remember I fainted due to the pain, I remember pressing again and again the call button to call the nurses, and I remember them patiently answering me the same question, that the doctor had been there to see me, he had to leave, and he would be back as soon as possible.
Finally, the doctor arrived. I do not remember talking to him, I only remember I was repeating over and over that I was in pain. After a minute, the nurse gave me an injection (not sure what it was) and a few minutes after, the pain eased and I fell asleep.
I am not sure for how long I slept. However, after some time, I woke up, went to the bathroom and vomited. Finally, I started to bleed.
That was a good sign. It meant that the tablets had worked and I would not need more. In the bathroom I passed some tissue, referred to as ‘products of conception’, which was not scary to see, probably because I was in hospital, safe, and not at home alone. I called the nurse, she was very kind and sensitive, she took these tissues and went to the lab with them. My strong pain was back, so I asked for painkillers again, I got a paracetamol and a suppository inserted in the rectum, which eased the pain and I could rest.
I stayed in the hospital overnight. The night was bad. As a side effect, I had all my muscles twitching all night, so I could not sleep, but at least I had no pain. I woke up without pain the next morning, which felt like a blessing. My blood pressure and temperature were checked and I was sent for an ultrasound, where it was confirmed that no tissues were left inside.
I was told that I could finally go home very soon. My bleeding was to last for about a week and after that, I could go back to my normal lifestyle. In 6 weeks after that, I was to get an appointment for a check-up.
At home, I was taking paracetamol+voltrex, but I still had some cramps and bleeding, and I also passed the same tissues. After a few days I still had cramps and bleeding, so I went to hospital for a check-up. They admitted me into the hospital and was prescribed antibiotics to treat an infection which had developed.
I believe that detailed information is crucial. If I had more information right from the beginning, I would have been able to manage the whole situation in a much better way, which is why I decided to share my silent miscarriage experience with you.
It’s been more than 3 weeks already after my first personal experience with a silent miscarriage. As I started to recover from physical pain and discomfort, I started to think what I could do differently from the beginning, and what lessons I have learned from this experience.
My advice to all girls and women in a similar situation:
- Find a good doctor or midwife and keep contact with him/her. Make sure you have doctor’s number, because you will have many questions and you would not know if those new symptoms are normal or it is something you need to worry about. In the beginning, my source was mostly a google search that cannot be reliable and the whole situation can look scarier than it is. A good source is your close friends, but you might not be ready to share your story with them yet. What I learned from my friends is that many of them have experienced the same in some point of their life, but this topic is still not spoken aloud. Therefore, your primary source ideally should be a professional doctor who would know you and your history.
- Make sure you ask as much as possible during your hospital visits, and if needed, prepare all questions beforehand.
- If you are sensitive to pain like me, ask for stronger painkillers before this pain will reach you during the miscarriage. Or consult with your doctor about pain relief beforehand.
- Make sure someone can stay around during this tough times, to support you, be it physically or on the phone. Or, if that is not possible, reach someone from women’s online groups, you will be amazed how many people out there are happy to help.
- If you have a silent miscarriage, while you wait, prepare large sanitary pads and a bag for hospital stay.
One thing I understood, even though we are all different and this experience affects everyone differently, lots of women have already gone through this experience and almost all of them had healthy babies in the end.
I was advised in hospital to wait 2 periods (approx. 2 months), and to try to conceive again. I stay positive and believe we will be having our desired baby soon!
You can read further about what happens during a miscarriage as well as about how it is handled here in Malta here.
