Am I Having a Miscarriage? There’s No Heartbeat
The subject of this post has nothing to do with why I’ve been MIA for the past few days. The reason I’ve been so quiet on this here blog is that I volunteered to evaluate charter applications for the state. Last year, they only gave me three to score; this year, I had to do six. Each one is between 250 and 500 pages. So between reading applications, working, getting Magnolia Montessori For All up and running, and watching TV at the end of the day because I’m too mentally exhausted to do anything else, I haven’t had much time for Feeding the Soil. The bad news is that I’m wondering, “Am I Having a Miscarriage?
I owe you some pregnancy-related updates. First, I’ve started having itching in my palms and feet again, which is a sign of choleostasis. Choleostasis is a pregnancy-related disease that causes liver malfunctioning. It usually happens in the third trimester, and it’s a very serious thing. Choleostasis often involves induction to prevent stillbirth.
It affects less than one percent of Americans (it’s more common in Scandinavian countries). However, the recurrence rate in second pregnancies is very high. I got it with Henry in the third trimester, and it caused a lot of stress as we tried to make decisions that would be best for Henry.
So I’m 11 weeks pregnant, and the itching is already starting. I got worried very fast because there is no cure for choleostasis and the treatment usually involves medicine that may or may not be harmful to fetuses. The best way for me to assuage worry is to develop an action plan. So, at 2:30am one morning, I decided to:
- Hurry and commit to a midwife, so I could go to my first prenatal visit and talk about this issue (we interviewed two different candidates but hadn’t decided on one)
- Schedule an acupuncture appointment to try and stimulate proper liver functioning
- Send an e-mail to a local nutritionist to figure out the best way to ease up on my liver through diet (although I subsequently had to rule out this option because she costs $200)
- Purchase this book about a healthy liver diet
At our midwife appointment, the midwife could not hear the baby’s heartbeat. Although the uterus is sometimes tipped back and therefore obstructs one’s ability to hear the heartbeat, it’s not very common to not be able to hear the heartbeat at 11 weeks.
When I thought about it a little more, I realized that some of my first trimester symptoms have been waning. At first I thought it was because I was moving out of the first trimester. Upon second thought, however, I realize that it could also be because of a miscarriage. For those of you who are new to this blog, I also had a miscarriage scare with Henry.
So I cried and then formulated my next action steps:
- Go get a blood test to measure my pregnancy hormone levels
- Get my bile acids checked to investigate the choleostasis situation a little more
I’m still going to acupuncture tomorrow. Wish me luck! I know the needles are hair-thin, but still. They’re needles! In my body!
When I start to get sad about everything that’s happening right now, I remind myself that I can’t control the outputs. I’ve done my very best with the inputs. I prepared my body for conception. Rest and well-balanced nutrition are part of my daily routine. I take my prenatal vitamins religiously.
The most important things in life can’t be controlled. We can’t control when we’re going to meet the person we want to commit to forever. We can’t control when we get pregnant or when our loved ones pass away.
It is what it is. The best I can do is make space for my feelings and then take healthy action steps forward. I still feel like the baby is alive, so I’m optimistic that it’s going to work out. My optimism is going to make everything harder if it turns out that it’s not okay.
I hope all is well with you…
31 Comments
Anonymous
I'm sorry this is happening.
You should consider seeing an OB since liver issues especially this early mean that this is no longer a low risk pregnancy. A midwife who takes you on at this point doesn't have your best interests in mind. I know you want a home birth but being healthy should come first.
Good luck
Erin Curran
I am so sorry to hear that you are going through this! I don't know much about it (except what you just told us) but I'm hoping that somehow it all works out!
Piggybacking on the comment above, you might consider seeing a perinatologist (high risk OB) as they usually know more than a regular OB about what can be done when complications arise.
I originally worked with a homebirth midwife but developed preeclampsia so I ended up delivering early with an OB. Before conceiving our second child we consulted a perinatologist to know our chances of it happening again and what should be done during the pregnancy. During the second pregnancy she several times had different (better!) ideas for how to manage the pregnancy than did our regular OB.
Just a thought.
Wishing the best (whatever that is!) for you and your family!
Adrienne
Dear Sara,
What a stressful time–you seem to be juggling the possibilities well in your mind but I just wanted to send some through-the-tubes support your way.
I'm a doctor-in-training and also wanted to echo the previous two commenters that it would be a very good idea to see an OB (you may need a referral from a regular OB in order to see a high-risk OB, which is why I didn't start by suggesting a high-risk OB; on the other hand a referral from your midwife or primary care physician may be all that is necessary). Regardless of the outcome, OBs have more specialized training in the complications of pregnancy including cholestasis. This doesn't mean you have to give up having a midwife, though! I would suggest this as an addition to your existing birth plan, not as a replacement. It may turn out that things get so complicated that a home birth is not a good idea, but that's not necessarily the case, and a midwife may still be incredibly valuable in managing many other aspects of your pregnancy that are important to you.
Taking care of your body and your pregnancy just sometimes means expanding the circle of consultants.
I've been reading ("lurking" sound so ominous, although this is the first time I've commented in several years…) your blogs since I discovered them during my own wedding planning 3 years ago, and will continue to cheer for you as you go through the next steps.
Best,
Adrienne
Mindy
You are in my thoughts and prayers 🙂
Sara
Thinking and praying for you and your family, Sara! I've missed your posts.
Julie M
Sending good thoughts your way, I hope all is well……
Anonymous
thinking of you and sending virtual hugs your way
mpeachase
I am so sorry to hear you are going through this. 🙁 In March, I miscarried my second child at about 7 weeks, so I can completely empathize. I will be praying and hoping for you that everything is ok.
Megan
Add me to the list of people hoping good things for you.
And I bet you will really enjoy accupuncture. I used it for help with fertility and absolutely loved it! Quiet time for relaxing and medatation–it was so soothing I looked forward to every appointment. The only downside was the $$. I've actually been considering it for pain management for my upcoming birth I liked it so much.
saracotner
Hi, Megan. I was able to find a community acupuncture place that is pay what you can: $20, $25, $30, or $35. It's done in a group setting (meaning a bunch of chairs in one big room). I'm excited to try it!
Anonymous
We're one week behind you in our pregnancy and it's been fun to read along. Perhaps the most reassuring thing would be to go have an ultrasound so you can see the baby and the heartbeat. I've had two (we also had a little scare early on) and there is nothing better than seeing the little one move! Hope all is well.
Jenny
Best of luck for your little family. I saw a high risk OB and midwives during my pregnancy. It can be done! Both the high risk OB and the midwives were very respectful of each other and worked to give me the best outcomes. I really hope that all turns out well for you.
Unknown
Hope all is well. Sending virtual support.
Gretchen
I love you for keeping your optimism during this scary time. I don't know that I would be able to do that. You are truly an inspiration! Sending good thoughts and prayers your way.
Maureen
Thinking of you and your family, and hoping for the best! xoxo
Anonymous
I hope it works out well for you. I'm an apprentice CPM and I would echo with many of the previous posters- generally choleostasis is a risk factor that is best overseen by an OB.
I wish you and your family all of the best!
Erin
Sara-
I'm so sorry about the pregnancy related uncertainty and stress that you're experiencing. My hope is that you will get good news soon and will go on to have a healthy and happy pregnancy and birth.
However, if that's not the case, I want you to know that you will be OK. I know this because I experienced a complicated pregnancy loss at 11 weeks myself last fall. I also want you to know that your "mantra" regarding inputs and outputs was so, SO helpful for me both during and after my pregnancy. That and the Serenity prayer have given me strength and brought me peace, and I wish the same for you.
Julia
Sarah,
I really appreciate your attitude and how you are able break things down in actionable steps. Truely an inspiration to me.
I am trying accupuncture right now before my husband and I try to conceive. I have found that it has helped tremendously with my ability to cope with stress. Didn't notice this at the first visit but for sure at the second.
Sending you peace and good energy,
Warmly,
Julia
Casandra
Sending best wishes, light and strength to you, Sara.
Jennie
Hoping for the best and keeping you in my thoughts ~ try not to stress over the inputs either, some things are just truly out of our control. Good luck and keep us posted if you feel like sharing (and don't worry about a thing if you decide you don't feel like sharing either!).
Sarah
You're in my thoughts, Sara. Best regards to you and your family. You do wonderful work and deserve the best.
Julie's Blog
Hi Sara,
I posted on your page a long while back when you shared your birth story with Henry and I was still pregnant. I developed Cholestatis around 20 weeks and it was an extrememly severe case (no fun!!). I feel for you and I'm so sorry you're experiencing this.
I wanted to echo some of the other comments posted here. I had a midwife, who was fantastic. After developing the cholestatis though, we brought a high-risk OB to the team and it was the best decision we could have made. My daughter was born healthy, happy, albeit a little early. And, the midwife was my support and helped deliver our little girl.
A cooperative approach to cholestatis is definitely possible and might just offer more peace of mind knowing that you have support from all different angles.
All the best!!
Anaïs
Good luck Sarah! I wish you all the best and hope you will have good news soon. Your optimism is an example for us all. Thanx for sharing. x xx
katharina
Good luck! I hope it will work out fine. Acupuncture is really nothing to worry about. I didn't like it the first time but after a while I started looking forward to it and it worked miracles…
Kylie D'Alton
Thinking of you. Hope you have some good and reassuring news soon.
Anonymous
You said it, and beautifully: we can't control the most important things in life. Thank you for sharing your amazing spirit in this space. Thinking of you and wishing you peace, hope, and trust.
Elizabeth
Sara- I echo the thoughts of the other commenters. I've been reading your blog for several years (since my own wedding planning days, in fact) and I've reread many of your posts from your pregnancy with Henry now that I am 20 weeks pregnant with our first kiddo. An option that might be worth looking into: my midwife works in a practice associated with our local hospital that also includes a team of top-notch OBs, so any complications mean a seamless transfer of care should complications arise. We are planning a midwife-assisted, natural hospital birth, which I have complete faith we'll get, but it's good for my peace of mind to have all of my records in one inclusive practice should an emergency arise. I'll be praying for you and your family in this difficult time! Best wishes to you.
Kelsey
Thinking of you.
Stephanie
Sending good thoughts your way from someone who has been there.
Rosalie
Hi Sara,
Firstly I hope all is well with baby, thinking of you. I developed Obstetric Cholestasis in my second pregnancy at 37 weeks. I only had mild itching but when my bloods were checked my bile acids were very high and I was booked for induction that very week. A shock after having a home water birth planned for the second time. I still managed to have a natural delivery even through induction including drip with gas and air and hypnobirthing. It was a long tiring process but a positive birth. Since having it I am having a few issues with gallstones and am looking at natural remedies to help my liver and gallbladder. I know that artichokes and artichoke supplement is supposed to be good for bile levels so have started this. It might be helpful. Anyway, sending love x
Liz
Oh my gosh, you're so brave! I have to echo what another commenter said, "Thank you for sharing your amazing spirit in this space." I'm sending you all of my hopeful thoughts and good wishes.