Content Warning: The following article discusses some of the challenges faced with miscarriages and may be distressing for some readers.
It takes a village to raise a child. We’ve all heard the saying. And being a part of a culture in which tight-knit communities are normalized, it can be a positive thing. But it can also be the source of painful experiences, if you veer off, even slightly, from what your community accepts or encourages.
For Nisha the questions around when she and her husband were going to have kids began within months of getting married. Knowing what a huge responsibility it would be, and anticipating how much their lives would change, Nisha and Nelantine decided that they would wait a year before trying.
Like many other couples they wanted to be able to travel, have a few different experiences, and get themselves financially ready first. Feeling sure that the first two reasons wouldn’t resonate, especially with older relatives, they settled with using financial stability as the explanation for why they were waiting. Since Nelantine had just opened a clinic around the time that they got married, this seemed to keep the questions at bay.
Around the year mark, as they’d planned, they decided to try. And about a year later they were celebrating their son’s first birthday. Though the happy occasion was met with a lot of well wishes, the questions and comments started again.
“When are you planning on having the next one?” “Hopefully this time it will be a girl.” “You’re settled now, so you’re ready.” “You should try for a girl this time.”
Even though they’d thought about waiting a couple of years after the birth of their first child, the pressure started to get to Nisha and Nelantine. They weren’t necessarily feeling ready, mentally or physically, but started to feel that maybe they should try anyway.
Looking back, Nisha points to this time as when things started feeling more complicated and stressful – as though they were feeling the weight of others’ expectations more than they ever had. This on top of juggling all that came with having and raising their first child.
From an emotional and mental standpoint, it began taking a toll. Conversations with friends and family left her feeling like her only worth was in being able to have a child as quickly as possible. Or that this was worth more than anything else. Regardless of her own plans and aspirations. And when she tried to speak to the challenge of juggling all this, she often found there was a disconnect between her own experiences and those of her support system.
Her mother and mother-in-law for example, faced many different challenges in raising their children in Sri Lanka. And saw a ton of resources and opportunities for raising a family in Canada. So initially it was all too easy for them to dismiss the difficulties Nisha faced. She was trying to balance roles and responsibilities they hadn’t had to deal with, and weren’t aware of firsthand, making it hard for them to sympathize.
And the pressure wasn’t placed on Nisha alone. Nelatine was also regularly asked when their next child would be coming along and received comments about it being good if it would be a girl.
In between trying to separate their own feelings from the opinions of those around them, in the fall of 2017 Nisha began feeling unwell. She visited the doctor and was told that she was pregnant. But a week later she experienced a miscarriage. And all of a sudden fear and uncertainty set in. Though she knew that miscarriages can happen, this brought the reality home in a painful way.
At the time she also found herself wondering what her family was thinking about her miscarriage. And whether they felt something was wrong with her. For a few months, overwhelmed by all of the emotions the miscarriage brought on, she was unable to go out and socialize or attend events she was invited to. Baby showers and gender reveals were especially hard to think about attending.
With Nelantine’s support and encouragement she tried to put the experience behind her and move forward. From his standpoint, the best thing they could try to do was be positive and believe that whatever was meant to be would be.
But as she began going out again, and was asked the same questions and received the same opinions, about hurrying up to have another child, this wasn’t always possible. Trying to avoid the conversations and cut them as short as she could, she stuck to smiling and saying "we’re trying".
With the concerns about the miscarriage on their minds, Nisha and Nelantine went to a fertility clinic to make sure that everything was okay. At first, they didn’t disclose this to anyone, as there seemed to be a lot of misunderstandings about the role of fertility clinics. And even some stigma around pregnancies that aren’t “natural”, even though fertility clinics offer a wide range of support and resources.
As they completed a few check-ups they realized that they were actually pregnant again.
It was a surprise and they weren’t sure at first how to take the news in, because of how quickly things had changed the last time. As they were still wrapping their minds around it all, they went for an ultrasound to make sure everything was ok. Having had a few ultrasounds by this point, Nisha felt like something was off in the technician’s reactions. While the technician couldn’t actually disclose anything, when Nisha pushed, they asked how soon she had a follow up with her doctor. And they told her not to have her hopes up too high.
A few additional tests and follow ups later it was confirmed that Nisha had a blighted ovum. According to The Mayo Clinic “A blighted ovum, also called an anembryonic pregnancy, occurs when an early embryo never develops or stops developing, is resorbed and leaves an empty gestational sac.”
For those who experience a blighted ovum, the gestational sac that has formed has to be aborted. Nisha’s doctor provided her with a prescription for this process. And although she knew that it was an empty sac that she was aborting, Nisha felt that she was losing her child. Besides the physical pain involved, she was overwhelmed by the loss and filled with doubts and fears. Was she forcing something that wasn’t going to happen? Was there something wrong with her?
Little by little, with the support of Nelantine and her family she worked past what she was feeling. And she tried to prioritize recovering from this experience over everything else. But she couldn’t kick the fear that if she got pregnant again, it might not last. And it took some time before she was able to congratulate loved ones on the news of their pregnancies, without breaking down into tears once she was alone afterwards.
A year after the experience with the blighted ovum, Nisha and Nelantine had moved to a new home, and thought they felt ready to try again. They visited the fertility clinic to make sure everything was okay, and following a month of observation, got pregnant once more.
About a month in though, there was something abnormal in Nisha’s bloodwork. Her HCG levels were dropping. And one day after lying down to rest found that she was in so much pain that she couldn’t move or call out. At the hospital, the initial assessment was that she was having an ectopic pregnancy. Which meant that the fertilized egg which should have travelled through the fallopian tube to the uterus, had implanted in the fallopian tube instead.
In the fallopian tube it’s not possible for a baby to develop, and if the ectopic pregnancy continues it can put the mother’s health at risk. Despite this they were sent home being told to rest and monitor the situation. And in a follow up with her doctor, Nisha was told that it didn’t look like an ectopic pregnancy but that they should continue to monitor the symptoms.
When the intense pain returned, Nelantine rushed Nisha to the hospital and refused to leave until they had run all of the necessary tests to figure out what was going on and how to address it. The ectopic pregnancy was confirmed, and Nisha was given medication to begin the process of aborting the pregnancy. When she was discharged from the hospital she was told to rest and that within a couple weeks she would experience some pain as the process was completed.
By this point in time she had experienced 3 different types of miscarriage in 3 years. It felt disheartening to even think about talking to those around her about her experiences. And for much of the past year, leaning on her spirituality and Nelantine had been her way of coping. But at this stage Nisha made a point of sharing how difficult all this was with her family.
And this time when the feelings of depression came on, she felt able to face them a bit more. Through her experiences she’d come to see just how common of an experience miscarriages are. And Nisha and Nelantine began making peace with the fact that maybe this just wasn’t meant to be. They were blessed with their son, and maybe that was their family.
As they tried to move forward, one day they got to talking about going to Sri Lanka to visit some family. They left soon after and once they landed Nisha found herself feeling sick. But with the long flight and time differences she didn’t think it was out of the ordinary. In Colombo she couldn’t stop feeling nauseous and throwing up. Again, she wrote it off as maybe just the change in food or climate. A couple days later as this continued Nelantine couldn’t kick the feeling that it had to be something else. Nisha took a pregnancy test. And it was positive.
After so many tough experiences, they didn’t know how to react. They called Nisha’s doctor who asked her to get bloodwork done daily if possible, to monitor how things were progressing and if anything was abnormal. It was the last thing she expected to do on a month-long trip, but she found a way to get it done. And Nisha’s doctor let her know to come in for an appointment as soon as she was back.
The appointment confirmed that she was two and a half months pregnant. Things were progressing well. And within a week, they’d be able to know the sex of the baby. 9 months later their family of 3, became a family of 4. But that wasn’t the only way they found themselves growing.
Going through the miscarriages encouraged Nisha and Nelantine to speak about what they had experienced, in an attempt to help normalize them. The responses were in part supportive and encouraging, as others felt that it was necessary to have more conversations about miscarriages. And in part, supportive and apologetic, as friends and family who hadn’t realized the negative impact of what they were doing, reached out.
Still, they do receive questions and comments about when they’ll be having their third child. Or when they’ll be having a girl.
But having gone through what they have, and sharing their experiences, Nisha is hoping to help change some of the conversations around pregnancy. Asked what words of advice she would share with others facing similar challenges, Nisha said that it’s important to recognize when you are physically and mentally ready. And to know that miscarriages can happen to anyone, at any time. It doesn’t make them any easier, but it’s important to recognize this and get the support you need to get through such a difficult experience at a pace that makes sense for you.
As for her thoughts on pregnancy in general she wanted to emphasize that no matter what your intentions are, it’s never a good time to ask someone about when they’ll be having a child. Or why they aren’t having one. There are so many different challenges people face. And they shouldn’t have to rehash these experiences and bring up painful emotions for the sake of making small talk. Women are so much more than their ability to have children. And while that’s something that is wonderful for those who choose it, they should never be reduced to it.