Author: Elizabeth Ann Strube

If you’ve seen my post announcing our first pregnancy you’ll know how overjoyed we were to have received such good news. Just two weeks after finding out we were expecting everything changed – mentally, emotionally, and in some ways physically. For the sake of context I’ll start from the beginning.

My husband & I found out we were pregnant very early on. I got my first positive pregnancy test a few days before I was expecting my period. For those of you who are up on the TTC (trying to conceive) lingo, that was CD26 (cycle day 26) and 10DPO (10 days post ovulation) which is pretty early. I continued to take tests every other day until I got a solid line five days later (15DPO).

We got to enjoy this news and adjust to the life change for about a week before I started having some strange symptoms. I believe I had what would be considered implantation bleeding around 8DPO. This is, of course, normal. But when the intermittent spotting didn’t stop I became worried. How much bleeding is normal? What color should it be? When should I be alarmed and when should I see a doctor?

At this point I was only 5 weeks along and hadn’t had my first prenatal visit. I had chosen to use a certified nurse midwife for my regular pap smear just a few weeks before so I gave that office a call hoping I could get some clarification. At this time I won’t be disclosing what office or which provider I spoke to. Because the midwife who had done my exam wasn’t on duty I spoke to the midwife on call. After describing some of my symptoms the best answer she could give me was “I don’t know if that’s normal.”

Disappointed (and quite frankly, pretty shocked) that the midwife had no idea if what I was experiencing was normal, I asked if she thought I should come in to confirm my pregnancy and possibly do some bloodwork. She responded in the most demeaning way I could have imagined.

“Is this your first pregnancy?”

Indeed, it was; regardless, I was having some symptoms that to my knowledge were out of the ordinary, and cause for at least some preliminary tests. Just her tone indicated she did not take me seriously at all. By the end of the conversation the verdict that she had reached was “wait & see.” She quite patronizingly explained that sometimes when women first fall pregnant they can be hyper-aware of what’s happening with their bodies and may panic if they see something out of the ordinary. She told me to call back in a week if my symptoms persisted.

Dissatisfied with this answer I scheduled my first prenatal appointment with an OBGYN in a different office. I described my symptoms and she said there were two things that could be happening: either I was having a miscarriage, or I had developed an ectopic pregnancy. The latter seemed unlikely for my age and stellar health history, but she asked me to keep a close eye on my symptoms and to call if anything changed.

Within 48 hours my spotting had increased to steady, fresh bleeding accompanied by moderate cramps. That afternoon I rushed from work to the doctor’s office in desperate need of answers. I had been scheduled for a transvaginal ultrasound a few days away, but I couldn’t wait any longer. I was examined by the doctor and then had an external ultrasound performed which ended up being inconclusive. This early on in a pregnancy, the doctor told me, it’s often hard to see an embryo through the abdomen. Off I went to the ultrasound tech to have an internal exam done, which was pretty quick and totally painless, contrary to popular belief. After that I was sent across the hall to have some blood drawn and then was released to go home.

Not an hour had passed since arriving home when I received a call from my doctor with the results of the ultrasound. The embryo hadn’t made it out of the fallopian tube, and had implanted there and would need to be removed, either via medical treatment or surgical intervention. Because of the appearance of the tube on the ultrasound my doctor recommended surgery, and immediately. I had begun to cry a little while on the phone with the doctor, told her I needed to discuss everything with my husband, and as soon as I hung up the phone burst into completely unabashed tears. How could something so joyful suddenly turn out so badly? I had to collect myself before I could even tell Aaron that our first pregnancy had failed. We discussed the options and quickly decided I should go ahead with the surgery and opt to have the entire tube removed. Making haste, we showered, dressed and packed before leaving for the hospital around 7pm.

I had arrived home after my appointment around 5:30pm and was admitted for surgery by 8:00. There had been a nurse waiting for me in the lobby at the hospital, and they had already processed most of my admitting before I got there in order to expedite the check-in process. It wasn’t fifteen minutes before I was being wiped down, gowned and put on IV to wait for the surgeon, who happened to be my regular OB – she happened to be on call at the very same hospital that night. After a quick debriefing I was left in the capable hands of my husband and a nurse to await surgery. I would be having my entire fallopian tube removed via laparoscopy, a minimally invasive procedure also used for appendectomies.

The procedure only took about 45 minutes total, and after a couple hours to come out of the anesthesia we were cleared to go home.

What I learned at a later appointment is that my tube had actually ruptured in two places before it was removed. I had told my doctor that if there was too much risk associated with leaving the damaged tube in place to just remove it entirely. She had attempted to save it before finding the second rupture but unfortunately there was too much damage for it to be salvageable. One of the dangers of ectopic pregnancy is that is can be very hard to stop any bleeding in that area, which is the potentially fatal aspect of the condition. I’ve read that if there’s excess bleeding the removal of certain portions of the reproductive system may be the only way to prevent hemorrhaging.

We were very lucky to have caught this in time. I was not in a large amount of pain (this can possibly be contributed to high pain tolerance and physical resilience; I’m a pretty tough cookie!) but I already had 200ml (about 8oz.) of blood pooling in my abdomen. The surgical staff as well as my doctor did a wonderful job and I felt very well cared for during my brief hospital stay. Except for 3 tiny scars and the loss of our baby, it’s almost like it never happened.

Another factor in this event was the discovery of my blood type and what it means for myself as well as our children. I am RH negative, which determines the minus following my blood type. This indicator is called Rhesus factor – or RH factor – a misnomer for the presence or absence of the D antigen on the surface of your red blood cells. This just means that people with negative blood types have to be extra careful when receiving transfusions or becoming pregnant. Because my husband is O+ and I am A-, there is a good chance that any babies we have will have positive blood types and my body will try to attack them. This is because a negative blood type cannot come into contact with a positive blood type without dire, and sometimes fatal, results.

It is imperative that people with negative blood types only receive RH negative blood if they need transfusions, and even more important if you are a woman of childbearing age: if you are exposed to a conflicting blood type, whether it be via transfusion, miscarriage, ectopic pregnancy, or labor & delivery, you can become what is called RH sensitized, and it is irreversible. After your immune system builds up antibodies due to that first exposure, it can prevent you from having a successful pregnancy in the future by causing RH disease, a condition of severe anemia which results in birth defects, and even causes preterm miscarriage and stillbirth.

During my recovery I perused the TTC forums and discovered that many women struggle with conceiving and experience multiple miscarriages before ever finding out that they’re RH sensitized. This is one of the reasons why I decided to share my story online. It would have been much easier to not have to talk about it or revisit the pain that comes with losing a pregnancy. But if reading this helps even just one person it will be worth the heartache.

Please, if you are thinking about getting pregnant or find yourself expecting, seek proper medical care. Most providers will include blood typing and RH antibody screening in your preliminary bloodwork, and most routine prenatal care is fully covered by your medical insurance. For those uninsured, there are many options out there for you to receive  quality prenatal care at little or no cost to you.

Don’t hesitate to seek medical care as soon as you find out you’re pregnant. So much of the development of your baby’s brain, spine and major organs happens in the first few weeks, so it’s never too early to start thinking about the health of your baby as well as your own. It might mean the difference between having future children and not.