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There were far too many points in my experience with infertility and miscarriage where I heard myself wondering, "What the actual fuck? How does NO ONE KNOW what is happening in my body?" There's a lot I could say, but to your point about education, the single best piece of advice I can give any pregnant person is to know what an MFM is and how and why to demand to see one.

An MFM is short for maternal fetal medicine specialist. This is a doctor who goes to three more years of medical school than a regular OB/GYN and specializes in diagnosing and treating high-risk pregnancies. And in the MFM's clinics, they have specialized technicians who also go to (I believe it was) two extra years of school beyond the regular OB/GYN ultrasound techs. They're trained to identify abnormalities far beyond the scope of the basic folks.

If you're a pregnant person and you even suspect that your OB is glossing over you, not listening to you or you're feeling especially concerned that something is "wrong" with your pregnancy, tell your OB that you want a referral to their MFM. This is something none of my friends knew about, but apparently ALL regular OB clinics have a working relationship with an MFM because the MFM also co-manages things like gestational diabetes in otherwise safe and healthy pregnancies. But they're also there in the event that things become dangerous / high risk.

I started bleeding at 9 weeks and went into my regular OB for 12 different scheduled/emergency scans and it wasn't until the MFM looked at my scans did I have a diagnosis (chronic placental abruption). She looked and pointed at the scans from the regular OB's office and said, "The abruption is here; it grew to here; and I bet in about three days you'll pass this clot which should be about this size." (She was 100% correct.) We ended up losing the baby at 21.5 weeks because I lost all my amniotic fluid. And it's taken years to piece together the sequence of events, the gaslighting and the unquestionable clarity that the MFM brought to my situation. (Three years and one more second-trimester loss later, that same MFM managed the pregnancy that gave us our girl, Evagene.)

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Ok, where to even start? Two second trimester losses...I can't even imagine, Amanda. I think one of the things I really underestimated about infertility and pregnancy loss is how it can define a whole era of one's life, and, of course, leave you changed. I can't even imagine how much extended pain those losses brought, and how many years of your life went to them physically and emotionally. Feeling a lot of things for you, and also, it brings tears to my eyes to imagine Evagene (I really have tears in my eyes right now, it's not just an expression).

Also, ok, I have never heard of MFM, and thanks for sharing...and also WHAT THE HONEST FUCK. How am I still learning about BASIC, RELEVANT medical specialists THAT I HAVE POTENTIALLY NEEDED, and also IN THE FIELD I WRITE ABOUT. What is actually going on, it is so goddamn disorienting and infuriating. Ugh, I need to go walk around the block or something.

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The best way I describe it is, it wiped me down to my most feral instincts. We lost Bunny in March 2019 and then Briony in December 2019, and I just had this “knowing” that I needed swift, immediate help with my body or I wasn’t going to come back. I’d been in EMDR (a body trauma therapy) before and instinctually knew to find a therapist who could guide me toward what I needed to, first, survive and then to heal.

But also, and I know this sounds woo woo but I began dreaming about animals for the first time in my life. So when I say feral instincts, I mean, every human recommendation on how to grieve was absolute garbage and my instinct was to claw every person’s face off and toss it in the river. And I knew it. And so somewhere, something, began nudging me to grieve like an animal.

A lot of my writing I’m preparing now is all rooted in bringing this animal body to the table -- in writing, in decision making, in care of self. And before I lost my babes, I don’t think that was ever a road I would’ve walked.

So you’re right. It changes you, but I don’t know how any of us make it back unless the people around us can let us grieve and roam the earth like an animal. Even your instinct after reading my story to cry and need to move your body from the anger you feel: that’s an instinct with a lot of power.

And for what it’s worth, I have a piece of poetry about the bear who ravaged my dreams and have been stuck about where such a piece wouldn’t send the editors for the hills. And your preamble about your published piece in Literary Mama (Congratulations btw!) felt like a light -- I’ll be reaching out to see if my words belong there.

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I can become very animalistic in these times, that is a perfect way to describe it. I once took an ax and just slammed it into the ground repeatedly while screaming (and I am tempted to say "like a crazy person," but I wont, because...yeah, all the reasons). I am looking forward to your work on the subject. I also recently wrote about a baby-oriented dream located in a horse barn...very interesting parallels here.

And yes, the Literary Mama team was great. They also have solid editorial, so they helped make my essay stronger before publication. Good luck with the submission!

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I felt a tug in my arms just imagining getting to slam an ax into the ground while screaming at the top of my lungs. I think you just created a new category for writer’s retreat, Rae. ;-)

And yes, very interesting parallels... 🤔

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May 23, 2023Liked by Rachel Katz

My experience with miscarriage was with Ohio State University infertility clinic in 1975. I too had an empty sac, and the doctor’s explanation was that it was a false pregnancy, that I had wished to be pregnant so much that my body was trying to accommodate. The assumption of female hysteria. When in doubt, blame the woman.

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THAT'S what they told you?! I can't even.

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oh my gosh, I'm so sorry. that had to be so hard.

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Don’t even know where to start with what happened to me with my first miscarriage. Physically brutal, traumatic, lasting months, inducing my first foray into an anxiety disorder. Then the second. The care was so minimal. I’ve written about it a bit, but still a long way to go in processing. Thank you for writing Rae, and giving voices to those of us who still can’t put what happened into words.

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Also to say, I’m so sorry for your loss x

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And to you too <3

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Ack, I'm so sorry that all happened to you. I was so shocked at how intense and dramatic the hormonal changes were--like all the most intense parts of pregnancy packed into a couple short months. I could absolutely see those changes triggering drastic new mental health experiences--not to make assumptions about the cause of yours, and of course there are plenty of things about a miscarriage that would induce anxiety in anyone.

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I am sorry all of us had to go through miscarriages. I married late and was not sure I would be able to have children. But I did, for which I am grateful. I had nine pregnancies, with 3 of them resulting in live births, and the other 6 as miscarriage. One was an abnormal extra-embryonic sac that kept on growing, another was an ectopic pregnancy and the other 4 were ordinary miscarriages. At the end I only had one ovary left. It was brutal emotionally. I don't think I could have survived another.

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Oh my goodness, those numbers are really hard to imagine. I've only had one miscarriage and I already feel like "I don't think I could survive another." But I guess we just get through one way or another, and you are proof of that. I am always stunned at the persistence of the women I meet who are going through these types of experience and the strength that comes from somewhere we don't even know exists. I'm so sorry for your losses, and I love thinking about your three children.

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I’ve never had a pregnancy or miscarriage and I thank you for sharing your ghastly, heartbreaking experience and so beautifully. We all need to know about this basic biology and how to do better. I’m pretty sure that did not qualify as informed consent, which I think is technically maloractice?

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Oh wow, didn't even think of that...that's how used to this stuff I am.

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May 23, 2023Liked by Rachel Katz

Mine was much easier, gratefully. My sisterly sympathy !!❤️🤗

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I'm really glad to hear that!

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♥️ thanks for sharing this. I've had two "uncomplicated" miscarriages - blighted ovum is the official term. my body recognized the empty sac and released the pregnancy naturally. I bled for 10 days during the first (at 7 weeks), less for the second (at 5 weeks). importantly, my midwife, who has been with me for years and helped me through the birth of my youngest daughter, explained everything that would happen and why, plus the importance of asking for support and telling the story when I felt ready. she even called several weeks later to check-in. for me, there was beauty within and during the process, though it was emotionally confusing - the hardest part for me to reconcile has been the aftermath, the grief and gratitude that comes in waves, the distrust I feel with my body (even though I felt deep trust during the miscarriage).

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It sounds like you got some really incredible care, and I wish that for everyone! Thank you for sharing your story, it's really helpful to hear these details.

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♥️ yes, this is the kind of maternal healthcare that's vital for everyone. I hope we move in that direction, soon.

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I did two things that helped. One, I had D&Cs for the ones that I could, when I knew the heart was no longer beating, and always under general anesthesia. I did not want to remember the event. I can believe you were shocked when they did not even offer it or ask you your preference. It is a painful and emotionally traumatizing experience to go through awake. My experience is that for medicine surrounding female reproduction, some doctors or nurses are pretty cavalier. When I has an ectopic pregnancy, the ER staff didn't believe me because they couldn't find anything by ultrasound. I heard the male nurses laughing about me down the hall as I waited. Then I heard shout, "Wait, has patient X left yet? Her labs are back and her pregnancy hormones are still going up! She was telling the truth!" One, they shouldn't have been talking about me where anyone could hear, and two, the myth of the hysterical female who is imagining things still continues.

Thank you for thinking of my three. The youngest is 28. This topic is painful for anyone who has lost a child for any reason, and for women who wanted children and couldn't have one for some reason. My heart goes out to them too.

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Thanks you so much for sharing. This helps women everywhere

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Read both of your accounts and totally resonate with them. I am also a "twilight mom" having briefly carried, then lost, a wee one. You sharing your story brings me a step closer to me sharing mine. First I need to tell the onion cutting ninjas to mind their own business...

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Those pesky ninjas :)

Looking forward to reading yours if and when that ever feels right.

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