My Shameful Pain

Trigger Warnings: Abortion. Miscarriage.

Part One: Background/The Events.

The following is a two part story, anonymously provided by a contributor. This first part provides us background, and will also feature in a future discussion feature.

A week before my husband and I got married, I had a sense that I may be pregnant. My period was late, which is not unusual for me, but I also knew I had missed a few birth control pills the previous month, the possibility of pregnancy was strong.

The day after the wedding, I took a over the counter pregnancy test, confirming I was pregnant. My husband and I came to the decision to terminate the pregnancy, and three weeks later I had my appointment for a Therapeutic Abortion (TA), via dilation and suction. (This would be having a procedure as opposed to a medical abortion, which is known as taking the “abortion pill”.)

I have never really had any sort of procedure before, so I was pretty nervous and opted to take Ativan before the surgery and was given fentanyl by IV for the pain.

While it may not seem relevant, it will be later on, but the procedure was preformed by one doctor and a nurse. It was painful, but tolerable, and it was over fast. I was told to expect light to moderate bleeding for two to three weeks afterwards.

After the procedure I felt physically fine, I bled for about 3 weeks until it slowed down to just very occasional light spotting. I was given a new type of birth control during the procedure (an injection of depo-provera), which I expected was causing the spotting,
a very common side effect of any new birth control.

About a month later I was having breakfast about an hour before my shift started at work, when I suddenly got the strongest period cramps of my life. Immediately after I started bleeding VERY heavily, soaking through several pads in less than an hour and passing huge blood clots. I knew immediately this was very unlikely to be my period, while depo-provera usually causes extremely light periods, or an absence of a period at all, this was the opposite.

It’s important to realize that I have a condition called thrombocytopenia, in layman’s terms a low platelet count (the cells that produce clotting factors), despite it never having been a serious condition for me, heavy bleeding of any kind is always a concern.
I called in sick for work and my husband and I went to the ER. I was seen immediately, which was my indication that my symptoms must actually be deemed concerning by the triage staff. I was given a PVA exam and sent for an ultrasound. A gynecological resident
and a med student went over the results of the ultrasound with me. They told me that my symptoms indicated I had retained products from the TA.

Retained products is a relatively uncommon complication where not all of the fetal tissue is removed during the procedure. They thought I was a pretty unusual medical anomaly, because the symptoms of retained products pretty much always appear within a week of the procedure, and it had been two months since mine.

They told me that for some unknown reason my body had stopped bleeding, and when the sudden bleeding began it was as if I was having a miscarriage of what was left. They sent me home with a prescription for the abortion pill with the hopes that it would help the remainder of the tissue in my uterus evacuate.
I spent the weekend at home after using the abortion pill feeling crampy and sick. I was still bleeding but it had slowed down. The ER residents had told me that the bleeding should be fully stopped within 2 weeks, and if not to see my doctor.

Two weeks later I was still bleeding so I went to the doctor.

She told me that in all her years of practicing medicine she had never heard of something like this happening. I was sent for another ultrasound and told that I still had some tissue present in my uterus and what appeared to be an arteriovenous malformation (AVM).

An AVM is a condition that can occur anywhere in the body although it is extremely rare in the uterus. You can be born with them or they may appear as a result of healing from surgery. They can be quite dangerous because if they rupture they cause very heavy bleeding. For reference, a ruptured AVM in the brain can cause a massive stroke.
Next I was sent to a clinic for early pregnancy complications and urgent gynaecological care. At this point it had been over a month since the ER visit and I was still bleeding. I was on antibiotics after showing some signs of infection. The clinic residents sent
me for another ultrasound, and recommended I come in two days later for a hysteroscopy (insertion of a camera in the uterus) to look for an AVM, dilation, curettage and suction procedure to remove the remainder of tissue in my uterus, and if an AVM was present possibly a biopsy and cauterization to stop the bleeding.

This procedure was done in an OR (unlike the TA which was in a clinic) so the whole thing seemed much more intense. It was a very quick procedure but this time I was sedated (I was out cold, don’t remember a damn thing) and there was a surgeon present, several residents and med students, an anesthesiologist, and several nurses. After the surgery I was high out of my tree so I don’t remember much, but I was told to make a follow up appointment.

I would eventually stop bleeding after the surgery, and all is well now.

To Be Continued;

Part Two. My Painful Shame – The Emotions.


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