Jennifer Phelan, a nationally certified and award winning pilates instructor in Boston, MA - with a focus on perinatal fitness, @jppilates1

I am not writing this for sympathy.

I am writing this because I don’t personally know a single person who has gone through an ectopic pregnancy. That fact feels isolating. What helps is knowing that maybe I can help someone else feel a little better.

I’ve done a lot of googling. It’s obviously a slippery slope of chatrooms and frightening medical statistics. But I did stumble across a few blogs where women like me, talked about their experiences and their journey of surviving an ectopic pregnancy. Their stories answered some of my questions and took me a few more steps out of this dark cloud.

This is for sure the most intimate information that I am publicly sharing, but I quickly realized I would and could not hide it. I cannot just walk back into the studio where I teach women everyday after a few weeks and pretend I had the flu. I share my life and my energy with others and this my friends, is my life right now.

. . .

Mother — a title that holds so much love, so much weight, so much pain, a swelling experience that consumes and connects us.

I knew I was pregnant immediately. This would be my third baby. I’ve always had a strong connection with my body. So, it was no surprise when the pregnancy test read a big, bold “YES,” days before my period was even due. The thing with knowing your body is that you’re aware of both the good and the bad and I knew right away something didn’t feel quite right. But I nudged it aside because it’s also a known fact that I’m a worrier. Why would something be wrong? So, I let the joy jump on in. The excitement and the day dreams took over right away. I started looking up bunk beds for the boys. I laughed with Ryan at how even more crazy our lives would become. And I had a vivid dream. The kind that pulls you in and mirrors your most magical real day. I was holding a peaceful little boy in my arms.

My heart was bursting with happiness. But still I couldn’t shake the feeling that something was wrong.

The Tuesday before I had a long day of teaching. After two classes, three clients and running around all day I found myself sitting in my oldest son, Grayson’s piano lesson experiencing some mild cramping set to the tune of Mary Had a Little Lamb. That night, Ryan and I both agreed that I had probably just done too much and as always, I needed to slow down. The next morning, I started to spot and the cramps didn’t go away. In that moment, I knew I was having a miscarriage. My heart was in my stomach as I called my doctor. She talked me through everything, saying that it could be nothing but that I should still come in. Ryan took over everything with the boys and I literally sat in silence in my bedroom until my 11am appointment. My mind was all over the place. 

I told myself I needed to come to terms with the fact that I might be losing the baby. My brain told me this is okay, it’s common and I’m not alone. But my heart, oh my heart, did not let go. It told me I was probably okay. And I held onto that notion tightly.

I went alone to the appointment. After going over my symptoms, it was obvious the doctor was prepping me for tough news. She said she might not be able to see much on the office ultrasound because it was so early on. I was one day away from being 6 weeks. As I lay there watching the screen I couldn’t even look. The doctor found nothing. She couldn’t even see the sac. That’s so weird I thought. Where is it? She told me she was going to send me for an actual ultrasound first thing tomorrow. She said this other location had technology that was more powerful than what she had in the office and they’d be able to tell us what’s going on. She briefly mentioned the unlikely fact that perhaps the pregnancy was in one of my tubes but we didn’t need to worry about that right now. Obviously, that cued me to start worrying, but it seemed so scary and so risky that I couldn’t let my mind linger on it.

I walked two miles home from the appointment. With each step tears streamed down my face. I didn’t try to hide it. I walked through the heart of Boston, past crowds of people on their lunch breaks and I just stared straight ahead.

It was the most beautiful first day of spring but I felt dead inside. I didn’t call anyone. I had nothing to say. What is there to say when you know you are about to lose a baby?

The next morning Ryan came with me to the ultrasound center. We said goodbye to the boys at 7:30am and we were on our way. I felt relieved to be getting an answer. I think we both knew at this point that it was likely not good news. As we drove we talked about how many people we knew who had suffered through miscarriages. We knew we would not be alone. I remember exactly saying, “I can get through this as long as it’s not ‘one of those tubal pregnancies’. That’s terrifying. I couldn’t handle that.”

The ultrasound center was separate from my doctor’s office. This means the technicians can’t tell you anything. After the tech scanned me it seemed clear, even from my untrained eyes that there was nothing on the screen. Then a doctor came in and looked. Very matter of factly she said, “There is no sac in your uterus.” A split-second feeling of sadness, flushed with relief ran through me. It’s what I had anticipated.

“You are having an ectopic pregnancy. The baby is in your fallopian tube.” I stopped listening after this. I didn’t cry. I didn’t blink. I just stared at the screen. I was in shock.

What happened next was awful. After the doctor left, the technician told me she was going to call my doctor to find out what they wanted to happen next. She told me I could stay in the exam room or go back out in the waiting room and she would come get us. I asked, “What do you mean what happens next? What are my options?” But she couldn’t tell me anything.

I cried for a moment. I cried because it was real. We lost our baby. I cried because I was scared for what was to come. I pulled myself together and we sat in the waiting room next to other expecting couples. I tried to control the grief, fear and uncertainty that sat nestled between my husband and I. Ryan had no idea what an ectopic pregnancy was and neither did I really. I just knew it was scary, my life was apparently at risk and I might require surgery. We waited for a long, long time. The tech called us back. We weren’t even taken into a room.

Right there in a side hallway leaning against a wall we were rashly told we needed to immediately go to the hospital.

We were supposed to go straight to the tenth floor which is the Labor and Delivery unit – the exact same place where my younger son Max was born.

Panic set in. Like real panic. I am phobic of all things medicine, hospital, you name it. When I was pregnant with Grayson I went to an info seminar at the doctor’s office and I fainted just listening to information about future testing and blood work that you do throughout pregnancy. So this… this was unimaginable. As we drove a few blocks to the hospital I started googling our options. Obviously, that is always the worst idea ever but I didn’t know what else to do. I needed information. When we arrived, we took the familiar path up to Labor and Delivery, this time the elevator ride felt heavy. We checked in. I had to sign paperwork for me and the baby. Tears fell onto the paper as I filled in the line reading “relationship” and I signed “mother.”

Immediately they walked us past the rooms where women were giving birth and put us in a tiny room at the end of the hall. It was hell. They asked me to get changed into a robe and told me a nurse would be back to give me an IV and get bloodwork. What?!? We still had no idea what was happening. I asked Ryan “Am I being crazy? Isn’t this wrong? It’s been hours since we found out what was going on and yet not a single person is telling us anything.” Looking back now, I know each nurse and staff member was just doing their job, but it was complete torture to me. I practically attacked the nurse when she walked in the room. 

“I don’t want an IV. Am I having surgery? What’s happening?”

And thankfully the course changed, if just for a moment. That kind, kind nurse was the first person that day to actually look at me in the eyes and say, “Oh dear. I am so, so sorry this is happening to you. This is a lot to take in isn’t it?” And now my tears exploded. I cried so hard. The kindness, the acknowledgment, the simple moment she took to just stop and talk to me was everything. I was terrified and she told me it was ok. In fact, she said that everything I was feeling was normal. Even Ryan’s face was flushed with relief that someone was here for us, finally.

A short time later my actual doctor just happened to be on call and she walked in. “Ohhh Jenn, why are you here? I’m so very sorry. Oh Ryan, how are you guys holding up?” I thought I had finally gotten myself under control until she came in.

The sincerity of a familiar face who understands gripped my broken, fragile heart and started to pull some of the pieces back into formation. She walked us through everything. It had been almost four hours since we had found out and for the first time we now knew what was happening to me.

“An ectopic pregnancy occurs when the fertilized egg attaches itself in a place other than inside the uterus. Almost all ectopic pregnancies occur in the fallopian tube and are thus sometimes called tubal pregnancies. The fallopian tubes are not designed to hold a growing embryo; thus, the fertilized egg in a tubal pregnancy cannot develop properly and must be treated. An ectopic pregnancy happens in 1 out of 50 pregnancies. If the fertilized egg continues to grow in the fallopian tube, it can cause the tube to rupture. Heavy bleeding inside the abdomen is likely and this is a life-threatening event. To prevent life-threatening complications, the ectopic tissue needs to be removed. Depending on your symptoms and when the ectopic pregnancy is discovered, this may be done using medication, laparoscopic surgery or abdominal surgery.”

My baby was six weeks old and had no heartbeat.

Because I was not in severe pain and it was caught so early on, I was given the choice as to how we’d like to proceed. I could either have surgery or be treated with medication.

We went over the pros and cons of both options but from the start, I’ll be honest in saying I was willing to do anything to avoid surgery. In my opinion there are so many risks and complications that come along with any surgery. Plus, I am so afraid of it. They would have to remove my entire fallopian tube, something which I didn’t want to happen. The biggest benefit I saw to surgery is that it would simply be over. Once I physically recovered after a few weeks, I could begin the process of moving forward. It’s not as long and drawn out like the medication route is.

But I chose to start with medication. The drug that is used to treat ectopic pregnancies is Methotrexate. Methotrexate stops the growth of rapidly dividing cells. It’s also used in chemotherapy. It’s a serious medication. It’s administered as an injection and while the odds seem favorable, there is no guarantee it will work. The side effects aren’t pleasant either and can include extreme fatigue, nausea, cramping, bleeding, and dizziness.

The tricky part is that some of these symptoms are like when your tube ruptures. I was told I needed to differentiate between mild cramps and bleeding to anything that seems excessive. For a neurotic like myself, this is stressful. Everything concerns me.

After we made our decision with the support of our doctor at the hospital, I had to have my blood work done up and evaluated to make sure I was a candidate for the drug. This took almost two more hours of waiting. Waiting is particularly gruesome with those neon lights reflecting off the windowess walls. I remember asking Ryan to see if there was a dimmer. He searched but had no such luck. I guess it truly wasn’t our lucky day and the lights shined on. 

Isn’t it ironic how the darkest of news is delivered under the brightest of lights? There’s no harsher way to face a stark reality. 

As we sat in silence I clasped my hands and closed my eyes. All I could see were the faces and stories of dear friends who have suffered a pregnancy loss. As heartbreaking as their stories each are I found comfort in knowing them. Their words, their experiences wrapped around me and hugged my heart tight during these difficult hours of uncertainty. It was because of their openness that I found bravery. I felt much less alone.

Finally the injection was ready and we were told after that we could go home. The nurse sort of smiled and said, “You have such a little arm so we’re going to do this in your behind.” For the first time that day I laughed. Of course, this experience was going to end with two shots in my ass.

I was sent home at 3:30pm with the full knowledge that this is far from over. I was still at a high risk for my tube to rupture. For weeks, I could only “rest.” No housework, no picking up my children, no long walks, and no exercise.

In those weeks, there was plenty of time for me to do some thinking. I couldn’t help but feel bitter about the spring sun shining. Signs of awakening are outside my window while I was lying inside with “poison” filling my body. Just a few days before I was pregnant with my third child. But now I couldn’t stop the waves of sadness that wove in and out of the bed sheets every time I turn to another side. I felt a twinge and wondered, is this it? Am I going to start bleeding? The words “high risk” and “life threatening” drift through the air like high winds before a storm. I’m ok. I’m not ok. I’m ok. I’m not ok. Over and over and over again.

I thought back to when we were leaving the hospital room. The nurse took my hand one more time and stopped me. She said,

“I’m truly so sorry you are going through this. I want you to know there is nothing wrong with you. You are not alone. People don’t talk about these things like they should. It is okay to feel sad. You should let it all out. You should tell your story.”

What wonderful people nurses are. What a beautiful human this woman was. I will never forget those words she said. She was the deciding factor in why I decided to share all of this. Because it’s okay to tell the world what happened.