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My doctor had told me all the risks, and I had read up dutifully on Dr. Google: slight risk of ovarian cysts, maybe the kind of headaches and hormone changes you’d see on the birth control pill, and the so-teeny-tiny-you-could-hardly-see-it 0.1 percent increased risk of ectopic pregnancy.
These small risks seemed worth it. I’d had horrible migraines on the pill and often had uncontrollable shakes; I was still breastfeeding my six-month-old daughter and wasn’t ready for another child; and, given that I was well under 35 and had no other contraindications for use, statistically, my medical student husband agreed: Nothing adverse would happen to me.
And yet, over a year after getting my IUD inserted, I discover I'm smack dab in that 0.1 percent. I'm strapped to a bed in the pre-op room being prepped for an emergency ectopic pregnancy removal, and my husband's fellow medical student is leaning over me saying, "Don't worry. Some day you'll laugh about all of this."
I should have known things were wrong from the start. I had an excellent doctor who had done many, many IUD insertions and who very carefully explained the procedure to me. I was so confident nothing untoward would happen that I brought my daughter with me to the procedure. Yet, after the doctor had inserted the speculum and guided the IUD through my cervix, I felt an acute and overwhelming sharp pain. I was aware of my vision going black — and then nothing. The next thing I knew, the doctor was putting a warm blanket over me and saying, “So what happened there is you just passed out.”
After I’d recovered my senses, the doctor sent me for an urgent ultrasound. IUDs should, theoretically, be easy to find on vaginal ultrasound (yet another pleasantry in the whole affair), and I knew things were not right when the tech called the radiologist in. They looked. And looked. Finally, the radiologist said, “There, that’s it. I think.” That “I think” became as good as certainty, and I went home thinking all was well.
Yet for months afterwards, pain shot through my abdomen whenever there was any pressure on it. I never thought to check for the string — I assumed the IUD had been placed so high up (hence the pain) that the string just wasn’t long enough to come through the cervix. I also wasn’t menstruating, which I thought must be a combination of breastfeeding/IUD. In fact, I didn’t get a period until I weaned my daughter at 22 months.
By then, that ridiculous biological clock that seems to strike when babies are between one and two was ringing loud and clear again. In my illogical, hormone-driven state, I thought because my husband was finished with medical school and entering residency, life would be easier (ha!) and having another child would make perfect sense (ha! Ha!).
So I trundled off to my doctor to get the IUD removed. Like insertion, IUD removal is supposed to be a simple process — that is, if your doctor can find it.
“Are you sure it didn’t fall out?” she asked me (the first of many times I would hear that question, like it’s as simple as being a chicken who forgets she lays an egg). Um, yes, I was sure. “Well,” she said, “it must be higher up than we thought.”
She referred me to another GP who had even more experience than she did in removing tricky IUDs, who also asked if perhaps it had fallen out, and who then referred me to an ob-gyn.
Because life is infinitely hilarious, while I was waiting to get in to see the ob-gyn, I had a period that was very light — almost not there at all. I’ve just weaned, I told myself, my body is still settling into a new hormonal rhythm. But my nose was telling me otherwise. In my first pregnancy, I’d had a superwoman sense of smell. I threw up in the grocery store when passing the milk aisle. I had to leave the house when my husband cooked garlic. And here was that supernose back again. My arms and legs were heavy, and I wanted to sleep all the time. My boobs were sore.
I’m being ridiculous, and I’m wasting money, I thought as I waited in line at the pharmacy with five pregnancy tests in my hand. Yet, when I got home and peed on the five sticks, having to explain to my daughter that they were a test and that no, she could not help me hold them, there they were. Five second lines.
Off I went to an urgent visit to the gynecologist, who opted for a wait-and-see approach and for checking my HCG levels every two days to make sure they were going up a respectable amount. “But,” he said, “if you have any bleeding, get yourself to an emergency room right away.”
My HCG levels continued to go up at a slightly slower rate than he would have liked, but there was nothing to do but continue on with life, which, at the moment, was crazeballs. Our landlords had just sold our house to a new couple who would not give us the extra six weeks we needed before we moved. My husband had just finished touring the country to interview for residency positions, and we would find out in a week where we were moving. We didn’t know where we were going to stay, what we were going to do with our stuff or our cats. My husband's grandma died. We were very broke. Our car overheated every time we stopped at a red light. We had a two-year-old. He was supposed to be studying for his medical school exams and all he could do was play Guitar Hero. Our two-year-old got a raging ear infection. Etcetera.
Still, the night before “match day” — the day we found out where we would be moving — we went to celebrate with other medical student friends and their spouses. I told them I was pregnant. My husband had a drink or two. Then I went to the bathroom and discovered I was bleeding.
Because he’d been drinking, my husband couldn’t drive, so I drove us to the hospital while having uncontrollable shock tremors. I was given a bed soon enough, but I didn’t see a doctor for 12 hours. The nurses, I’m sure, thought I was just being a hysterical pregnant woman because I wasn’t in any pain and only had a slight fever. I couldn’t sleep, what with the constipated Alzheimer’s patient beside me. When I very politely asked if I might have a pillow, a nurse snapped back, “You’re lucky you have a bed!”
Sometime in the night, my husband had gone home to care for our daughter so I was alone when the doctor finally saw me (“Are you sure it didn’t fall out?”), and then I waited another two hours for the ob-gyn resident to see me (who very kindly didn’t ask if it had fallen out). She performed an exam, then sent me down to radiology for an ultrasound.
The tech was chatty until she couldn’t find the gestational sac in utero. She wouldn’t tell me what was going on, but called the radiologist in, and that’s when I knew it was bad.
The fetus, he said, was in my left fallopian tube, and I was going to rupture any minute. Hopefully, they could save the tube.
From there, things went fast. I was whisked back up to Emerg, where suddenly everyone was sympathetic. The crusty nurse asked if I wanted morphine. Through snotty tears, I declined. A grief counselor poked her head in. I was transferred to gynecology.
Within half an hour of having the ultrasound, I am in the OR prep room, where my husband’s colleague is leaning over me (and I’m thinking, WTF?), where another colleague, a woman, is holding my hand. Then I’m in the OR. Then I’m counting backwards from 10.
I emerged from the anesthetic with a nurse yelling in my ear, “Do you know where you are?” (Why do they always yell? It doesn’t help anyone be less confused.)
I gripped her hand, saying, “Don’t ever get an IUD.”
“Actually,” she said, “I have one, and I’m just fine.”
The surgeon came by after I’d woken up and said they’d found the IUD right beside the fallopian tube. It had, probably after insertion, began its migration through my uterine wall.
I went home after a day or so, but the surgeon had allowed his resident to close the wound, and the wound kept opening. My husband cleaned and closed it with Steri-Strips twice a day. My mother-in-law graciously flew out to help look after our daughter while I packed the house as best I could even though I couldn’t stand up very well. A friend said we could stay in his condo for the month he’s away. We boarded our cats at a ridiculously expensive “cat hotel” and payed for it on a credit card. We sold our faulty car and went to my husband’s grandmother’s funeral. We rented a U-Haul and drove across the country with a two-year-old and two howling cats.
For a long time, the grief was heavy. An ectopic pregnancy is an incredibly confusing thing. There is no choice in the matter: baby must be removed. It’s just piss-poor luck the egg attached where it did, and I felt — still feel — I’d lost a little soul.
I’ve had four more pregnancies since then. Two have turned into full-term, healthy babies, two were miscarriages. For all of them, the possibility of them each being ectopic threw a long shadow — each required close monitoring of HCG levels and early ultrasounds.
And dammit, my husband’s colleague was right: I do laugh about it now as in “this was the craziest, most awful time of my life,” but the laughter is never without one note of grief and another of relief that I will never have to go through that time again.