It's Not "Just" a Chemical Pregnancy

When Matt and I decided to start trying for a baby, we assumed it would happen quickly for us. It had for all our friends, why not for us too, right?

So when we saw a positive pregnancy test after our second month trying, we were thrilled - and a little shocked! I bought a tiny onesie to surprise Matt with. I started a prenatal workout program. I was ready.

But barely a week later, I started to bleed.

I called my doctor’s office, and they said I had a chemical pregnancy - a very early miscarriage. They cheerfully reassured me, “Don’t worry, this is a good sign that you can get pregnant. We know we’ll see you back here soon with another positive!”

Six more months of trying went by. Then one morning during another grueling two week wait, I woke up with the taste of copper in my mouth (a symptom I definitely had to Google). My breasts were tender. Morning nausea had me reaching for crackers as I rolled out of bed.

I took a test - and saw two pink lines.

Our predominant feeling was “Well, here we go again.” But we were excited! By now, I had been devouring pregnancy books and blogs, so I knew the statistics. Experiencing two losses in a row was not common. I found solace in this: I had never been on the wrong side of the statistics before in my life.

I never could have imagined it would happen a second time. In the back of my mind, though, I counted down to the number of days that the first pregnancy lasted.

Sure enough, a week later, I bled again. I was crushed. Matt and I cried together. The fear that this was something larger started to loom. So I called my doctor.

A chemical pregnancy is an early miscarriage that happens within the first five weeks of pregnancy before the pregnancy can be seen on an ultrasound.

Chemical pregnancies happen before many people even know they’re pregnant. If you’re not tracking your cycle or taking pregnancy tests, you might simply think it’s a late period.

But if you are taking pregnancy tests, you see those two pink lines.

Miscarriage is common. It is estimated that up to 20% of all known pregnancies end in miscarriage - though it’s likely that number is even higher when accounting for very early losses (like chemical pregnancies) that occur before a woman even knows she is pregnant.

Further, only about 2% of women experience recurrent miscarriage, or two miscarriages in a row. It was when I saw myself in that 2% that I began to worry something was wrong.

Chemical pregnancies in particular can feel… complicated. When it comes to recurrent miscarriage, the guidelines can feel confusing and invalidating if you have experienced a loss with those first five weeks. While some guidelines outside the U.S. include chemical pregnancies as part of the definition, ASRM guidelines - which many doctors in the U.S. abide by - state that recurrent miscarriage is defined by two or more clinical pregnancies, or pregnancies recognized with an ultrasound. This in itself can make you question the validity of your emotions around these losses, and around the depth of the implications.

So if you have experienced a loss and you have seen the statistics, you know you’re far from alone. But that doesn’t make the loss, and the heartbreak that comes with it, any less staggering.

When I had my first positive pregnancy test, I felt a slight but significant shift. I wandered through the Target baby section mentally picking out outfits. Talking about baby names with Matt meant picturing an actual person. I thought about my career through the lens of supporting my future children.

Although the pregnancy was brand new, we were already out the gate. We had begun to see the vision for our family coming true. So when I began to miscarry, the sadness was crushing.

I hadn’t seen anything on an ultrasound; I hadn’t heard the heartbeat. What we were grieving wasn’t so much the loss of a baby itself, but the vision of what our life was going to look like.

There were so many moments that I felt a self-consciousness: I thought, “At least I wasn’t further along. So many women have had later term losses more traumatic than mine.”

But what I have come to understand (with the help of a healthy dose of therapy) is that no matter the stage of your loss, this is grief. And no one person’s grief is more valid than any other’s.

If you are grieving a loss, no matter how early, your pain is valid. Your feelings are valid. A loss is a loss. And you are grieving not only the loss of a future child, but the loss of potential. The loss - at least for the time being - of the life you’ve dreamed of.

If this is happening to you, this is a time to take care of yourself.

More likely than not, there’s nothing you could have done - chromosomal abnormalities of the developing embryo account for more than half of all miscarriages.

This was not. Your. Fault.

You can’t control this situation. What you can do is advocate for yourself:

• Take time to grieve: Don’t try to push through the pain; don’t fall into the trap of telling yourself it’s not a big deal. This is a loss, and you’re mourning - take the day off work if you can, cry your eyes out, zone out on the couch. And come back stronger.

• Trust your gut when something feels off: Particularly if you have had two or more chemical pregnancies or early losses, don’t brush it off as nothing if your intuition is telling you otherwise.

• Check in with your doctor: After my second chemical pregnancy, I asked for a referral to a fertility specialist (a board-certified reproductive endocrinologist) to investigate. ASRM guidelines aside, I was fortunate to have a provider who was willing to listen to me and do a work-up, which led to my Asherman syndrome diagnosis and subsequent treatment. I’m glad I listened to my gut.

I hope you know you’re not alone. We’re in this together.