A Man’s ABCs of Miscarriage

Elison Alcovendaz is a writer based in Sacramento, CA. His work has appeared in several publications, including The Portland Review, Under the Gum Tree, Agave Magazine, and others. "A Man's ABCs of Miscarriage" was first published in The Rumpus. For more information on the author, please visit www.elisonalcovendaz.com.

A is for Alphabet. Long before Patty got pregnant, my Facebook friends populated my newsfeed with articles discussing the importance of words in a child’s development. So when, a couple years later, Patty woke me up at 5 a.m. with a positive pregnancy test in her hand and a smile on her face, I started buying children’s books that day. Where the Sidewalk Ends. The House on Pooh Corner. I leaned my face to Patty’s stomach and talked to our baby about everything—my workday, the 49ers, how much we already loved him (I always imagined a “him”). I imagined teaching him a literary alphabet. “A is for Absalom!, Absalom!. B is for Borges…” If words were important to a baby’s development, then he was going to hear as many words as he could stand.

B is for Baby, of course, though not the squirmy thing that looks like an old man until they’re six months old. I’m talking about the common term of endearment. As in: “Baby, scoot the fuck over, you’re taking up the whole bed!” Baby as in the thing I called Patty for eight years until I didn’t.

After the second procedure (see “D is for D&C”), the doctor advised Patty against overexertion. When we got home from the hospital, I situated her on the couch and went upstairs to grab whatever she wanted—socks, pajamas, the Harry Potter book she couldn’t wait to read to our kids someday—but just to make sure I got everything, I yelled, “Baby!” I’d intended to follow that up with, “Need anything else from up here?” but the words caught in my throat. The silence was the loudest I’d ever heard. And my saliva tasted dirty, as though “Baby” was a word to be spat and not spoken. I sat on the edge of the bed and flipped through the pages in her favorite book, watching the words flitter through my hands.

C is for Cliché:

• “That happened to me and I had kids.”
• “Just a bump in the road.”
• “You’ll be fine.”
• “God doesn’t give us anything we can’t handle.”
• “Stay positive.”
• “Have faith.”
• “You should see a therapist.”
• “Things are going to be alright.”
• “At least you know you can get pregnant.”
• “God works in mysterious ways” (see “J is for Jesus”).
• “It just wasn’t your time.”
• “It’s nature’s way of getting rid of an unviable pregnancy.”
• “Time heals all wounds.”
• “Only God knows the plan.”

D is for D&C (or Dilation & Curettage).

“Dilation and curettage (D&C) is a procedure to remove tissue from inside your uterus. Doctors perform dilation and curettage to diagnose and treat certain uterine conditions—such as heavy bleeding—or to clear the uterine lining after a miscarriage or abortion.

“In a dilation and curettage—sometimes spelled “dilatation” and curettage —your doctor uses small instruments or a medication to open (dilate) your cervix—the lower, narrow part of your uterus. Your doctor then uses a surgical instrument called a curette to remove uterine tissue. Curettes used in a D&C can be sharp or use suction” (mayoclinic.org).

E is for Expect.

to look forward to; regard as likely to happen; anticipate the occurrence or the coming of (Dictionary.com)

One of the first things we did was download the What to Expect When You’re Expecting app on our phones. The app tracked the baby’s size, provided helpful reminders (take your folic acid!), and listed remedies for the horrific morning sickness Patty would soon experience. For the most part, the app did what it said it would (tell us what to expect) though it was oddly light on the whole miscarriage thing.

I get it. Why drown yourself in negative possibilities? Let’s drown ourselves instead in the love! The cuteness! The miracle of the female body! The expected! But what about what to do when a doctor lets the “hysterectomy” word slip to your thirty-one-year-old wife? Or when the doctor tells you the amount of blood your wife lost in her second D&C is the most he’d ever seen? Or when you, a writer, can’t come up with any consoling words, much less the right ones?

F is for Fetus. Right after the first D&C, Patty, in her still-anesthetized-but-slowly-waking-up stage, was busy entertaining the medical staff and me. She’d wake up for a few seconds, shake Dr. Strong’s hand and thank him (for the fourth or eighth time) for his “fine work,” fall back asleep, wake up again singing old rock ballads, and between all of that, tell me repeatedly how much she loved me.

While the nurse took Patty’s vitals and entered it into the computer, Patty woke up again. The nurse and I exchanged grins, curious to what comedy would spout from Patty’s mouth. “Did they say if the baby was a boy or a girl?” she asked before falling back asleep. I grasped onto the cold, metal armrests of my chair and felt the floor slipping beneath me.

“It wasn’t a baby,” the nurse whispered, “it was a fetus. It’s important to know what things are and what they aren’t.”

Patty nodded, her pale face relaxed as though in a daydream.

G is for Gender. A few months after the miscarriage, I called for a boys’ night at a sports bar in Downtown Sacramento. Me and three of my best friends, three dudes who’d been groomsmen in my wedding. We were the stereotypical “bros” who usually didn’t talk about shit like miscarriage, but I needed to.

Thirty minutes into dinner, as we stuffed our mouths with fries and beer, I talked about the miscarriage. They nodded as they listened, and when I was done, one friend said his wife miscarried the month before. I asked him how they were doing. He said “fine.”

That was it. A minute later, our attention turned to the female bartender using her breasts to extract a bigger tip from a gaggle of drunk businessmen.

That night, I scoured the Internet for tips on how, as a guy, I was supposed to talk about miscarriage, but most of the information was about how to help your partner. How to be the “strong” one (as though she isn’t the strong one). But there was nothing about how seeing a father holding a newborn makes you scream into your shoulder. Nothing on how your inability to raise your wife from her melancholy makes you feel like a failure as a husband. And definitely nothing on how to talk about miscarriage with the men you’ve been friends with your whole life.

H is for (T.)Hanks. Patty crushes hard on Tom Hanks (I know, I don’t get it either). The “SF Girls,” two of Patty’s friends from San Francisco, do everything in their power to keep this crush alive. They randomly quote lines from his movies, buy random trinkets with his face on it, and write “thanks” as “T.Hanks” on Patty’s birthday cards.

After a particularly rough day, we came home to find a package on our doorstep from the SF girls. In the package, we found popcorn, theater-sized boxes of chocolate, and five DVDs, each one starring Mr. Hanks. Their note said they wanted us to have a date night, and what better way to do it than with the other man in Patty’s life.

We stood in the middle of our kitchen hugging, wiping our faces on each other’s shirts. We were Wilson the volleyball, and our friends weren’t going to let us drift away.

I is for IMDB. When your wife miscarries and can’t stand hearing about pregnancy or babies, IMDB is a wonderful source for synopses of films and TV episodes. This means that you know before your wife does that in the first episode of Downton Abbey, Season Six, Mrs. Bates miscarries. And this means you can delete the first episode when it records on your DVR. And this means that when she asks why the first episode didn’t record, you can tell her you’re not sure, but then you feel bad lying, so you tell her the truth, and she immediately asks if you can find it On Demand, and that’s when you realize she doesn’t need you to protect her in this way anymore and that, perhaps, it wasn’t her you were protecting, anyway.

J is for Jesus. I’ve always been a superstitious Catholic. Anytime I saw an accident or even had a bad thought, I’d perform the sign of the cross and say a silent prayer to Jesus.

I stopped cold turkey three months before the miscarriage. After, I wondered if doing so caused the miscarriage. Numerous family members told me that “God works in mysterious ways,” so maybe that was one of the mysteries! If you don’t sign the cross often enough, bad things happen to you! Because if Jesus is God and God is good and all-powerful, then he/He wouldn’t just allow such things to happen, right?

When my right hand finds its way to my forehead now, I don’t stop it. Of course, I don’t really believe my cross-signing has any pregnancy power, but hey, God works in mysterious ways.

K is for Kübler-Ross. For months after the miscarriage, I couldn’t write. Instead, I turned to Fantasy Football for distraction. I committed myself to endless hours researching advanced football metrics. When people asked what I was working on, I lied about a novel. I didn’t tell them that if they planned on starting Marshawn Lynch against the Packers that week, they shouldn’t.

I’m not sure what stage of grief I was in at the time. Not denial and definitely not acceptance. Anger? Certainly. I called in sick one day and threw a glass on the floor just to see something break. Bargaining? Sure. I told God I’d go to church every damn Sunday if that meant no more miscarriages. Depression? Yeah, maybe.

The five stages of grief were developed by psychiatrist Elisabeth Kübler-Ross, who had two miscarriages of her own. During both pregnancies, she’d been disqualified from a residency in pediatrics due to being pregnant. She lost her potential career, her dream, for babies that never arrived. Instead, she turned to psychiatry and envisioned the now famous grief model.

“K is for Kübler-Ross” is the first thing I’ve written since the miscarriage. I’m not sure what that means, but I hope it means something.

L is for Lola. The first time Patty met her, Lola (Tagalog for “Grandma”) was punching the air from her seat on the couch, her paralyzed leg resting on an ottoman, her oversized sunglasses perched loosely on her nose. Our family had convened for a Pacquiao fight, and Lola was in fine form.

“I thought you said she was blind,” Patty whispered to me.

“She is.”

“But how can she see—”

“She can’t,” I answered, laughing. “She’s a fighter. She wants to get in that ring.”

Our wedding was the last Lola attended. She was already sick then, but when we visited her table, she grabbed me tightly by the wrist and said she wanted to meet my kid.

“Maybe in five years,” I teased.

“No,” she said seriously. “You’re starting tonight, aren’t you?”

In a family of a hundred people, I’m the oldest without a child. My uncles constantly tease my mom about being the oldest non-Lola in our family. Whenever cousins have babies, you’ll find them in my mom’s arms while my uncles remind me how penises and vaginas work.

A few weeks after we found out Patty was pregnant, we hung honeymoon photographs (see “P is for Paris”) on the walls and invited my brother, his wife, and my parents to see the new additions. After taking them through the house to see photos of the Colosseum, the gargoyles of Notre Dame, and Stonehenge, we ended in the guest bedroom. There, on the dresser, was a framed photograph of me holding the positive pregnancy test, smiling.

“What’s that?” my mom said, wiping her eyes.

“Well,” I said, hugging her, “it means you’re going to be a Lola now.”

M is for “mis –.”

a prefix….meaning “ill,” “mistaken,” “wrong,” “wrongly,” “incorrectly,” or simply negating (Dictionary.com)

While miscarriages are often called “spontaneous abortions,” for many women, including Patty, there’s nothing spontaneous about it. Patty had a “missed miscarriage,” where the fetus has died, but the mother’s body continues to think she’s pregnant, meaning all the joys of morning sickness and other early trimester symptoms generally continue until the fetus is expelled.

At our first ultrasound appointment, when Dr. Walker measured the fetus at six weeks when we should’ve been at seven, she mentioned it could have been a miscalculation. The formula sounded easy enough—count from the first day of Patty’s last menstrual cycle—but as we walked to radiology for more tests, we both derided our poor math abilities (“I got a D- in Calculus in college,” I told her) and thought maybe the good doctor was right.

She wasn’t.

Perhaps because of some leftover Catholic guilt (see “J is for Jesus”), or some outside hope that that the baby would magically grow to if we just waited, we decided against any kind of medical intervention. But two weeks passed and nothing happened. At that point, still wanting to avoid a surgery, Dr. Walker gave us Misoprostol, a drug to induce abortion.

It didn’t work. We tried it again. It still didn’t work. We finally signed up for the D&C, but the pathology report showed no pregnancy tissue was removed. So we signed up for another D&C, and they got everything that time, but not before Patty hemorrhaged on the surgery table. Outside, in an innocuous hallway, Dr. Strong, the surgeon, his pristine tie hanging straight from his neck, would tell me there was no puncture to the uterine wall, no mistake made, and I’d call Patty’s parents and tell them there was no mistake, the doctor has great reviews and went to Stanford and has done this procedure hundreds of times, that Patty’s hospitalization was precautionary, to monitor her, to see if she needed a transfusion, and I promised I’d stay on top of the medical staff to ensure there was no miscommunication, but I didn’t tell them that we’d been misled, that pregnancy was supposed to be a beautiful thing and it wasn’t.

N is for Nicole Miller. A few weeks after the positive pregnancy test, Cristina, one of Patty’s best friends, gave her a pile of stylish maternity clothes. Patty eagerly showed me each blouse, holding them up to her body.

“Those don’t look like maternity clothes.” I’d always imagined maternity clothes as shapeless, bland frocks. “What brand are they?”

Patty picked up a blouse and eyed the tag. “Nicole Miller?”

“Never heard of her.”

Patty shrugged and folded the clothes into a neat pile.

The day we arrived home from the hospital, I went upstairs (see “B is for Baby”) to grab some of Patty’s belongings and saw the pile of maternity clothes. I picked them up and tiptoed to the unused third bedroom, where I hid them in the closet under a heap of blankets used only when guests stayed the night.

Two months later, when the SF Girls (see “H is for (T.)Hanks”) visited us, Patty appeared in the master bedroom door, the maternity clothes in her arms.

“Did you hide these?” she asked.

I sat up quickly in bed. “I’m sorry. I should’ve hidden them bet—”

“Stop,” she said and laughed. It was a real and unabashed laugh, the kind I hadn’t heard in months, the kind that made me think things really were going to be alright.

O is for Odds. I played professional poker for a year, which means I know odds. For example, I know that top pair post-flop will win against two overcards three out of four times. When you have those kinds of odds, you want to get all-in and get called if you can.

Every doctor and well-meaning person reminded us three out of four pregnancies turn out fine. We just happened to be in that one-in-four. Except the Misoprostol pill normally works 97 out of 100 times and that failed twice. And the D&C procedure also works 97 out of 100 times and the doctor said he hadn’t seen that much bleeding in his twenty years of doing D&Cs. Assuming he does a hundred of these a year, the actual odds of Patty’s situation are:

1/4 * 3/100 * 3/100 * 3/100 * 1/2000 = 0.000000003375

In other words, the odds are better to win the World Series of Poker Main Event and get struck by lightning in a lifetime… but still worse than winning the Powerball jackpot, and people play that shit all the time.

P is for Paris. We saved up for a European honeymoon and were excited not only to see the sights, but also to start trying (see “T is for TTC”). Our hotel in Paris sat in a narrow alley a mile from the Eiffel Tower. We laughed as we entered the room, which was big enough for a queen-sized bed, a skinny nightstand, and not much else. No matter what, we told each other, the room was perfect. It could be the place we conceived our first child.

We were romantics that trip. We drank champagne atop the Eiffel Tower, shopped for books along the Seine, got our caricatures drawn under the warm shadow of Sacre Couer. When we arrived back home, we framed our caricature and hung it above the toilet in our master bedroom. Months later, a day after the miscarriage, I stood in front of that toilet and stared at our cartoonish faces on the wall, unable to realize I was urinating all over the floor.

Q is for Quarantine. We avoided everyone for weeks. We plopped on the couch and watched The Big Bang Theory and distracted ourselves with our phones. We hardly spoke and when we did, the conversations were cautious. Neither of us wanted to rip off the Band-Aids just yet.

I came up for air much sooner and prodded her with questions: “What’s on your mind?” or “What do you want to talk about?” Sometimes she’d respond with a quiet “nothing,” but other times, she’d stay silent and blink away the tears and I’d feel guilty for bringing it up so soon. But with each passing day, cooped up on that couch, rage grew. Why us? Why couldn’t I fix it? I got up and stormed through the front door without a word.

Dusk had fallen, and a dusty light bathed the streets. I half-walked, half-ran toward the park two blocks from our house.

I didn’t hear it as I approached—a basketball bouncing against the blacktop. I’d reached the fence surrounding the court and saw, through the increasing grayness, a boy, maybe seven, dribbling circles around a line of orange cones.

“That’s it!” a man encouraged from somewhere. “Way to go! Don’t lose focus! Good job, son!”

I gripped the fence for balance. The man yelled something else (at me?), but I turned, dizzy, and hurried back home. Patty still sat on the exact spot on the couch, playing Candy Crush. I sat next to her, and she leaned her head against my shoulder.

Let’s never go back out there, I thought, just as another Big Bang rerun came on.

R is for Raspberries. Three days after the second procedure, all we had in the refrigerator was a moldy block of cheddar cheese and a bottle of Hershey’s syrup, so I went to Safeway and picked up foods I hoped Patty would eat: wheatberry bread, Yoplait, Jiffy. After a few minutes, I found myself frozen in front of some raspberries. “Is everything okay?” a middle-aged woman with a dog in her purse asked, offering me a Kleenex. No, I wanted to say. Our What to Expect App said our baby fetus was the size of a raspberry when it stopped growing, but thank God you’re able to carry your poor excuse for a canine in your knockoff purse! Instead, I wiped my eyes, said “thank you,” and bought vanilla bean ice cream to pair with our Hershey’s syrup back home.

S is for Sawyer. We spent a lot of time debating boys’ baby names (we’d agreed upon a girl’s name rather quickly). She loved classic names like William or John. I wanted a literary name, but Patty was skeptical. Carver sounded like a serial killer (she had a point there), Hemingway sounded like we were trying too hard, Calvino sounded like cheap Italian wine, and Faulkner sounded like “Fuck her.” I discarded the authors and tossed character names around. Ender. Achilles. Atticus.

One morning, four weeks into the pregnancy, we were sitting at a red light when a man crossed in front of us, pushing a shopping cart jam-packed with plastic bags and clothes. Recently homeless, I thought; a round stomach curved his red tee into a near-perfect semicircle and his cheeks were rosy, like he was used to regular, full-course meals. He lumbered across the street, his curly brown hair bouncing on his shoulders. He resembled someone I knew, but not until we hit the freeway a few minutes later did I realize that someone was Hurley from the TV show Lost. A few mental associations later, I arrived at my favorite character on that show:

“Sawyer!”

Patty didn’t immediately say no, so I knew I had a chance. I vowed then that any time we talked about the baby, I’d call him Sawyer. “Will Sawyer have your freckles?” “Will Sawyer love basketball or books more?” And it met the “literariness” criterion. Though I’d never read The Adventures of Tom Sawyer, anyone who has watched Lost knows how literary a TV show can be.

We don’t talk about names now. While in the car, we’ll sometimes hear an intriguing name on the radio. Our backs straighten and our eyebrows raise and we turn to each other to ask, “What about that name?” Instead, we smile and stay silent. Or ask more questions about each other’s day. Naming your child after a con man is a bad idea, even if he’s a fictional one.

T is for TTC. Throughout the ordeal, I visited various online chat boards where moms, moms-to-be, and moms-who-were-supposed-to-be-but-miscarried discussed anything and everything related to pregnancy. When the Misoprostol didn’t work, I found a board for that. When we thought the issue might’ve been a fibroid, I found a board for that. What I didn’t find were any dudes.

In order to participate in these conversations, you have to create a profile. Most of the profile names had something to do with motherhood. MOMMYOFTHECUTEST, for example. What was my name supposed to be? DAD2BJUSTKIDDING? ONLYGUYONTHISWHOLEDAMNSITE? I settled on MANWITHQUESTIONS and started reading.

The lingo! I swear they invented these acronyms purposely to ensure any man who happened upon the website would have no idea what the fuck was going on. Some were easy. MC meant miscarriage, for example. But it took me a whole week to realize AF meant Aunt Flow (I never knew she was an aunt). It took me even longer to realize DH meant Dear Husband (how nice), DuH meant Dumb Husband (that’s more like it), POAS meant Pee On A Stick (should’ve figured this out sooner), and TTC meant Trying to Conceive.

I introduced myself on a TTC thread for women who’d had complications from a D&C and received warm welcomes. Most of them hadn’t seen a man on the boards before and were curious. I asked what their mentality was on TTC after the procedure. Most of them said they got PG quickly, carrying healthy babies to full term. But one lady scoffed.

“I hate the word ‘trying’,” she said. “You either get pregnant or you don’t and that’s all there is to it.”

U is for Ubiquitous. Now that my Clueless Guy Goggles have been removed, fuck! There are babies everywhere! Pregnant women everywhere! EPT commercials everywhere! Just when you want the world to turn down its baby fever for one fucking second, there’s another friend posting her daily newborn photo (you realize they look the same as they did yesterday, right?). Then there’s all the follow-up appointments, sitting in the lobby with women whose bellies are bursting with life, trying to tell Patty through an arm around her shoulder or a massage of the neck that I’m sorry and we’ve got each other and things are going to work out (see “C is for Clichés”).

But there are women in that lobby, too, who’ve been through what Patty has. Maybe several times. Maybe they’re going through it now. Once we told people about the miscarriage, the stories poured in. A co-worker’s stillbirth. Close friends with multiple miscarriages, some who have kids now and some who’ve accepted their childlessness. Cousins with fertility issues, old classmates undergoing IVF, parents who admitted they’ve likely had multiple losses. All these people with their own miscarriage stories and all these people, silent my whole life.

When people did share their stories, they were told to Patty, of course. The would-be fathers in those stories had nothing to say and I’m certain the women would’ve felt uncomfortable talking to me.

“I want to write about the miscarriage.” The words came out slow.

Patty and I were on our way to work, picking through slow traffic. She turned away and stared through the rain-dropped window.

“We’re not going to get away from it,” I continued, just as we passed a billboard for an IVF clinic. “Since we’re not going to get away from it, I want to contribute. There’s hardly anything about the man’s perspective out there. Plus, I think it’ll help me.”

She took a long time to respond. Adele’s “Hello” whispered through the speakers. Then she turned to me and placed her hand on my knee. “It’s your story, too,” she said.

V is for Vocabulary. Years ago, I signed up for a daily email that contained a unique word and its definition (see “U is for Ubiquitous”). If I wanted to be a writer, increasing my vocabulary seemed necessary. And yet, here’s a list of words I’d love to unlearn:

• fibroid
• septum
• hysteroscopic metroplasty
• Mullerian Duct Anomaly
• arcuate uterus
• reproductive endocrinologist
• placenta accreta
• Asherman syndrome
• incomplete evacuation
• salpingitis
• Misoprostol
• Rhesus negative

W is for Wooh Woooh. Pictures and Christmas cards of babies covered the far wall of Dr. Walker’s examination room. All the photos were from patients who’d successfully given birth. In all the photos, the babies were at their cutest, with bows atop their frizzy heads or tiny Air Jordans on their feet. Patty sat at the end of the examination table, feet dangling, while I squirmed in a plastic chair near the door. It was our second post-diagnosis appointment, and Patty was Dr. Walker’s last patient of the day. Thankfully, OB/Gyn offices are generally quiet; these offices are for the women, not for the children, so you rarely hear any baby sounds.

“Wooh. Woooh.”

The sound boomed as though from a giant, invisible speaker. I looked at Patty, but she kept her head down, staring at her swinging feet.

“A baby’s heartbeat,” she said. “That’s what it sounds like on the Doppler. Probably from the room next door.”

After Dr. Walker left and Patty was putting her clothes back on, I was vaguely aware that the other room was silent, but I still heard it, the incessant “Wooh, Woooh” thumping my eardrums. I glanced up at the babies on the wall. They were all smiling at me, their little hearts pounding in unison.

X is for X-mas. Christmas with my family: a hundred people, a pile of 500-plus gifts, an uncle dressing up as Santa, kids running around with sparkles in their eyes until everyone goes home around 3 a.m.

I’d told my mom to warn the usual offenders not to ask when we were having babies and not to mention the miscarriage. But as soon as we got out of our car, there was Uncle Tony, telling us God has a plan (see “C is for Clichés”). Inside, newborns cried in their mothers’ arms, everyone reminded my about-to-pop cousin that she was about-to-pop, kids with endless energy seemed to multiply by the second. We grabbed some Filipino food and picked our spot on a loveseat away from the action.

People came and went, talking to us as though we were broken. Every pause in conversation provided opportunity for my family to walk away or force small talk about work or the Kings. Patty breathed slowly beside me, holding onto my arm. I imagined us in an action movie, her hanging over a cliff, my sweaty palm trying to pull her up.

Y is for You. In case you read this someday, thanks for trusting me to write this. It’s one of the countless reasons I’m thankful you’re you.

Z is for Zeus. At the time of this writing, we’re in a better place. We’ve made an appointment with a reproductive endocrinologist. We laugh more, hold hands more vigorously, can be around babies without a complete breakdown. Yesterday, we even discussed our hypothetical daughter (I think of a “she” now), wondering if she’d be a kid who wanted their parents to put an “I’m on the Honor Roll” bumper sticker on a car (and wondering if we’d be the kind of parents who’d say “okay”).

But Patty and I are worriers, overthinkers, capable of fretting about a million what-ifs while simultaneously analyzing the word choice in a doctor’s email (what exactly did she mean by “possibly”?). I once heard the only thing faster than the speed of light is the speed of thought, and I wonder if simply thinking about Sawyer’s sister until my head hurts could get us to the place we fear talking about. Like Zeus spouting Athena, the Great Goddess, from his brain. Just keep thinking and thinking and the next thing you know, she’s here.