I Hate (the EPA)U

Trauma (noun): A deeply distressing or disturbing experience

URGH. I had to return to the Early Pregnancy Assessment Unit (EPAU) today. Even though:

  1. I’m not pregnant
  2. I have so many traumatic memories of the place

It’s a couple of hundred meters from Room 7, the place where Summer was born. It’s not far from the hospital backdoor we were shown out from or the cold store room we had to leave her behind in. Nothing good comes of this place. Well not for me, anyway.

And today, I had to visit again, alone. Because of the pandemic restrictions. Understandable, but even more difficult, seeing as James had the day off.

It’s a small unit and I have been in ALL of the rooms.

The Waiting Room: This is the room filled with the not-so-nice receptionist. It’s where the pregnancy bumps are and relieved mothers come to sit with their healthy scan pictures. It is like a car crash for me, rubbernecking. I cannot hep but stare, even though I know I shouldn’t. At every single baby-filled tummy.

Assessment Room 1: This is the room where we had the best ever scan of My Baby. But subsequently, also the room where two separate doctors coldly asked “why are you crying?” after two different miscarriages. It’s the room with the stirrups.

Assessment Room 2: This is the room where we had our first scan with Summer, where we first saw her heart beating at 6+2. But it’s also the place where they confirmed that BoC’s heart had stopped.

The Consultation Room: This is where I’ve previously had to change into my hospital gown for an ERPC (post-miscarriage surgical procedure). It’s also where they referred to Summer as an “early loss”.

I know I shouldn’t think about all these things, but how can I not? So much of my doomed pregnancy ‘journey’ has been spent there and I was dreading the return.

So today, I was back in assessment room 1, for some ongoing medical investigations.

I was so close to tears, I just stared up at the ceiling and tried not to think about how horrible everything was. I started thinking about the word circle, and how triangle makes sense as a word, but square doesn’t. Wouldn’t it be easier if it was called a quadangle? Anything to not think about the probing reality of being back here, again, without a baby.

I don’t know what to make of the day. Thankfully, the staff and doctors were wonderful. No-one said anything to push the already-sensitive-me, over the edge. One consultant asked me “how are you doing, today?” instead of the dreaded how are you?” which was perfect (James says I always manage to put this particular doctor on edge. I guess it was unkind of me to once respond to his first post-Summer “how are you?” with an awkward “sorry, I don’t answer that question anymore. The question is just too BIG”). Anyway, long story short: they found an adhesion in my womb and I will have to have a surgical procedure, then a six week wait, before we can start trying again.

Adhesions can cause second trimester miscarriages. Summer was a second trimester miscarriage. Adhesions can be caused by ERPC’s. I had two ERPC’s: one after My Baby and one after Summer. So is this a new problem since Summer (therefore a backwards step) or an old problem since My Baby? (and therefore the reason why we lost Summer?) We will never know for sure. And in the absence of that, I need to figure out what I am going to choose to believe.

One thing we’re both relieved about is that we never chose to have an ERPC. I had to have both after medical management was no longer a recommended option. So it’s not something I can feel guilty about. Of course, I will spend this evening trying to convince myself otherwise. But right now, I am feeling numb. There is never any good news: finding something wrong, is not good news. Not finding anything wrong, is not good news. Even finding a potential reason for your loss, is not good news – for nothing brings them back.

My, rather apt, waiting room reading material.

P.S. This is the blog I’ve felt most awkward about publishing. I don’t know why, perhaps because it’s so in the moment, or personal. Although all the blogs are. I guess I just feel that perhaps it doesn’t have any value for you as a reader. I’m sorry for that. But one of the reasons for launching the blog, was to ensure I didn’t have to tell people the same things over and over. So here it is. Personal medical details, for all to see.

N.B. If of interest, I’ve written a bit about the various miscarriage treatment options below, as an educational piece. I knew nothing about this, until I had to.

The Tommy’s website says there are three ways of treating a miscarriage and unfortunately, I’ve been through all three.

  • Medical Management: Taking medicine to help things along
  • Expectant Management: Waiting for the miscarriage to happen by itself naturally
  • Surgical Management: Having surgery to remove the pregnancy

BoC was a missed miscarriage. There was no heartbeat on his scan, he died in the womb, but I hadn’t had any symptoms, such as bleeding or pain. I opted for medical management (taking medicine to ‘encourage’ a miscarriage), as I wanted to physically feel something to fully register what had happened. I also wanted to be at home.

My Baby was both expectant management (i.e. the out-of-the-blue miscarriage where you miscarry naturally – probably the way most people imagine miscarriages occur) and surgical management (having a surgical procedure  – an ERPC) to remove the remaining products of conception, weeks after it all happened.

Some women opt for surgical management to remove their baby after a pregnancy has ended. There is no right or wrong decision – it’s a completely personal choice. From a medical perspective, I was told that there’s no better/worse approach in terms of trying again/future pregnancies (but it’s always worth rechecking that statement with your doctor – especially as I now feel we’ve evidence to the contrary).

For completeness, Summer was a natural labour and birth, followed by her neonatal death shortly after. A week later I had my second ERPC surgery, as there was still some remaining placental tissue.

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(5) Comments

  1. Claire says:

    Anj, what to say? Is this good news? Is it bad news? It’s not either really is it? That’s the point. I do know that I would rather my amazing friend didn’t have to go through yet another procedure. But then if I could, I would change so much for you. Lots of love. Cx

  2. Karen Palmer says:

    Hi, Anjulie, sorry it’s been such a difficult day with so many hard memories, and now difficult to pin down thoughts about the result of the investigations. Praying for a sense of peace for you now, that continues into the weeks ahead xx

  3. Melanie says:

    Anj – all these dreadful things you have to keep going through!!! I wish you didn’t have to experience any of this. It is simply cruel and how much can one person take?! Xxx

  4. Rhi Rusius says:

    You’ve a strength in the words above that I don’t think you are ready to see. It took me a long long looong time to understand why people called me resilient or brave or why they might be proud of me. I’m still really uncomfortable with it. But you should be proud that given information that could send you down the emotional garden path, you’ve already spotted that there is no way to know whether the adhesion was there before Summer or as a result of the EPRC you had afterwards. It might not feel like a big thing, but that mum guilt, the constant second guessing, is bloody awful, and by spotting this so quickly you’re giving your head a chance in the battle between it and your heart xx

  5. Ruth Ireland says:

    Ahhh Anj so sorry for all this you are having to go through.

    Just something else to point out that I have always thought was sooooo wrong is why they would have the Early Pregnancy Unit anywhere near where there are mums going through a ‘normal’ pregnancy.

    Surely they must know that the sight of a healthy pregnant mum is not going to help any mums out there who are going through complications or experiencing miscarriages or had neonatal losses.

    My sister-in-law first made me aware of this when she was going through treatment that she too was made to sit next to other happy mums who were going through normal pregnancies. I’ve always found it so insensitive and something they have got so wrong. Surely things can be changed. I’m sure Anj and my sister-in-law are not the only people to have had awful experiences having to walk through waiting rooms of happy mums.

    I have personally had a negative experience at the EPU too. How many more women out there have?


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