After the scare is over - the final trimester continues

I ended up spending two nights in hospital. I thought they were going to keep me in another day at least, so I was pretty happy with being discharged early.

Once I was admitted to hospital the bleeding settled down and thankfully I had no new bleeds. Every time they ran a trace on mini matty he was as happy as a baby swimming in the perfect amount of amniotic fluid can be. Kicking and swooshing away. They also did six hourly observations on me, where they did an ultrasound of mini matty's heartbeat too.

On the first morning I woke up and was looking at my patient information white board. It contained the name of the current midwife, frequency for my observations, frequency for the baby trace, my condition and there was a little section for things my doctor wanted me to do. Written there was ICN tour.

ICN tour. ICN tour. I remember my ob said he'd like us to do a tour of the nursery. The IC nursery? The penny drops - the intensive care nursery. It's 6am, I've barely slept being pumped full of steroids and full of worry. Thinking about going to the intensive care nursery I start to cry. I keep thinking about mini matty being born now and how little he would be. I don't want to get myself unnecessarily worked up. I text hubby to tell him I'm awake and am pleased with his reply that he has packed my bag and will be heading back to the hospital shortly. Not long for me sit on my own and over-think the tour.

When Matt arrives we decide it is time to call our families and let them know we are in hospital. It is hard to tell your family when this stuff is going on as you don't have a lot of information and can't reassure them.

When my ob visits in the morning he again feels my tummy and asks questions about whether I've had any tightening or additional bleeding. All good on both fronts. He says he is going to have me sent for an ultrasound, but that they might not be able to do it that day as it is a Sunday. He says getting the ultrasound won't make any difference to the outcome (that is, if I'm going to go into labour, it is going to happen whether I've had an ultrasound that day, or the next). The ob says we definitely aren't going to our antenatal class that day either. Resting is the order of the day. He says bed rest doesn't mean I can't get up and go for a walk. A walk around the ward is fine, even into the hospital grounds, just don't be going down to Southbank (that would be about 1 kilometre from the hospital).

Matt pops down to the antenatal class and tells the midwife we aren't going to make it to the second day of classes as we were instead trialling the facilities.

I'm all washed out with terribly dark circles under my eyes so we decide after we've had the first trace that we will go to the cafe in the hospital foyer and sit in the sun while having a coffee. It is a beautiful day outside, a bit of sun on the skin is a delight. Matt goes back to the car to get something sorted out with the parking and I head back into the hospital.

Being in the hospital is pretty boring for Matt, but as a patient I feel relatively busy, with all the regular monitoring, meals and snacks arriving every couple of hours. Being hooked up to the trace for 30-45 minutes twice a day sucks up a lot time just watching what baby is doing.

Matt trying to rest on the hubby day bed

One of the downfalls of the monitoring is that it gets you hooked on monitoring. I know this from our early pregnancy issues. You don't believe everything is okay until you are getting the ultrasound. The post ultrasound happiness and confidence wears off in a few days and you find yourself counting down to the next ultrasound, to be reassured the baby is still okay.

I quickly got obsessed with the monitoring. I wasn't worried about my observations, just mini matty's. What his pulse was doing, how much he was moving. If he was quiet for a little bit during the day I'd be looking at the clock counting down to the next trace or baby heartbeat ultrasound. I could sense I was getting a little too into it. I started on the self talk to get myself back to earth - you can feel him moving - he is okay. He is moving as much as he was before the incident - he is okay. All the monitoring has shown he is okay.

On the Sunday we finally are ushered off for the intensive care nursery tour. I've confessed to Matt during the day that I'm nervous about going to pieces during the tour. When we get to ICN the team leader asks questions about how many weeks we are and if we've been told an estimate of the baby's weight. When we say 30 weeks and 1.7 kilos, she says that's great, he's a good size. Another couple joins us at this point for the tour - they are 28 weeks and don't know an estimate of their baby's weight.

The nurse explains the different nursery rooms to us and starts our tour in the most intensive care room. We have to disinfect our hands before we go in. She points out to us a tiny little baby that was born at 29 weeks, and weighs about what our little fella would. Baby is in an incubator, with a feeding tube in his nose. The nurse explains he isn't on a respirator, but is breathing for himself with a CPAP machine (like people with sleep apnea use). The baby is so tiny and so cute. The room is so quiet, with 8 - 10 of these incubators with tiny babies in them. One of them is glowing blue, which the nurse explains is a treatment for jaundice babies.

We go to the next room. There are more mothers in this room and the babies are in a mix of incubators and cots. A mother kindly let's us look at her little baby who is in a cot. He is now 4 weeks old, having been born at 29 weeks and weighing around 1.5 kilos. He has gained 500 grams and looks absolutely adorable, although tiny. He is wrapped up tightly in blankets and is making this cute squeaky sound. He looks perfect. He still needs a feeding tube, but is being trained to moving to sucking for his food. I thank the mum for letting us see him and congratulate her on her cute baby.

We then move onto the last room. This room has loads of people in it. It is the last room the babies go to before they go home. We can't go in as it is already so busy. The nurse tells us that from here, the parents then come back to hospital for a couple of nights and have the baby room in with them and they have the same type of support as women who have their babies at full-term do, to help them get used to taking care of the baby on their own. She tells us that babies are usually the equivalent of about 35-36 weeks before this happens (quick mental calculation - mini matty would be about 5-6 weeks in ICN if born now).

The tour is over and we head back to my room. It was a lot better than I thought it would be. A lot more comforting. A lot calmer. I thought there would be beeping machines and wailing mothers. But no, it was all very quiet and all those tiny babies looked so cute. But still, we want mini matty to stay put!

We have a few visitors on Sunday afternoon. Matt goes home again overnight. I have my second baby lung maturing steroid injection and settle in for the funniest baby trace ever, with mini matty going at full speed pumped up on steroids. They ended up having to leave the trace on a really long time to get a base rate where he wasn't moving.

Mini Matty's roid rage trace. The black squares on the bottom trace indicate when he moving!

Monday was about the same as Sunday, with the only thing to break up the day being the ultrasound, that didn't happen until after 4pm. Mini matty looked perfectly fine during the ultrasound. They did all the measurements again - and again he had a 97th percentile tummy! They did an internal scan to try and measure where the placenta was in relation to the cervix, but the bleed was in the way, so they couldn't really make out the edge of the placenta. The best thing about the scan was the 3D face images. I usually hate ultrasound images especially the 3D images. I always think it they make the baby look wrong. The last one I'd had at 20-weeks, the baby looked like voldemort! Here we were at 30 weeks and finally picture of mini matty's face was quite cute. He looked like a baby. 

Mini Matty's face, with his arm behind.

A couple of hours after the ultrasound our ob arrived and explained the result of scan. The scan had confirmed the diagnosis of a placenta edge bleed. Although they couldn't quite tell where the edge of the placenta was due to the remaining bleed, that will slowly clear, we didn't have any big nasty bleed clots over the cervix that would be cause for concern. So, would we like to go and rest up there for the week instead of in a hospital bed. We are advised about what to do if more bleeding occurs - come back to the hospital - if it is a big bleed call an ambulance and come back to the hospital. Rest is the order of the week. Don't venture far from the hospital. Don't do too much. My ob encourages Matt to spend the week at home so that someone is around if anything goes wrong.

Hooray. Of three bad things and one good thing that could happen, we are looking like we are going have the one good thing happen - nothing!

At home I get a chance to really rest - including having a much better night's sleep in our own bed. We made it through seven days with nothing else happening and both of us started to breathe a little easier. We missed out on a family wedding in northern New South Wales, as the ob thought just in case anything did go wrong - it was too far from the hospital.

In fact I'm now an amazing 32-weeks pregnant! Mini matty is still in utero having a lovely time swishing around. I'm not worried about the monitoring, because our baby moves and moves. I know some people don't love it, but I LOVE my baby moving. The bigger the better. I love it when I can see my whole tummy wobbling with mini matty swooshes and kicks.

When my awesome pregnancy takes a tricky turn

I didn't really get around to writing about the start of this pregnancy. I was too busy globe trotting, visiting family and friends in Hong Kong and England to keep up with it. It is probably worth mentioning that as with nearly all of our pregnancies, I had a scary bleed around week 7. I was in Hong Kong and beside myself when I saw the bleed. I thought it was the beginning of end and despite following up with health providers in Hong Kong who said the baby was still viable I was very surprised to make it back home and do a scan around week 9 that confirmed the pregnancy was progressing well. I still took my time to announce the pregnancy - waiting until week 17 when this little fella seemed well and truly settled in.

This weekend we ticked over into 30-weeks pregnant and dutifully attended our first full day of antenatal classes at the hospital. I've been excited about the classes - it is another marker in the progress in our miracle pregnancy. Hubby thinks 6 hours of sitting at antenatal classes on our Saturday is a drag, but a necessary and useful one.

Day 1 of antenatal classes is a little about familiarising ourselves with warning signs in this later stages of the pregnancy but mostly about understanding the process of labour, how long each stage takes and what is happening at each stage. As demonstrated using a small doll and female pelvis, it is clearly hard work to squeeze a small person out through the female pelvis. Yay!

We did a tour of the birth suites, so we could see where we most likely be bringing our baby into the world. We were shown the parking for dad's bringing in their partners and the pregnancy observation unit, where we will most likely go first up when arriving in labour.

The day was undeniably informative, even it it was a little slow moving and I had to sit in the most uncomfortable chair. I was pretty uncomfortable on the day. I just couldn't settle into my seat. My back and hips were sore. All the other pregnant ladies looked alright, but I kept shifting in my seat.

Pleased with an early mark we headed off to do a little appliance shopping - as I've now decided given it is only 10-weeks to mini matty's arrival that I really should get the damn kitchen renovated. I'm mad! So after some time standing around looking at kitchen appliances, we are pretty happy we have decided on the items we will need to finalise our cabinetry and head home.

I'm tired and sore so I head for a lie down. We have another day of classes tomorrow and I don't want to be a wreck for it. The second day's class is all about caring for our new little chap when he finally arrives.

An hour and a half later I wake up and feel a lot better, I wander out to the lounge room to chat with hubby and suddenly find myself feeling wet. It was weird - I say maybe I've weed myself, but I don't know. Matt is laughing at me as I whisk myself off to the toilet. I do a wee and look at my pants, where I clearly seem to have wet myself. Confused I pat some toilet paper on the wet spots to find the fluid is pink, not wee coloured. When I wipe myself it is clear that blood it definitely a part of the mix and the other fluid could be wee, or given I've just been at antenatal classes I begin to wonder if possibly my waters have broken.

I call Matt in and he isn't giggling about it anymore. He gets changed back into leaving the house clothes and rings the hospital as I try to find something else to wear and a mega pad to catch what ever is going on down there for the nurses and doctors to consider. The pregnancy observation unit want us to come straight in. First win from the antenatal classes - we know where to go and where to park! Oh, and of course we know that bleeding at 30-weeks is a bad sign - but I think we would have been on to that.

It doesn't take us long to get to the hospital and into the pregnancy observation unit. They immediately want to look at the mega pad, so I'm given a fresh one to swap to. The midwife gets me into the bed. She has called my obstetrician, he will be there in about half an hour, meanwhile they want to run a trace on baby to see how he is going. Two different monitor things are connected to me with big elastic straps. One listens to baby's heartbeat, the other monitors what my uterus is doing and the baby's movement. I'm also given a button to push every time I feel baby moving. Despite being pretty busy during the day, I'm not really feeling him much now, so I'm given some water and ice to crunch to try to get him going.

Soon enough our obstetrician arrives. I bumped into him in the morning during the antenatal classes, so he makes a joke about not expecting to see us back so soon. He pushes my tummy a bit to see what my uterus is doing. He tells me it is soft, which is good. He asks about how I've felt, have I had pain, have I had any tightening or contractions? I tell him the whole thing has been painless, just a shock. He wants to do a speculum examination to see what's happening near my cervix. Here things aren't so good. He can see a fair bit of blood and clots. He takes some swabs to be tested for infection.

Now for the verdict. The obstetrician explains he thinks I've had an edge bleed from the placenta, known as an antepartum haemorrhage (APH). He explains that the amount of blood loss I've had and how the cervix looked suggests it was more than just the cervix bleeding. He explains an edge bleed can be a one off and if it settles down with no fresh bleeds over the next 7-days that is considered pretty stable - this is good! However a few not so great things can happen and the window for this to occur is the 48-72 hours following the initial bleed. Firstly - the bleed I've had can cause irritation and trigger contractions and labour - this is bad. Secondly more edge bleeding can occur, leading to irritation of the uterus, contractions and labour - this is bad. Thirdly a complete placenta abruption can occur, leading to contractions and labour - this is bad.

So I have one chance of good, three chances of bad. Hmmmm. The conversation from this point gets a little harder. My ob is going to admit me to hospital for now and with three chances of bad happening the obstetrician wants to start me on a course of steroid injections just in case mini matty is rushed into the world. The steroids will help mature his lungs and give him the best chance if he does arrive early.

At this point my mind starts to catch up we are now seriously preparing for a worst case scenario early delivery. I tell my ob that I'm starting to get a little stressed out and don't mind if I have a little cry. He remains calm and says he'll just continue on. He explains the benefits of the steroids and if it were his baby he'd definitely be taking them. Also even though mini matty is 30+ weeks there would be a benefit in me taking magnesium if I do go into labour. Magnesium is commonly used in pre-term delivery under 30-weeks and has something to do with brain development of the baby. He explains research is currently being undertaken into the benefit of magnesium in delivery of 30-34 week babies, and it seems there is a decreasing benefit, but given I'm so close to 30-weeks there is probably a real benefit in our circumstances.

So he wants me to stay in, do the steroid injections and have twice daily traces run on baby to make sure everything is going okay for him. As if I'm going to say no thanks, I'll go home and take my chances.

My ob leaves and says he'll be back in to see me in the morning. The midwife - who happens to also be 30-weeks pregnant - comes in with the steroid injection and jabs me in the leg. She tells me they are just preparing a room for me upstairs and kindly gets us some shabby hospital sandwiches to chow down, given we've missed dinner and are now staying overnight at least.

Soon enough we are transferred to the antenatal ward and I get settled into my room. The midwives here are very busy and we have a decent wait before I get greeted and checked in properly. We have arrived at hospital with nothing - so I have no pjs, no toiletries, no snacks. Just Matt and I in the room in a kind of shock, both of us willing this to be the one off scenario not any of the other three options.

Once the midwife comes in she tells me about the room. She is very specific about my call button and tells me if I have a problem hit it once, if I have a big problem, ie a big bleed, hit the button three times and they will be there ASAP. This is the first time I've been told about this type of button function and reiterates in my mind they are genuinely concerned about this bleed progressing into something more serious.

We decide Matt should go home and try to get a good night's sleep. I can always call him if anything happens, and he can be back in 15-20 minutes. I've prepared a list of things for him to pack and bring in for me in the morning.

I slip into a hospital issue gown and settle in for the night.

Scanning

Well, I've been on holidays at the beach for the past 12 days. We holiday in a small beach side town each year. It is an incredibly beautiful part of the world. I had decided to take the risk and book in our first viability scan for the day we were leaving for holidays. I thought this showed great faith in that the pregnancy would be okay. If it wasn't okay, I planned to head to the beach anyway and drink myself into oblivion.

The scan was with our fertility specialist - the first viability scan. I've actually never managed to have a viability scan with him due to bad holiday timing over the past year. As it turned out, this time he was going on holidays for the same days as us, so we managed to squeeze the scan in.

I was a little disappointed with the scan. He showed us one baby, with a heart beat, right at the top of the uterus. He was pretty happy about it. He said "I'm not hearing any oohhhs and aaahhhhs". So he tried to hear the heartbeat. I tried explaining, it wasn't that we weren't pleased, it's just that we've seen a lot of tiny babies, that don't even look like babies, with heartbeats. He printed a picture for us.

I have grown to hate ultrasound images. I hate everybody's ultrasound images, not just my own. If a see a friend post their ultrasound image to facebook, I have to delete/hide the post. To me they just look freaky. So Matt took the picture. He thought his family might like to see it, I said "really, why would they want to see that?"

Due to my specialist usually being on holidays, our first scans have generally been with ultrasound clinics. These scans give you sooooooo much information. You get the crown to rump length, the heartbeat rate, the size of the gestational sack, the gestational age. So when the fertility specialist showed us a blob with a heartbeat and said it looked about the right size, I was underwhelmed.

As we were both about to head off on holidays the fertility specialist gave us a referal to get a diagnostic scan done, just in case anything went a miss during the week of holidays.

We packed the ultrasound referal in our gear and headed off on holidays hoping we wouldn't need it, but that wasn't to be the case. The very next day I had a pretty heavy bleed, dark red with little clots in it. I lost it. I was crying and crying. I just hate it. One day everything is 'fine' the next day, it seems like we are about to have another miscarriage.

The worst part is, there is nothing to do about it. You just have to go to sleep, get up the next day and somehow try to enjoy your holiday at the beach. The bleed was on a Saturday so we couldn't even go for the scan until Monday at the earliest.

So we soldier on. Force yourself to get outside and enjoy the beautiful place you are in. Try not to think about it all the time. Try not to let your bad mood spoil it for everyone else who is there.

On Monday we get the diagnostic scan. The baby is still there, but we are told it is only measuring 5 weeks and 6 days and the heartbeat is 96 beats per minute. Basically, the baby is more than a week smaller than it should be. The sonographer also told us that the heartbeat would preferably be over than 100. In closing, he said the pregnancy was viable at this time, but given the result no doubt another ultrasound will be needed in another week or two.

So the baby is small, with a slow heartbeat. The same sonographer gave us similar news last year with our heterotopic pregnancy, and that baby miscarried soon after. We don't leave with smiles on our faces. My husband says on the way to the car "We know how this played out last time, but I guess we just need to give the little trooper a chance."

We had a little more spotting over the next day, but for a week now I've had nothing. I've had not bleeding. I've also had no morning sickness or other symptoms that wouldn't be caused by the progesterone pessaries I have to use morning and night.

Our first appointment with the ob/gyn I chose for this pregnancy is coming up, so I haven't bothered following up with our fertility specialist about getting another scan. I have some hope - hey, maybe it will be fine - I really hope that it is. I also have some doubts.

Hospital days

Hospital days are never fun. They generally start with no food or drink, which for me is never a preferred way to start the day.

On Friday morning I thought a lot about the first time we were going in for a curette. I felt a lot like I did the first time, the suddenness and unexpected nature of the diagnosis were just like the first time. It was August 2009 - I remembered as I was being wheeled into theatre the anaesthetist was with me. Big tears were welling up in my eyes and began sliding down my cheeks. He looked at me and asked something along of the lines of "what's wrong? are you scared?" I told him I was sad. The anaesthetist had nothing to say to that. I also remembered when I woke up the first thing I did was start to cry. At least the nurses in recovery were a little more aware of why I might be crying.

Today I didn't want to cry so much. I'm not sure if that is healthy goal, however I knew that not being able to control my emotions in the setting of QFG day theatre was going to be very uncomfortable for a lot people, including myself. At QFG you wait for the short while before your surgery in a joint waiting room. I've waited in there before egg pick up, before 3 embryo transfers and now 2 curettes. It is a mixed bag of people, some are there for wrist surgery. A crying person would really stress everyone out.

On admission to the day theatre the nurse has to ask me all the questions again about how many times have I been pregnant - how many children - any live births - etc. Attempts to not cry fail at the first step. You see, I've already had to write all this down on the admission forms in the morning. I had to go through it with the new obstetrician yesterday. It's a horrible story and it is our life. I cover my face. Matt starts to give the answers. I pull it together and proceed with the blood pressure and pulse tests. The nurse says I'll benefit from having a good sleep, I deserve a good sleep. It takes me a while to realise she means, assisted by anaesthetic sleep.

Matt and I part ways - I'm going up to the open waiting room, he is going home to wait for the call to come and pick me up. Deep breathes. I must calm down. I am calming down. There is nothing to be done for it, it is over, I must deal with this. I can cope with this. This isn't the end of the world. Life goes on. Matt and I will go on. We will have more chances. I don't know what to do, but uncertainty is just a part of it for us. There will be other opportunities. Deep breathes. Be calm.

Before the surgery I am calm. I meet the anaesthetist, the doctor is there, I'm walking into the operating theatre. As per usual my veins are impossible to find. A jab here, a jab there, another jab and another, and finally I feel the anaesthetic taking hold. I'm breathing in the oxygen. I'm out.

I wake up in recovery. I don't feel too bad. I'm a little sore, but nothing unmanageable. It takes me about an hour from the time I realise I'm awake to being functional. They ring Matt to come in to get me. I get up and get dressed and happily chomp down my hospital sandwiches and ginger ale.

Warning - at this point I hit some fairly gross stuff - so tune out if you don't enjoy the gross bits.

When Matt gets there I've already been through the discharge process so we can head off straight away. I'm pretty slow on my feet as we make our way to the car. On the way home we decide to stop and rent some DVDs. We are in the video store for about 2 minutes when I realise I'm feeling wet around my crotch. I touch my pants and my fingers are covered in blood. I call out for Matt, I show him the fingers. He says holy crap. I've got to get out of here. Matt unlocks the car - I shuffle out and find a grocery bag to sit on in the car. Matt has quickly rented the videos we had in our hands. I tell him I'm not sure what has caused the overflow. I'm wearing a hospital issue surf board size pad. I wonder if it has had an absorbency problem.

In a flash we are home and I am shuffling inside with my grocery bag. I throw the bag in the bin and shuffle to the bathroom. I want to jump into the shower without leaking on the floor. In the end I have no choice but to get with my pants on. When I take them off a massive blood clot hits the shower floor. It is clogging the shower. The hospital issue surf board size pad had no chance of dealing with this! I'm try to pick it up. It is massive. It is the size of my hand and 1cm thick in parts. More, smaller clots are coming out. This is really disgusting and again, I need Matt's help. I ask Matt to bring me a zip lock bag for the clots - they are so big I'm wondering if they are the placenta. I ask Matt to pop them in the fridge until I can speak to the doctor. Poor Matt. This is so gross and he is fully taking it in his stride. When I ask him to put the clots in the fridge his face is a little grossed out. So I suggest they go in a non see-through bag.

It didn't take long and the heavy flow issue passed. I rang the obstetrician and she asked me to lie back down again for a half hour or so and then get up again and see if the issue repeats itself. It seems she expected these types of clots would have passed before I left the hospital, or have come out during the curette.

Matt pops back out to finish the things we were going to do on the way home and I rest up. The doctor rings me back and I tell her the bleeding has settled and there hasn't been any repeat of massive clots. When Matt gets home he takes my clothes and puts them in the wash.

All gross bits finished.

I feel a bit better after the curette. I'm still sad, but it seems manageable. Having a physical issue to deal with takes my mind off the mental side of it all. It is over.

Mission failure

Today I am recovering from a curette. This is the third time I've had this procedure, which is necessary after a partial miscarriage. I'm certainly a lot more philosophical about it today than I was on Wednesday, the day before the curette. 

Wednesday morning started like any other. I happily rolled out of bed preparing for work. After going to the loo I noticed a very small streak of pinkish, redish blood on the toilet paper. I immediately grab more paper and wiped again - nothing. I repeat this again, still nothing. 

I've had bleeding in every pregnancy. Every time doctors have told me bleeding happens in loads of pregnancies and that it is fine. This is smallest amount of bleeding, it is so tiny, I actually consider if I should even bother with telling Matt. I know the effect telling him will have.  

I have a shower and think about all the possibilities, I wonder if it is because I stopped the progesterone support on Monday, perhaps I need to start taking it again. I decide I will ring my fertility specialist's office, even though I know my doctor is on leave still. I'm hoping they will have someone on back up who can make a call on what I should do. I tell Matt about the spotting and tell him I'll ring the doctor and see if I can get a blood test or even better another ultrasound. As I'm leaving for work I tell Matt I'll call him once I've spoken to a doctor.

On the train to work I keep thinking about it. I was going to wait until I got to work to make some calls in private, but I just can't get it out of my mind. I decide to make some discreet calls on the train. My first call was to my fertility specialist and again, with my doctor on holidays it is hopeless. The receptionist suggests I ring my obstetrician. I ring the obstetrician, her receptionist initially recommends I speak with my fertility specialist - once she knows he is on leave she suggests I make an appointment with my GP to get a referral for an ultrasound. I ring my GP, she is on holidays too, however now she is in a GP super clinic so I make an appointment with another GP for 4.30pm. 

I ring Matt and tell him I'm going to make a sneaky appointment, before I have the ultrasound referral, so once I've seen the GP we can go straight to the ultrasound. 

My fertility specialist's receptionist rings me back, she has spoken to another specialist who said the bleed might be a reaction to going off the progesterone and that I can start taking them again. Personally I didn't really find this helpful. Then my obstetrician's office rings me back, the obstetrician has given me a referral for an ultrasound and has already made me a 1pm appointment with the Women's Diagnostic centre at the Mater. The receptionist is even going to take the referral up to Women's diagnostic for me, so I just go straight there. Awesome, this is super helpful.

I'm really impressed and relieved. This obstetrician is supposed to be the best. She is really hard to get in to see. I figure now that she has organised the ultrasound that she'll be on hand to review the results of the scan and will take me on, two weeks before my initial appointment, if I need any medical intervention at this point.

At 12.30 Matt comes to pick me up from work and we head to the Mater. I was genuinely thinking this is just another crazy pregnant lady scan. I'm 99% sure everything is fine. Maybe even more than that. Our last scan was only 11 days ago and it was perfect, bleeding in early pregnancy is normal - I've been told that soooooo many times.

As per usual for these scans I'm busting to pee. You need to drink 600ml of water the hour before the scan as it is easier to see the uterus with a full bladder - or something like that. The sonographer gets the scan underway with squirt of cool gel onto my tummy. This room has a screen at the end of the bed, so it is really easy for Matt and I both to see the scan. 

I can see where the baby is, the sonographer zooms in. It is different to my last two scans. I can see the baby, it looks still, completely still, no flicker, nothing. The sonographer pokes around a little bit more and then says, I don't think I can see the heartbeat. She asks when the last scan was and suggests it is best to do an internal scan to get a closer look. She sends me off to pee before the internal scan and in the toilet I start crying. I can't believe it. This was supposed to a reassuring scan, not a confirmation of the worst scan. I try to pull myself together and head back into the room. When Matt sees me he looks a little shocked, I must look bad, or maybe he still had some hope, I'm not sure.

The internal scan is no better. Definitely can't see the heartbeat. Baby measures 8 weeks, which marginally smaller than the last scan. The sonographer wants to bring the doctor in to be extra sure. The doctor is also certain. They both say they are sorry. When they leave room for me to redress I lose it. I just can't believe it. I'm growling a series of questions out loud. Why is it always that the baby stops developing almost immediately after our last scan? Why do we have almost 2 more weeks thinking everything is great? Why do we get further along than before, with an absolutely perfect, no signs of trouble pregnancy only to once again lose the baby? How many times can this happen to us? How much of this can we take? I finally say I don't even know what to do anymore.

Matt is more the quiet thoughtful type, so he says nothing. We are both gutted. 

To their credit the Women's Diagnostic unit is all kinds of awesome, unlike the ridiculous situation that occurred last time we had the same result in the Mt Gravatt Qld Xray. This time they bring all the paperwork to me in our room, so we don't have to go back out to the front counter and pay in a distressed state at reception. They recommend we head straight down to our obstetrician's office, that they will ring in advance and let them know the outcome.

When we get downstairs the obstetrician has already left for the day and the receptionist will have to reach her to find out what to do now. She doesn't think they will be able to fit me in as the obstetrician is fully booked and besides doesn't have any of my complex medical history. Again she suggests I ring my fertility specialist and find out who he has on call for him. I already know the answer is no one, that is the answer every time. She suggests Matt and I hang around the medical precinct for a while so she can try to sort something out with our fertility specialist. 

Matt and I head down to West End and have some lunch. I can't believe the obstetrician can't help me. I thought that she would, given that she'd arranged the ultrasound. I know I need a curette, I know this is a really common obstetrics procedure, but my obstetrician won't take me, my fertility specialist is holidays until Monday and I'm stuck ringing around like a beggar trying to get someone else to take me. I ask my fertility specialist if the doctor who did my last curette, because my specialist was on leave, can take me? I tell the obstetrician's receptionist that another doctor in their group did my first curette, can she take me? The receptionists start ringing around for me. 

The first offer from the fertility specialist is a Friday appointment at 4.30pm. I know I won't be able to get the curette on the same day, so it will probably be Monday before I am having the procedure. I accept it as it is the best that can be done. Great we have days of carrying around the dead baby, with the chance that it could start to fully miscarry (which is apparently very painful and has the risk of me hemorrhaging and losing lots of blood). 

Matt and I decide to head home as there is little chance we will be seeing anyone today. We are almost home when the obstetrician's receptionist rings me back having made an appointment for me with the newest obstetrician in their group. She can see me right now. We have to get over to Spring Hill. We head back to town and meet another doctor. I think she's a good fit for me because she is a part of the Queensland Fertility Group (where I get my fertility treatment) and rivercity obstetrics (where I've had my small amount of obstetrics).

The new specialist has to ask all the horrible questions about my gynecological history:

• How many pregnancies? 4
• How many live births? 0
• How many miscarriages? this is number 3
• What other problems? 2 ectopics - 0 fallopian tubes left and I had my gallbladder removed.

At this point 3 + 2 doesn't equal 4, so I explain the last pregnancy was heterotopic, so I had the pleasure of ectopic and miscarriage. Once again, the new specialist tells me how rare heterotopic pregnancy is and reflects on what a tragic year 2011 was for us. 

Thankfully she has taken the liberty of already making a surgery time for us. At noon on Thursday at the same day specialist surgery most of the QFG stuff is done. She steps me through the risks of the procedure. She is very sympathetic. I'm really grateful she would take us on. 

Matt and I head back to the car. I tell him I'm glad we got with in with someone, I have a little moan about how stupidly hard it has all been. I then say, I'm not looking forward to having to ring the family. Matt says, neither am I. 

More ultrasounds more tears

My first impression of the alternative specialist I am booked into is good. He is really understanding of everything that has been going on and helps me feel at ease.

He goes through everything that has been chased down by his receptionist and my fertility specialist's office, tracking back through all the medical incidents of the past few weeks. Dates, dates, dates. We agree the baby should be bigger than the 6 weeks it measured at the ultrasound. He then adds, the heartbeat is a little slower than he would liked. He asks if he can do an in room scan.

I'm across the hall in a foreign ultrasound room. It is fancy! There is a big TV high on the wall, so it is easy to see the screen when reclined in the bed. Matt is with me, standing next to the bed. I'm looking at the TV and even though the doctor isn't even scanning I'm looking at the big screen thinking I'm going to be looking at the baby up there and it might be dead. Oh crap, this is going to be hard. I'm already getting choked up.

I am just holding it together when the doctor comes in. He is quickly getting on with the scan, another internal scan. He is poking around I can't see anything of note on the screen, then the doctor starts talking me through it. There is the gestation sack, there is the baby, there is no apparent heart beat. The baby measures 6 weeks. He says he is sorry, but there doesn't appear to be a heart beat. He leaves me to get dressed and come back across the hallway to the other office. I am crying as I get redressed. Matt is angry. He says he is just sick of it.

The specialist explains that the in-room scan is not as good as the diagnostic ulstrasound, and although it doesn't look good, he would hate to recommend a curette (to clean out the uterus) without getting a diagnostic scan done. He refers me to have another scan done. I feel it is all over, but I'm hanging onto the little bit of hope, perhaps the diagnostic scan will miraculously see an 8 week old fetus with a strong, fast heart beat.

The next day Matt and I again roll into an x-ray centre. In the diagnostic ultrasound the sonographer says the baby is still the same size as our earlier scan (which was nearly a week ago) and there is no longer a heartbeat. Even when you are expecting it, it is horrible. I am weeping on the bed. I want to have a private and dignified grief, but here I am stuck with a stranger in a clinical little room and I can't contain my sadness. And I know I have to pull it together enough to get up and go out and pay (I had asked if I could pay before I went in, given the expected result, but apparently this is not possible). We ditched waiting for the scan films - all those baby ultrasounds of babies just look freaky to me these days, let alone knowing it is your dead baby.

As this was the mostly expected outcome, the alternative fertility specialist had tentatively booked me in for a curette on Friday. A curette to remove the products of conception (this is now the medical term for what was only days ago called the baby). In just a couple of phone calls the procedure is confirmed.

I don't understand my own thinking through all of this. In part I'm relieved it is almost all over. This has been such an incredibly traumatic experience and if the pregnancy did continue, I don't know when, if ever, I would have stopped worrying about the damage all the drugs I had to take early on might have caused. In part, the much larger part, I'm devastated. Why has it been so hard? Why have we had so many pregnancies, but no babies? Why all the loss?

For certain, the whole of me is worn thin. I can't fathom going back to work as it has been for the past few years.

Something's got to give.