back, and finally a little more okay

Hey friends,

I know it’s been a while. 

I've missed you, truly, and have been trying to find the right moment to come back.

The truth is that the last couple of months have continued to be a roller coaster, and I wasn’t ready to write until I made it through to the other side.

I think I'm finally there, so this one’s another personal issue before we get back to regularly scheduled programming. Pour yourself something cold, and let's get into it.

As I mentioned in a previous issue, I found out in April that I miscarried. 

I chose to go the medication route (excruciatingly painful) and did pass tissue…but a follow-up ultrasound confirmed I hadn't passed all of it.

Our options were to:

 My husband Andrew and I did some thinking and research.

Waiting is free and lowest-risk, but if I didn't pass the rest naturally, I'd be looking at a rising risk of sepsis. I'd already stopped bleeding entirely the week before, so I wasn't hopeful.

Medication is cheap and had worked last time…but not entirely. And it was brutal.

The D&C is fast, but it's still surgery with general anesthesia. And more expensive.

And friends…
Here’s where our political and health system reared its ugly, dysfunctional, dickwad of a head.

I was in the middle of this decision when a federal appeals court blocked the mailing of mifepristone, the drug that blocks the progesterone needed to sustain a pregnancy. It’s usually the first pill taken for an abortion.

The medication I was prescribed was misoprostol, which is what causes your uterus to empty (painfully, I might add). It's often the second step in an abortion, but it's also used on its own for miscarriages.

Yes, the Supreme Court temporarily restored access to mifepristone and technically, it wasn't even the drug I needed.

But it added a whole new layer of anxiety while I was trying to make an already painful decision.

I also currently live in Kansas City on the Missouri side. 

In 2024, Missouri voters approved a ballot to add abortion rights into the state’s constitution.

However, Republican lawmakers were advancing another ballot to repeal the right to an abortion at that time. I'd specifically picked an OB on the Kansas side, ten minutes across the state line, just in case.

The first time I picked up misoprostol, I drove to a Walgreens on the Kansas side rather than my usual one. I'd heard Missouri lawmakers were trying to create a registry of pregnant women. Probably nothing would happen at my regular pharmacy…but I wasn't taking any chances.

All of this mental gymnastics about where to pick up my pills was the last thing I wanted to be thinking about while grieving.

As freelancers, Andrew and I have insurance through the marketplace. When I first got pregnant, I looked into updating my plan.

For those who don't know, you can only get or change health insurance during open enrollment or for a "qualifying life event."

These include:

I figured the “changes in household” would apply to me. After all, I was going to have a child!

Unfortunately, these household changes only apply if:

Getting pregnant does not count. Only after this child comes out of me does it count towards a life changing event. I guess a miscarriage doesn’t count either.

Hmmm. But I thought life begins at conception…?

I digress.

Andrew and I pay about $1,000 per month. My deductible is $8,000. Once I hit that, insurance covers 50% co-insurance until I hit my out-of-pocket max of $10,500.

I called Blue Cross Blue Shield to find out what the D&C would cost at the two places my OB operates: a surgery center or the hospital where she delivers.

The bad news:
The surgery center is out of network. About $3K out of pocket, and none of it would count toward my deductible.

The worse news:
The hospital is in-network! However…it would be $6800 out of pocket. But hey, at least it'd count toward the deductible.

To recap:
I pay $6K a year for insurance, and still have to pay $7K for a surgery I need.

(Fun fact: OBs are considered specialists, so all my ultrasounds thus far were also out of pocket.)

What a fun system!

I went with the medication route.
I can endure a few hours of pain and two weeks of bleeding to save $7K.

I drove to the Kansas Walgreens and picked up the meds. We were traveling that weekend, so I planned to take it on Monday.

Luckily (?), I woke up in the middle of the night on Saturday. Something felt weird. But familiar.

Shit.

I ran to the bathroom, and found my underwear and shorts drenched in blood. I was passing more tissue.

When we got back Monday, I wasn't taking any chances. I did the medication again. Less painful this time, but more bleeding and tissue. I felt cautiously optimistic about my follow-up ultrasound.

Obviously…it didn't work out that way.

At my appointment at the end of May, my OB gently told me there was still 18mm of tissue left. It would have to come out surgically.

I cried in the car. Partly out of sadness that this was dragging on. Partly out of frustration.

One of the downsides of people not talking about miscarriages is that no one realizes how common they are. So we feel alone.

Another is that we don't know what the journey could actually look like.
I had no idea a miscarriage could mean two rounds of medication and a D&C.

Andrew and I decided to do the D&C at the hospital. $4K more, but at least it'd count toward the deductible. And worst-case, emergency costs would be in-network.

The surgery was the first Friday of June.
Everything went smoothly. The doctor removed the remaining tissue, cauterized the area, and stitched up my cervix.

I was up and about the next day, although slow and sore. Sunday was rougher. Not cramps, more like…well, like a wound with stitches inside me.

I bled for about another week. By that point, I’d been bleeding for almost two months straight.

It's really been this week, more than two months after finding out I'd miscarried, that I finally feel normal. I'm working out again. I'm no longer bleeding. I don't have that constant, lingering anxiety that the miscarriage might not be done.

Okay, deep breath.

I know this was a lot.
If you made it this far, thank you.

To be clear, my goal isn’t sympathy. I just didn't know any of this could be part of a pregnancy journey, and I wish more people talked about it. After all, 1 in 4-5 pregnancies ends in miscarriage.

Not 4-5 women.
4-5 pregnancies. 

My goal isn't to scare you either!

I just hope that by sharing my story, more people will feel less alone and a little more prepared. Whether it's for your own pregnancy journey or for supporting someone through theirs.

I don't want this newsletter to live in the heavy forever!

There's wine to drink, women to celebrate, and so much more I want to share with you.

Now that I feel like I finally have my body back, and that mental weight off my shoulders, I'm excited to be back in your inbox regularly in a couple of weeks.

Until then, go enjoy a glass of something refreshing (perhaps a Vinho Verde or a chilled Beajolais).

See you soon,