I’m at a conference and my uterus is trying to kill me, I text a friend. The bleeding is heavier than my periods usually are and the cramps have me doubled over in pain. I can’t concentrate on fundraising strategies and can barely stomach a few bites of the scrumptious parfait that’s served for dessert.
I’ve never gotten serious cramps and, since having an IUD inserted, I have barely gotten my period at all, so this is a new and unsettling experience. Is this what my friends have been complaining about since we were 13? I wonder. How can anyone get up and go to work and live through this pain?
After nearly two weeks, the period and intense cramps still haven’t subsided and I make an appointment with my OB-GYN for the following week. The receptionist asks me if my issue is an emergency and I say no. I think I just have a period that will never end. I assume it will be gone by the appointment.
A few days before my appointment, I feel fine when I leave home in the morning, or as fine as I’ve felt in the past few weeks, but by the time I get to work half an hour later, I’m nauseous and lightheaded. I decide I’ll get some work done and leave early. I’m on the phone when everything starts to spin and my vision goes blurry. I excuse myself from the call and go into my boss’ empty office to lie down for a minute. Suddenly my legs go weak and I fall, my head narrowly missing the corner of the desk.
I think I pass out for a few seconds and when I come to, I have to rush to the bathroom to vomit. I go home and rest, but every time I try to get up, I get dizzy and have to sit back down. The world is a blur. I think it’s just a virus or something on top of the merciless cramps. My body feels like it’s dying ― I’m sore and weak with severe pain pulsating through me.
I’ve had a Mirena intrauterine device (IUD) inserted for three years without any issues. It’s convenient not to have to take a pill every day and IUDs are one of the most (if not the most) effective forms of birth control on the market. The thought occurs to me that something could be wrong with my IUD, but the pain fluctuates in intensity and I figure that if the IUD has somehow come loose and is puncturing my uterine walls, the pain would be constant.
The OB-GYN tells me that if there’s heavy bleeding with an IUD they have to test for pregnancy, just to be sure. That’s extremely rare, though, she says, and the test is just a precaution.
“One of the residents tells me that an ectopic pregnancy, which means the fertilized egg has attached somewhere other than inside the uterus, is 'a ticking time bomb.' They don’t yet know that it’s already gone off.”
I test positive for pregnancy — My first patient who got pregnant with an IUD! she says — but, she tells me, the bleeding isn’t good. I may have already miscarried and I’ll have to have an ultrasound to see if the fetus is viable, but the receptionist tells me they’re scheduling eight weeks out. The thought of not knowing what’s going on in my body for two months, enduring this debilitating pain even longer, makes me cry right there at the front desk and the doctor promises to get me in as soon as possible.
I call my fiancé, Dylan, from the parking garage, which I can’t figure out how to exit as I drive in circles, sobbing and hysterical. As always, he rationalizes and calms me down. “It’ll be OK,” he says. I’m at work the next day when I get a phone call that the doctor’s office can fit me in that morning. My car’s in the shop so Dylan has to give me a ride. I have my dog with me, as I often do at work, so he takes her to the park while I wait.
The technician can’t tell what’s going on in my ultrasound so she calls in a doctor, who then calls in another. They’re crowded around me, trying to decipher the clouded mess on the screen. It feels like a “Far Side” cartoon. It takes nearly half an hour of them prodding me and consulting each other before they decide that the fetus is in my left fallopian tube and it’s too late for medication. I need surgery today. One of the residents tells me that an ectopic pregnancy, which means the fertilized egg has attached somewhere other than inside the uterus, is “a ticking time bomb.” They don’t yet know that it’s already gone off.
Dylan drops the dog off at a friend’s and comes to sit by my side and watch reruns of “The Daily Show” and “South Park” with me on the tiny screen in my ER room. They hook me up to an IV because I can’t eat or drink before surgery. My mouth is dry and ashy. Nurses and residents keep coming in to check on me and bring me blankets. They ask if they can do anything more for me, and finally, I snap that unless they can get me a glass of water or into surgery right away, they can stop asking. I have enough blankets.
A doctor periodically comes in to explain that an elderly patient is the top priority right now but they’ll get me in as soon as they’re done with him. I wait for 13 hours before they finally wheel me into surgery at midnight. Dylan drinks bad hospital cafeteria coffee to keep himself awake while he waits. It’s nearly 5 a.m. by the time I wake up from the procedure and he’s right there waiting for me with a ginger ale in hand.
They remove my left fallopian tube and tell me that it won’t significantly impact my ability to get pregnant in the future. Before surgery, I had to sign a waiver giving permission to remove an ovary if they needed to, which, fortunately, they didn’t.
I’m at home the day after surgery, recovering on the couch and watching bad TV, when the surgeon calls to apologize. They didn’t realize that my fallopian tube had already ruptured and that blood was pouring into my stomach, making me nauseous. The massive blood loss was what was making me dizzy. They caught it just in time, he says. A tubal pregnancy and ruptured fallopian tube are life-threatening. I was lucky, he says. Ectopic pregnancies are the leading cause of maternal deaths in the first trimester. Between 1980 and 2007, ectopic pregnancies killed 876 women in the U.S. Not taking immediate action, as I failed to do, can result in death.
The surgeon admits that they should have rushed me into the operating room right away and says that this is the problem with pain scales. I told them I wasn’t in much pain, he says accusatorily, as if I’m to blame for not complaining more. I wasn’t in much pain at that moment, compared with the past few weeks. The excruciating pain had normalized somewhat; I was used to it by then. He tells me he’d thought that anyone with a ruptured fallopian tube and that much bleeding would be on the floor in agony. As if he knows the pain a woman can bear.
“I can’t explain why I feel so empty, so lost. I didn’t even want a baby and might not have kept it if I had the choice, which I didn’t. And yet, something inside me feels missing.”
After surgery, I can’t move much and every time I turn, the pain in my stomach surges. I have only three small scars on my hips and belly button, which is scarred and hard for weeks, but my insides feel all twisted up. A nurse points out to me that they were considerate enough to move the incision up on my left hip to keep my tattoo of the Hand of Fatima intact.
I’m not allowed rigorous exercise for at least a month, which means no snowboarding or hockey games. No sex. Even if I was allowed to do these things, I don’t feel up for it. I’m always tired and feel completely drained. I stay on the couch or curl up in the recliner in front of our wood stove most of the time. The physical pain I can handle — as the surgeon said, I have an incredibly high tolerance for pain — but the emotional pain incapacitates me.
I can’t explain why I feel so empty, so lost. I didn’t even want a baby and might not have kept it if I had the choice, which I didn’t. And yet, something inside me feels missing. Depression hits me hard. I can barely bring myself to leave the house for weeks. I feel a loss I can’t explain.
Bills recently introduced in states such as Georgia, Ohio and Alabama prevent doctors from performing necessary surgery in the case of an ectopic pregnancy, threatening the life of the mother, and could even result in a criminal investigation. These bills also prevent such necessary surgery from being covered by insurance. And, despite what a sponsor of the Ohio bill might think, “reimplanting” the fetus in the uterus is definitely not a thing.
My life was in danger due to an ectopic pregnancy and I can’t imagine what might have happened if I wasn’t able to access or afford that surgery. Luckily, I was able to get the care I needed, and though it was extremely physically and emotionally painful, I was able to heal and can even have children in the future, should I choose to.
I am not against Mirena or IUDs in general, but I want women to know of the risk, to be able to identify the symptoms much sooner than I did and to get the care they need to save their lives. IUDs are billed as over 99% effective, but that less than 1% is someone, like me, whose life may be in danger without her knowing it.
Erika Nichols-Frazer is a writer who works for the Children’s Literacy Foundation. She has an MFA in fiction from the Bennington Writing Seminars. Her work has appeared or is forthcoming in OC87 Recovery Diaries, Runaway Parade, Please Do Not Remove: A Collection Celebrating Literature and Libraries, and elsewhere. She lives in Vermont with her husband, dogs, cat and chickens.