My Fallopian Tube Burst Due To An Ectopic Pregnancy. An ER Doctor Sent Me Home.

"I had been bleeding internally for five days before anyone figured it out."
The author scrubbed in for surgery.
The author scrubbed in for surgery.
Photo Courtesy of Sarah Nolan

I found out I was pregnant on Mother’s Day 2022. Six days after Politico leaked Justice Samuel Alito’s draft decision on overturning Roe v. Wade.

When I began having pain in my lower abdomen, I thought I had a urinary tract infection. My sample revealed something else. The urgent care doctor told me I was “like, super pregnant” — her exact words. I cried as she gave me instructions for next steps.

The front desk secretary brought me one of the balloons her own daughters had given her. It had the words “Best MOM Ever” displayed on a pastel rainbow background. She handed it to me and said congratulations. I thanked her for something I did not want.

I held hands with my husband, Andrew, who was as shocked as I was. We tried to be polite as the doctor asked us how long we’d been together. We told her since high school. She said it was about time we had kids.

Everyone around us was thrilled. I was a great anecdote. The young woman who found out she was pregnant on Mother’s Day. I couldn’t believe that even with my IUD, with the surprise and my lack of enthusiasm, not one of them seemed to register that I was devastated.

The over-happy doctor told me my due date was Dec. 28.

I’ve never felt so alone.

At 26, I’m living in Los Angeles. I’m about halfway through a Ph.D. program in English literature, trying to get my dissertation topic approved, so I can write about the politics of gendered embodiment in science fiction. As the word “dystopia” is bandied about by anyone with a smartphone, I find myself much too close to the intersection between my research and personal experience.

Pregnancy was not in the short-term plan; my IUD — an intrauterine device — was supposed to have over 99% effectiveness within 3-5 years. But statistics don’t seem to matter when you become the less-than-1%.

When we got home, I tried on excitement to see if it could fit. I imagined what it would be like to have a baby in less than a year. I thought about where to put the crib in our apartment. We’d always planned to move closer to home when we got pregnant, but neither of us felt ready to leave LA yet. I wondered how our cats would react to a baby. I imagined telling our families.

Andrew’s mom and sister would be overjoyed; the two of them wear motherhood better than anyone else. My own family is big and chaotic; they would welcome a baby with fanfare, like we all welcomed my twin nieces a year ago.

And the best, the brightest vision, was a Christmas spent in our small apartment, both of our families in attendance, and me either too swollen to move, or holding a little winter baby, so delicate it would command the reverence reserved for a representative Christ child.

The day, I spent attempting happiness.

The night snuffed it out.

I woke up in the dark, engulfed in the certainty that the life Andrew and I had built — our friendships, our careers, our financial independence, our future plans — was being swallowed up.

I couldn’t have a baby.

I told Andrew in the morning. His relief was apparent, making it clear how he wanted this to turn out. Together, we willed the pregnancy to vanish.

The next day, I made a last-minute OB-GYN appointment. Tests confirmed a pregnancy, but the ultrasound revealed nothing inside my uterus. Given the date of my last period, the doctor told me, there was probably something growing outside of it.

I was sent straight to the emergency room. A missed ectopic pregnancy will grow too large for the fallopian tube, which is not meant to hold anything larger than an unfertilized egg. The tube will burst. Blood will seep into the abdominal cavity. The patient will double over in pain and begin to bleed to death.

I took my time walking back to the car and driving to the ER, afraid that any undue jostling would bust that sucker open. The wrong step and it all comes down.

It was odd, being in the hospital without either of my parents for the first time. When I was a kid, my dad was a cardiologist, and my family visited him at his office all the time. After he was diagnosed with leukemia, we spent seven months visiting him in the restricted oncology ward. He died when I was 17. Waiting in the ER, I itched to call him and tell him I was being poked with needles.

That night, I was subjected to an agonizing transvaginal scope. The tech moved the wand around inside me with a terrible certainty, not pausing or even talking to me. It went on much longer than I expected, and I stared at the print of a tree branch that’d been laid over the ceiling light, convincing myself it was almost over.

The laborist on-call came hours later to discuss my test results. He had the largest eyebrows I’d ever seen, like gray feathers pasted above his eyes. He asked what had brought us in, so I began to run through it all again.

I told him we’d had a positive pregnancy test, and he stopped me to say, “I assume this was a home pregnancy test?” I said no, that I had an IUD and didn’t plan to be or want to be pregnant, that I thought it was a UTI. That the doctors at the OB-GYN were certain it was ectopic.

He said, “OK, let me take a look at your chart here.” He brought the paper he was already holding to eye-level, glanced over it.

“OK,” he said, “I’ve got your levels on here, and it looks like we’re going to be sending you home. You should come back on Thursday, when I will be working again, so I can see you and we can determine the kind of pregnancy. If it is ectopic, we should be able to give you some methotrexate and you’ll pass it.”

“And if it isn’t ectopic and I don’t want it? The treatment will be the same?”

He looked up, seeming to see me for the first time and replied, “The treatment will be the same, yes.”

We thanked him despite not feeling particularly enlightened or understood. He took his eyebrows elsewhere. We made a plan to come back on Wednesday night to avoid him.

The balloon from urgent care.
The balloon from urgent care.
Photo Courtesy of Sarah Nolan

On Wednesday, I felt normal — I had no pain, and the promise of answers in the evening gave me some confidence. I went shopping to distract myself. Standing in an aisle at Target, I started to feel wrong. My head began to float, my hands shook, my stomach dropped. I drove home, and Andrew brought me our biggest bowl to throw up in. I began having cramps — not terrible, but unsettling, given the situation. We decided to head back to the ER.

We waited in a triage room. The physician assistant assigned to us came in only twice in six hours. Around 8 p.m., a nurse poked her head in and informed me I was being moved to a room. Feeling frayed, Andrew and I ventured deeper into the hospital.

We waited only briefly before the doctor, a woman with very dark skin and an ageless face, came in to greet us. She informed us that after seeing my ultrasound and looking at test results, they had determined that the pregnancy was indeed ectopic. She clicked around on the computer, grabbing an image from the transvaginal ultrasound. She pointed to the screen: “This is your uterus, right here. Here’s your intestine.” She paused to make sure we understood.

“This,” she said, circling a large black area with her finger, “is fluid that shouldn’t be here. This is blood. There’s a lot of it in the wrong place, which is how we know that your fallopian tube has ruptured.”

The doctor came to sit next to me. She took my hand. “These ultrasounds are nearly identical to the ones you had two days ago. I’m going to be honest, I don’t know how anyone sent you home after seeing this.”

She told me that based on the amount of blood in my abdomen, the tube ruptured days ago. The pain I felt the day before Mother’s Day was not because a pregnancy was causing strain on my bladder. It was because my left fallopian tube had ripped open.

I had been bleeding internally for five days before anyone figured it out.

Dr. Eyebrows, then, had sent me home despite clear medical evidence that my life was in danger. Despite the very real likelihood that I could have died between my two ER visits. I suspected he sent me home to create time, to delay further procedure, just in case the pregnancy that I did not want turned out to be viable.

In looking for a baby, he did not see me.

I got through the surgery without complications. It was laparoscopic, meaning the time to heal and scarring would be minimal. My throat hurt from being intubated, but the meds kept most of the pain away. I got to go home less than 24 hours from my arrival the evening before.

Andrew cared for me for the next few days. He lifted me in and out of bed to go to the bathroom. He went to the store over and over as my appetite changed. He walked around the apartment complex with me and waited every time I had to stop and sit down on the low walls and benches.

At my check-up, the doctor told me she couldn’t believe I had surgery less than two weeks ago. She removed my IUD; seeing it in her hand was an enormous relief. So long, you defective bitch. She placed a Nexplanon in my arm. She told me she’s placed hundreds of these and had never seen anyone get pregnant.

In the limbo of my surgery, the world seemed to move on without me. I missed a trip to Yosemite with Andrew’s family. I missed beach days and movie nights and drinks. My friends stopped by with flowers and baked goods. My mom sent a huge bouquet. My family FaceTimed me over and over so I could see my nieces, and I spent a lot of time pretending to eat the crackers they tried to feed me through the phone.

In the days after my surgery, it seemed like everyone was pregnant. A woman in my department is due Dec. 28 — the same day I was supposed to be. A friend from high school announced she’s having a girl. My cousin — who has also had an ectopic pregnancy — announced her second child.

I didn’t want a baby. I still feel like I lost one.

I used to rationalize my conservative upbringing and pro-choice ideology by telling people that although I didn’t think I’d ever get an abortion myself, I would never remove that option for someone else. Someone who needed it in a way I didn’t.

I had a super-effective form of birth control, a partner who loved me above anyone else, a steady income, health insurance, a network of siblings, parents and in-laws who were already enthusiastic aunts and uncles and grandparents. I thought I would never have a reason to hesitate.

On my fourth wedding anniversary, the decision is announced — Roe v. Wade was overruled, struck down in an argument of “faulty historical analysis” and the claim that the Constitution “does not confer a right to abortion.”

I read stories like mine. I read stories that are much worse. About abusive relationships. People who don’t have access to contraceptives. A 10-year-old who was raped and refused an abortion in Ohio. People who were raped by men they knew, by men they didn’t. Ectopic pregnancies that were left too long because abortion pills are inaccessible, and miscarriages that turned septic because without assurances for sexual assault reporters, admitting to a pregnancy can be a life-threatening action. Without sex education, without widespread contraceptive access, without medical care, without parents who are open about sex, preventing a pregnancy is incredibly difficult. Knowing how to respond to a pregnancy is even harder.

Today, you can hardly tell anything happened to me. I have some scarring in my belly button, and two pink dots to the right and left. I’ve returned to my research, to my writing, my running, my social life. But the malaise lingers.

Now more than ever, I understand that a womb can be a terrible burden. That there will always be those who will only see me in terms of reproduction.

After the surgery, so many people checked in. So many people were kind and concerned. So many people wanted to know if this would affect my ability to get pregnant again. I reassured them that it won’t be an issue. I still have one fallopian tube, a small connection to my visions of a future with children.

A small connection I’ve never been so tempted to sever.

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