My Delayed Ectopic Pregnancy Diagnosis

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For almost a year I artfully dodged questions like “So, when are you going to have another baby?” while trying, unsuccessfully, to have another baby. Eventually, as we were coming to terms with the idea that we may never have a second child, I became pregnant.

The morning sickness came in waves, much like it did with my firstborn. It brought with it reassurances that the pregnancy was developing as it should.

Around the nine-week mark, I noticed that my morning sickness symptoms were becoming less bothersome. I tried not to think much of it until the bleeding started during a lunchtime yoga class at work.

I bolted from work and called my family doctor.

The next few days were a blur. My HCG levels (the hormone produced during pregnancy) continued to rise, though not as quickly as you would expect with a viable pregnancy. I continued to bleed.

My doctor ordered an urgent ultrasound. I was a mess of emotions and stress. My fingers and eyes were tired from the late-night googling sessions “Can you have a healthy baby if you are bleeding?” “Can a pregnancy be viable if HCG levels are slow to rise?”.

My ultrasound technician was an unsmiling, sharp-edged woman. Before she began the test she asked me why I was having the ultrasound. I told her about my bleeding.

This next part will stay with me for the rest of my life.

She said, “Do you lift your other child?”

Well of course I lifted my toddler. I could sense what she was sniffing at, and I did not appreciate it.

“Well, Mrs. Zeltzer, THAT is why you are bleeding” she barked at me.

Now let’s get a few things straight:

I made a mental note to get her fired.

Later that same day my doctor called to report that they could not find my pregnancy. Not in my uterus, not in my fallopian tubes, not in my ovaries. It was a horrifying game of hide and seek.

Days turned into weeks, and my HCG levels continued to rise, albeit abnormally slowly. My family doctor and I were baffled. Eventually, he referred me to the Early Pregnancy Clinic at the hospital to be examined by a team of specialists.

My husband and I arrived at this appointment feeling anxious, which in our marriage means we cracked all the awkward and inappropriate hospital jokes at a too-loud volume. The team conducted their intake assessment and sent me for a repeat ultrasound.

Ultrasound technicians are the people you do not want to play poker with. I worked hard to interpret every micromovement of her face, predicting what she might be seeing, but she revealed nothing. In contrast to the previous ultrasound tech, this one exuded a warm and caring silence.

I met with the obstetrician next, who simply and breathlessly said “Lisa, we need to talk.”

What is an ectopic pregnancy?

She told me that based on my ultrasound she would have expected me to appear “much sicker”. She explained that the pregnancy was ectopic, which is when the pregnancy implants itself outside of the uterus, and in my case, in the right fallopian tube. Medication can sometimes be used to end an ectopic pregnancy, but my tube was already rupturing, and a ruptured fallopian tube could lead to life-threatening internal bleeding. I would need immediate life-saving surgery.

My husband called our parents to tell them about the loss of a pregnancy they hadn’t known about in the first place.

I remember this day with absolute clarity. How I fought back tears as I called my best friend to wish her a happy birthday from the surgical waiting room. How I regretted eating that Tim’s chocolate chip muffin that would have to work its way through my system before I could have anesthesia. How this ultrasound technician had gently draped a blanket across my legs, and how this simple gesture of kindness felt significant.

Fortunately, the surgery was a success. The doctor managed to save my affected tube and remove several adhesions from my previous c-section, as well as a large ovarian cyst.

The next few weeks were a balancing act of being strong and present for my toddler and mourning the loss of my pregnancy. An ectopic pregnancy, I learned, can never become a viable pregnancy. I struggled to understand how I could miss something I never really had in the first place.

I cried. A lot. Privately.

At the time, simply seeing pregnant women and healthy babies was triggering. I felt petty for being resentful of others, especially since I already had one wonderful, healthy child. I needed some room to breathe and process and grieve, and sometimes forget.

Knowing that repeat ectopic pregnancies were common, I was hesitant to try again. So when I had a positive pregnancy test a few months later, I was immediately filled with fear and anxiety.

Forty weeks (and possibly as many ultrasounds) later, I gave birth to a beautiful and fierce baby girl and our family was complete. And still, every year on the anniversary of my surgery, I eat a chocolate chip muffin and take a moment alone to think about the pregnancy that was never meant to be.

Like many women, I never announced my pregnancy, and that made it harder to announce my loss. So I didn’t. I rushed back to work to avoid explaining why I was absent. I hesitated before reporting that ignorant ultrasound technician because it required me to put words to my loss (but I did, and she got canned).

Now, years later, when I decided to write my story, I still hesitated to use my name.

We are conditioned to keep pregnancy loss to ourselves. This veil of silence prevents us from turning to our usual networks for advice, and it leaves us feeling alone with our grief.

After many muffin-binging anniversaries had passed, I started to process my pregnancy loss with a clearer head. I reflected on how my own silence was perpetuating the exact culture that I fell victim to. I began to feel an overwhelming sense of responsibility to talk about my experience, and in turn, I found that other women began to share their experiences with me.

So when a friend who had heard about my pregnancy loss reached out to describe her early symptoms, I confirmed that it sounded like an ectopic pregnancy. She was able to advocate for herself and get the necessary treatment before it became an emergency.

One in 50 pregnancies is ectopic, and up to 20 percent of known pregnancies end in miscarriage. This culture of silence around pregnancy loss isolates women, and in cases like mine, it can lead to dangerous delays in treatment.

To echo the words of my obstetrician, we need to talk.