The pain of giving birth is always worth it when we get to hold our babies for the first time. But what if you have to let your baby go and feel the extreme pain altogether? That’s what I have gone through – a painful ectopic pregnancy; not just once but twice.
Motherhood is a painful, stressful, and dreadful experience. The only thing that makes everything balanced is the deep happiness that we enjoy with our children. However, as we know it, not every pregnancy has a happy ending. Miscarriage, complications, and ectopic pregnancy can happen.
What is an ectopic pregnancy?
Ectopic pregnancy means the baby or embryo is implanted outside of the uterus. The woman’s uterus is the only area where the embryo can survive to full term. Most ectopic pregnancies occur in the fallopian tube; however, there are some that are also implanted in the ovary, cervix, or the abdomen.
Wherever the baby is situated will eventually make that area burst as it is not meant to nurture and accommodate the growing fetus.
Who is at risk for this pregnancy?
Any woman at child-bearing age can have an ectopic pregnancy but there are risk factors as well.
- having fertility issues
- taking ovulation medications
- pelvic inflammatory disease
- previous tubal surgery
- previous ectopic pregnancy
- cigarette smoking
- previous pelvic surgery
Why can’t an ectopic pregnancy be moved?
Sad to say that even with all the advanced technology we have at this modern age, there is no medical technology that can move a developing embryo from one area to the uterus.
What if there was a way?
Every mother would probably take the risk to try and save the baby if there was a way even how expensive it is. I know I would have during my second ectopic pregnancy since the baby had a normal heartbeat and was detected before it ruptured.
Where is ectopic pregnancy pain located?
The pain would likely be located where the baby is growing. During my first ectopic pregnancy, I first had a sharp pain on my lower right back. Positioning did not help. With my second, I did not have any back pain but I definitely had discomfort on the side where my existing tube is located.
Ectopic pregnancy isn’t very painful when the tube is still intact. When it ruptures, that’s when heavy bleeding may occur together with the worst pain that you could ever imagine. I lost two litres of blood and have to undergo emergency surgery during my first ectopic.
When does it happen?
An ectopic pregnancy happens right when the embryo is implanted in the wrong area, for example, the fallopian tube. However, at that point, you won’t know or feel anything just yet.
Around 5-8 weeks signs usually surface hence you will seek a doctor’s check-up. With my first, I did not have a chance to be seen by the doctor as it was too late. It ruptured the early morning that I was planning to go to the doctor.
The second one was different since I was already watchful for signs due to my anxiety. 10% of women who had a previous ectopic pregnancy will have another one. I still did not lose hope, yet it ended up being another faulty one. You can only imagine how heartbreaking and stressful it was.
What would HCG levels be in ectopic pregnancy?
Others knew that their baby isn’t thriving because of the low HCG levels. Some reported it to be “still a faint line after couple weeks”.
With both of my cases, they were dark lines and my HCG level was normal. It made me hopeful both times.
However, a low HCG level is not enough to diagnose an ectopic pregnancy. Doctors only conclude it to be one after a confirmation ultrasound. If you have low-rising HCG levels and faint lines, it does not always mean that you are having an ectopic gestation.
Other reasons for low HCG levels:
- too early or you’re not very far along in the pregnancy
- you are further along in your pregnancy
- you’re miscarrying
What week would you notice an ectopic pregnancy?
An ectopic pregnancy can be known in as early as 5 weeks to 14 weeks. With my first, I was on my 8th week when my tube ruptured, and the second was confirmed at around 7th week. If you suspect that your pregnancy isn’t going well, please go to your doctor as early as you can.
Long wait times for the ultrasound schedule can delay diagnosis and is dangerous for you. If your gut tells you that there is something wrong, bring it up to your doctor and request an ultrasound ASAP. This is what I did with my second as they refused to schedule me on a sooner date. I told them that I could not wait on that day because I was that far along when my tube ruptured a year and a half ago.
Good thing I insisted, otherwise I would end up being on the verge of death again. As soon as they knew it was an ectopic, they sent me to the ER right away and had the operation done the following day.
Why need Methotrexate for ectopic pregnancy?
Some ectopics are treated with Methotrexate. It is a drug that stops cell division. An embryo undergoes rapid cell division. Methotrexate prevents it from doing so since the goal is to eliminate the growing baby that is implanted in the wrong area.
My Obstetrician explained that she could not give me Methotrexate because I was further along and my baby was otherwise “healthy” or viable. It means that if my baby would have been implanted in the uterus, he/she will grow normally. Since it is an ectopic pregnancy, I have to swallow the painful truth that I am losing him/her even though he/she had a normal heart rate with a yolk or sac.
What is the sign of ectopic?
Having experienced this tragic event twice in different situations, I will mention the signs that occurred to me. This is not to scare but to remind to be watchful for abnormal changes.
My first ectopic pregnancy ended up in a ruptured fallopian tube. I was on a month vacation in my home country. A vacation that turned out to be a nightmare.
The first sign that I noticed was extreme fatigue. Why extreme? Because while I was talking to my siblings which were supposed to be bond for years of not seeing each other, my eyes would shut on their own as if I had not slept for a week. They would tell me to go to bed.
During that time, I did not know that I was pregnant yet. Until I missed my period for a week and had multiple double lines in my home pregnancy tests. But the fatigue still went on.
It wasn’t my first pregnancy as I already have a healthy 4-year old at that time (thank God). So I have experienced a normal pregnancy already and it wasn’t like that.
The next sign that appeared is a sharp needle-like pain on my lower right back. I first thought it was a sciatic pain. Although I knew sciatic pain in pregnancy usually occurs around the third trimester when the baby is heavy enough to cause it, I masked my doubt.
I had that sharp pain for 2 weeks until my tube ruptured. No matter how I position myself, the pain does not go away or alleviate.
At my second pregnancy, I knew I am at higher risk for another painful ectopic pregnancy so as soon as I had a positive home test, I immediately called for a doctor’s appointment.
The day before I had my appointment which was around almost 6 weeks along, I already am feeling discomfort on my lower abdomen. I suspected for an ectopic already but I was praying constantly for God to give me the baby.
A day before I almost fainted due to the extreme pain, my abdomen felt heavy and I had brown discharges. I knew something is really wrong so I decided to go to the doctor the next day.
At around 5 in the morning when I stood up from the bed, I felt extreme pain in my abdomen together with dizziness. I told my husband what I felt and from that moment on, the pain just kept getting worse.
You will be noticeably pale as well. It’s an indication for health professionals of a ruptured ectopic. Once my OB saw me from the door, she immediately said, “You are very pale. You’re having an ectopic pregnancy!”
It was around 1 o’clock in the afternoon that same day when I underwent surgery. I can remember begging the nurses and doctors to start as I could not take the amount of “referred pain” that I felt throughout my upper body.
How long does ectopic pregnancy surgery take?
It depends on each case. If your tube has ruptured like mine, it will take an hour or so in the operating room, not including your stay in the recovery room. It also depends on your surgical team and any unique situation they may encounter while operating.
A ruptured tube will cause bleeding from the inside or what we call internal hemorrhage. My OB described it to be “oozing” as what she saw in the emergency ultrasound. The pooling of blood and clots will take time to be “cleaned up”.
I thought that would be my first and last time to be in an OR as a patient. As a nurse, my husband had full confidence in me dealing with the situations.
At the hospital waiting for the second surgery of my life, I was just calm. I knew exactly what will happen so I did not need to panic. Panicking will not help at all. What I did not expect was to be in the OR twice this time.
My OB explained that they will try to save my tube that’s only left. It was a Laparoscopic Surgery and they put me in general anesthesia.
I was in the Operating Room for approximately an hour. And then another hour when I went in there for the second time. Yes, they had to do the surgery twice due to a complication.
An hour after I was back in my room, I noticed that my extremities felt weird and my heart is racing. I could feel my heartbeat really well, beating like crazy. I let the nurses know about it and they also noticed it due to my higher than normal heart rate. Needless to say, I was back to the OR after probably three hours as my OB is suspecting bleeding from the tube.
I went through the process again but that time, they removed my tube. I was officially out of any fallopian tube.
It’s been two years and two months from my first surgery yet my scar is still there. Unlike the caesarian section, my incision was vertical with 4 inches in length due to their need to explore and a bikini line is insufficient.
Six months had passed from my second surgery (and third technically), and I still feel discomfort on the biggest wound when I use my stomach muscles to get up.
I don’t mind these physical changes. The most important thing is I still get to spend my life with my family, especially my son.
Mental and emotional effects
Mentally and emotionally, it was a mess for me. I was easily triggered. Anxiety was higher, depression kicked in. I could not help but feel like I was at a dead-end.
I only have a boy and was asking for a girl all the time. But that hope was just taken away forever. My doctor mentioned IVF (In Vitro Fertilization) but we are not considering it as of the moment due to being expensive. My husband developed a fear as well of me going on another surgery if I will have another baby because it will be definitely delivered via C-section.
Like physical trauma, I am slowly mentally healing. Time does help a lot. I gradually accepted my fate. Thankful that in spite of everything, I am still blessed to have a loving son who is now 6 years old.
What I learned with painful ectopic pregnancy
Painful events like this happen unexpectedly. As a nurse, I knew about this condition per book but never did I thought that I will get to experience it twice.
It’s okay to cry, it’s okay to mourn. It’s a normal process, but don’t dwell on it. Bring yourself back up. Think about the positive side of things. I am an appreciative person but after those painful events that ectopic pregnancy did to me, I learned to be more thankful.
Tragic life events are inevitable. Be thankful for the good things that you have right now instead of dwelling on the past painful experiences such as an ectopic pregnancy.
There is light at the end of the tunnel – that’s what I tell myself every time and it helps.
Tragedy should be utilized as a source of strength.’ No matter what sort of difficulties, how painful experience is, if we lose our hope, that’s our real disaster.Dalai Lama