Nice to meet you: Part 1

My name is Melanie. That is a pseudonym, since my wish to speak frankly might have very embarrassing outcomes if I reveal my identity. But I am no one in particular. I could be you. I am every woman coping with infertility . . . so no need for formal introductions.

My official diagnosis - the one that the insurance company looks for before forking over payment for tests and doctors visits related to infertility - is "recurrent miscarrier" or "habitual aborter."

Nice.

I'll trade you that label - I'll take bad tipper, bitchy neighbor, pretentious snob . . . All of those have been true at one time or another. But they are all easily shouldered unlike this recurrent miscarrier title. That prize comes with equal parts shame, fear, anger and anguish rolled up in an inadequate, broken body.

My first miscarriage occurred in the Fall of 2008 with my now husband who was then my boyfriend, Jason. Being a veteran of one failed marriage, the marriage-go-round was not a ride I wanted to get on again anytime soon; but I was ready to have a baby with this man. I know it doesn’t make sense, but it doesn’t have to make sense. Life doesn’t make sense.

We got pregnant immediately and I remember feeling so happy and proud that we nailed it on the first try. I was always an A student - why should pregnancy be any different? A +, Melanie! I didn’t have many pregnancy symptoms either, just a little bit of breast tenderness. I was so smug with success.

Then an early 6-week vaginal ultrasound revealed an empty gestational sac. I never knew such a thing was even possible. A "blighted ovum;" that was my first inadequately-explained, infertility-related diagnosis that I would have to research.

The doctor explained that maybe my timing had been off and I was actually not as far along as I thought, suggesting that I come back in a week for another ultrasound. I went home holding on to the hope that I had counted wrong or misremembered. I’ve left many a doctor’s office since then with vague palliatives echoing in my head that “everything looked great” and “just keep doing what you’re doing.” But I knew full well what my window of fertility had been and that they should have been able to see a 6-week-old embryo. The next day my breast tenderness abated and for the next week I played the waiting game, sure about my own accounting of days, but hoping against all hope for a medical miracle. Strange things happen in the body, after all.

This marks the first time I fell in hope. One week later, the blighted ovum was confirmed and I was sent home with an oral and vaginal pill to induce the miscarriage.

The fallout from this miscarriage was pretty catastrophic. I ended up in St. Agnes right after Christmas - an inpatient unit of the hospital serving mentally ill individuals who need a little "time out." My time out was three days long, ending on my 35th birthday. Yay life.

Many factors landed me there. The unsuccessful end of the pregnancy obviously, compounded by the fact that I was still in the midst of healing from my divorce and completely unsure of my ability to make decisions regarding my romantic life. I was also forced to grapple with my fourth major bought of impotency with respect to my "life plan." The most damaging factor of all, however, was that I tried to muscle my way through pregnancy, miscarriage and the weeks afterward WITHOUT my antidepressants.

I have been on antidepressants since I was 19 years old. It is amazing to reflect that I have taken SSRI's my entire adult life, but I count myself unbelievably lucky to be born in a day and age when SSRI's are available and effective for me. I have checked in with my brain a few times since I was 19, trying to determine if a now mentally stable and properly-therapized brain could successfully take up where the medication leaves off.

Nope.

Even after exercising all my willpower and analytical skills, writing countless heart wrenching journal entries and spending thousands of dollars in therapy - my brain's natural normal is "clinically depressed" (another happy label), and just like with my miscarriages, there seems to be no rhyme or reason why I pulled that short straw since my childhood and family life was stable and loving and I have 2 siblings who have never (that I know of) taken an antidepressant in their lives.

I have happily taken first Zo.loft and then Pa.xil to curb my depression for 17 years. But before getting pregnant, I decided that I wanted to attempt pregnancy without my medication. It had been a long time since I had tested the sans-meds waters, and it seemed like the responsible thing to do considering the dearth of information on the effects of SSRI's on babies. It was rough going, and mostly hard to differentiate among the various stressors. Were my moods due to the discomfort of withdrawal symptoms, pregnancy hormones, or the brand new "oh-my-god-we're-having-a-baby!" panic? I muscled through the meltdowns.

But the shit really hit the fan when, after the miscarriage, I decided to remain off the medication - already planning my second pregnancy, which I still intended to attempt without antidepressants; I didn’t want to suffer the withdrawal symptoms all over again.

That was the beginning of a downward spiral that left me one morning - for the first time in my life despite some serious bouts of depression in my past - unable to get up and go to work, too paralyzed with fear, anxiety and hopelessness to face another day of my life. That afternoon, I was bunking with drug addicts, schizophrenics, and otherwise brain-damaged people (counting myself among them), calmed by a haze of Klon.opin and Ati.van. I celebrated the arrival of 2009 in that facility with my fellow loony tunes, glad I didn't have to be out in the world celebrating. I completed a 5000-piece puzzle instead.

After my release, I got back on my meds, got a psychiatrist, and added a new medication – Klon.opin - to my daily routine. You cannot take Klonopin while pregnant. I had to step way back from my plan, spending nearly a year picking up the pieces very slowly, very carefully and very very gently.