I didn’t plan for this to be my second Substack ever, but it felt like too long/too delicate/too intimate of an essay to hand over to an editor. Sometimes, you just want to let your words be your words.
“Is that…a baby?” I asked, laughably, breaking the silence, looking up at a screen that displayed what appeared to be fuzzy proof of life.
For weeks, I remained in joyous disbelief — as well as every other emotion on the spectrum — that the countless pregnancy tests I took were, in fact, accurate.
As a woman automatically deemed high-risk at 40 and someone wasn’t even sure pregnancy was personally possible, I’d vowed to remain cautiously optimistic; at least until data existed beyond urine-soaked sticks and a palpable hormone imbalance.
And there it was. Stunning visuals of how our lives might change in the wildest, sweetest way.
I stared at the monitor in awe, feeling the transducer glide over my lower belly; a scene I'd only witnessed a thousand times in films and TV shows.
Adam squeezed my hand tighter, as if to say, “See, babe, it’s real!” and I felt my collection of unorganized doubts begin to fly out of the office window, one by one.
Again I asked, realizing the technician didn’t initially respond: “Is that really a baby?”
“I can’t say it’s a baby,” she replied. “But I can say it’s an embryo.”
The screen displayed a measurement of SEVEN WEEKS, just one week earlier from what our multiple pregnancy apps had calculated.
“Can we hear the heartbeat?” I asked, letting myself — finally, finally — feel pure optimism of this odds-defying feat.
In three weeks time, we’d lived a hundred lives. We went from being DINKs who were getting married in two-and-a-half months, to alleged soon-to-be parents.
Adam and I found out I was pregnant on July 31, 2024. We’d previously discussed meeting with a fertility doctor in early 2025 to see what might be possible for family-planning in the future, but — as every good pregnancy story begins — we were not not trying in the meantime.
I’d spent a good portion of my twenties and thirties being thrilled I did not have children — actively making safe sex a priority — but always letting the idea of being a mom stick around the quieter parts of my raucous brain.
Two years ago, I wrote about the uncertainty of motherhood when you’re “the late-thirty-something fun, single aunt,” and it resonated with so many women who were equally juggling the possibility — in such a volatile dating era — of finding a loving partner and procreating before it was biologically “too late.”
When I lost my mom, my life compass, in the fall of 2022, the answer became excruciatingly apparent. I wanted more than anything to recreate and perpetuate this incredible bond and adoration my mother and I had for one another.
Shortly after that self-admission — and, after a decade of dating — I met a fantastic and loving partner, Adam. I made sure he knew from the start: if we could have a child, I would like that very much, especially as I inched closer to 40.
A few days after my very-on-time missed period in late July, I ordered both pads and pregnancy tests, unsure what the following days would offer. While I’d felt a slight shift in my body, I assured Adam I had zero confidence in a positive result, since I’d never once had a pregnancy scare. When the tests arrived, I went upstairs, peed without much concern, and came back a few minutes later to witness my entire world altered.
I cried in disbelief. I cried in exhilaration. I cried in uncertainty and hope and revelation.
After I reveled in a few moments alone with this breaking news, I revealed the information to Adam, and we hugged each other tightly, our excitement and shock ricocheting off one another in the sweetest way. (I could mostly muster “Holy shit!” over and over again with an unstoppable grin.)
We teamed up to Google everything in the world and started to make big, cautious plans. But how do you truly plan, prepare and enthusiastically exhale when you’re about to embark on one of the most uncertain biological endeavors in human existence?
Google didn’t have a good answer for that.
I started journaling my pregnancy thoughts, recounting every impassioned detail. The first day’s entry ending with: More than anything, I just wish I could call my mom. But for now, happy thoughts, happy thoughts.
After our first virtual appointment a week later with our new OB care team, the dial on my “Is this real?” meter shifted a smidge, while Adam’s moved to maximum reality; he was all-in, crowning himself the “Presume Positive” police, certain we’d have a happy, healthy pregnancy. Meanwhile, I was reading every worst-case-scenario message board on the internet, learning the countless and wicked ways an extra-geriatric pregnancy can go awry.
But I wanted to feel the unbridled joy, too. I wanted to allow myself the possibility of this ordinary feat becoming extraordinary. I dreamt about all the fun ways to tell my dad and my loved ones and Adam’s family — in due time, of course. I bought What to Expect When You’re Expecting, and Adam read chapters to me at night while I lay my head on his bare chest, begging the universe not to let us down.
The suspense between a positive pregnancy test and seeing an OB in real life is ungodly. Time crawls. Days feel like weeks; hours like days — a waiting game I wasn’t prepared to play. Your body is producing new data 24/7 but you have no access to it until you’re 7-8 weeks along, spread-eagle with a full bladder in a dimly lit room. In the meantime, life is simple: you just have to juggle reality, possibility, viability and vulnerability, all while hoping to not see blood the next time you pee.
Because time is a funny thing, my bachelorette party was just days away in New York City. I worried how to hide my pregnancy from the people who knew me best; the people who have never in this lifetime heard me say, “No, thank you” to a cocktail. There’s no way they’d believe I was just “taking it easy” on what was supposed to be one of the wilder weekends of my 40th year on earth.
To relieve that concern, I spilled to my best friend, Emma, so she could help me maneuver the dynamics of the group. (She has always deemed me the Queen of Plot Twists.) While out celebrating, I ordered vodka sodas, then had Emma run off to tell the waiter to make them seltzers with lime. At one point, I had several “dirty martinis,” which were all water with a splash of olive juice, dressed exactly like everyone’s real drinks. We laughed and danced all weekend long, and I counteracted my severe exhaustion with the notion of one day telling my child this epic tale of party deceit.
I gushed to Adam over the phone how perfectly I had pulled off this elaborate scheme. He gushed about how excited he was to become a dad. I brought him home a little onesie from New York and allowed myself to escape the Reddit boards, the disheartening “Pregnant Over 40” group posts and the constant whack-a-mole of That won’t happen to me and That can’t happen to me and Maybe I’ll be ok if it does.
Life carried on as usual, and wedding-planning talk gave way to how we might re-do the second bedroom, the baby names we both liked, the way Adam’s aging cat (okay, our cat) would get to meet the little one. We joked about giving a toast at our wedding, when I’d be 15 weeks, and just blurting out the hot gossip in the name of being in a room with every single soul we loved.
Back at the doctor’s office, Adam and I tried to contain our excitement about seeing the embryo on screen. Before the technician would let us listen to the woosh woosh woosh of the heart, she suggested a transvaginal look first. She was mostly quiet as she probed my lower half, and the longer she stayed mute, the faster I felt the joy leave my body.
“I’m not seeing a heartbeat,” she said, finally, as if she’d delivered that line a million times.
No movement, no sound, no evidentiary life — from the embryo; from the two of us.
I couldn’t speak. I couldn’t look at Adam. I was paralyzed by the sudden emotional drop. The radiologist on duty came in, mournfully, and told us the embryo had “passed.” He offered sympathies, and I nodded and blinked and tried to remember how to breathe.
I managed a few words for the doctor: “Is the test ever wrong? Are there ever scenarios where the heartbeat comes back?”
He assured me it was conclusive. They let us know there were no appointments for another half hour; we were free to stay in the room for a bit, if needed.
They shut the door, and Adam and I embraced each other like two magnets, precisely how we did when we found out we were pregnant. This time, we just cried and cried and cried. The way life can change in a few weeks, and then back again, was staggering.
We walked the 15 blocks home from the hospital to our house, letting the fresh air dry our tears. And when we entered the comforts of our living room, we sobbed again in unison.
I had felt great loss before, almost two years ago. I knew this kind of hurt; I was familiar with the brutal sting, but Adam was not. I tried to say all the things I had read from others over the years; your standard miscarriage proverbs: It’s not our fault. The timing wasn’t right. This is our guardian angel now.
I knew, at some point, we’d need to find the silver linings. But for now, there was only one thing on the agenda: merited grief.
When our OB followed up the day after, she explained we had three options: 1. Wait until my body caught up with the news and let the miscarriage happen naturally. 2. Take Misoprostol and initiate the process. 3. Opt for a D&C (dilation and curettage).
Just 24 hours ago, I was beginning to wrap my conscience around the thrill of impending motherhood, and now I was likely going to have an unwanted abortion.
I decided to give it a few more days to happen naturally, offering my body encouraging words: C’mon, babe, just let it go. We’ll have another try soon, I promise. During the wait, my body felt shockingly neutral, despite carrying around a 9.7 millimeter loss that felt heavy and infinite. Keep calm and miscarry on, I suppose.
When it didn’t happen on its own, the doctor prescribed both Misoprostol (abortion tablets you place inside your vagina to prompt the process), and Oxycodone for the accompanying pain.
Misoprostol is a drug that has saved many women’s lives by inducing labor and is one of the first medications utilized when treating a postpartum hemorrhage. It is also a drug that was recently deemed a “controlled dangerous substance” in the state of Louisiana. Adam and I repeated again and again how privileged we were to live in Washington — a state that didn’t question the prescribed solution. But it shouldn’t be considered a privilege at all. Everyone deserves the right to be treated as needed.
On a Tuesday afternoon, I mentally prepared as best as I could and inserted the Miso (too cute of a nickname for something tied to such agony), waiting for whatever reaction was to follow. It happened slowly at first, some cramps, some blood; then, around midnight, as my uterus began to furiously contract, it felt like I was being punched in the gut over and over and over again. Adam was by my side through every wince, groan and teardrop, offering whatever services he could, patient and loving as ever, just wishing to take the pain away. I didn’t need an ounce of proof that I wanted to marry this man — we’d both never been more sure of anything — but if I did, this night would’ve been it.
The morning after, I was sore and exhausted. I had seen a few serious clots in the toilet throughout the night, so I deemed the worst part over. That week, as I recovered from the trauma, Adam and I watched the Democratic National Convention every night, hearing tragic stories from women and families who had been through what I had, but more severe due to lack of access with the overturn of Roe v Wade. I didn’t think I’d be watching the DNC the same week I’d be contemplating my own D&C.
I’ve always staunchly believed in a woman’s right to choose, but this experience reminded me of the amount of people who likely don’t understand that abortions are not always a choice.
A week went by, and just as I thought I was starting to feel like myself again, I began to bleed unexpectedly and heavily, and the severe, paralyzing cramps returned. We were up most of the night as I cried through the pain, wondering why this was happening, debating a hospital visit as even larger blood clots than last time appeared. It turns out, the Misoprostol did not complete its mission; my system was reacting to the remaining tissue still inside of me. All I could think was: Did I insert the pills wrong? Is my body betraying me? Is this my fault?
My care team had me take a pregnancy test the next day, which still revealed a dark-pink positive line. But a few days later, they asked me to come in for a blood test and another ultrasound to ensure the pregnancy had finally resolved itself.
It was quietly disheartening, being in the ultrasound room again; Adam grasping my palm like before as the technician probed. We weren’t here to ensure proof of life this time, but to ensure we had permission to move on with ours.
Withholding pregnancy news from those you love most in the name of hope, means not having necessary support in the wake of grief. During both phases, I felt relief in at least confiding in my cousin’s wife, who had endured miscarriages before and between two beautiful children. It was comforting to have a trusted source for discoveries and dialogue outside of my partner and a bottomless internet, but I think about all the women who have had to process their confusion and trauma quietly — too quietly.
For those who have even thought about trying to conceive, there is a strong reliance on message boards, Facebook groups and pregnancy apps because they foster important conversations and establish community; they are accessible arenas to feel less alone, no matter what stage you’re in. (Who else understands being bombarded with targeted baby ads in the midst of a loss?)
But there is an inherent loneliness in The In-Between, the prenatal limbo, the seemingly never-ending Will They/Won’t They dynamic that begs anxiety to manifest. For days, for weeks, for months, we carry a secret that shouldn’t feel like one. As a collective society — one that simply wouldn’t exist without mothers — we should be working harder to make it feel less intrusive to share the complexities of these biological wonders, wants and worries with others outside of such specific walls.
In a single month, I saw several positive pregnancy tests, cautiously prepared for our new future, met my OB care team, attended my bachelorette party, worked, continued to wedding plan, became the healthiest version of myself, let myself feel joy and fear all at once, had an ultrasound with unfortunate results, had a necessary pill-induced abortion that didn’t complete — and had a natural miscarriage.
Women are miraculous beings. The way we not only exist in these bodies that endure, but thrive in them despite.
In the U.S., about 1 million pregnancies a year end in miscarriage, with almost half of those cases occurring without explanation. It’s astounding — the amount of women carrying on as usual, holding onto complicated feelings, emotional bruises and physical stress from these experiences. I cannot imagine facing the pain and hemorrhaging I did without the proper care, preparation and support. No one on this earth should be denied the same. Abortion is healthcare. As it stands, there are too many people working to make sure that’s not our reality.
As Adam and I began to recover from an August that brought us both delightful and devastating news in one fell swoop, and the fog of loss began to break, we were able to see our future a little more clearly. Everything after the miscarriage became the Gospel of Silver Linings: It was possible for me to get naturally pregnant at 40! We were more sure than ever we wanted to grow our family. We brought home the puppy we’d talked about for months. I enjoyed several very expensive martinis at my own wedding. Our honeymoon was indulgent without guilt. My intricate and intimate understanding of reproductive rights (and wrongs) multiplied infinitely — and so did my empathy for those who suffer this kind of loss at any stage or any age.
But while I’m lucky to find solace in those personal silver linings, many are not. We should be talking more about the discomfort of pregnancy, the agony of uncertainty, the poignancy of loss and the inequity of access. We should be making it easier for women to get the care they need and to share their stories — good, bad, ugly — so no one feels alone, so more people better understand the diverse and unique plights of fertility.
Like it has for countless women and families for lifetimes, I am scared the journey is going to be dotted with detours and disappointments — for both myself and this country. But for now, happy thoughts, happy thoughts.
Thank you for reading, relating, sharing, subscribing, commenting, understanding, existing, etc. I appreciate your support.
Oh Sara, thank you for this and for sharing your grief with us. It's so important that these stories see the light of day for a multitude of reasons. Beautiful writing as usual. Hugs, and here's to whatever is next!
Such a beautifully written, poignant article, Sara. I had a difficult pregnancy where I was put to bed for three months, then hospitalized and completely bedridden until she arrived prematurely via natural childbirth at 5 pounds 2 ounces. Thankfully that was back in 1978 where we were both allowed to stay extra days in the hospital to recover. Her father and I divorced when she was two, so that was the end of my childbearing. However, I have many fond memories of my students who became like family to me!