A Thorny Truth

My rose bush in better days

There is a bedraggled rose bush in my back garden, stooping limply in a black painted terracotta pot to try and get away from the sweltering November sun.

The plant is a picture of perfect neglect: unpruned arms have wrapped around themselves and spindly offshoots curl up toward the sun. The potting mix has turned to dust and the thorns have deflated into an embarrassing rubbery mess. 

Completely out of place, one lonely bud sits atop the plant tower, defiantly trying to unfurl in the face of overwhelming gardening adversity.

In ordinary circumstances, I would probably pluck this wilting rosaceae from the pot and replace it with a nice green succulent from Bunnings, still strong with the power of industrial strength fertiliser and in with a far greater chance of surviving both the summer and my appallingly lax gardening routine. 

These are not ordinary circumstances, though, and this is not an ordinary forgotten backyard plant. No, this shining example of plant abandonment is my very own heterotopic pregnancy rose bush, planted in memory of the saddest time of my life and two little chances that slipped by the wayside. 

What is a heterotopic pregnancy? Medically speaking, a heterotopic pregnancy is a multiple gestation where there is at least one pregnancy implanted in the uterus and at least one implanted somewhere outside the uterus (such as in a fallopian tube). 

Keeping on the garden path, we can think of a heterotopic pregnancy as when one little seedling grows in the designated baby patch, while another jumps the fence and tries to grow in impossible territory, like in the middle of the lawn or smack bang under the garden shed. 

Heterotopic pregnancies in natural conceptions are relatively rare, occurring just once in every 7000 - 30,000 pregnancies. They occur more often in pregnancies where ovulation induction and assisted reproduction techniques are used, with numbers estimated to be as high as 1 in 100. 

Of course, heterotopic pregnancies are far more than the sum of reproductive organs, statistics and medical jargon. Like blighted ovums, like miscarriages, like ectopic pregnancies, like all pregnancy losses, they are human stories involving people like you - and people like me. 

My story began rather unremarkably, with the simple act of putting my contraceptive Pills in the bin and a quick Thursday afternoon roll in the hay (and yes, kids, one time really can last a lifetime). 

Within weeks I was sobbing when the morning tram was late, outgrowing my favourite jeans, and generally being shittier at the world than usual. I progressively broke up with my favourite foods until the only thing left to buy during the weekly shop was spiral pasta, rice crackers and a pregnancy test. 

Despite my obvious up the duffness, the first test was negative - as was the second, the fifth, and the ninth. I worked my way through the entire market of available tests - pee in a cup, pee on a stick, pink dye, blue dye, two lines, single crosses, even the fancy digital varieties with date markers and yes/no answers. 

After weeks of expensive peeing, I finally got the (barely perceptible, when you squinted, husband wasn't certain he could actually see it) positive result I had been waiting for and skipped off to the GP for my obligatory early pregnancy confirmation blood test. 

The day of truth was a Wednesday. I woke up with a stomach ache, which I put down to an unfortunate combination of nerves and a dodgy bacon and egg roll, and my husband put down to my famously overactive imagination. 

We shuffled nervously to the appointment, where the doctor confirmed that we were definitely pregnant, although the hormone levels were reading lower than he had anticipated - this suggested we weren't actually as far along as we thought, and was probably why I had gone through a veritable forest of pee sticks before getting a positive.

We went home as happy and high as little kids set free on a sugar bender in a theme park. Nothing could bring me down, except my tummy ache, which hadn't dissipated with the worry and was still rumbling away with an unpleasant intensity. 

Over the course of the evening, the pain shifted out of dodgy egg and bacon roll territory, through excruciating pain, into the undeniable reality that my insides may actually be exploding and I needed to get to the hospital pronto. 

A short eight hours after being confirmed pregnant, I found myself lying in the Emergency department under the heavy influence of morphine, listening in to a huddle of nurses in the hallway discreetly discussing my likely miscarriage, or ectopic pregnancy. 

I was poked and prodded, tested and turned, measured and monitored. The night staff hooked me up to several machines that went beep and wheeled me to the critical ward to doze under a blanket of painkillers until the ultrasound technicians arrived at sunrise. 

A delightful orderly wheeled me to radiology, where the ultrasound technician quickly got down to business and zoomed in on my reproductive bits. The first wave of the wand showed everything to be in order, with a tiny baby jellybean located inside my apparently normal looking uterus. The technician smiled and I allowed myself to breath. 

The second wave of the wand showed a completely different scenario and I stopped breathing altogether: I could see a jellybean in my uterus, which didn't seem to have a heart beat, and I could also see a big mess where I thought my fallopian tube should be, and a large roundish mass free floating around my abdomen. 

The technician disappeared and returned with the head radiology honcho, who immediately lit up like a Christmas tree and started rattling off the features of my internal disaster zone: Incredible, just incredible. Failed uterine pregnancy. Ruptured ectopic pregnancy. A true heterotopic pregnancy. You don't see these very often. Were you an IVF patient? No? Really? That makes this even more interesting.

My exhausted, morphine meddled mind struggled to comprehend what was going on. Yesterday I had been happily pregnant and ready to tell the world, five minutes ago I had been pregnant and sore, and now I was doubly pregnant and rupturing and about to be prepped for emergency surgery. 

Immediately and irrationally, I sided with the uterine pregnancy: it had done nothing wrong and was seemingly being punished for the ectopic pregnancy's failure to abide by the rules and park in the correct bay. Why did it have to do that? Why did this have to happen? Why couldn't it have worked out? Why couldn't I just have a baby?

I burst into tears and couldn't stop. The delightful orderly reappeared and wheeled me back to the ward in respectful silence, where the nurses quietly tucked me in and placed a nil by mouth sign at the foot of the bed. The intern nurse held out the tissues and looked terrified. My husband arrived and crawled into bed with me. 

The surgeon came to prep me for the procedure: they would go in with keyhole surgery, remove my ruptured fallopian tube and the ectopic pregnancy and maybe even my ovary, and perform a curette as well. 

She reassured me that the heterotopic pregnancy was not my fault, just a rare natural occurrence and a horrible case of sheer bad luck. She also explained that in cases like mine, up two thirds of accompanying uterine pregnancies survive, and it was just even unluckier that both of my pregnancies had come to their natural end. I nodded, and cried, and cried, and cried some more. 

In the hours before surgery, I napped in bed with my husband and fell into an incredible state of calm. This sense of quiet and peace stayed with me until a week into my recovery, when I sat down on the shower floor and cried like a maniac - then got dressed, went out and got drunk. 

I drank vodka and wine, and wine and vodka, and then some more vodka for good measure, and stayed up till dawn before doing it all again. I danced to bands and accidentally did some drunken star jumps, before realising the hard way that abdominal stitches and star jumps are truly terrible bedfellows. 

Once the hangover died down, I made my husband drive to the nursery and pick up a rose plant and a big black terracotta pot, which I potted and stared at right through the winter and into the spring. My heterotopic rose bush, with its specialised bag of potting mix and its thorny glory. 

I met with the hospital counsellor, who strongly suggested we wait at least a year before trying to fall pregnant again - focus on work, go to the theatre, take a holiday. 

I put her theory into practice for three whole weeks. I went back to work and I bought tickets to a musical and I felt okay - until I saw my husband play with a friend's baby and was brought to my knees with the realisation that the only thing that could bring me to terms with losing a pregnancy was to bring another to fruition. 

I wanted to be a Mummy, and in that split second of watching my husband bounce someone else's baby I knew that no amount of quality cabaret or trips to Tahiti could make that want go away. 

A month down the track I started crying on the tram again, and ten months later I gave birth to my beautiful daughter - in the space of a year my husband and I went from being that unlucky heterotopic couple with the sad story to the luckiest couple you can imagine. 

There is nothing remarkable about my story. It does not define me and it does not control me, but every now and then, when the world is quiet and no one is watching, I let it out of the genie lamp to prick at my eyes and sit on my heart.

I have experienced sadness and joy. I have one daughter, two pregnancy stories, three keyhole surgery scars and a ridiculously hardy rose bush that I really must remember to water before summer arrives in earnest. 

M x 

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