CONTENT WARNING
This story is about pregnancy loss and portrays the anxiety, self-recrimination, and helplessness of miscarriage. It contains depictions of a physician operating without consent and providing dehumanizing treatment. Although this story is fictional, it will likely be all-too-familiar to people who have experienced dismissive, insensitive care and the countless patients who have been intimidated by forceful physicians into treatment they didn’t want (and perhaps also didn’t need).

The ultrasound technician refuses to tell me my baby is dead.

She’s young, with a heart-shaped face, only a year or two out of college. She’s probably never had a baby or even wanted one.

“Is there a heartbeat?” I ask.

“I’m sorry. I have to wait for the doctor,” she says.

That means no. My baby is dead. If there were a heartbeat, she would have told me. They always tell you right away if everything is okay. “The baby looks perfect,” they’ll say, or “heart rate is one-forty,” and smile. That way you don’t have to wait for the doctor.

But you have to wait for the doctor if your baby is dead.

“I’ll go get him. I’ll be right back.” She speaks softly, as if we’re in a funeral parlor, all sad eyes, hushed voice. Why won’t she just tell me?

It’s dark in here, too warm, and so humid the air is slippery. I count water stains in the drop ceiling while I wait, lying on my back in a hospital gown with my feet still in the stirrups. Cold gel drips between my legs, and the paper covering sticks to my ass.

The ultrasound images are right next to my face, but they’re impossible to read. Maybe she’s lying. Maybe my baby is alright and she’s an idiot who doesn’t know what the fuck she’s doing. The doctor will laugh and apologize and say she’s new.

When the doctor comes in, I wipe the tears off my cheeks. Got to put on a brave face, act professional, never hysterical, in this bizarre interaction where a stranger informs me my baby is dead.

He says quietly, “It looks like you’re in the early stages of a miscarriage.”

A choked sob escapes my lips before I cut it off. I nod. Don’t make a scene.

“I’m sorry,” he says, like that changes anything. “Do you have any questions?”

I shake my head, too afraid of what else will escape if I speak.

“The OBGYN will be by to discuss options,” he says. “I’m just the radiologist.”

I keep staring at the ceiling, blinking away tears before they roll down my face and expose me. He takes the opportunity to leave, and I’m alone again.

There’s a strange two-ness when you’re pregnant. I was something more, but now I’m just me again. I should text my husband. Or should it be a phone call? What’s the protocol for revealing a miscarriage? Do we cut a cake and then throw it out?

He was so happy when I told him I was pregnant. We didn’t think it would ever happen.

I tuck the phone into the pocket of my hospital gown. Let him be happy for a little while longer.

Not even five minutes later, the OBGYN sweeps into the room. He’s in his late fifties, or early sixties, with neatly trimmed grey hair, wearing Dockers and a pinstriped button-up shirt. He looks like he just left the bake sale at church. His nametag reads “Dr. Forsyth.”

“Ms. Blackford, I’m so sorry for your loss.” Without pausing for breath, he continues, “We’re going to have to get that fetus out immediately.”

“What?” I swallow a thick lump of mucus.

“I said we have to remove the fetus. The tissue. Immediately.”

The tissue. My baby.

“Why? Won’t I just . . . you know . . . bleed it out?” Isn’t that how this is supposed to happen? I wake up one morning and go to the bathroom and the toilet bowl is full of blood. Sad music swells in the background while I sob over the toilet then maybe curl up in the fetal position on the tile floor. That’s how it always happens in the movies.

“I’m afraid not,” he says. “You have what’s called a ‘silent miscarriage.’”

“Silent?”

“The fetus is no longer growing, but your body hasn’t realized it yet. Hence the lack of usual miscarriage symptoms.”

“My body hasn’t realized it?”

He holds up a hand. “Don’t take it personally. Not your fault at all. None of it’s your fault, really. Miscarriage happens in a quarter of all pregnancies, very common. Usually due to inferior sperm.”

This was my husband’s fault? But I was this baby’s mother. How did I let this happen? “Why does it have to come out?”

“Oh, all that dead tissue is delicious for bacteria.” He makes a motion with his hand like it’s gobbling up the air. “They love that stuff. They’ll eat it up and multiply and make you very sick. You don’t want them to eat your baby, do you?”

“No! No.” My baby deserves better. “How . . . do you take the baby out?”

“There are a few options.” He puts a leg over a chair and sits down backwards on it, leaning against the seatback and resting his forearms on top. He could be the guy at the auto shop trying to sell me new air filters for my car. “We could give you a pill. But I wouldn’t recommend that.”

“Why not?”

“Oh, you’re far enough along at nine weeks; you’ll be pumping out clots of blood and tissue for days.” He knits his brows. “You don’t want that. Very traumatic.”

“No,” I whisper.

“Or, I can take you down to the operating room right now and clean out the little bugger. We’ll give you some propofol, maybe a little midazolam. I’ll be in and out. You’ll wake up feeling right as rain.”

“How long will I have to stay in the hospital? My husband . . . he’s dependent on me. I take care of him.”

“Aww, that’s sweet.” He makes a face reserved for puppy dogs and little girls with pigtails. “You’ll be good to go as soon as the propofol wears off, usually about thirty minutes. How’s that sound? Quick enough for you? I can skip my lunch and take you downstairs right now.”

I’m not ready to let my baby go, but the only other choice is to flush it down the toilet in pieces for days.

“Oh, one more thing,” he says. “You’ll need somebody to drive you home. The anesthesia can make you a little woozy for twenty-four hours afterward, so no driving, no making any big decisions. Your husband will have to come to pick you up.”

“That won’t work; he can’t drive.”

“Any family nearby?”

“No, they’re on the other side of the country.”

“Friends?”

I shake my head.

“Well,” he says, sounding exasperated. “How about an Uber?”

“I could do that.”

“Great! Sign these. I’ll have the nurse get you ready.” He hands me a clipboard. “Any questions?”

My tears stain the pages. My hand shakes as I scrawl my name under warnings about bleeding, infection, and death.

“Are you sure my baby is…you know?”

“Dead? One hundred percent. In a normal pregnancy at nine weeks, there’d be a clear heartbeat. It’s pretty obvious. Even an idiot could read this ultrasound. If you look here—” he points at the black and white images “—you can see there’s basically no blood flow in the area. This should all light up with oxygenated blood. There’s no heartbeat, no sign of a fetal pole.” He circles the screen with his finger. “There’s just a lump of dead tissue here. Best that you miscarried really. Whatever was going on with this baby, it wasn’t right. Have you finished filling that out?”

I wordlessly hand him the clipboard.

“Wonderful!” he says. “Now cheer up. Fields are most fertile right after a harvest.”

“Really?”

“Absolutely. You go home tonight and tell your husband to put another baby in you right away. It’ll happen, mark my words. You can always have another!”

But I wanted this one.

A woman in scrubs enters right after he leaves. She’s middle-aged and doughy, white roots peeking out from under blonde hair dye. Her chin and neck run together. The badge clipped to her chest reads “Cindy F.”

“Just a few things to get you ready, and I’ll wheel you down.” Her voice is so calm and so pleasant, she might be about to escort me to the massage table at an all-inclusive spa day.

“Left or right, dear?” She checks my hands and runs her thumb over the veins. “Hmm, this one looks juicy.”

“I don’t like needles.”

“Just look away, a little pinch.” She jabs the needle deep into the thick vein on the back of my thumb. I didn’t know you could even put an IV there.

“That hurts.”

“It’s not that bad. I’ll remove the needle and you’ll be fine.” She does so and leaves the plastic catheter inside the vein. Next, she drives a spiked end of IV tubing into a bag and hangs it on a pole. Then she connects it to the line in my thumb.

“What’s that?”

“Oh, just some antibiotics before the procedure. I know Dr. Forsyth told you about all those nasty bacteria.”

The ones that want to eat my baby.

The fluid winds through the tubing and into my vein. “Fuck! That burns!”

“That’s just the penicillin, hon.”

“Please, it really hurts.”

“Sorry, hon, but we have to. You don’t want to get an infection, do you? All that rotten tissue down there.” She sits on the bed next to me and pats my leg, giving me a reassuring smile. “Open wide.”

I do before I think to ask why.

She sticks her ungloved fingers into my mouth, feeling around, tapping on my teeth and the back of my tongue. “Your mouth is tiny. You’ll need a pediatric bite block.” She removes a chunk of plastic and a strap of leather from her pocket.

“What? Why?”

“So you don’t swallow your tongue while you’re knocked out.”

“I didn’t think that was possible.”

“And who is the nurse here?” Just before shoving the bite block into my mouth, she says, “Any other questions, dear?”

I should call my husband. An ultrasound wouldn’t take this long.

“The doctor is waiting,” says Cindy. “He’s skipping his lunch for this.”

I don’t know how to tell my husband. I’ll tell him after the procedure is over. He would only worry.

She puts the bite block in my mouth. “If you don’t have any questions—”

“Is it roo?” I ask around the plastic.

“What’s that, dear?” She removes the bite block, sounding impatient now.

“Is it true? That after a miscarriage, you’re . . . more fertile?”

“Oh, absolutely.” She rubs my shoulder. “Now open wide.”

I wish I could stop crying. Because of the bite block, the saliva pools in the back of my throat and I keep choking if I’m not paying attention.

Cindy sighs as she wheels me into the elevator. “Oh, cheer up. You can have another baby soon.” Then she jabs the button for the basement.

The doors open to a bare hallway with cinder block walls and an unpainted cement floor. There’s no one else down here. Aren’t operating rooms supposed to be busy?

The end of the bed bangs into a door and shoves it open. Cindy wheels me into an operating room that looks more like a storage closet. Dust and cobwebs drape strange machines and dirt streaks the once-white walls. The overhead lights buzz loudly. It’s cold and it smells in here, like blood and metal and rot.

Cindy parks the hospital bed in the center of the room, on top of a dark brown stain.

“Blood?” I ask, but it sounds more like “lud?”

“Oh no, that’s just iodine. I was clumsy and spilled a bottle on the floor.”

Enough. I want to go home. I’m not ready for this. I need to talk to my husband.

I fish my cellphone out, but Cindy grabs my arm and wraps leather around my wrist. She plucks the phone from my fingers and tosses it down the bed. I try to jerk my arm away but her fingers dig into the flesh.

“Caw?” I say.

“You can call him afterward.” She loops the leather restraint around the bed railing and cinches it tight. I try to fight when she grabs my other arm, but she has two hands free, and she’s stronger than she looks. Soon both of my wrists are tied down.

Fighting the restraints only rattles the bed rail.

“That’s for your protection, hon, so you don’t move while you’re under anesthesia. Wouldn’t want the doctor to nick you in the wrong place down there, would we?” She disappears behind the bed, out of my sight. Glass clinks on metal.

“Please.” It comes out as “lees.”

“What’s that, hon?” Cindy leans into view holding a syringe full of milky white liquid.

“Lees. Don wanna. Lees. Home. Lees. Lees.” Tears and snot stream down my face. They run into my mouth and I start to choke.

Cindy wipes my face with the blanket. “Shh. Everything will be alright. We’ll get that baby out of you soon. Miscarriages happen when the chromosomes don’t line up right. You don’t want a fucked up baby, do you?”

“Wan my bay-hee.”

“Well, your baby’s dead, hon. Best start thinking about the next one.” She twists the syringe into the IV in my thumb and slams the plunger down. In a second, a wave of dizziness crashes into me.

“Lees. Lees.”

“What’s she saying?” asks Dr. Forsyth. He’s still wearing his Dockers and button-up shirt. In the operating room. No scrubs. No gloves.

“She’ll be out in a second,” says Cindy. “I gave her a generous dose of propofol.”

Dr. Forsyth sits down on a stool at the end of the bed. Cindy lifts my legs into the stirrups.

“Lees. Lees…” My eyelids droop. I have to stay awake. Have to stay awake for my baby. What’s left of it. It needs me. It deserves better.

Dr. Forsyth holds up several steel instruments like a hand of cards. “This is a speculum. I’m going to use it to hold open your vagina so I can see your cervix. I’ll use these rods to open up your cervix. That way, I can get at your uterus.” He waves an instrument that looks like a long spoon with a sharp edge. “And then I’ll use this curette to scrape out the fetus. After that, you’ll be on your way home, all fixed up.”

“It’ll be over soon, dear.” Cindy pats my arm. “You’re doing great.”

It’s so hard to stay awake. I want to sleep and forget this. Forget I ever had a baby.

Cold steel slides between my legs. It expands, widens me, then pinches deep inside me. The pinches slide into pain.

“Opening your cervix now,” he says.

“Nnnnn.” My abdomen suddenly cramps hard. “Nnnnn.”

“Give her some more propofol,” says Dr. Forsyth, inserting more steel rods into my cervix. Cindy disappears behind the bed. More clinking of vials.

“You’re doing beautifully.”

“Haaaaah!” My body jackknifes on the bed.

“Jesus, Cindy, didn’t you tie her legs down?” says Dr. Forsyth. “She almost kicked me in the fucking face.”

Cindy ratchets new straps around my ankles. “She’s sweating. Her heart rate is one-eighty. Maybe we should stop.”

“I’m almost into her uterus.”

“Respiratory rate twenty-six, oxygen saturation ninety-two percent.”

“I said I’m almost in.”

The next cramp hits like a tsunami, washing over all of me. I’m drowning in pain. Someone is screaming and I realize it’s me.

“We have to stop,” says Cindy. “If she dies, there’s going to be a lot of questions. A healthy twenty-four-year-old getting a simple D&C, and she dies on the table? Are you listening to me?”

Dr. Forsyth doesn’t answer. Cindy says, “You’re a fucking idiot,” and undoes the strap on my right wrist. She’s leaning across me to work on the strap around my left wrist when Dr. Forsyth drives the sharp curette through her ear. She makes a noise like “Grrrk!” and falls on top of me, twitching.

The next cramp—no, contraction—forces my body to curl around her. Up close I can see flecks of bone and brains oozing from her ear. After the contraction passes, her body slides onto the floor.

Dr. Forsyth bends over and rips the curette out of Cindy’s ear. He doesn’t bother wiping off the blood and brains.

Another contraction hits. Intense pressure between my legs. I have to push. My voice is hoarse from screaming.

Dr. Forsyth slaps me hard across the face. “Will you shut up?”

Hot fluid gushes from my vagina, followed by warm tissue. I’m losing my baby. There’s a wet splat as it hits the floor.

“Goddammit.” Dr. Forsyth turns around and ducks to wipe up the mess on the floor—

Then he screams.

He stands up with something wrapped around his hand. It’s dusky blue and climbing up his arm quickly with fat, short tentacles. He tries to pull it off, but his other arm doesn’t work right. His whole body doesn’t work right, stumbling and pitching around the operating room. A curious tentacle reaches his mouth and forces its way inside. Another does the same to his left eye. A third tentacle takes the right.

Dr. Forsyth collapses on the floor, his screams muffled by the tentacle in his mouth. It re-emerges soon with his detached tongue, stuffing it into its beak. He dies, not from the injuries, I think, but some kind of neurotoxin. His lips turn blue, and red foam dribbles from the corners of his mouth.

The creature makes slurping noises as it eats. Then it disappears from sight and reappears on the bed rail, climbing over it one tentacle at a time until her head crowns over the side.

My baby. Yes, it’s a girl. I’m sure of it.

She crawls towards me as I rip off the bite block. Her tentacles are warm, but the sharp beak inside her mouth leaves a thin line of blood on my skin. The tentacles wrap around my arms and then my neck. Her razor-sharp beak slowly opens and closes an inch from my face.

“My baby girl.”

She comes closer. Her head nuzzles my cheek. The skin is soft and rubbery.

“Do you feel better now?” I ask. “Now that your widdle belly is all full?”

She nestles between my head and shoulder and chitters happily in my ear.

“That’s my beautiful baby girl.” I nuzzle her back while I pat around the bed for my phone. It’s still there, buried under the blanket. I dial home.

“Sweetheart? Are you okay?” asks my husband. Water splashes around in the bathtub. “I’ve been so worried about you.”

“I’m sorry, my appointment went a little long.”

“Is everything all right? How’s the baby?”

“Oh love, she’s perfect. She looks just like you.”

FROM THE EDITORS: We felt this story was important to share. Medical personnel who distance themselves from their patients often do so to protect themselves from trauma without realizing they may be inflicting it on others. Even the terminology used to talk to patients about pregnancy loss (“blighted ovum” and “incompetent cervix,” for instance) can be dehumanizing and leave patients psychologically scarred. As an infertile woman who endured countless treatment cycles, experienced pregnancy loss, and tolerated pushy, abrasive doctors herself, Alin found “The Silent Miscarriage” relatable in its horror and grief—and cathartic to read. We hope you did also.