Work On My Mind: How My Miscarriage Forced Me to Change My Work Habits
Content Warning: Miscarriage and suicide ideation
Introduction
I was working at the public library on the late shift. I was supposed to stay until 7pm to close the library with two other library workers. At 5:15pm my cramps became increasingly more painful and harder to bear without crouching down and pulling my legs into my chest. I learned that I was pregnant just three weeks before. I was told that cramping and some reddish brown discharge was normal because the uterus was expanding to make space for the fetus. I went to the bathroom and an enormous amount of blood and tissue dropped and I felt an immediate release of pressure in my stomach and uterus. Intuitively, I knew that I was no longer pregnant. Soon after, I had surgery to remove two large ovarian cysts that were affecting me in ways I had not yet realized. I found it despicable that my first thought was, “how is this going to affect my work and my new position at an academic library?” My experience with grief and depression that struck after these major events have continued to shape how I let work impact me, and how I manage work and home in the future. I had to learn how to care for myself differently.
I have never read a personal account of a miscarriage. I had nothing to compare, interrogate, or engage with further. My hopes are that my account makes you aware of this particular human experience and you continue to love yourself as you dissolve the need to overperform at work.
Doctor Visit
The day I found out about my pregnancy, I went to see the OB/GYN for the extreme pain I would experience when menstruating. Over the last few years it became increasingly more painful. Brutal, was the best way to describe the gut-wrenching feeling from my abdomen to my upper thigh. The pain was so intense, I would become nervous when I knew it was coming. Seeing other people with a uterus describe how they changed their painful cycle gave me hope. I changed my period products, my diet, exercise routine, alcohol consumption and the pain still remained. I had to take sick days from work and would nearly finish a bottle of 650 mg of Tylenol during that week of my period. When explaining my symptoms to the doctor he completed a routine vaginal check. I explained my fear that it could be related to ovarian cysts that I first experienced at the age of 9. While a cystectomy and appendectomy were completed, I have had a continual fear that the cysts would come back. The agony of the ovarian cysts took me out of school for months during my fourth grade year. The doctor asked two questions in response to my inquiry. One being, “is the pain and heavy bleeding so bad that you feel you may pass out?”. My answer was “no”. The second was, “if I felt sharp pain when he pressed on my lower abdomen”. Again, my answer was “no”. I did all that I could, to express how unsettling my period was and he only asked two short questions with no other follow-up. Strange, but I let him continue. Then he asked if there was a possibility that I could be pregnant. My response…”of course”.
The pregnancy test was positive and that news overshadowed the previous discussion. I was upset with myself for not questioning the doctor further about my symptoms. I immediately went into planning for the future.
With no experience in the next step after getting the results of a pregnancy test, I called the hospital in hopes of booking an appointment with an Obstetrician to begin planning for the pregnancy. Turns out, you find an OB first and end up at whichever hospital they deliver. I found an OB office online with a midwife, something I always thought about. At this point there was dark brown spotting in my panty liner. Nothing too unusual according to the midwife that I called when making my first appointment. She recommended pelvic rest which includes, not lifting heavy objects, no excessive exercise, and no sex. No problem, the doctor visit is only a week away. This was the earliest I could get in anywhere.
The Loss
The spotting continued and on June 22nd, two days away from my first OB appointment I called again as the spotting and pressure on my uterus had increased. I pushed for an earlier visit as I was growing more concerned by the hour. I was at work and when I used the bathroom I felt a large clot expel from my body, approximately 5 inches in diameter.
My future changed when I felt intense cramps during my closing shift around 5:30pm at the small town public library where I worked. I grabbed the librarian and told her that I was going to take myself to the ER, grabbed my things and left. I drove to the closest ER as there was not one located in the town where I worked. It was about 25 minutes away and as I sped through the one road leading into the city I called my husband to meet me there. The pain came in waves and I felt like I was leaking blood, afraid that it would be all over the seat when I got out. But the panty liner surprisingly kept everything contained. After checking in, and taking my seat in the waiting area, the nurse in charge of the ER for this day shift shot up to make sure I was moved from the unsigned COVID section in the front, to the area in the back. My goal was to sit as close to the bathroom as possible because everytime I went, so much blood and tissue would drop into the toilet. I cried after every visit to the bathroom. I never had plans of having a baby and waves of grief coincided with these visits to the bathroom.
My husband finally gets to the hospital and finds me in the back waiting area. I was so grateful to have his hand to grasp when the physical pain and emotional acknowledgement continued to come in waves. When he is with me I feel more confident to confront someone for their wrongdoing. The extreme pain was not stopping and no one checked in on me or took my vitals. I began going to the nurses desk every 30 minutes to see when I could see a doctor to confirm what was happening to my body and what I should expect next. I have experienced callous, numb nurses and doctors in the past so I knew to follow my mom’s favorite saying, “a squeaky wheel gets the grease”. Still, the nurse’s callousness to my heart sinking, worry, and fear shocked me.
Tressie McMillan Cottom recounts in her book Thick: And Other Essays, bleeding out in the waiting room of the hospital and then having to birth a baby that had passed away in her womb. The imagery of her horrific experience kept crossing my mind the week leading up to my miscarriage. I pledged to not let that happen to me, and yet there I was bleeding in the waiting room. Getting up every so often to use the bathroom where more large clumps of tissue released into the toilet, then checking in with the nurse to see when I could see a doctor. The first nurse mentioned how my due date of January (six months from then) is so far off then giggling, as if that made the wait easier or the miscarriage less impactful. My partner and I were caught off guard. We didn't know what to say. My reaction time is something that I still beat myself up about. I thought that after previous horrific experiences with doctors and my awareness of medical biases against Black women that I would be a better advocate for myself. I thought that I would never allow that disrespect again. But, it did happen again.
I've read and been told by other Black women that if you need to see a doctor, dress presentable, stay calm, speak clearly and concisely, annunciate, and bring a partner. Yet, I'm still sitting there waiting in the dingy hard plastic chairs in the waiting room. Making sure to speak to the nurse every 45 minutes to describe the pain I'm in and the amount of blood and tissue I find in the toilet every time I use the bathroom. You can't see my pain, the cramping, or the bleeding. I don't have a limp from a twisted ankle like the white woman who was taken back to the doctor earlier, or migraine like the white man, or unknown ailments of the other eight people taken from the waiting room to the doctors area behind the large badge locked automatic door. Six hours passed. I noticed a change in shifts and the white male nurse that checked me in was switched out for a young white female nurse. I decided that now is the time to plead my case again to see a doctor now. I explained what I was experiencing and saw a doctor in less than 30 minutes.
I get to the hospital bed and all the tubes and IV get connected. The pulse oximetry is showing that my heart rate is far above normal, which is uncommon for me. No nurse or doctor was concerned but I tried to breathe slowly, in through my nose, and out through my mouth. I concentrated on breathing. In through my nose, out through my mouth. My heart rate was still accelerated. The doctor and ultrasound explained what I already felt was true. My baby was gone. Barely developed, but fully experienced in my body. All the morning sickness, bloating, uterus expansion, exhaustion, and tender breasts. It was nearing midnight when I went to another room, to see yet another nurse for a routine vaginal ultrasound. No fetus, but a large solid image appeared on my ovary. After ten hours, I was sent home from the hospital with maxi pads that are nearly 3 inches thick, Aspirin, and an OB/GYN referral. I drove home in my car as my husband followed me in his truck.
Next
The next day I saw the OB/GYN that was referred by the ER doctor. My appointment was first thing in the morning after only a few hours of sleep. Some staff knew why I was there and others didn’t. After checking in at this office I had to go through another vaginal ultrasound. The nurse doing the procedure stated how excited she was for me to see the baby. I did my best to keep a composed tone then explained that there should not be a baby. I experienced a miscarriage last night, but please confirm a dark image on my ovary that is likely ovarian cysts. I’ve learned that a spiteful nurse can wreak havoc. In my case, she needed to check that the pregnancy tissue had left the uterus. Each nurse or doctor that I spoke to from this moment on did not seem to read my medical chart handed to them and I had to explain my experience and what I needed from them. Each time was exhausting, but this is how I advocated for myself by clearly articulating my medical history and their role in my care.
When I see the OB/GYN, he explains the process of miscarriage to me and confirms what happened with hormone level results. He reiterates that it was not my fault and there was nothing I could do to prevent it. While I knew this truth, it was nice to hear from a doctor. It is such a strange feeling to not feel confident in what my body is doing and if I can trust this feeling. The doctor and each nurse that came to speak to me after this event kept trying to encourage me to try to get pregnant again and explain how motherhood is still an option. But, I did not plan this pregnancy and was never certain that I wanted children. When I received the pregnancy results, I was shocked at how excited I was. How I immediately began planning for a new future with enthusiasm. The stress about getting pregnant again had never crossed my mind. I was still working my way through this experience.
75-80% of people with a uterus have a miscarriage within the first 12 weeks of pregnancy. It should be discussed more how this uncontrollable act is physically excruciating. No medication was prescribed to me to manage the pain. The cramping from the miscarriage was worse than the periods that I had been experiencing that left me feeling nauseous and in the fetal position for days. Like a period, the pain after a miscarriage comes in waves. The pain subsided for a few minutes and then crouched over in pain for the next 30 minutes. When a nurse from the OB/GYN’s office called two days after the loss, I had to ask if this pain was normal? She replied, “yes”. I told her no amount of Tylenol was helping. At that point I was taking 650 mg of Tylenol every two hours.
Ovarian Discovery
The OB/GYN referred me to an oncologist to share the next steps in determining what the mass on my ovary was. The resident doctor comes into the examination first and I explain why I am there and what happened to me two days previous.There were two options, some of which could be combined. It could be cancer or a benign ovarian cyst. Due to the extreme pain that I would experience during my period he would also check if I had endometriosis (endo). He took my request to check for endo lightly until I mentioned the pain from my period caused me to miss work. The recommended treatments for endo surprise me and none of them were suitable. They include becoming pregnant, birth control, hysterectomy, or continual surgical procedures to remove tissue build up around the uterus. This surgery could be life altering given the results. With my previous history of ovarian cysts and my family history of breast cancer, I felt that the results could actually come back as malignant. I had entered into a darker mental space.
Work On My Mind
I was close to my last day of work as a full-time staff in a public library, to work in an academic library as a graduate assistant the last year of my MLIS program. I had to change my last day to two weeks after the miscarriage so that I would not be liable for the tuition paid by my employer. Throughout the entire experience work was on my mind. I went back to work after two weeks to wrap-up my responsibilities at the public library.
I built in a six-week buffer between jobs because I had several follow-up visits with an oncologist. The cysts were removed six days before I was scheduled to begin my new position. The oncologist mentioned several times that I would be fine after three days with the ability to walk around with no pain. He mentioned once that I should have six weeks to feel comfortable after the surgery. Surgery had changed a lot since I last had my ovarian cystectomy in 1999. I was ecstatic to hear this so I would have no disruptions when starting my new position.
I never would have considered myself a workaholic. I like to do my job well and feel confident that I completed my tasks to my standard. This experience showed me how much the expectations of work with little rest had penetrated my thought process. Grief had set in. The traumas my body experienced rewired something. I noticed this rewiring happening to Black women around the world at this time.
During this time many of the world’s top athletes, Simone Biles and Naomi Osaka were coming out about the capitalist nature of their work destroying their self-esteem and positivity. And they were exhausted. Many people talk about the unacceptable nature of a librarian’s workload, but continue to work late hours and put themselves last, these women were putting that talk into action. Being fully aware that they may lose money by taking a break, that is what they needed. I grew up being told that I had to “work twice as hard, to get half as much”. We know this African American proverb too well. I didn’t think that I was embodying this statement as I consider myself to be a laid back person who intentionally separates work from home. But beginning a new career in a field that I really enjoy has proved me wrong. I wanted to set myself up for success because I had one year to work in an academic library and prove myself before graduation in May 2022.
Family Reaction
The reaction of family after confiding in them about the experience was also life changing. I was not expecting my family to blow over the trauma my body experienced and quickly change the topic. I certainly did not expect to hear anti-vax rhetoric spewed at me as a cause of the miscarriage. I already felt weak and helpless, now I was also made to feel that the choice to stay safe and vaccinated was my fault. I was truly hoping to be heard and consoled. I no longer speak to the family member who felt the need to argue these anti-vax points with me. This person also did not check on me before or after my surgery. I was so ashamed by this response, I didn’t reach out to anyone else to share how I felt. If my closest family members didn’t care, how could I expect anyone else to?
There was no way I could be honest about the deep depression that followed. My concern for my well-being was not taken into consideration. I had never been more concerned about myself. I realized that I did not have the support system that would circle around and care for me.
Surgery
The day before my surgery in our new apartment, I do my hair in a style that will last several weeks and cook a pot of chili. In my mind, this strategy made sense because I was supposed to begin my new job and the new semester three days later. The day of my surgery I arrived early with my husband and my mother. My mother came down for two days and then she had to return to work. Due to the COVID-19 Pandemic, I was only allowed to bring one person inside. We gave my mother the keys to wait in the cafe across the street as my husband went through the surgical check-in with me. This process was unexpectedly quick. I leave my husband to the surgical waiting room where they check all vitals as I lay in a bed in the coldest room I have ever stayed in. Every five seconds I am requesting more blankets. While I arrived when I was told to by my oncologist’s surgery planner, I waited to be rolled into surgery for five hours. By this time, my husband found a way to bring my mother with him to the waiting room.
Before I awoke from surgery my medical results were explained to my family. No cancer and two ovarian cysts were removed. Do the cysts explain my heavy and painful menstrual cycle or my miscarriage? Could this happen again? Things never answered by my doctors. I learned later that my oncologist was retiring just weeks after completing my surgery, which I believe contributed to his ambivalence to my condition.
I was ecstatic that my mother stayed with me and made sure the burden of my care did not only fall on my husband who had already done so much. Happy that he had a job where he worked from home everyday and did not have to take many days off to care for me. The joy, excitement, and positive energy my mother brought with her kept me up for the two days she stayed with us. I only slept for a few hours between those two days.
The amount of times that surgeon reminded me that I would be up and walking three days later and the scars would be minimal due to small incisions needed by the robotic arms who now take on much of the work. I relied on the surgeon and his nurses to relay the information I needed as it was difficult for me to think with clarity and prepare questions like an interview as I told myself I would. This surgeon failed to communicate that the surgical scars would be across my abdomen. Preventing me from wearing some of the clothing I wanted. The surgeon asked no follow-up questions.
In-between
There were six weeks between the loss, the surgery, and beginning my new job. The grief was insurmountable. I felt eternally exhausted. I felt like the walking dead. This including extreme hormonal changes affected my needs to sleep, eat, cry, or speak. I was still recovering from the difficulty of dealing with apathetic health care workers. Knowing how common miscarriages are, does not stop the mental disruption.
The feeling of not being able to trust my body and how food, stress, and anxiety is affecting me is causing a great amount of tension on my desire to do exceptional work. I can't trust my decisions. My mind to myself. It became difficult not to do anything but sleep. My partner left easily digestible food by my bedside so I could nibble on throughout the day between naps. I was extremely proud of myself for managing to take daily showers. When I had to return to work I made sure to look presentable. Trying not to look how I felt so I wouldn't get any questions. All my staff knew was that I was out for two weeks. I received no questions about where I'd been and what happened. I struggled to get out of bed and finished my last two days at this job quietly.
While in the waiting room for my check-up after the surgery I had to fill out a mental health assessment. I decided to actually be honest about how I was feeling. I was shocked when I received a call from a social worker about the assessment. Her intention was to couple me with a psychiatrist. By the time I received this call I had already finished my first two weeks as a graduate assistant and began the Fall semester. It was the first time anyone outside of my husband had acknowledged the struggle I was experiencing with my mental health. I was consistently battling anxiety, depression, and daily feelings of failure. I began my last semester, starting taking meetings as a new member of a BRASS (an organization for business librarians) and writing discussion posts for my Fall classes.
It should have been natural to slow down, but all I could think of was my future committee work, my last Fall semester, where I would get an internship, graduating, and where to apply after I graduate.
Blame
I blamed myself for not knowing how to find an Obstetrician or what I should do in the case of a miscarriage or how to process this experience. The trauma from this event shocked me because I did not want children. I did not expect all the emotions that followed losing it. I was in such shock throughout the entire process, I missed opportunities to ask comprehensive questions. Oftentimes, I didn’t feel that I could question the process or seek second opinions because I wanted everything to pass quickly before starting the new semester and new job.
New Start
My director forgot I had surgery just one week prior to my initial start date. At my new job at a large academic library, no one I was working with had any idea what I was experiencing. I made sure not to remind him. I would have waves of complete apathy when I did not care about anything. I had no ambition. I tried to blame this on a type of senioritis as I was finally completing my third and final year. When describing my lack of interest to do anything to others in my class and the response was blank stares. I realized at that point that what I was feeling was abnormal. At this time I still had to complete an internship and we still had to move to our new apartment. An apartment that we paid the deposit for weeks before I found out about the pregnancy.
My first day in my new position in an academic library, I had an anxiety attack for the first time in my car when returning from lunch. The pressure that I put on myself to start this position after one week after surgery and still mentally recovering proved to be too much. Although I pushed back my starting day by two weeks, I did not want to put off starting this work as it was my last year and I felt I had to learn as much as possible if I wanted to have a career in academia. I had no time to waste. The walk from the parking garage to the library was more exhausting than I could have expected. The combination of the heat, weight of my laptop and notebook made me pause and reminded me that my body was not ready for this much movement. I never told anyone what I experienced on my first day. It is much more difficult to obtain a career in academia versus public librarianship and I did not think I could hold off my start date any longer.
To make it through each day, I would pack fruits, vegetables, and Pedialyte. There was so much to do in this new job and I did not know where to begin. It was never lost on me that this job was temporary. It would only last for one academic year and I needed to begin working towards the job I wanted. I did not know that it was my choice to create projects and carry them out. I was accustomed to taking orders from a manager. It was quite a task to show up for Grad School and work, while I struggled to get out of bed and eat a meal that provided the nutrients necessary. I had to be ON. I was meeting new librarians, professors, and students each week. It was exhausting.
It is never missed on me that Black women in the workplace also tow the line between invisibility and hypervisibility. Unfortunately, I have experienced both sides of this in previous jobs, so it is not just a theory for me. While I may be viewed as powerless, my work overlooked, and resources denied under invisibility I can also be under greater scrutiny, mistakes magnified, stereotypes and biases reinforced, and treated as a token under hypervisibility. I did not want to give anyone an excuse for passing me up for the job I wanted. I also needed to contribute financially to my household.
Grief has a wave structure. There is some detail to remind me of the event and I feel fine, I can handle this. The beginning of the wave. Then as hours go on, the feelings build and I'm sobbing. I go into most situations hopeful. When the real world gets revealed I grieve the life that could have been. I begin to imagine what should have happened. The nurse could have taken me to see the doctor as soon as I came in but chose not to. The nurse could have shown some sympathy but chose not to. Instead he made a joke. I could have been more aggressive demanding that I speak to a doctor. If every doctor visit was not due to emergency and first availability, I would not have chosen men doctors. I would have spent time searching for the right woman doctor. I don't know if that would change anything but at least I would have tried. I could have given myself weeks to return to work. But it's past that now. I have to care for myself.
Care + Support
I was fortunate enough to assume an internship in an Archives Unit with women that took the elements of community of care seriously as the upending pandemic was affecting everyone in this department. I did not have to explain that I was struggling to make it through each day, because of their care. I felt I was drowning and they didn’t know. I felt that I was failing and they didn’t know. They respected me and my opinion and allowed me to grow and introduce new ideas and thoughts. I was never going to tell them what I was experiencing. I still showed up to work even when I cried in the car on the way there or in my office space. While I incorporated their definition of rest and self-care into my life to lay in bed or go on walks with my husband and dog.
When they recalled the breaks they provided for themselves it made me see that the breaks I was giving myself were okay. These were women that I admired and they attempted to take the necessary steps to put themselves first. They did not brag about working for hours at home after leaving work. They did not force themselves to come into the office when not necessary. They were putting their families and mental health first.
The Knowledge River Scholarship Program (KR) provided a network of other MLIS students and librarians that supported my work and allowed me to be myself. It provided an outlet where I could seriously discuss how BIPOC librarians impact our communities and how necessary this work is, as well as a space to have fun.
The BCALA Leadership Institute gave me the opportunity to meet inspiring Black librarians and MLIS students. Several of which I keep in contact with. They listened to me and valued my contributions to the field. They continue to cheer me on.
The simultaneous global events of The Pandemic, the Trump presidency, the many killings of Black people by the state were taking a toll on everyone. While this has been affecting me for some time, I thought it peaked at the murder of Trayvon Martin. It had been escalating since then including many Black women in its path. I realized the treatment I received as a library worker in a public library was unexpectable. I was also grieving the racist murders of my people as it seemed each day protests were erupting in cities across the world. It was to my benefit that I stay home, not only for health safety but, I did not want to risk lashing out instead of ignoring or highlighting the hypocrisy in their statements. It was vital that I surpass the ignorant conversations my public library co-workers were having about the protesting. It’s the same rhetoric about destroying our own communities as heard on Fox News. Although they would not know about our struggle with state-sanctioned violence without protests, these statements are made out loud regardless. My experience with these topics in white spaces have proven to only be harmful to me when I bring statistics and historical contexts to the conversation.
Action Plan
I created an action for what I wanted to accomplish during my Graduate Assistantship and Internship and I could not complete it all. I received great grades and actively participated in committee work. I created a network of librarians who continue to support me. That is all I needed to do. I worked on my CV and interviewing skills. I allowed myself to take breaks, not work much after I left the library or outside my scheduled time.
Black librarians are passionate about creating access to information to address social issues and make a positive impact on our communities. I wanted to be a part of this network of Black librarians. This same network provided me with advice and encouragement. Informing me that I had done more than enough work to meet my goal of becoming a Business Librarian. I received several job offers and obtained the job I wanted, closer to my family.
I expressed to my mother how so many people were helping me along my journey of Grad School and job search. She responded by saying, “of course people are willing to help you after they see you are willing to help yourself, people want to help good people”. This simple statement made such an impact because I had forgotten that I am a good person who also deserves good things. I am someone who is deserving of positive outcomes. I realized that I had truly believed the negative thoughts that depression was telling me.
Now
My menstrual cycle is still something I struggle with. While the extreme pain no longer lasts for the entire week, it is always there the first 2-3 days and extremely heavy. I've learned to not put the pressure on myself to be active on those days and rest. The symptoms of my period are more drastic than before. Nearly 4-5 days before, I cry, feel depressed, have suicide ideation, begin cramping, and become drowsy, all symptoms of Premenstrual Dysphoric Disorder (PMDD). I have to be prepared to explain my symptoms to my current Gynecologist and advocate for my care. My new body and mind are still adjusting. Admittedly, due to past experiences with doctors I don't go as often as prescribed and should be more proactive. I am working on that. It is worth changing doctors until I find the right one for me. I now understand that I must use the key phrase, “these symptoms disrupt my ability to go to work”. Then my symptoms are taken more seriously.
I am currently working towards tenure as a Business Librarian and still lean on my network for help, encouragement, and inspiration. I continue to take breaks and enjoy my time at home. Working from home has been a bigger life saver than I realized it would be. I do not constantly check my emails and work chats when away from work. I practice yoga and pilates to get comfortable in my body. I never contribute to the bragging competitions about how many hours I worked during my time off. I wish I could say that work no longer remains to hold so much space in my mind, but it does. I push it to the side by caring for myself. The work to build stronger connections with my family and friends continues so I can be for them when they need me and they do the same in return.
I still don’t know if I can carry a baby and at this point in my life, I’m not interested. It is possible that this could change, but in my mind, I will never be ready.
I can be proud of many things that I did for myself. I surrounded myself with caring people. While I pushed myself to complete projects, I realized how much energy it consumed. Online meeting places like the BIPOC in Mental Health Summit and Therapy for Black Girls hold me over until I find a professional therapist I am comfortable sharing these intimate parts of myself with.
Many of us struggled through these last few years, but what you are doing is enough. It is worth giving yourself space and room to breathe. No one is going to care more about your body and mind than you are. I am constantly working to get to Cozy as defined by Beyonce,“Comfortable in my skin; Cozy with who I am; I love myself, goddamn”.
Timeline:
See doctor about extremely painful period cramps
Receive positive pregnancy test
Reddish brown discharge and cramps begin
Make appointment with OB
Miscarriage
Leave work for 6 weeks
Move to new apartment
Come back to work for 2 days
enter Knowledge River cohort
Surgery
Begin new semester AND BRASS committee activities
Start new job
Care at work
Graduate
Begin Librarian job