As soon as the doctor inserted the wand and located the sac onscreen, I knew we'd lost this one. I wasn't looking for a heartbeat, so that's not what I noticed. What I noticed was the lack of room inside the gestational sac it was even more crowded than it was a week ago. There just wasn't enough room for the embryo to grow.
The doctor searched for the heartbeat for a few minutes. She brought in a colleague to confirm her findings. No heartbeat.
I surprised myself by my response, or lack thereof. When I'd imagined this happening (and I had, playing it over and over in my head as if I could rehearse my way into acceptance), I'd wondered whether I would gasp, or cry, or squeeze Paul's hand until I broke his fingers. No: I lay on the table feeling enormously detached, as though I were a disinterested onlooker just watching this all happen.
I didn't cry at all. The most emotional I got was when I felt a crazy urge to complain: "You didn't give us a picture this time!"
I got dressed and the doctor took us into the consultation room. I've always liked this doctor before; she's the head of the department and inspires great confidence with her friendly manner. This time she was all business still kind, but absolutely grave as she outlined our options. I'd heard this before, but I let her explain.
A natural miscarriage could happen that day, she said, or it could take up to a month there was simply no way to predict. This wasn't an option for me. The thought of going about my business as normal and waiting to expel the pregnancy that was already over...no.
I could take misoprostol again. This option at least had the virtue of predictability, but I would still have to endure the ordeal of cramping, bleeding, and passing massive amounts of tissue. I was too scared to do that. Waiting for the ectopic to resolve last time frightened me enough that I wasn't going to volunteer to sit at home and bleed.
If I chose a D&C, it would be more involved than the one I had before; since I'd had no Cytotec to dilate my cervix, I'd have to go to the hospital for the procedure and undergo some kind of major anaesthetic. I asked how long I'd have to wait for a D&C to be scheduled. The doctor said I didn't have to choose immediately, but I could get it done the same day once I'd decided.
Well, that was that, as far as Paul and I were concerned. We asked to be scheduled that day.
I think we surprised the doctor, who seemed more used to counseling people who'd been surprised by such sad news. For better or worse, we'd expected it, and had already spent some time talking about our options. The sooner my body could begin to heal, the sooner my heart could. Theoretically.