Thyroid function and miscarriage in Uganda - Lauren's Story
Eric and I got married at the end of August 2018 and three weeks later we were on our way back to Uganda! Both of us had been living in Eastern Uganda in a town called Mbale, but most recently Eric had been finishing his masters degree in the US and was finally returning back after 2 years. I had been living and working in Mbale and returned to the US in June to prepare for our wedding and marriage. We were so excited to come back and start our African journey together! Since I was a bit older, we decided we did not want to wait long to start having children, yet we decided to give ourselves a few months to enjoy newlywed life and settle into Mbale then we would get serious about adding to our family in January.
Well, we had just celebrated two months of marriage and found out that I was pregnant! Shocked and excited, we started the journey by telling our parents and close friends and I met with a dear friend in the community who had recently gone through pregnancy in Mbale to figure out what do I do next!
It was about 2 weeks later that I was at work on a Friday and started feeling feverish and decided to leave work early to go home to rest. I also noticed some bleeding and as the afternoon and evening progressed I was bleeding a lot and had the worst pains that I ever experienced. I called a friend in the area who is a doctor to get her opinion on what was happening- she graciously informed me to rest and get a scan on Monday. I knew that miscarriage was a real possibility; my mom had two challenging miscarriages before having a healthy pregnancy and birth and a handful of my friends had had pregnancy losses. I knew that it was all too common. As Eric and I went to get a scan on Monday, the sonographer confirmed that in fact there was a sack but no viable pregnancy. This pregnancy was so unexpected that as soon as I was getting my mind around that fact of actually being pregnant, the baby was gone. This loss hurt more physically then it did emotionally.
I healed really well and was able to go about life, work, etc. My cycle came back in 6 weeks and we resumed with the plan of getting serious about pregnancy in January. Would you know that January came and weeks later we found out that I was pregnant! So excited and more prepared; still with a small hint of concern about a loss, yet hopeful that this would be a viable pregnancy we told our parents and close friends. Then a few weeks later I woke up one morning with excessive bleeding. I woke Eric up and I was completely devastated. I knew that I had lost this baby too. This loss hurt me so much more emotionally than physically.
It would be days before the tears dissipated. I called my friend again who is a doctor and asked her what she thought- she confirmed what I knew to be true. I did not even go for a scan because I knew all I needed to. My husband and friends cared for me and let me cry and those who has experienced loss before empathized with me by listening and sharing their own stories.
I still had hope that I would have a healthy and viable pregnancy one day. Without delay, Eric encouraged me to reach out to a good friend who lives in the capital of Kampala (about 5 hours away). In Kampala, they have better medical care than I would find in Mbale. My friend, who had prenatal care for her two pregnancies in Kampala, led us to a doctor who she had just worked with. I scheduled an appointment and we made the trip to Kampala a week later. This doctor did a thorough blood work panel and one of those being a quick TSH level test to assess my thyroid level. This is the only blood work that came back a bit out of the normal range. Through much reading, I learned that ‘within range’ TSH levels are vital for a viable pregnancy and out of range TSH level are a major cause of early miscarriage. The developing baby is reliant on the mother’s thyroid and if I am not producing enough TSH for me, then I am not able to produce enough for my growing little one.
The doctor put me on a low dose of a simple medication and wanted to check my levels again in 6 weeks. She instructed that I was not to try to conceive until after the 6 weeks results.
I took the next few weeks to read books on miscarriage, listen to podcasts of pregnancy loss, to join an online community called The Joyful Mourning. I also learned a lot about egg health and the many reasons miscarriages can occur. I read that most doctors will not test TSH right away and it is good to ask you doctor for it. Another fascinating thing that I learned was most infertility doctors will not take on a patient unless she has had 3 or more miscarriages. I am so glad that I did not have to endure another loss in order to see a doctor. We were so fortunate in be in Uganda during this time where getting an appointment with a quality doctor only took a week, the cost was low (compared to the US), my doctor tested for TSH right away, and I could see her (the doctor) after only two losses instead of three.
I also took these weeks to share my story with my community of ladies who I prayed with each week; they were all so loving and caring and walked with me in prayer. Eric and I shared with other friends and our families too. I am also big into writing in my journal and I so I did that a lot! I wrote out some poetry and spend beautiful time in prayer and reflection that way. Another beautiful gift that came along was a new friend who I met in the Mbale community. In January, Eric and I decided to start going to a new church. Our first Sunday there, the lady next to me (who did not know me or ANYTHING about me) grabbed my hand during worship and started praying over me. I may not remember everything she said, although I do have it written in a journal somewhere, but she spoke Proverbs 3:5-6 over me.
Trust in the Lord with all your heart and lean not on your own understanding; in all your ways submit to him, and he will make your paths straight
So I got home and wrote that on my chalkboard wall and believed afresh this passage that I had known for years! My friendship with this dear lady really formed when I learned she was an exercise teacher, so I went 3 days a week to exercise with her and she would pray over me and she cared for me so well. Her faith and life was a turning point in my own faith and hope.
After 6 weeks, my TSH levels were within a good range and a month later I found out that I was pregnant. My doctor monitored me every two weeks and what we found was a strong growing baby!
I will share the rest of my pregnancy in another post!