An infertility story by Carla Seetaldass-Ramesar (a co-authored blog)
Photo credit- Carla Seetaldass- Ramesar
"I felt the urge to stoop in a sitting position as something began sliding out of me while pushing. There it came- a ball of blood. I picked it up and held it in my hands. A melee of curiosity and despair made me pull apart the ball to see what was inside. There I saw a small clear jelly-like ball, with a small bean-like figure with dots that resembled eyes. I called out to my husband to look at it but he was too distraught at the sight of blood pouring out of me like a tap. My body and emotions were numb, I couldn’t cry nor laugh."
Imagine trying to bring life into this world with your partner and a Grim Reaper living inside of your womb. That's the daily struggle for women battling infertility. After six years, several compromised pregnancies, and over TT$700,000 (USD $103,000) worth of treatment, Carla Seetaldass-Ramesar still clutches her dream- cradling a newborn baby; one birthed from her own body.
I cried during our interview earlier this year; something I'd never done with any of my blog protagonists. I struggled to process the intensity of her story; her unflinching determination twirled around layers of fathomless grief. Carla's story gripped my senses. It's raw and riveting.
The World Health Organization suggests that between 48 million couples and 186 million individuals live with infertility. There are two manifestations- primary infertility, whereby there are no successful pregnancies by a person, and secondary infertility, where at least one pregnancy was achieved. In 2010, a renowned study of 277 health surveys spanning190 countries and territories revealed that approximately 10.5% of women struggled with the latter; the former reflecting a much lower rate of 1.9%. I honestly thought that having at least one child made it almost impossible to become infertile. Clearly, I was wrong.
These alarming stats also mean that there are many Carlas out there in the world. Many...
In 2015, Carla's diagnosis of polycystic ovaries ( a condition that affects 4%–20% of women of reproductive age worldwide) largely contributed to failed attempts at hormonal therapy and artificial insemination. She eventually found herself on a rugged In Vitro Fertilization (IVF) trek. Without the buffer of insurance coverage (insurance companies in Trinidad and Tobago do not offer IVF coverage), Carla secured a loan to initiate this process.
She jetted off to Barbados with her friend Nirmala for her first IVF treatment. The dreamy white sandy beaches and glistening aquamarine waters offered no solace to a wounded woman craving motherhood.
IVF entails harvesting eggs from one's ovaries, fertilizing the mature ones of the right size, and transferring the egg(s) to the womb. It's basically a costly game of luck. Carla's first trial harvested 18 eggs with a successful transfer of two embryos. Six weeks later, she saw those elusive two pink lines on a pregnancy test. She was expecting! Her elation though was short-lived -
"The doppler was turned on and there was a deafening silence in the room, NO HEARTBEAT!!! The nurse looked at me with glassy eyes and I knew my baby had died. He said to me “my dear it seems that the baby’s heart stopped beating."
Opting for medical management of her miscarriage, Carla opened up about her husband's grief; something we rarely hear about in infertility stories -
"We got into our van. I just stared blankly at the prescription and started crying. My husband screamed. To this day, his cries echo in my head as the last time he cried was when his mother died. We held each other and cried he said to me “it’s not your time love, everything happens at the right time."
Her traumatic miscarriage at home took me right back to my own experience; reminding me of that haunting, hollow space buried in my conscience. Carla's torture travelled beyond the walls of her home- she required a dilate and curettage (D+C) procedure to remove the remaining tissue inside of her. Sher recalled waking up in a hospital room with the piercing sounds of newborns that scorched her heart -
"I was awakened by the sounds of crying babies and I was thinking to myself “Am I dead?” I realized that my room was exactly next to the maternity ward at the nursing home. All I heard was crying newborns for hours. I begged my husband to get me discharged from the nursing home quickly as possible- I just wanted to go home in my bed."
Carla's depression was paralyzing; she struggled to get out of bed for weeks. Three months later, she mustered enough courage to head back to Barbados for her second attempt. Her heavily medicated body yielded a cervical pregnancy. Refusing the D+C procedure yet again, she detailed a fascinating technique used by a Trinidadian doctor to expel the compromised embryo -
"He tried a simple procedure with a deflated balloon. He filled it with water upon inserting inside of me, then pulled it out in a quick motion. I was the first patient he applied this technique on, and luckily the balloon procedure worked!"
(Yup, a balloon procedure. Science will never cease to amaze a sufficiently curious mind).
Carla is an expert test-taker. She's faced a battery of tests and consecutive disappointments with conviction. A Hysteroscopy. New medication added to her already exhaustive routine of progesterone oil shots and Viagra. A chemical pregnancy. Testing for elevated natural killer cells (whereby the body attracts any foreign matter such as a foetus). Another routine with Humira and Prednisolone to suppress her immune system; this time the Humira spiking her natural killer cells level, terminating any chance of pregnancy.
Hope as well as her savings were diminishing, but if you're an IVF warrior you'll move heaven and earth to hear your baby's heartbeat.
Eternal friendships ease life's most daunting moments. In July 2019, Carla and another friend Sarah headed back to Barbados on a "girls' trip with meds." She delicately balanced sightseeing, laughter and her medication. Sadly, motherhood evaded her once again.
Fast-forward to November 2019 and another trip to Barbados when Carla became pregnant once again-
" I finally said “Yes this is it! I was the happiest person alive. At night, I would rub my stomach and say “Mommy loves you more than you will ever know, please baby stay safe for mommy, I need you to keep safe.” My hCG levels were doubling and the numbers were exactly where they needed to be. I prayed that night, telling God “Please don’t give me something that I have yearned for, then to take it back. It’s best you don’t give it to me at all.”
Carla was finally convinced that this was a breakthrough; a light caressing her womb and lifting her worn soul from its depraved state. But the stars weren't favourably aligned. Instead, they foretold loss.
"On the morning of December 10th 2019, at 2am, I went to the toilet and as I wiped, I saw bright red blood! I shouted out “Not again, God not again!” My husband ran out of bed to see me holding the piece of tissue with blood. He looked at me in horror as we both knew it was another miscarriage. I cleaned myself up, got dressed and went back to lie on the bed.
As the sun entered our bedroom, I was already dressed to visit the lab to test my hCG levels. I have been through this so many times that I knew what had to be done without even calling my doctor nor the clinic. While sitting in the waiting room of the lab for my blood to be drawn, I felt a sudden gush out of my vagina. I rushed to the bathroom and there and then, it fell into my hand. A ball of blood. Again, I don’t know if it was curiosity, but I pulled apart the blood and saw the same clear jelly-like ball with a rather small piece of tissue. I knew it was my only hope and dream in my hands. I cleaned myself up did the blood test and went home.
I had no more emotions, and my tears were dried up. The same day was my (now) deceased mother-in-law’s birthday. I just wanted to jump in front of a moving truck. The sadness and pain that I felt were indescribable. I always struggled to explain exactly how heart-breaking this was. To endure one miscarriage is hard, but recurrent miscarriages were too much to bear. At this point, I had hit rock bottom. The doctors kept telling me that my losses were nothing more than bad luck. My intuition told me differently. At that point, I was truly lost. I felt anger, sadness, let down by my clinic, robbed of my babies and so much more."
Carla's propensity to endure physical and emotional pain is vast. Despite an abysmal six years and running medical tab, hope still flickers within her. It wanes some days and burns zealously on others. She's open to other pathways to motherhood including adoption and has considered surrogacy, (I came across an article from 2008 whereby 'Suzy' was selling surrogate babies in the local market for TT $60,000.) There is more that needs to be done locally to support IVF women - insurance coverage, surrogacy legislation to legitimise this process (and perhaps offer comfort to women like Carla), and a societal cultural shift that offers greater compassion to infertile women.
IVF women perhaps question why their journeys were handpicked for extra obstacles to be strewn along their path. Carla's limbs may be battered from her trek, but she's still got life in her. Perhaps the Grim Reaper didn't win after all.
"It’s not ‘just a miscarriage’ and it was a ‘proper’ baby to me. I carried it for every second of its life and that’s not something I take lightly. It was and will always be our favourite “what if.” A family is something we both desire more than anything so it is not a fight we will give up easily."
To Carla, thank you for your bravery and for writing your IVF story.