I am a mother of two little girls. Every day I look at my youngest and I think about the fact that she almost didn’t happen, thanks to a routine procedure doctors perform. Five years ago, I got diagnosed with Asherman’s Syndrome. It’s a condition where the walls of your uterus scar shut, most frequently after a medical procedure involving your uterus. The most common example is after D&C (dilation and curettage), which is often done after a miscarriage, abortion, or in my case postpartum bleeding.
My husband and I had our first daughter in 2008. We got pregnant in the first month of trying and it was an easy pregnancy. Her birth was uncomplicated. Two weeks after she was born, I began bleeding. I was taken to the ER where they assumed I had retained product from the delivery and immediately scheduled me for a D&C. Before the surgery I specifically asked my doctor if what they were going to do could impact my fertility and she said “no.”
Fast forward 10 months later. I still had not had a period. Tests concluded I had Asherman’s Syndrome. The doctor referred me to a specialist and said they could fix me and I’d be on my way.
At the time I was an investigative producer for a news network, so research was my thing. That night I googled Asherman’s. I cannot begin to tell you the tears I shed in front of my computer. I found out that many women never have another baby after developing the condition. Worse yet, one in four women develop Asherman’s if they have a D&C due to postpartum bleeding, as in my case. It seems like my question at the hospital of “could this impact my fertility” should have been answered with a resounding “yes.”
My husband and I went to the specialist. After her own tests, she told us we should consider adoption or a surrogate, and that my case was one of the most extreme she’d ever seen. I was devastated. How could I have gone from having no fertility issues to having to ask someone else to carry my baby? How could this be as a result of a procedure that didn’t even have to be done on that day? — More on that later.
The news producer in me wouldn’t take no for an answer. I kept researching and found an online forum of women just like me. This forum of women is so organized; they actually have a list of the world’s top doctors that treat Asherman’s. I found one who lived in Long Island, and my husband made the drive to see him. (I realize that this is such a privilege; many families can’t take two days off work to go see doctors in other states!)
The specialist also told me I was one of his most extreme cases, but he would try to fix me. After the procedure and one month of bed rest, we returned for a check-up. It never should have happened in one surgery (many women have to have multiple surgeries), but my uterine cavity had opened and he cleared us to conceive.
One month later, the second miracle happened. We were pregnant! In July of 2010, we had our second daughter.
I am blessed with a happy ending, but every day women with Asherman’s look at empty nurseries, boxes of unused baby clothes and the extreme cost of adoption or surrogacy all because the medical community isn’t being honest about best practices.
If you research Asherman’s you will find mounting evidence that a D&C should be the last resort for women, particularly women who were recently pregnant or had a baby. There are alternative methods of accomplishing the same thing, such as misoprostol. Beyond that, if a D&C is deemed unavoidable, it should not be done blindly. Experts will tell you it should always be done under ultrasound guidance. Without that, doctors are literally scraping the inside of a woman’s uterus with no idea what their utensils are doing to her body.
Operating under the current protocol of performing D&C’s as if they have little risk is lazy medicine and it’s dishonest to women. We deserve to know the risks and to know we have options.
Ironically in my case, the doctors misdiagnosed the cause of my postpartum bleeding. What they mistook for retained product was actually a ruptured fibroid tumor. If they had done more testing, I would have been released the same day to go home to my daughter and husband.
I’m sure you’re wondering … did I take those doctors to court? I tried. Believe me.
I hold my daughters and I wonder what women in my situation do without financial resources and the knowledge of how to do proper research. I believe Asherman’s Syndrome should be a topic of a brochure you find at your doctor’s office, and part of obstetric education, much like gestational diabetes is, or SIDS. Until then, we need to educate our friends and ourselves. For the most part, Asherman’s is avoidable and we need to give ourselves the tools and information — because the gift of carrying a child shouldn’t be taken away because of a lack of education.