I just realized that I had my miscarriage happened exactly three years after we found out we were chosen to adopt our daughter. What a bad memory to add to such a special day.

The good news is that Monday will mark three years since we brought our daughter home. This year it's the same day as the annual ice cream social at our adoption agency. We plan to attend, so it will be a great way to celebrate our family's adoption. My daughter is already looking forward to jumping in the bouncy house like she did last year.

Yesterday morning I called my midwife and left her a message to tell her I had the miscarriage and see if she wanted me to keep my appointment for today or schedule something else. She called back, asked some questions, and said she'd like to see me that day.

A few hours later I was at the clinic. My midwife thought that things had gone well. She said she could either look at my cervix to see if it was closed or do an ultrasound to see if all the tissue was gone. I said it didn't matter, and she said looking at the cervix would be easier.

She looked at my cervix and said that it was closed and firm, just what she wanted to see. She said I should expect some more light bleeding (which I had both today and yesterday).

She asked me how I was doing emotionally, made sure that I had a woman friend to talk to, and checked to see that I was getting out and doing things. She said she didn't want me to get depressed. She also gave me a book about miscarriage/infant loss written from a Christian perspective. She said it was discovered by one of the doctors at the clinic when she had a miscarriage while in medical school. I don't think I mentioned before that this midwife is a Christian and knows that I am one too. Normally a medical professional would never give you literature that has anything to do with religion (that's why they have chaplains at hospitals), so I thought that receiving that book from her was pretty special.

I am to have two more appointments, one next week Friday, and one after about a month to make sure that my uterus is back to normal.

One of the last things she suggested before I left was that I start taking "baby" (low dose) aspirin. She said it couldn't hurt and could help with clotting. I bought some, but I'm not sure how faithful I'm going to be with taking them. All this talk about being more fertile and taking aspirin in case I get pregnant again just causes me to get eager for what probably will not happen.

However, I can't help but wonder what caused the conception. Has there been some sort of improvement in our fertility? If so, maybe we could get pregnant again quickly. This way of thinking just doesn't seem right, and I don't feel right about the idea of trying to conceive. I really don't want to face the disappointment. I think it's better to keep focusing on our adoption...but I can't help but feel a renewed sense of hope for a possible pregnancy.

If you are interested in biology, please read on. I have always wondered about my cervix and why doctors seem to think it is unusual. I finally have some answers (one benefit from this miscarriage).

When the midwife was looking at my cervix, she asked me if I had ever had an abnormal pap smear. I said I hadn't. She said it looked like my cervix had been frozen. I said that I did know what that means, but that I know I have a weird cervix. I've been told that I have more mucus cells than normal outside my cervix, and that it can be more sensitive, more prone to infection, and that I can have more mucus than normal. My fertility doctor once told me that it looked like my cervix is inside-out.

The midwife started telling me how the two types of cells on my cervix meet abruptly, and that they normally have a more gradual transition. People with HPV may have their cervix frozen to remove abnormal cells, and then there isn't the gradual transition.

Then she got out a mirror, so I could see what she was talking about. No one has ever shown me my cervix before, and I have never thought about asking. I was a little freaked at first, but it was really interesting when I saw it. I saw the smooth pink cells and the bright red cells. The red cells were in the center and made up about half of the diameter of the cervix. There was a definite point where the two kinds of cells met.

I just finished doing a little research online, and I discovered the medical terms for things.
The two types of cells lining the cervix are called:

- columnar (or "glandular") epithelium - red, one-cell thick, typically inside the cervix (endocervix), secretes mucus

- squamous epithelium - smooth, skin-like, pale pink, many layers of cells, found outside the cervix (ectocervix)

These two cells meet at the squamocolumnar junction (SCJ). It can be located at different places based on age and hormone levels. For women of reproductive age it is located outside the cervix at various distances from the opening of the cervix (called the os).

An abrupt transition between the two epithelium is rarely seen because there is a transformation zone where one type of cell is replacing another type. (Apparently my cells are not moving around like they typically do, so there is no blending of the two types of cells.)

When the SCJ moves away from the outside os of the cervix it is sometimes called cervical ectopy.

Now I know the term. I have cervical ectopy and my SCJ has no transition zone. There are usually no syptoms and no treatment for cervical ectopy. You can have extra mucus and/or bleeding after intercourse. The treatment for that is...freezing the cervix (or cauterizing it). Now that's ironic.