A tubal ectopic pregnancy while visiting the UK from Australia

02 Mar 2024 | By Kerri

I want to share the story of my ectopic pregnancy for a number of reasons, but mainly in the hope that it helps – helps others to know what symptoms to look out for, helps others to not feel so alone in what is a very common, yet seldom spoken about, medical event, and helps me heal. I am going to share my story in detail – detail about the bleeding, the pain, the treatment, and the ongoing healing process. I hope you will come along with me as I share my ectopic pregnancy story.


My pregnancy journey started with a trip to my doctor due to some unusual spotting after my period. Since my husband and I were trying to conceive, she recommended I take a pregnancy test right then and there. To my surprise, it came back positive. The timing didn’t make any sense to me – I had only finished my period a week prior and had been spotting for the past five days. She assured me it was implantation bleeding and asked me to do some pre-pregnancy bloodwork, but to wait a week or two since I was so early on.


The spotting continued and after about a week, I noticed some bright red blood. I had a follow up appointment with my doctor scheduled in just four days’ time to get the recommended blood work, so my husband and I decided we would wait until our appointment and hope for the best. When I attended my appointment and told her about my bleeding, she organised an ultrasound for later that day. She told me the bleeding was not normal and it was likely a miscarriage or an ectopic pregnancy. I drove across the city where they did a transabdominal ultrasound. While they didn’t offer me a transvaginal ultrasound – a procedure I now know is essential with a suspected ectopic pregnancy – I did sign some paperwork giving permission to do the procedure. Needless to say, they didn’t see anything with the transabdominal ultrasound. They told me there were signs of a miscarriage with a thinning uterine lining and that I last ovulated from my left ovary. They advised that even if it was an ectopic pregnancy, I was so early on (three weeks was their estimate) there wouldn’t be any signs or symptoms for another 3-4 weeks. My doctor also ordered some blood tests to see if falling hCG (Human chorionic gonadotrophin is a hormone produced during pregnancy) levels could confirm a miscarriage, or if rising hCG levels could indicate an ectopic pregnancy.


The twist in all of this was that my husband and I were due to fly to the United Kingdom from our home in Australia the next day for a whirlwind ten day trip for my husband’s friend’s wedding. My doctor did tell me that if it was an ectopic pregnancy, then I shouldn’t fly, but with the ultrasound technician’s reassurance and pending blood test results, I felt fairly confident it was a miscarriage and I boarded the three long haul flights back-to-back from Melbourne to London via Tokyo and Helsinki. The longest two were 10 and 14 hours. Looking back, I feel so lucky that nothing happened on those flights. It is really scary to think now how risky that was, even without a diagnosis.


I organised a telehealth consultation (an appointment held through live, interactive videoconferencing to allow you to see and speak with your doctor) with my GP for 4am local time the first morning I was in London to get my blood results, hoping she would give me good news, but expecting the worst. It turns out she had actually called me only a few hours after I had taken off from Melbourne to tell me my hCG levels were rising sub optimally and she was very concerned that it was an ectopic pregnancy. I didn’t get that message as I didn’t have access to my voicemail while overseas, so I am so glad I took the initiative and made a telehealth appointment to follow up! She advised that if I had any pain or bleeding that I should head straight to accident and emergency. I also asked the clinic to send me my hCG results just in case something happened while I was overseas.


I told my husband the news when he woke up. He was off to host his friend’s bachelor party in just a few hours, which was the main reason we were even in London, and I was off to wander the streets of London on my own to do some sight-seeing and see a musical. He asked if I wanted him to stay with me, but I told him no, it would be okay, surely it wasn’t an ectopic pregnancy and if it was, I was only three weeks pregnant, too soon for anything bad to happen.


I contacted a good friend from college who had unfortunately suffered an ectopic pregnancy nearly two years ago to the day, and who had fortunately shared her story on social media. She was the best source of information that I could find as she shared the story of how her symptoms progressed, her unfortunate rupture, her emergency surgery, her recovery and her healthy pregnancy soon after. Hearing the similarities and potential outcomes scared me, but made me take my symptoms much more seriously. At this point, the only key symptom missing was pain. I went on to explore London on my own, trying not to think of the persistent bleeding and what could be happening. I tried to stay positive, but it felt like I had a ticking time bomb inside of me, ready to rupture my Fallopian tube at any time.


Two days later, at around 9pm, as I was watching the second act of Newsies the musical, I felt a dull, yet very clear pain on the lower right side of my abdomen. I was trying to convince myself it was in my head – after all, I had been told I ovulated last on my left side so this couldn’t possibly be an ectopic pregnancy on my right, could it? I worried myself sick on the hour-long tube ride back to my hotel in Shoreditch.


When I got back, I called my husband as calmly as I could, to share with him my newest symptom. He immediately came back to the hotel, leaving his friend’s bachelor party early with the other best man so I could use his phone to call NHS 111 (a free-to-call single non-emergency number medical helpline operating in England, Scotland and Wales). The nurse on the line told me that a doctor would call back to do an assessment around 4am as this was the first available time. By this time, it was nearly 1am. I fell asleep, emotionally and physically exhausted after trying to analyse my symptoms and figure out the UK health system.


When I woke up at 8am the next morning, there was still no phone call. The pain was gone, and my husband and I were meant to fly to Spain that afternoon to visit his family for a few days, so I made the decision to just carry on, really hoping it was all in my head. Minutes later the doctor called. I relayed my symptoms, still hoping it was in my head and she would tell me to just keep monitoring myself. Not wanting to be the bearer of bad news, she gently told me that I should not fly to Spain and organised the earliest ultrasound appointment available in the nearest hospital for the following afternoon. I was then advised again that if I had any pain, I should go straight to accident and emergency. We cancelled our flight and booked another night at our hotel and waited for my appointment.


The pain subsided for the rest of the day and night, and into the next morning, which was the day of my appointment. It stayed at bay right up until I turned the corner to the hospital the following afternoon and the same dull pain returned on my right side. They did a transvaginal ultrasound and then the news came that I was already expecting. They confirmed an ectopic pregnancy in my right Fallopian tube.


The specialist gave me the different options for treatment – watch and wait (expectant management), methotrexate (medical management) or surgery (surgical management). They told me that with surgery they would likely need to remove my Fallopian tube along with the mass and recommended against watch and wait based of the size of the mass and my rising hCG levels. The surgery would have a more definite timeline, but I was a very good candidate for a successful treatment of methotrexate and they always recommend the least invasive treatment. When we were told methotrexate would take up to eight weeks to resolve the ectopic pregnancy, it was hard not to take our flight home in one week into account when deciding which treatment option was best. We were moving house in three weeks, my husband was starting a new job in four weeks, I was meant to start a yoga teacher training course in five weeks, and we were fostering two cats that were in respite care while we were overseas.


Through it all, my husband was the logical one and told me that we just needed to make sure I was safe – everything else could wait. We decided methotrexate was the best choice for me, a decision I still constantly question. They needed to order the methotrexate in, so they booked me in to get the treatment the following afternoon. We were sent off with The Ectopic Pregnancy Trust information leaflets about ectopic pregnancy and treatment options. They again advised that if I had any pain, I should go to straight to accident and emergency.


We headed back to our hotel, our temporary home. It is amazing how quickly the shelter you have during a crisis becomes your home. It became our safe place, the place where we cancelled flights, hotels, and car rentals, called our families to tell them our news, starting with our pregnancy and immediately breaking their excitement by telling them that it was ectopic. We read up on the details of an ectopic pregnancy and what this could mean for me, my fertility and our future family. I can still picture the lobby so vividly where we (mostly my husband) spent hours and hours on the phone. It is nearly as much work to undo a trip as it is to plan one in the first place.


We went out to dinner that night and the pain persisted throughout the evening, coming in waves. It was hard to navigate, but was it enough to go to the hospital? Was it all in my head? I had, after all, just had a scan that may have irritated everything a little bit. They told me that there was some bleeding, and the bleeding would hurt. My husband kept asking me to rate the pain so he could keep track and help me analyse it. It stayed around a 5/10 and I didn’t end up going, instead I fell asleep, and the pain went away again.


We spent the next morning continuing phone calls to cancel our travel plans, packed our bags and checked out of our hotel. When I went back to the hospital that afternoon, they checked my hCG levels once again to make sure they were still rising, and that methotrexate was still needed. They had risen, so we went ahead with the treatment plan. I was admitted to hospital for a few hours so they could monitor me before and after the injection. The nurses were the most caring people I have met. They were light-hearted and sweet, making jokes to lighten the mood, but ensuring I was feeling okay through it all. I didn’t really feel anything.


We left the hospital around 2pm but having changed all of our travel plans, we had nowhere to stay for the next few days. There were no rooms left at our hotel and we were in the middle of London during Wimbledon – there were no rooms available at any hotels. Absolutely exhausted after the whirlwind that was the last few days, we ended up booking a two hour train journey to stay with my husband’s family friend until my follow up appointment in four days. This was our next homebase, our safe place and this time with a familiar face.


I was tired, emotionally and physically exhausted, but we had a lovely first day there. We enjoyed the English seaside with fish and chips and a Mr. Whippy with a 99 flake in 18°C weather in true British fashion.


It was the following morning that the most severe pain came. I was told that it would come, and that if it was bad enough, to go to the hospital. I had been given pain relief, and it barely took the edge off at times. My husband continued to support me, asking me to rate the pain to try to gauge whether we should go to hospital. It reached what I called an 8/10 but the pain relief finally took the pain away enough for us to walk around the city and sit down for a nice high tea. My husband tried so hard to make the most of our unfortunate change of plans, to cheer me up and take my mind off the emotional and physical pain. Thanks to him, we have some good memories from the days leading up to the next blood test to dim the bad ones.


Because of the impact the diagnosis and treatment journey had on our trip, we both needed to inform our employers what was going on. We were very open about everything, and they were so supportive. My husband had the very important task of training his replacement when he returned, something that was now indefinitely interrupted. We didn’t even know if we would be back in time for him to commence his new job on time. But they assured him that my safety was the number one priority and everything else could wait.


We also needed to figure out what to do about moving house, because there was next to no chance, we were going to be back in time to execute the move on time let alone pack our entire house up. We hadn’t signed our lease until we landed in London, so we left our house in Melbourne without an intention to move – aka, our house was a mess. We called our friends in Australia to tell them about our extended trip and the unfortunate reason behind it. Without batting an eyelid, they asked, “So do you need us to move house for you?”. A job we didn’t ever want to put on someone else, but with the care of our closest friends, we knew they would do it if that was what it came to. Thank Goodness it didn’t! With open communication to both our current and new landlords, they agreed to push out our move date by a week, which turned out to be cutting it close, but doable.


During the hectic rearranging of our travel plans, my mom also booked a refundable flight for two weeks later so she could stay with me and swap out with my husband to take over “Michelle 24/7 supervision duty”, he could then go home and take care of everything that needed taken care of back in Australia. I was looking forward to seeing my mom, but also hoping my hCG levels would drop quickly and I could just go home and get back to normal life.


We headed back to London for my first follow up appointment scheduled four days after the methotrexate was administered. The hope was that my hCG levels dropped, but the specialists advised that they rise in 50% of cases on the first follow up blood test. We were thrilled when we found they had dropped to around 500. It felt strange to celebrate the pregnancy leaving my body, but our main focus was my health and getting home.

We set off to the Lake District where the wedding that brought us to the UK would take place. It took us eight hours in the pouring rain to drive there. We made it just in time for dinner the night before the wedding with the wedding party. The bride and groom knew something was going on, after all we were meant to be arriving that morning to help set up and my husband had left the bachelor party quite abruptly the previous weekend, but they didn’t ask, and we didn’t tell – we didn’t want to take any focus away from their special day.


The wedding was beautiful. The sun shone for the exact thirty minutes of their outdoor ceremony, then the skies opened up and it poured the rest of the afternoon and into the evening. It was a lovely event, but as I was advised not to drink after methotrexate – the drug could interfere with my liver function and alcohol could significantly harm my liver – I was drinking non-alcoholic bubbly. The only other people who were drinking non-alcoholic bubbly were visibly pregnant women. It was hard not to get down, but my husband and his friends drank enough to entertain and cheer me up for the time being. I didn’t realise this would be the first of many triggering scenarios over the next few months. I’m not sure when they will stop popping up, or if they ever will.


With the wedding over, all we had to focus on was getting my hCG levels down and getting home safely. We travelled back south where we met my mother-in-law at her late mother’s house. The house had been cleared of its furniture to be rented out a few years back, but my mother-in-law made it cosy with the little that was left for us to stay there, and it truly did become home over the next few weeks as I continued to heal.


My husband and I continued to travel into London for blood tests. My hCG levels continued to drop and on my last appointment, I did a urine test instead of a blood test, something my bruised arms were very grateful for – the last few times my veins had started shutting down and I had to get multiple pokes in each arm to get enough blood to test. When the urine test came back without detecting any hCG, they did one final scan to see if the mass was gone. They advised that with quick falling hCG levels, it is often found that the mass does not disappear as quickly. If it was still there, I would need to come back for a follow up scan in six weeks. I didn’t know what this meant for our travel back to Australia. We hadn’t been told this from the start. Would I have made a different decision for treatment if I had known I would risk staying six extra weeks on top of the “up to eight weeks”? When I got the news that the mass was still there, I wasn’t sure what we would be able to do. Would I need to stay in the UK for the follow up scan? Did my husband need to stay with me? Was it safe for me to fly? Was there still a risk of rupture? Could I go back to normal life?


The answers to my questions varied, but we were given the green light to fly back to Australia and continue to follow up once we arrived home. We rescheduled my flight to match my husband’s rescheduled flight and we were all set to fly back home two days later.


It wasn’t until after I returned to Australia that I was able to process the loss that was the ectopic pregnancy itself. I didn’t understand what it was that I was grieving – I never truly believed the pregnancy was viable, I had been bleeding since before I found out I was pregnant and the timing was all off. What was I grieving? Was I grieving the loss of my holiday as it was planned? The loss of attending my yoga teacher training course I had so been looking forward to? The loss of getting the two cats back from respite care that we had grown so fond of after looking after them for five months? The loss of the time and money spent on rearranging and extending our trip to the UK? What I came to realise was I was grieving much more than that. I was grieving the loss of an easy pregnancy, the loss of trust in my body, the loss of the ability to enjoy a future pregnancy without fear, and the possible loss of my natural fertility.


I followed up with my doctor when we arrived back in Australia. She helped me schedule a follow up scan for six weeks time with a different ultrasound clinic, one with a specialist who could tell me what they were looking at and give me direct results. She showed disbelief that the previous ultrasound clinic sent me on my way with confidence I was having miscarriage. She comforted me and she set me up with specialists for if and when my next pregnancy occurred to make sure it was implanted in a safe location. My ectopic pregnancy journey was one of the better ones I could have hoped for – no rupture, low hCG levels, the mass was small and I responded quickly to methotrexate; so I was lucky; I should feel lucky, right?


I am still healing, both physically and emotionally. I’m not sure which one will heal first. I get pain from time to time where the mass is sitting, taking it’s time to resolve completely. I also find certain situations hard to face, particularly working in an early childhood setting where new parents groups and new mums and babies come to visit the maternal child health nurse for their first six key stage appointments within the first year of birth.


Ectopic pregnancies account for 1-2% of pregnancies – that means 1 or 2 out of every 100 pregnancies is ectopic. Often ectopic pregnancies happen with no obvious reason behind them making any woman of child-bearing age at risk. Ectopic pregnancies are life threatening without medical intervention and are a recognised cause of maternal mortality in developing countries.


I hope that by sharing my story, in all its detail, that someone will be able to detect their signs and symptoms of an ectopic pregnancy early, that they will feel empowered to advocate for their bodies that they know better than anyone, and get the help they need to prevent a more significant outcome of an ectopic pregnancy. And most importantly, that they will not feel alone at the start of such a scary and unknown journey. There are still a lot of unknowns in my own journey, and it is hard to just wait, but at this point that is all I can do. My ectopic journey is far from over, and I have to give myself time to heal, ease into normal life and see what happens in the future.

Thank you to Michelle for sharing her experience. If you would like to share your experience of ectopic pregnancy, please visit our guide for more information.

Please remember our support services are available at any time. 

Get help