Trigger warning: Miscarriage.

4 weeks later

Meredith couldn't sleep. She rolled onto her side, glancing at the clock. It was only 4:30 in the morning and she didn't have to be up for another hour but she simply could not sleep. She took a glance over at Derek who was sound asleep, guilt washing over her.

She never told him. She had debated time and time again but she could never bring herself too. She was only 9 weeks but she had already noticed changes in her body.

At 9 weeks she shouldn't be showing yet but Meredith was naturally a thin, petite woman so any amount of weight gain was noticeable on her. She had just hoped Derek had not caught on yet.

She slowly got out of bed, heading to the bathroom to relieve her bladder thanking her lucky stars she had hardly had any morning sickness with this pregnancy.

Before she knew it, 5:30 came all to fast and they were both getting ready for work. She decided to change in the bathroom which was new to Derek. Normally Meredith had no issues changing in front of him.

"Alright, I'm ready whenever you are" Meredith announced leaving the bathroom. Arriving to work for hand in hand they got off the elevator stopping to give each other a quick kiss before splitting up.

"Have a good day honey" Derek said.

"You too" she smiled. She headed off to her first patient of the day, the morning was going smoothly as it could for her and she was glad. mid-morning found her staring at the OR board itching to scrub in on a surgery.

"Dr. Grey," she heard her name be called. She smiled to herself, loving her name coming from his mouth.

"Yes Dr. Shepherd." She turned to look at him, his signature smile staring back at her that always made her weak in her knees.

"I have a craniotomy in OR 2 in 30 minutes, care to scrub in?"

"I would love to" she smiled. She watched as he walked away and sighed, that man, he knew what got her going. She couldn't help but notice the small twinge of pain she felt in her abdomen but brushed and headed to see if she had any patients to see.

Meredith stood at Derek's side feeling more lightheaded by the second, sweat pooling on her forehead.

"Dr grey are you alright?" Derek asked noticing Meredith swaying on her feet.

"Yeah, im-im fine Dr. Shepherd." She lied. She certainly wasn't alright but she didn't want him to worry about her.

As time went on and the surgery progressed she felt more and more lightheaded eventually asking for a bottle of water thinking she was maybe just dehydrated. She took a swig and set it down onto the table when she felt it. A feeling that was all too familiar to her and sent shivers down her spine.

Slowly she looked down, watching as her scrub bottoms turned a crimson red as blood filled them. Tears sprang to her eyes. She knew what was happening and in front of Derek who didn't have a clue no less.

"Derek" Meredith whispered quietly, gripping his arm. His eyes followed hers that was glued to her ever soaking bottoms and the last thing she remembered was her name being screamed as she passed out.

The lights in the hospital room seemed especially bright to Meredith as she attempted to open to her eyes. She groaned throwing her arm over them as she took a minute to adjust, the first thing she noticed was the iv that was placed in her hand. Slowly she moved her hand placing it onto her stomach already knowing the little life she had been carrying was gone once again.

"Meredith" Derek whispered. She turned towards him, tears pooling in her eyes.

"I lost it didn't I?" she whispered already knowing the answer.

Derek sighed. "Yes, sweetheart."

"I'm sorry- I'm so sorry" she whispered before loud sobs filled the hospital room and this was the part that hurt Derek, seeing her in this pain.

"When were you going to tell me?" He asked his voice indicating he was a little hurt.

"When I knew I wasn't going to lose yet another one of our children. I found out a few weeks ago-- I just...wanted to protect you." She choked out. She knew it was no excuse though.

"Mer were in this together. You should have told me."

"I cant Derek, I can't go through this again. I'm done trying."

Derek was afraid of this but completely understood. He didn't think he could go through this again and he certainly did not think he could watch Meredith go through this again. He watched as she fell back to sleep, holding her hand as he mentally replayed all the other times they had been in this position.

Slowly he got up, leaving the room looking for the nearest coffee pot. He needed something right now, he looked a mess.

"Hey," Christina said as she walked up to Derek. "I heard, did she lose it?"

"Yeah, she did" he choked out. Not making eye contact with her. "Did you know?"

"I told her to tell you, she was terrified of losing this pregnancy." Christina whispered

"I don't get it, Christina, I know she has a hostile uterus but...we keep losing them and now she wants to give up."

"Give her some time and down the road maybe you guys can try again. right now, You guys have lost 5 pregnancies almost back to back. She needs time to process all this."

Derek just nodded his head, heading back to the room with his coffee in hand. He sighed, standing in the doorway watching the love of his life sleep, hurting for her.