# Why not opt for D&C after miscarriage?



## Freckles (Mar 8, 2004)

I found out last week that I miscarried. My D&C is scheduled for Tues but now I'm worried b/c I've read here that some of you avoided a D&C at all costs and waited, or are still waiting, for baby to come out on its own.

For me, I can't go back to work and put on a happy face knowing my dead baby is still inside me, especially now that my coworkers know I miscarried. They are expecting me to return to work w/o being pregnant anymore.

Why is a D&C so scary? I don't know what to do now! I feel fine and have had no signs of miscarriage like bleeding or cramping.

I'm so sorry for your losses.


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## Arduinna (May 30, 2002)

It's a personal decision that only you can make. In my case I wanted a natural m/c because I didn't want the hospital to dispose of my babies remains. Plus I didn't feel that I needed one. I was confidant that my body knew what to do.

I am so very sorry for your loss.


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## sunbaby (Sep 30, 2002)

i am sorry for what you are going through. i hope you find the best answer for yourself in this difficult time.
i wanted to do it naturally because i felt that would be the most respectful thing for the little being who had passed. i also really wanted to do it naturally because i think generally it is healthier for a body to do its own thing than to be interfered with- dont fix it if it aint broke, ya know. but then, if it causes you more emotional upset to wait for your body to do its thing, then that is not necesarily healthier. do whats right for you.
as it happened, i had to go in for the dand c, because my body just wouldnt do it- i waited 3 months, until my midwife *strongly* reccomended a d and c for my own health. i am still recovering from the emotional effects of anesthesia and hormone crash. maybe it would have been easier if i'd naturally miscarried. i dont know.


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## Ms. Mom (Nov 18, 2001)

Freckles, I'm so sorry for your losess









What a difficult time you must be going through. I agree with Arduinna and sunbaby, it's a personal choice and you will be support here on your decision.

There are pro's and con's with both natural miscarriage and D&C. So you're going to have to weigh them and make the best decision for you and your body.

You may want to take some time to read some of the threads here. What you'll find is that each loss is unique and individual. Some women chose to let a miscarriage take it's course, some women feel the need to move it along (or need to for medial reasons). Either way, these women have been supported fully on the decisions they've made.

Please let us know how your doing.


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## traci5489 (Oct 27, 2002)

As the others said, whatever your choice, it is yours and you will find lots of support here.

I am sorry for your loss.

I chose to have both my mc naturally, basically it just felt like the right thing to do and I have "issues" with bleeding (my blood just doesn't clot well) and both my ob and I agree that the less "surgical" intervention the better in my case.

Whatever path you choose, I hope that you can begin to find comfort and heal from your mc and please let us know how you are doing.


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## butternut (Jan 3, 2004)

Freckles...I am so sorry for all your losses and for your anguish. Being in the midst of a loss can feel like the worst time to have to make such big decisions. I have had both natural miscarriages and a d&c. I agree with everyone else that is a personal decision and one which needs to be made considering your own medical history and your own wishes and beliefs. I was not given this choice with my first m/c at 12 weeks, but instead was whisked away to the OR for a d&c the very next day. I really felt at the time that while it was a relief to move things along, I also was floored by the speed and also felt incredibly empty afterwards--like I had barely had time to realize my baby was no longer living and now she was already physically gone as well. The next time it happened at 12 weeks, I was specifically told by that doctor that a natural would be better. She said the body can handle it usually and that any time you can avoid surgery you should--and having a d&c is surgery. She also said that any invasive surgery like d&c should be considered a risk to your uterus. But, I felt like she did not at all prepare me for what a natural miscarriage entails. I was shocked at how much it was like birth, with labor pains and all, and also at how intense it was and how much it hurt. The doctor had made it sound like just a bad period, but the bleeding was much worse for me. The shock of the difference between the d&c and the natural made the emotional aspects that much harder. Quite honestly, at the time, I thought NEVER again will I have a natural m/c. But now when I had a m/c at 8 weeks last month, I was also told that avoiding surgery was in general a good thing--which I can agree to. I also felt like this time I knew how a natural m/c could progress--and I think just this knowledge and information made it somewhat easier. No m/c is "easy" but do inform yourself--there are aspects of each which may be more or less important to you. I think to be realistic, you should know a natural m/c can take much longer and thus can affect your everyday life (work and such) longer. But it also gave me a much greater sense of involvement--I know we are never in control of our m/c but letting my body do its own thing let me feel like at least my body was in control.
Do read through other threads here. Everyone has different experiences. No matter what you choose, you have a whole circle of mammas here ready and willing to support you and send you many warm wishes for healing.


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## fireflies~for~me (Jun 24, 2003)

I just "felt" something telling me to miscarry naturally...my OB was totally supportive-she said "always tell me if you have a gut feeling about something"

She did perscribe cytotec though which has its own issues, but I did fine. (Maybe I should say I miscarried with drug intervention, but not surgically) It took several doses and was not particularly comfortable, but I avoided surgery. I didn't want the risks of perforation, infection, etc. My doc monitored my progress, and initially didn't feel like I had a whole lot of tissue to pass, so she let me try it. I think alot of the baby (actually babies- it was a multiple pregnancy, too - no fertility meds....) was reabsorbed into my body.

Then I went back repeatedly for quants to make sure my levels went down to zero.

Hope that helps-take care of yourself and take time to heal.


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## Freckles (Mar 8, 2004)

Melinda, I'm so sorry for your loss. I just started Cytotec today and will take two more pills today and then see my doctor in the morning to see if I'm contracting.

He checked my cervix today and it has already started to dilate.

I asked him about the D&C and he said I will still need to have it but I forgot to ask him why if I'm on this pills now?


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## Ellie'sMom (Aug 10, 2002)

This is such an individual decision, and please know that Ms. Mom speaks the truth: you will find support here no matter what you choose to do.

I chose a medically induced m/c (using cytotec, aka misoprostol). I had started spotting at 11.5 weeks, and an u/s showed that the fetus had died at about 6 weeks. I decided to wait for a natural m/c for the following reasons:

1. I didn't want an invasive medical procedure.
2. I wanted to be at home.
3. I was hoping to deliver my little one intact and bury it.
4. My pregnancy was early, so I (and my midwife) felt this could all happen with a pretty low risk of pain or complications.

I waited for 2 weeks and did not miscarry. I really needed some closure. I was going to work everyday, and most people thought I had already miscarried. It was very tough emotionally. I finally opted for the induced miscarriage. I ended up bleeding alot, and had to go the the E.R. I miscarried there. It was not what I had hoped, but for me this was still a better choice than a D&C. I was able to see my baby after the miscarriage and had time to say goodbye. That was very important to me.

That said, it would not be the right choice for everyone. For me personally, I might have made a different choice if I had been further along in my pregnancy. I did not have to endure the "labor-like" contractions that some people describe.

I have been with many women during D&C procedures (worked in a clinic). If you have good support, it does not need to be a horrible or scary experience. The most important thing is that you feel that you understand your options, and know that no matter what, you have made the best decision you could at the time.

Peace be with you whatever you decide. I am so sorry you have to go through this.

Edited to add: Freckles, I just read that you had started the Cytotec. I don't know why your doctor said that you would automatically need a D&C. Sometimes there is tissue that is retained, but that does not always happen. With me, the sac and placenta were intact, which was very reassuring. Be wary of having an u/s immediately after you pass the tissue. The radiologist at the ER said that because of the bleeding it is impossible to assess whether there is retained tissue immediately after a m/c. He recommended having one done a week later for the reassurance. I opted to just have my HCG levels checked instead. They have been steadily going down (which they wouldn't if I had retained pregnancy tissue).

Ask your doc for clarification about this.


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## sweetc (Aug 12, 2003)

Hi Freckles,

I agree with everyone that it is a personal and difficult decision. You'll find support here no matter which path you choose.

For me, I didn't feel that a D&C was medically necessary and carried enough risks to make me nervous. I opted to wait and my OB was willing to let me, at least for awhile. My midwife was very supportive. I couldn't do the Cytotec because it can cause problems in people who have asthma, which I do. I knew that if I wasn't able to pass all the tissue that I needed to, then I could always have the D&C and at that point I would have considered it a necessity. But, the possible risks of infection, uterine puncture, scaring or the uterus and cervix, and going under general anethesia, felt riskier to me than the risks of miscarrying naturally (too much bleeding, incomplete miscarriage, lack of support). I also felt it was more honoring to my babe to miscarry at home.

The miscarriage was very similar to labor. My midwife had prepared me for what it would be like, so I wasn't surprised. But it certainly wasn't comfortable.

That said, I am a SAHM and didn't have to go to work with all of my emotions raging. That would have made my decision more difficult. Unfortunately, neither choice removes the grief.

I hope you can find peace in the middle of all of this. Best wishes for quick healing.

Christine


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## saturnine25 (Mar 26, 2002)

Freckles- I'm sorry for your losses- I chose to have a natural m/c for several reasons, but the main reason was that I was told that for a d&c I would have to be kept in the hospital overnight and separated from my dd, whom I have never been away from overnight before and who is still nursing. I felt as though it would be potentially traumatic for her and wanted to avoid any additional trauma for her at all costs, since she was already sensing that something was wrong. No matter what your decision is, it will be respected here. Please keep us posted on how you're doing.


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## ma_Donna (Jan 11, 2003)

I was diagnosed with a blighted ovum at 6.5 weeks and waited almost 3 to m/c on my own. I very much did not want to go into the hospital under general anesthesia - it just didn't feel right to me. I looked into misoprostol and was ready to do that, then my OB offered me a D&E with local anesthesia right in her office. It was a bit less gentle an end to my pregnancy than a natural m/c or misoprostol. I had to debate it for a bit, but I had been TTC for a while and waited for a natural m/c and was just wanted to be able to go on.

It sounds like you have found a solution that works for you - I just hope you can talk to your OB about avoiding the D&C all-together - I don't know the full story, but it seems a bit much.

Take care,
Donna


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## JessicaS (Nov 18, 2001)

Freckles, I am so sorry for your loss.

Many women prefer to miscarry naturally as it has less risks than the more invasive D&C. The main risk with natural miscarriage seems to be hemorraging (sp?) Generally the rule for that is if the bleeding soaks more than a pad an hour then you need to go to the hospital. Infection is also a concern, which can generally be recognized by a high temperature.

However, the risks for these are the same as if one was miscarrying in a hospital.

The main advantage of a D&C is that it can be done quickly allowing the mother to go on with grieving her loss, as well as you know when it is going to happen unlike with a natural miscarriage.

A D&C has all the risks one would find in surgery and with anesthia being a part of that, many choose to miscarry on their own. Some miscarriages do not progress making a D&C necessary.

If you wish to have testing done to find the cause then often Drs will insist on a D&C as that is what pathologists recommend. I am really thinking that is why your Dr wants you to have the D&C, since you have had previous miscarriages.

But like everyone said it is a very personal choice and not one that will be questioned on these boards. Everyone deals with such tragic losses in their own way and it is important to just do what feels right to you. No one will question your decisions, we are just here to help you through your loss.


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## aimeemac (Apr 17, 2002)

Hello. So sorry for your loss. I lost my first baby at 8 weeks, but didn't find out until I thought I was 14 weeks, I had no spotting, cramping, etc. My doctor recommended the D &C b/c she was concerned infection might set in. For me, knowing my baby was no longer living inside of me was the hardest thing and the D & C helped me to move on.


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## taradt (Jun 10, 2003)

((hugs)) it is a very hard and emotional decission to make. we decided natural for a few reasons.. it was over christmas and i wanted to try to have some semblance of a normal holiday which i couldn't do in a hospital, i would have had major runaround to get the babies remains which i wanted to bury, i felt it was the final gift i could give her to have her peacefully at home surronded by love. i did cytotec as well and did not need a d&c, i think the only reason you would is if there is tissue retained. i had a very strong labor and birthed my daughter which was very healing for me.
if you search the boards you will find that each woman's story is unique, this helped me to have a better understanding of what to expect.

let us know how you are doing

take care

tara


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## Mamid (Nov 7, 2002)

I passed a "marble" in a clot my last cycle. I examined it and it exploded and smelled like amniotic fluid. And there was a form in it that looked like an embryo about the size of my nail at the most....

Instead of going in and getting "treatment" my then 15 month old son came bounding into the bathroom to see what mommy was doing. So I got rid of it all to keep him from seeing or getting bloody.

I spent the next week in tears.

28 days after that cycle started, 23 days after that, we are pretty damn sure I ovulated cause I'm now in my 16th week.

If I had had the D&C I wouldn't have gotten pregnant and I would have been told to lay off DTD for at least a month or two.

I'm glad I wasn't treated.


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## LizD (Feb 22, 2002)

Some doctors and midwives automatically recommend a d&c because they feel it's better to clean the uterus out and make sure no tissue is retained that might lead to infection later. It is the same or very similar procedure as an early abortion so that might be emotionally difficult for some women especially if you have had abortions in the past and are now losing a baby. However, it does not need to be a painful or frightening experience. You can have anesthesia or not, and you can always ask your practitioner to be especially gentle- some are more gentle than others and I think not being put to sleep leads some to be a bit more gentle than if the patient is out. It is very quick and in my experience soreness only lasts a day or so afterward, even with no pain medicine.

It is really a personal decision, as has been said, and some women prefer to avoid surgery or anything invasive at all costs; some prefer to have the process over with rather than have to wait and/or wonder if the miscarriage is complete.

Good luck and lots of love as you decide.


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## Mom2baldie (Oct 29, 2002)

Freckles,

Im very sorry for your loss.























I had a miscarriage last Sept. at 12.5 weeks gestation, however, baby had stopped developing at 9. I chose to have a natural miscarriage at home because I personally felt it was the most respectful thing to do for my baby. I wanted to bury her and plant flowers over her, do something special for her... I tend to dwell on things so I knew I really needed to make an effort to do something that would make me feel like I did all I could for her.

Another reason was that I didnt want to have surgery. The risks of a D&C are SO slim but they are still there, from what Ive read. I also didnt like that I wouldnt know what was done with her remains. That bothered me a lot.

Anyways, when I miscarried I was able to find her, but still ended up hemmorhaging and going to the ER. I had an emergency D&C. I really wasnt prepared for the amount of blood and when I was told what a miscarriage was like I was told "cramps and bleeding". Mine was more like labor contractions and bleeding that never stopped or slowed down.

We did get to bury her though. Thats all I really cared about.


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