# Did anyone opt to wait for a natural miscarriage and then decide on a D&C later?



## Birth Junky (Jun 14, 2004)

I'm having a really tough time with the knowledge that I am carrying a baby that passed two weeks ago, and wondering why my body won't start the process of miscarriage.


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## MeepyCat (Oct 11, 2006)

I don't know why your body is holding on. I'm so sorry. I know that when I miscarried, I really wanted it to be over. I can't imagine having to wait.

In my case, I mostly miscarried on my own, but took misoprostol for retained fetal tissue after a week. This was a process undertaken with a great deal of deliberation. I wasn't willing to do it until I was quite certain of fetal demise, but given the stage of gestation and the details of my case, I felt that misoprostol was less invasive and traumatic the d&c. It did not, however, give us remains to analyze, or to formally mourn.

My biggest concern with waiting is that you eventually have to worry about sepsis. Obviously, if symptoms arose, you could seek an emergency d&c, but depending on the time of day, the severity of symptoms, and what else is coming through the ER when you are, that could get very ugly. Plus, at that point, infection would complicate recovery.

If it were me, I'd talk to a midwife or OB and discuss the limits to waiting, and make a plan. How long can this go, when would you be willing to do the d&c, what symptoms would make it urgent, and what would you do if they happened?


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## Birth Junky (Jun 14, 2004)

My midwife is going to call in a referral for a D&C on Monday, and we will see how soon they can get me in. It could still be a few more days after the referral.

This whole process is surreal and horrifying. I just want it to be over.


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## MeepyCat (Oct 11, 2006)

Birth Junky, how do you know the baby died two weeks ago? Was there an ultrasound? Can you go back to that doctor or office?

At two weeks, I think they should try to get you in for a scan and a consult on Monday, and if you spike a fever or feel unwell, I think you should go to the ER. With your midwife if possible.


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## Shiloh (Apr 15, 2005)

I waited. Nothing.
Misoprostol. Most.
D&C. The rest.
I really resented my body for not cluing in for so long. I couldn't believe it just couldn't be over. Well physically at least. I contemplated going in for a d&c abortion as that could be done in an afternoon at a clinic instead of this wait and see, oh try these pills and 2 weeks of hell that compounded the loss. Looking back though it was all traumatic. The expectant management gave me more time to grieve. A d&c on the spot after dx might have actually been more assaultive. I think I would have wondered was my baby really gone. Expectant management saw my hormone levels decline, and gave me 2 ultrasounds to confirm it was over. Nothing about that time would have probably helped, I was so raw, so hurting, so hollow, the darkest saddest place.


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## dinahx (Sep 17, 2005)

We know about m/c earlier now than in the past because of U/S. There is now thought to be NO limit on expectant management.

For me, blood draws helped. HCG declines by 1/2 every 48-72 hours. It doesn't have to be zero to start your process but it has to be low. Mine started @ about 500.

I am really glad for my natural m/c, altho it was hard. Mothering's thread on what to expect really helped me.

I did pass out from a rapid drop in Hemoglobin, that would have been avoided if I had been taking Iron while waiting.

The best part by far is that I got to have a burial for my fetus as he came out intact (10 weeks gestation, m/c @ 13 weeks). I did take antibiotics from the time the actual m/c started until the baby passed.

HTH!


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## dinahx (Sep 17, 2005)

I also really appreciated the gradual hormonal decline & the time to grieve during the process.


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## Birth Junky (Jun 14, 2004)

Quote:


> Originally Posted by *MeepyCat*
> 
> Birth Junky, how do you know the baby died two weeks ago? Was there an ultrasound? Can you go back to that doctor or office?
> 
> At two weeks, I think they should try to get you in for a scan and a consult on Monday, and if you spike a fever or feel unwell, I think you should go to the ER. With your midwife if possible.


At the ultrasound on Tuesday, they estimated the baby stopped developing at 11 weeks. I am at 13 weeks today.

My midwife is generally comfortable waiting three weeks, which means one more for me. I've been running a low grade temp this evening, and yesterday during the evening, but she is not worried about infection at this point because my abdomen isn't tender or painful on palpation. (DH is sick, so she's guessing my temperature is the result of a
coincidental virus. Because just what I needed, on top of everything else, was to be sick during all of this.)

I'm going to go to bed soon and hope that something changes over the weekend. I don't relish the thought of being seen in the ER, but I don't know how much more waiting I can take.


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## dinahx (Sep 17, 2005)

It is key to have someone skilled to do your D&C if you go that route because of Asherman's syndrome which can affect your fertility going forward & is the rationale behind D&C avoidance generally.

An ER will only stabilize you anyway, unless you are bleeding profusely they aren't going to just give you a D&C, they will refer you. You might get them to give you Misoprostol, but then again, they would probably refer you for that too.

I considered an ABO clinic too, but they generally DO require a U/S & won't do m/c care, generally.

If you do start bleeding, use a colander to make sure you don't miss anything important. I wish someone had told me that.

Are you in touch with a CNM or OB? That would be my next step, especially with any fever . . .


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## Birth Junky (Jun 14, 2004)

Only with my midwife, who is also an ND.


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## LLQ1011 (Mar 28, 2012)

I miscarriage at that stage can be very hard on your body. I am sorry for your loss


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## dinahx (Sep 17, 2005)

Quote:


> Originally Posted by *Birth Junky*
> 
> Only with my midwife, who is also an ND.


Okay, I would ask her who she suggests for a D&C or Medical Management (Misoprostol) @ this point (unless she offers these), instead of getting whoever is assigned . . . Also if you can get your hands on Floradix this weekend, it will help no matter which way you choose to go, because @ this stage your body has not built up the extra blood/iron that your get to prepare for delivery . . .

Altho I did m/c naturally, I did have medical management lined up from about a week into it. I wound up doing a surgical consult even, but I just didn't go that route. I did wind up spending the night in the hospital after I passed out, I was checked in for observation overnight by my provider. It was pointless and expensive, but @ the time I guess it was where I was. They kept me overnight and gave me Misoprostol to finish the m/c but my CNM and I had a disagreement about the correct route of admin, so I wouldn't take the whole dose. (She wanted to admin vaginally, I had looked @ all the latest research and asked for it to be admin'ed sublingually, which is more supported, but she wouldn't look @ my research so I only agreed to 200 mcg, which did exactly nothing).

I went home the next day and the m/c finished a few days later @ home. In the hospital they had given me Opiates for the uterine cramping, which I took in tiny doses after I got home, I totally think that is what caused the last stage of my m/c to take a few days after discharge to complete . . .

One important thing I learned is that YOU know your body, you know what your body needs, trust yourself. As soon as I went into the hospital, I started ignoring my self knowledge, and in the end, I knew more than they were able to figure out there . . . ((((Hugs))))


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## MeepyCat (Oct 11, 2006)

BirthJunkie, I worry that your midwife may just not have adequate backup for a miscarriage of this kind. Expectant management is fine for as long as you're okay with it, and symptoms of other problems don't arise, but I worry you're past that point.

The fever would worry me. It may be a coincidental virus AND a sign of uterine infection, or it could be a virus that progresses to systemic infection.

My experience with ERs was that they referred me straight up to the L&D unit after quick triage. These were teaching hospitals with 24/7 OB coverage, and dedicated surgical facilities and anesthesia on the L&d floor. I don't know what the options are for hospitals in your area. At the least, you would leave the ER with blood cultures, evaluation for uterine sepsis, a list of things to watch for, and an urgent referral to an OB, possibly even an appointment.


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## Birth Junky (Jun 14, 2004)

I think I'm still okay on symptoms of infection--the temperature was only elevated in the evenings the last two days, which is pretty consistent with my body's behavior when fighting off something viral. My abdomen is still not tender or painful on palpation--I'm checking regularly, along with monitoring my temperature.

That's not to say things couldn't change quickly, and I promise I am being alert and aware. But as long as I can maintain my sanity waiting, I think I'm probably better off trying to get an appointment with an ob clinic on Monday vs. going to the ER, unless it is absolutely necessary.

Still no symptoms of miscarriage, other than the same general heavy/achy feeling in my uterus.


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## Shiloh (Apr 15, 2005)

Hugs.


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## Birth Junky (Jun 14, 2004)

My body continues to show no signs of letting go of this pregnancy. It's such an unending mindf*ck, this missed miscarriage. I have a D&C scheduled for Thursday afternoon, which surprisingly brings no sense of relief. Just a constant, aching grief.


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## Shiloh (Apr 15, 2005)

Its like being in an alternate paralel universe...I resented the d&c until it was over..then I started to feel like "myself" again...a version of myself not stuck in hellish limbo but quiet sad grief...


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## dinahx (Sep 17, 2005)

The only advice I can give is that it was *shockingly* mind/body for me. Like I waited & waited for my BFF CNM in another state to call me back. As soon as she said 'you can do this' like the minute we got off the phone, my m/c started.

When the baby actually passed, again *right* before that, something happened that allowed my body to relax & let go.

A HCG draw might be helpful while you wait. Otherwise, hang in there!!! It is great that you have a date now . . .

(((Hugs)))


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## fishywishy (Oct 19, 2010)

Birth Junkie. I am so sorry - what a difficult and horrible time.

I waited 4 weeks for a m/c to start. I woke up that morning, depressed and tired of waiting, called my OB to try to schedule the D&C and by the time his nurse called me back at 6 pm that evening, it was done and over. The m/c started at noon and everything major had passed by 5:30.

Good luck on Thursday if things don't happen sooner.


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## Birth Junky (Jun 14, 2004)

Thanks, everyone. I keep waiting, because there is nothing else TO do. A dear friend is taking the kids today for an overnight with her kids, so that too may give my body permission to finally let go. (Friends have helped with the kids over the last week, but neither time was for more than a handful of hours--maybe my body needs knowledge of a longer stretch of solitude to do its work?)


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## Birth Junky (Jun 14, 2004)

It's done. I was surprised to find that the D&C today was the least traumatic part of this whole experience. I'm home now, and resting pretty comfortably. I have this one last evening "off", and tomorrow the kids will come home from their extended sleepover.

Hopefully now is when the emotional healing can begin.


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## Shiloh (Apr 15, 2005)

Hugs


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## taichimom (Jul 5, 2013)

Hugs and wishes for healing for you.


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## squiggles (Jul 23, 2013)

Im so sorry for your loss







i had a mc in march '12. The fetus passed away between 6 and 7 weeks and it took until 10 weeks for natural mc. I took 2 days off from work to give myself a nice long weekend and scrubbed my house top to bottom. I clean when im upset lol. Take care of yourself and give yourself time to heal. I just had my dd in june


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## Birth Junky (Jun 14, 2004)

Thank you, mamas. My kids are home and providing some
good distraction.

Now that I the procedure is over, I am ANGRY, and so so sad. The first day it was mostly just a relief, to finally not be carrying the fetus that had passed, to finally look less pregnant. The cramps haven't been too bad. But last night the rage set in--anger at the universe for this newest insult (it has been a rough five years for my family), anger at my DH for his "no more kids" stance, anger at the world around me for continuing on while I feel as though I've been hammered into the ground. None of it logical, but all of it very intense.

To top it all off, I made the mistake of taking a new client (I work with newborns and infants), and am getting ready to leave for a visit with a 1.5 week old baby. (*sigh*) Too soon, for me; I will have to figure out a reasonable timeframe for a hiatus from work, I think.


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## squiggles (Jul 23, 2013)

Your anger is totally normal and understandable. Just try to keep yourself surrounded by supportive people. When i had my mc i felt like people avoided the topic at all costs. It was such a relief when my sil asked how i was doing (she went thru a very late term mc). Talking helps.

I too had a very rough past year or so. A few weeks after my mc, my husband had a stroke ( fluke thing, he was 31 at the time). I really thought i was going to lose him, and i honestly believe yhat if i didnt have the mc prior, the stress from his ordeal would have caused one, so as sad as it is to say, im glad t happened the way it did. A few months after that, my cat went into kidney failure. We went thru 4 long months of intensive home care before having to put him to sleep at only 5 years old









I guess my point is that sometimes things really REALLY suck and it takes all we've got to get out of bed in the morning. But we've got to be strong. I think taking the time to cry and grieve and get angry is so important to build that strength. Denying yourself those things will only leave u feeling hollow and bitter. It WILL be ok


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## Margaritaa (Aug 22, 2011)

I didn't do a D&C with one of my miscarriages.Took 2 months to miscarry  I did take things to help prevent infection. Lots of vit c, goldenseal, echinaca etc


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## aolive10 (Aug 4, 2013)

So sorry you had that experience. I hope you are healing and moving toward a happier place. I'm only 10 weeks and am slowly showing signs of a miscarriage. Fetus stopped growing almost 4 weeks ago I think. I cant wait until it just happens and is over with and I'm scared it will take too long. I have another appt with ob in 2 weeks. Blood seems to be darker and clottier but its still sort of on and off. It is SO angering. Last night I had cramps that were a little more noticeable but still nothis so far today. I'm trying to be positive and I'm ready to move on and try again. Keep telling myself it wasn't meant to be. But this is torture.


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