# Questions about missed abortion



## sarahmck (Feb 11, 2005)

I should be 10w5d today, but I had an ultrasound yesterday and discovered that my baby appears to have stopped growing around 8 weeks.

I knew that a D&C was an option, but I immediately discounted it. I'm a homebirther, non-allopathic sort of person, so I didn't even bother considering it, really. I have an appointment with my fertility acupuncturist today. She's going to do some stuff with both needles and herbs to get things going.

I've been imagining that this would all be pretty straightforward and like a heavy period, but I've just started doing a bit of reading and am freaking myself out. People are talking about how they wish they'd just done the D&C and that they had to wait forever for their miscarriage and when it came it was the worst day of their life, extremely painful, bloody, with little chunks of baby, etc.

Now I'm thinking I need to get informed to make sure that I'm making the right decision. Does anyone have information to share with me?

I know that some say that going through the labor-like miscarriage experience is important for closure. Maybe I'm in denial, but I don't feel like I need that. This was still early enough that I think I'm going to be okay. I had my suspicions about it, too, because my symptoms were quite different than with my other two successful pregnancies, which were pretty much identical to each other.

Please share your wisdom.


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## teeg1973 (Oct 15, 2008)

I don't think there are any right or wrong answers, but what simply feels right for you....It sounds like you are doing some serious thinking about what you want, which is good...

I have had 4 missed m/c's and ended up going with a D and C for all of them. With 3 of the 4 I even waited a few weeks after diagnosis and nothing was happening. For me I didn't need the process of miscarrying at home or seeing any products of conception to help resolve my loss, but I know for some women it can be a healing process. I was more scared to death of going through the process at home in a small apartment with a husband who works long and strange hours and trying to explain it to my daughter. All of my procedures were quite easy physically and I was back to my normal routine the following day, even if it did take a lot longer for the emotional aspects to heal.

Hoping you find what is right for you. (((hugs)))

Tracy

As an aside, I also have a DD named Eloise....not too common of a name!


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## jtrt (Feb 25, 2009)

I'm sorry for your loss...

I had three missed miscarriages and chose medical management with misoprostol. All three of my experiences were different but all were safe, gentle births of our tiny babes at home. Feel free to PM for details.

Warmly,

Amy


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## hannybanany (Jun 3, 2006)

I've miscarried at home 3 times, and after waiting a week for bleeding to even start this time (baby had been gone for 2 weeks), I went with a D&C. I can honestly say that I am happy I chose that route. Miscarrying, for me, is painful and bordering on scary with the amount of blood I lose.

This is new for you, just take a few days to let it sink in before you make your decision.


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## morganlefay (Nov 13, 2007)

I'm so sorry this has happened to you. I chose to take Cytotc (misoprostal) to induce a missed miscarriage last month. My baby was 6-7 weeks; i found out at 11 weeks. When I took the Cytotec it was extremely painful for about an hour and there was lots of blood; I bled for two weeks after, but I think for me it was less traumatic than a D&C would have been. I hope that you can find peace with whatever you choose to do.


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## kalamos23 (Apr 11, 2008)

I found out at 11w1d that the baby had passed - measured 8w5d, so almost your exact situation. Actually, at 10w5d they couldn'y find a heartbeat but since it was only the nurse, they just told me to come in that following week.

Anyway. I chose to go naturally with the disclaimer that if things hadn't started by 13.5 weeks, I would get cyto or a D&C. Usually in these cases, things will start up at the 12 week mark because the placenta should have been taking over at that point, so that body finally realizes the baby has passed.

The m/c itself was really not that bad at all. I have honestly had more painful AFs and I'm a total wuss when it comes to abdominal pain. The night it happened, I had definite contractions but no bleeding - and then I had this one contraction taht totally felt like a transition contraction - the skin crawling feeling I got with DD when I was in transition with her. I stood up and my water broke - I ran to the toilet and pushed once and the baby came out. It was actually very healing. The heavy bleeding and clots came afterwards for about 4 hours and then stopped - there was some big clots, but pushing them helped. I did end up taking 2 Aleve, so I could sleep as it was late at night, but it was more that the cramps were annoying rather than painful.

I had very little bleeding afterwards and then 3 days later ended up passing the placenta - I thought everything had gotten out but I guess the placenta was still in there. I was monitoring for fever, excessive bleeding etc. though, and had none of those so it didn't concern me. After that, I had maybe 3-4 days of light bleeding/spotting and that was it. In total it was about 10 days worth of bleeding with 2 days of that being heavy and teh rest moderate to very light.

Just wanted to give you a positive outlook on later m/c - my experience wasn't that bad.


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## StarMama (Jun 25, 2002)

I miscarried naturally at about 10 weeks (we had only see a fetal pole via u/s prior) while on vacation. It was very uncomfortable, but not horribly painful. The actual passing of the baby and tissue was about an hour of need to breathe through it cramping, but again it was not horrific. I'm so sorry you're going through this mama.


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## Kootenay-Cookie (Mar 25, 2010)

I am so sorry for your loss.







This is something very close and fresh in mind for me.

On Monday, I went in for a DNC. My baby passed somewhere around 5-10 weeks. They never gave me an actual date, just the measurements of the egg sac and my uterus. I had no bleeding, and no cramping for all those weeks. I was over 13 weeks when they did the procedure, and my midwife said it would be the best option. I was very afraid that it would happen at home (in my apartment with just my husband there... this was our first baby. I didn't feel emotionally that it would be a good thing for me to see the baby, I thought it would be a lot harder to get over the feelings of grief- but that is just me). I am also a believer in home birth, no medicine, and midwives- but I felt like it was the right thing for me to do to go to the hospital to have the procedure done. I got very concerned about the risks if the baby did not pass out of me (I tend to be a worrier). You should talk to a doctor/midwife to get some more information. Mine were very informative, and answered all my questions, and calmed my fears.

No body can say what is the best choice for you, but you will come to the answer yourself- and don't doubt that it's the right one.

My thoughts are with you. Take care.


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## Megan73 (May 16, 2007)

I second jtrt that misoprostol is a good option.
I recently had a missed miscarriage - found out at 8w4d that the embryo had stopped growing at 6w2d - and really wanted to avoid what I've read are small but real risks (infection, Asherman's syndrome, damage to the cervix, the risk of any anesthesia) of a D&C. I tried misoprostol and unfortunately I was among the small number of women for whom it fails. I did have cramps and bleeding - quite tolerable with Tylenol and Advil - but didn't expel everything.
I would still use the misoprostol again if I have another early loss.
I was lucky that I miscarried on my own at about 11 w, days before the scheduled D&C. It wasn't pleasant - I did have excessive bleeding and went to the ER - but I don't think that's too typical either. My other miscarriage was just a few hours of cramps then I passed the baby (in the sac, didn't see anything) then had period-type bleeding.
Hang in there, mama. Waiting is SO hard.


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## savithny (Oct 23, 2005)

I'm very sorry for your loss. I hope by now you have some closure.

I just posted this in another thread, but:

From a basic risk standpoint, D&C vs waiting for natural miscarriage each carry their own risks, and the Cochrane recommendation is that because while the risks are different, the overall impact (on health/fertility) is equivalent, it should be up to the mother to decide how to proceed.

That said, I know it is the common take here that naturally miscarrying is more healing and brings closure. That makes sense - this is a natural parenting site. But just because many people say it about themselves does not make it true for everyone, _and it does not make it true for you_. You are the one who has to wait, you are the one who has to go through the D&C or go through the miscarriage at home. You need to do what is best for you and your own psyche and your own family.

I was told at nearly 12 weeks that my baby had stopped developing around 9.5 weeks. I had no bleeding and no sign my body was letting go. The doctor was very compassionate and she suggested I go home to think about next steps. She laid out D&C vs. natural without making natural sound horrifying - really did a good job of making it seem like two choices that were equally okay.

I went home and after a day or two I realized that I needed closure in the form of ending. Walkign around feeling like I was a vessel of death was not a good thing for me in that time and place. I had little support, we'd just moved, everything was up in the air and I needed some finality. I scheduled a D&C.
(when I called to schedule, the nurse said "You know, in my experience over half of women whose babies are developed as yours wind up in the ER getting D&C after all." Note that no one told me that to scare me beforehand)

The D&C was not bad at all, and it was a relief. I don't regret it, and I don't think that waiting for it to happen on its own would have brought me any additional measure of peace of healing _at that point in my life._

I miscarried again several years later, and this time it started and completed at home. I don't regret that either. So I've done it both ways and each has pros and cons, depending on the full context in which it takes place.


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## sarahmck (Feb 11, 2005)

Thanks for all of the replies. I'm still waiting, no change. I'm 11+3 today. My plan is to have another ultrasound next week just to be absolutely sure, and then try stronger herbs. I'm not sure exactly what they are, but my acupuncturist told my friend who also sees her that she thinks that they should really do the trick. Unfortunately my husband will be out of town from Wednesday until Sunday, so I will have to wait one more week to begin that to avoid doing it on my own with two little kids wanting entertainment and waitress service.

I'm assuming that those are supposed to work quickly. So if they don't within a few days, I will give up and go for the dreaded D&C.

I dread the D&C because my son still nurses heavily and I just can't imagine dealing with the amount of time that I'd have to not nurse due to the anesthesia. I don't know what that amount of time is, but it's got to be in the 12-24 hour range, right? I also am quite pleased that no doctor has ever been near my privates with a sharp instrument and I'd rather not change that now. Also I've heard it said that it's advisable to wait at least a month to try to get pregnant again after a D&C, whereas it's not necessary after a natural miscarriage. If I miscarried right now and then got pregnant in a few weeks my kids would be almost 3 years apart. 3 years is my ideal spacing, but I'd rather be under it than over it.

Of course, if I wait around for nature to take its course, I could be waiting even longer.

I hate how there's so little information on the internet about this. It seems that the vast majority of people just go for the D&C right away, so I can't figure out what my chances are of having to wait a really long time, like my midwife who had a missed abortion and hung around waiting until 28 weeks, at which point she got the D&C. Who knows how long it would have taken? Do some people just reabsorb the whole thing and never miscarry?

I need to look into that drug more. It seems like a happy medium if my herbs don't work. And also the risks of waiting. I was glad to see those listed in a post. Now I'll have something to search for. Thanks.


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## sarahmck (Feb 11, 2005)

Yikes, I just read this on ashermans.org:


> The risk of developing Asherman's from a D&C is 25% 2-4 weeks after delivery (5-8). D&Cs also lead to Asherman's in 30.9% of procedures for missed miscarriages and 6.4% for incomplete miscarriages (2). Asherman's risk increases with the number of D&Cs performed; after a single termination the risk is 16% however after 3 or more D&Cs the risk jumps to 32%. (9).


I had never heard of this. Ugh. 30.9%???


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## cappuccinosmom (Dec 28, 2003)

Re: D&C, I chose to have one when diagnosed with a molar pregnancy (no baby, even







). I was very unhappy about it, and fearful, but I didn't feel that in that situation waiting around would be wise at all.

I was in and out of the hospital same day. It wasn't a pleasant experience but not nearly as dreadful as I'd anticipated. Because of my severe nausea, they just put me under completely, so I went from seeing the ceiling tiles of the OR to the ceiling tiles of the recovery room with nothing in between. Which was a relief for me, at least.

In the short term, that was actually physically easier than my natural miscarriage (which was horrifically bloody and painful







, and terrifying ). In the long term, though, I'm pretty sure it did a number on my system and it took 6 months plus starting Vitex until I stopped having hemorrhagic monthlies.









It's definitely not something I'd glibly recommend, but if the risk of waiting/infection starts to rise, it may end up being the least worst course of action, and I'm only hoping to relieve you of the pre-op fears I had. The level of fear I had turned out to be not proportionate to the actual procedure, yk?


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## Milk8shake (Aug 6, 2009)

In the past, I've been told that with a missed m/c, most women will complete it naturally within 6-10 weeks, at the latest. I would say that there is a very good chance that it would happen for you sooner than that.

Personally, I have had one natural loss and two d&cs. With my two 'missed' losses, I waited about 1 week, and a little over two weeks before choosing the d&c. Although it is not a decision to be taken lightly, I do not regret either. The emotional turmoil of waiting to miscarry, especially with my third, was more than I could personally handle. The recoveries were also much, much easier, and I was comfortable with the advice on how the hospital handled the remains of miscarried babies - cremation.

I have seen the Ashermans site - and I know the stats are shocking. However, I think that they relate to D&cs performed with a sharp curette - which largely increases the chance of developing adhesions.
Both of mine were technically D&Es - and were performed with a suction curette, which to my understanding is a lot safer in that regard.
I understand that D&E is the preferred option these days - perhaps you could confirm that with your doctor.

Best of luck


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## savithny (Oct 23, 2005)

THe Asherman's numbers are mixed and interesting. Some studies have found those high numbers. Others have found numbers more like 1 in 100.

It seems like the presence of infection is part of the equation, too, and the incidence goes up in direct relation to time between fetal demise and D&C, suggesting that infection is present in those cases - which is something that can also cause problems if left to resolve on its own.


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## hannybanany (Jun 3, 2006)

I don't think you have to wait that long to nurse after general anesthesia.

From Dr Sears: http://www.askdrsears.com/html/2/t025700.asp

Just good info to have


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## MamaGlow (May 15, 2008)

Thanks for the Asherman's info; my dr never told me about that risk.

I mc last summer at 15 weeks, thought it was complete, but it wasn't; had to go in 12 days later for a D&C, dr wasn't sure if I had retained fragments or a twin placenta that didn't want to let go. (I also had a fever, passing large clots, low hemo from excessive bleeding, etc). the procedure was short and non-traumatic for me; dr used a suction currette too; hospital staff was very gentle and kind.

I arrived at the hosp @ 9am, in surgery @11, home by 2 and nursing my 18-mo-old... I don't think if you are feeling up to it that you need to wait 12-24 hours...

I'm sorry for your loss.


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## Tahpenes (Jun 2, 2006)

I hate to add a word of caution, since I was always and remain a big proponent of home birth and natural miscarriages....

Please know the signs to look for if something goes wrong. I was miscarrying for over a week at about eight and a half weeks, waiting at home for it to get going, when around midnight one night I began to have sharp pains like cramps. They got regular, and eventually I passed the fetus. After that the pain stopped, and I thought about going to bed, but (luckily, I guess) I was so upset that I stayed awake.

Maybe half an hour later I began to bleed copiously, and began to feel faint. My husband took me to the emergency room, where I promptly passed out. I was in shock by the time they got me on the table, they got a cardio team ready, and they had to pump in three liters of fluid before I was stable enough for an emergency D&C.

It was one of the most terrifying experiences of my life, and I was very close to dying. If I had gone to bed, I probably would have; my midwives didn't warn me that I could start hemorrhaging.

Please be aware of the possibility, and keep a phone handy.

:







s::


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## sarahmck (Feb 11, 2005)

Thanks so much for your reply. I really appreciate the cautionary tale and will keep that in mind. I think mine may be coming soon. I've felt a bit crampy today and had one sharp pain. Fingers crossed that I get through it with one of the not-so-bad cases.


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## FMS619 (Nov 17, 2008)

Sarah,
We'll be thinking of you today. Do you have someone with you? I would encourage you to have someone with you as you go through this process.

Take care,
Becky


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## xtara2003x (Sep 25, 2006)

I am so very sorry for your loss.
















and









I have miscarried twice, both naturally at home. I can tell you that I wouldn't do it any other way. The very small chance of uterine rupture with a D and C scares the crapola out of me.

My natural miscarriages weren't that bad at all. Now I was only 5 weeks, so it may be more painful being further along, but it is my understanding that a miscarriage should occur by 12-13 weeks as that is when the placenta is supposed to start functioning on it's own.

I found out my baby had died, and about 3 days later begain to miscarry. Waiting was hard, but I am so glad that I did. I ended up being able to see my baby, talk to him, and have a really wonderful, precious, and sacred moment between both of us. It was really really healing.

I drank wine to ease my cramps which weren't that bad. My second miscarriage was easier than my first as far as cramps go. Wine was enough to do the trick for me and no pain medication was needed.

I am a strong proponent of natural miscarriages, and homebirths, and the like as well. You need to do what you feel comfortable with. I hope you are able to learn the pros and cons to both sides and make a decision you are comfortable with!!

Again I am so sorry for your loss!!


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## sarahmck (Feb 11, 2005)

Thanks. My husband is generally around, and my friends have all volunteered to help by taking my kids or whatever. So I have a good support system.

Nothing is happening yet, but I've been a bit achy all day so I hope that it's at least a sign that things are gearing up for a change. I will also have some breastfeeding-safe purging herbs arriving tomorrow. I will have to figure out whether I should still take them if things have started or if I'm pretty convinced that they're about to.

I appreciate all the support that I've gotten here.


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