# Another loss-- New questions about D&E vs D&C



## User101 (Mar 3, 2002)

We've lost this baby as well. Our last baby died at 7 weeks. I hadn't miscarried at 13 weeks, and had a D&E on July 31. I got pregnant again right away, but when I went in for an ultrasound yesterday, there was no heartbeat. The baby was only measuring 6.4 (it had been 6.0 two weeks before) and my HCG levels have plateaued.

I feel kind of numb at this point. My husband has been amazing, my kids have been wonderful, and I just alternate between feeling like I've been kicked in the gut and feeling nothing.

We've named our other babies that we;ve lost. I don't even feel like I can name this one. Isn't that awful? DH says we need to name this one too, but I feel stuck.

I go back in Monday for bloodwork and another ultrasound. The doctor said there's absolutely nothing indicate this is anything other than another loss, but on the off-chance that Fran (the ultrasound lady) was having an uncharacteristically bad day, he wants to be absolutely sure. Which I appreciate.

Letting nature take its course isn't really an option. My body doesn't really miscarry on its own. At least it hasn't the other times this happened.Plus, I'll admit that I'm just not strong enough to sit around for another 6 or 7 weeks waiting to see if I miscarry on my own. At this point, I have no bleeding or cramping. And I mentioned Cytotec, but he said it's painful and messy and awful and he doesn't prescribe it. He's recommending another D&E on Tuesday, but I'm worried about having two so close together.


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## NWmt_mama (Jul 22, 2005)

I'm so sorry and I can understand not wanting to wait for everything to happen (I couldn't). I honestly don't know about D&Es close together. It is so tough.


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## purplelilacs (Aug 14, 2004)

I am sorry. I cannot even imagine.

I am all for D&E's if that is what you want to do and have had 4 or 5 (choose not to remember), but I can't say I would have them this close together. I would think the risk of scar tissue and any other problems associated with D&E's increases.

I also agree with your doctor and would not use cytotec, but I am completely opposed to its off label- use for pregnancy purposes.

So I really have no idea. We always waited at least 3 cycles after a D&E before having unprotected sex, so of all the situations I have faced with miscarriages, this was not one. If you trust your doctor and he thinks a repeat D&E is safe so soon, then maybe that is the best option since your body (like mine) wants to keep pregnancies for as long as possible.

I hope you find a solution you can live with and find some peace.


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## User101 (Mar 3, 2002)

Yeah, the unprotected sex is a whole other thing. We don't use artificial birth control, but I didn't expect to get pregnant right away. I'm 37, I'm nursing my two-year-old, I just wasn't expecting to get pregnant. Stupid, I guess. I'm thinking I need to relearn NFP, but I don't know what that means for the first month before I have a period. I never had a cycle before I got pregnant after the miscarriage.


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## ladyjools (May 25, 2009)

im really sorry that you lost another little one
((((hugs)))))
Jools


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## User101 (Mar 3, 2002)

Thanks Jools.


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## Manessa (Feb 24, 2003)

I am so sorry for your loss. For what it's worth, I did a cytotec induction when I was 17 weeks (baby had died around 14) and for me it was not painful and no more messy than a natural miscarriage at home. If you want more info, pm me. You could find another provider willing to prescribe cytotec if that was something you wanted to do. Again, I'm sorry


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## MCatLvrMom2A&X (Nov 18, 2004)




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## tinynyota (Apr 13, 2009)

I'm so sorry this is happening to you.


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## William's Mom (Oct 6, 2004)




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## Amy&4girls (Oct 30, 2006)

I am so sorry that you have lost another precious little one.








I just wanted to gently remind you that naming your little one isn't something that you necessarily have to do right now if you need more time. It sounds as though your heart is just trying to protect itself. I think in time you will be ready to name your precious little one. Try not to let the guilt creep in just because your heart just can't handle it right now. I hope I'm not overstepping in saying any of this. My thoughts and prayers are w/you.


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## Mickiswing (Apr 10, 2005)

I'm so sorry! *HUGS* Praying that you'll be able to reach a decision that you all feel comfortable with. I hope everything goes as well as it can.

Micki


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## zonapellucida (Jul 16, 2004)

I am so sorry for your loss. Is there any way you can do an herbal induction?


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## User101 (Mar 3, 2002)

Quote:


Originally Posted by *zonapellucida* 
I am so sorry for your loss. Is there any way you can do an herbal induction?

I'd be interested in learning more about this.


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## User101 (Mar 3, 2002)

Quote:


Originally Posted by *Amy&4girls* 
I am so sorry that you have lost another precious little one.








I just wanted to gently remind you that naming your little one isn't something that you necessarily have to do right now if you need more time. It sounds as though your heart is just trying to protect itself. I think in time you will be ready to name your precious little one. Try not to let the guilt creep in just because your heart just can't handle it right now. I hope I'm not overstepping in saying any of this. My thoughts and prayers are w/you.









Not overstepping at all. I really need to hear this.

I'm having a very sad morning.


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## MFuglei (Nov 7, 2002)

I'm so sorry for your loss.


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## alternamama82 (May 28, 2009)

I'm so very sorry that you've lost another, and are having to face all these decisions... I really don't know what to recommend, but I can understand completely how you don't want to wait for nature to take it's course... Maybe you can do some research online to see what your safest options are? Lots of hugs coming your way.....


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## Jules09 (Feb 11, 2009)

I'm so sorry.







I understand not wanting to wait. I hope you're able to work out something that works for you.


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## MI_Dawn (Jun 30, 2005)

Ohh annettemarie... I'm so very sorry. I had such hope for this little one for you. Damnit. It makes me so mad... and sad...


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## SeekingSerenity (Aug 6, 2006)

AM, my heart just aches for you.


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## christophersmom (Sep 20, 2005)

I am so sorry for your loss. I have had three different types of miscarriage.

The first one I had a hospital D&C, very hard and expensive option. Also, very uncaring and unsupportive staff in the hospital.
The second my body actually lost on its' own, easiest option, but unfortunately you don't get to choose. My body held onto the other pregnancies.
My third was an office procedure, less hard and less expensive than a hospital D&C. It is called a uterine aspiration. We have a hospital near me that has a miscarriage clinic. They did what was called an aspiration. Everyone on staff was so compassionate and caring. My husband got to hold my hand and hug me during the proceudre while I cried. It also was less expensive as far as co-pays. It was a little painful, but it was fast. They let us stay in the room a little and take our time to grieve. It was a hard day as it was my third in less than 13 months.
You also can do a pill where it forces your body into action. I haven't tried this option. It is methotrexate. My OB did not give me any options except the hospital D&C, it was the miscarriage clinic that I learned there are more options.

So sorry about your loss. I hope this information helped.

https://www.ucsfhealth.org/adult/med...ion/signs.html


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## User101 (Mar 3, 2002)

Thank you all for your kindness. At a time when I'm feeling like the least little thing is going to send me over the edge, I really do appreciate it.

I will ask about the office procedure, but I really don't know that it's an option. I live in a smallish city, in a valley surrounded by mountains in PA. They tend to be very conservative in their medical treatment because if something goes wrong, it's a bit of a hike to get to a larger hospital.

One question I have-- I know the risks of a D&E. Are there additional risks in having two so close together? This is a concern for me.

I'm secretly hoping for a miracle, and then I want to kick myself for being so naive and stupid. There's not going to be a miracle.


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## HoosierDiaperinMama (Sep 23, 2003)

Oh, Annette.







My heart is breaking for you right now. I popped in here to check on you and am so sad that this is happening to you again. I wish I could do more for you, but for now I will pray for you and your family, for your body to do what it needs to do, and for peace.


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## User101 (Mar 3, 2002)

Thanks, Amy. I'm praying that my body does this on its own as well. Last night, I dreamed that I miscarried naturally. What a strange thing to wish for, and yet I do.

It will be OK, I know. I know how blessed I am with my 4 little ones. I keep cuddling Daniel, and thinking that if he does end up being my last baby, what a wonderful note to end on. I'm really blessed, even with this hard stuff happening.


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## onelilguysmommy (May 11, 2005)

Having two close together would worry me as far as lining issues.








I wish I could do something to help.







for your precious babes.


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## hippy mum (Aug 12, 2006)

Oh no! I was hoping for the best this time, I'm so very sorry. Is there anything you can take natrually to get things going? RRL tea? Any other herbs? I'm glad they're doing another u/s to verify.


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## User101 (Mar 3, 2002)

Another question: What is the difference between a D&E and a D&C. I mean, I know the basic difference, but what are the risks of each and how are each used in a missed miscarriage? I tried to google but I just can't handle the random stuff that's coming up.


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## zonapellucida (Jul 16, 2004)

http://symptomchecker.about.com/od/c...-pregnancy.htm

•Dilation and curettage (D & C) -- In a dilation and curettage, the cervix is dilated and instruments with sharp edges, known as curettes, are used to remove the pregnancy tissue. Suction is often used to make sure all the contents of the uterus are removed. The earlier in pregnancy this procedure is done, the less the cervix has to be dilated, which makes the procedure easier and safer.
•Dilation and evacuation (D & E) -- This is the most common procedure for ending a pregnancy between 14 and 21 weeks. It is similar to a suction D & C but with larger instruments. The cervix has to be dilated or stretched open to a size larger than required for a D & C. Suction is used along with forceps or other special instruments to ensure all the pregnancy tissue is removed. The procedure takes more time than other abortion procedures.


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## jcwmama (Sep 4, 2009)

I am so sorry that you are going through this. I just had a m/c about 10 days ago. I visited an acupuncturist/ herbalist to get things started for me. If you want to hear more, please pm me. Thinking of you and all the other mamas out there dealing with this kind of loss.


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## hippy mum (Aug 12, 2006)

Ouch! I would hope they use some time of pain killers with that. I would be worried about the scarring and lining with two so close together. How long will they let you go w/ some herbs or something to help along to see if you mc natrually?


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## User101 (Mar 3, 2002)

They knocked me out completely both times. It's done in a hospital operating room.

It's already been two weeks and my body is showing no signs of miscarrying on its own. I've gone 6 weeks before, but we didn't know the baby had already died before. Maybe I'm weak, but now that I know, I have zero interest in sitting around and waiting to see if my body does things differently this time around. I have no confidence in my body's ability to let go of this baby.


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## mrsbabycakes (Sep 28, 2008)

I'm so heartbroken for you. I'm so sorry.









I've seen people have suction D&C's (D&E is more of a second-trimester procedure where larger fetal anatomy is an issue) in close proximity and still be fine. I'm not sure that having two close together is much different in terms of risks than having two far apart. No one can say for sure. There are risks associated with whichever path you choose, but it's likely that if you chose to wait or use cytotec, you may need a D&C later anyway.

I hope you know that getting pregnant right away last time is NOT why this happened. The research shows that length of waiting time after a miscarriage does not predict pregnancy outcome.


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## User101 (Mar 3, 2002)

Thank you for that. I _don't_ feel like I know that. I feel like there has to be a reason, and it's easier to blame myself than to just accept this as some sort of random event. But I know that what you're saying is true.


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## User101 (Mar 3, 2002)

Question: When I have my consult with the doc tomorrow, would it be stupid to ask for one of the ultrasound pics of the baby from the day they saw the heartbeat a couple weeks ago?


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## Juvysen (Apr 25, 2007)

I'm so sorry for your loss.


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## Jules09 (Feb 11, 2009)

Quote:


Originally Posted by *annettemarie* 
Question: When I have my consult with the doc tomorrow, would it be stupid to ask for one of the ultrasound pics of the baby from the day they saw the heartbeat a couple weeks ago?

There are people on this board who have called the hospital later on to request the ultrasound photos, and have received a CD.

I'm so sorry you're going through this again.


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## teeg1973 (Oct 15, 2008)

annettemarie - I am sorry for your loss









I am in a fairly similar situation. I had my last D and C in March. I think my doc was hinting at wanting me to wait to miscarry on my own, but that has never happened for me either. I go back tomorrow for a final ultrasound and to discuss options. I would prefer the D and C, but I guess we will see...I too am a little worried about having two fairly close to one another. I will be curious to hear what you decide.

Again, sorry for your loss.

Tracy


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## Mosaic (Jun 20, 2005)

I'm so sorry, annettemarie.









FWIW, a friend of mine had 2 D&Es within a month. She had one miscarriage, but apparently the first D&E was not complete, so a second one was needed in a manner of weeks when the bleeding didn't stop. I think the risk of scarring may be slightly higher in case there was some inflammation or irritation remaining from the first. But you were able to build up a new lining, etc., which I think is a good sign of the health of your endometrium, so I imagine the concern at this point is more about the risks associated with 2 D&E's/D&C's and less so about their proximity.

FWIW, my friend did go on to have a healthy baby within the year, so in her case at least there was no damage from 2 D&Es so close together.


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## rumi79 (Aug 31, 2008)

I am so sorry! I know you can try with homeopathic remedies - I believe the name is cantharas, but I am not quiet sure because I didn't end up with it, I just miscarried on my own. Can you get in touch with a homebirth mw, they are usually more natural oriented and probably will give you some ideas?
I will pray for you to have the best and quickest end of this.


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## mrsbabycakes (Sep 28, 2008)

I requested a photo right after my us where they couldn't find a heartbeat. The tech gave me some crappy blurry pic and I said, "I need to speak with the doctor." When he came in I explained that this was my child and I needed a decent photo. He totally understood and fiddled with the machine until he found the one I wanted. I'm so thankful to have it.

They may or may not have photos to give you. Aren't they repeating it? If they can't give you an old one, maybe they can give you a new one.


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## User101 (Mar 3, 2002)

They repeated the ultrasound this morning. No miracle.







And I'm still not having any bleeding or cramping.

I go in for the consult with the doc this afternoon.

If any of you are the praying sort, please say a prayer for me. I do not feel like I am holding up well under all this.


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## expatmommy (Nov 7, 2006)

Praying for you.


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## mamatowill (Aug 23, 2004)

Sending prayers and hugs to you.


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## claireb (Apr 7, 2009)

Praying for you. I am so sorry you are going through this. I am sorry any of us ever go through these horrible losses.


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## ~Mamaterra~ (Jul 5, 2006)

Annettemarie,








for your pain, frustration, anger, guilt and the numbness that you are feeling.

As for D&E vs D&C, if you are already dilating or have dilated then it is considered a D&E because they don't have to manually dilate you.

For a D&C, they have to manually dilate you by putting in what look like mini ice-cream scoops in and graduate in size up several times until your cervix is dilated enough that they can do an evacuation.

Back to back, I would not recommend it because it puts you at a very high risk for an ectopic pregnancy. The misoprostol (cytotec) is a preferred option because it dilates your cervix without manual manipulation and you have a labour, very intense, but a labour and feel like you are birthing your baby. I found it helpful for me.

And please, please don't beat up on yourself for the back to back pregnancies. I had 4 back to back pg/mc, one right after a ruptured ectopic, literally 3 weeks after the surgery because I thought that there would be no chance in hell that I could get pg right after losing one fallopian tube.









I too was bf a 2 year old and the rhythm method didn't work because I was ovulating late on one cycle and then early on another cycle.








for your little one.


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## User101 (Mar 3, 2002)

Well, right or wrong I'm going in for a D&E tomorrow. They're inserting some seaweed thing to help me dilate at 9 and the procedure is around noon.

I feel absolutely horrid. I can't imagine feeling much worse. And you know, it's amazing how your prayers can change. I've gone from "please let the baby be OK" to "please let me miscarry on my own" to "please let me get through this without having a complete nervous breakdown" all in a matter of days.


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## Belia (Dec 22, 2007)

Oh, AM.... I am so sorry that you are having to go through this. I know you from the crazy, thankless "Jon & Kate" moderating you had to do this summer, and from your funny Dave Ramsey posts lately. You always make me laugh.

I am so, so sorry and I wish you nothing but peace.














You will be in my thoughts.


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## SeekingSerenity (Aug 6, 2006)

Strength and love to you, AM.


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## khaoskat (May 11, 2006)

If you are still really early, you may be able to use something like methotrexate or the Plan B bill to get the ball rolling. I would ask something about these types of options (ie medication vs D&E/D&C).


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## Tear78 (Nov 28, 2008)

I'm so sorry


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## expatmommy (Nov 7, 2006)

Thinking of you today.


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## christophersmom (Sep 20, 2005)

Quote:


Originally Posted by *annettemarie* 
Well, right or wrong I'm going in for a D&E tomorrow.

There is no right or wrong decision in this, you have to make the best decision for you at that moment.
My first I chose to have a D&E right away, I needed to be done with it. I prayed and prayed for my twins to make it and when my body didn't work, I could not take the time to let nature work.

My thoughts are with you, I understand your pain and grief all too well. I am sorry.


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## User101 (Mar 3, 2002)

Thanks all.

It's been a week and a day now. I woke up this morning with Braxton Hicks contractions and passing big blood clots that seem to smell weird. I have a call in to the doctor. Is it wrong that I really just want this all to be over?


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## Katica (Jan 13, 2008)

No, not wrong at all. You need closure and a break from this all. Praying for strength and supernatural peace for you.
So sorry fir your losses...it breaks my heart


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## User101 (Mar 3, 2002)

They were very calm and caring, and said the reason there was so much more bleeding this time is that they caught it sooner, so my hormone level was higher (last time, the D&E was at 13 weeks and the baby stopped growing at 7 weeks, this time the baby stopped growing at 6 weeks and they caught it within a week or two). I guess that's plausible.







I'm just tired and really second guessing myself on the D&E.


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## User101 (Mar 3, 2002)

So, just an update, if you're interested. I woke up this morning to no bleeding. Throughout the day, little to none. It's amazing how different my outlook was. I have noticed my OCD kicking into high gear-- since the loss, I've reorganized the basement food storage, the homeschool stuff, the books for sale, the toys, the art supplies, and our homeschool room.


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## poppiesinjuly (Sep 22, 2009)

I'm sorry for your loss.

I only had bleeding for about 3 days after my D&C. I'm glad that you seem to be feeling better.


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## ecstaticmama24 (Sep 20, 2006)

Annettemarie, I am so sorry you are going through this, it really stinks. And I hope you find peace with your decision, I know you had been sitting on the fence with what to do.... but you had to do what you had to do, know what I mean? I chose to let babies come on their own, but I took an obscene amount of herbs/vitamins to get it going. But I know many mamas who just had to get it over with and opted for D&C. There are no right or wrongs when it comes to this, just personal choices.

Quote:


Originally Posted by *~Mamaterra~* 
As for D&E vs D&C, if you are already dilating or have dilated then it is considered a D&E because they don't have to manually dilate you.

For a D&C, they have to manually dilate you by putting in what look like mini ice-cream scoops in and graduate in size up several times until your cervix is dilated enough that they can do an evacuation.


Just a little correction here... D&C = Dilation and Cutterage... D&E = Dilation and Evacuation (in this one they also include the cutterage but use a vacuum type thing for extraction). So in either case they manually dilate. A D&E is typically performed after 12 weeks and a D&C is generally performed before 12 weeks, although a D&E can potentially be done in that time too. As soon as they add the vacuum it's a D&E.


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