missed miscarriage, now need to decide whether to go for d&c or natural?

[nycsg]

I found out at my first prenatal visit on Wednesday (2 days ago) that i had a "missed miscarriage."  (i was technically 8 weeks preg).  there was no heartbeat and not even any developing fetus, just an empty amniotic sac. 

ive mostly come to terms with the loss emotionally, or at least i feel that way now.  my main concern at the moment is what to do next....  so far my body hasn't passed anything.  my ob (who is great, but leans to the intervention side) is strongly encouraging me to get a d&c asap.  his reasons are that (1) its "easier" (over after a day, don't have to go through a longtime of heavy bleeding, cramping; (2) more predictable (if i wait it could happen at anytime, may have to wait a couple of more weeks; (3) allows us to test the contents to help figure out why this happened; and (4) would prevent the risk that ill end up with hemmoraging that will turn into an emergency situation if i just let nature take its course.

i feel torn though because i worry about the risks of d&c, future fertility, etc., and also am SUPER afraid of general anesthesia and spinal anesthesia and i would have to definitely use one or the other.  the hospital said its so painful they dont even allow anyone to do it with just local.  i did a totally drug free birth that lasted 30 hours with back labor and they said that would be a walk in the park compared to a d&c even with local. 

my ob insists that even putting convienence aside, overall he thinks going the d&c route is safest.  but i dont know about that.  im so worried about making a wrong decision and so confused about what to do. 

i tried to find a more appropriate thread but couldn't find one, so maybe someone here has gone through this, or else can tell me where to post!!!

thanks in advance. 

[FrannieM]

First of all, I am so sorry to hear about your loss.  You are dealing with the practical now, and we are all here for you to help you dea with the emotional!  

ok now... take my advice with a grain of salt because of course this decision is totally personal in the end.

Go with the D&C.  I have a good friend who has been through both kinds of miscarriages, she leans towards non-intervention, and she said she would choose the D&C over regular passing anytime.   The D&C *is* safe physically, and emotionally easier.   This is my friend's opinion, who has gone through it.

When my other friend got an abortion (which is essentially a D&C... just to explain the comparison!!! because you are having a miscarriage, not an abortion) we researched the hell out of the risks because we were worried about her future fertility and came to the conclusion... it really is so safe.  

That is my opinion.

Strength to you during this difficult time!

 

[Kkrpata]

I'm so sorry for your loss...

I just wanted to chime in here.  I have had two miscarriages, both did not happen naturally for me.  The first was a blighted ovum, which sounds like yours, and the second the baby had stopped growing at 10w5d.  The first I tried to let pass naturally, but after a week or two I couldn't take the waiting and had the D&C.  They were able to do chromosome testing and although they did not find anything abnormal, it was more comforting to me than not knowing at all.  The other thing I was surprised that they were able to tell me was that the embryo was female.  I was shocked at first, because I was not expecting them to be able to tell me that because there was no embryo to be seen, but again it helped me have some closure in the end. 

The second time I chose to have a D&C right away because I knew that they would be able to do testing again.  They did, and again, nothing abnormal but I did learn the baby was a boy. 

Both of my D&C's went fine, my doctor is a wonderful surgeon and I have not had any problems and it has not harmed my reproductive future.  I had pain afterwords when passing a few clots, but I wouldn't say it was unbearably painful.  I did have general anesthesia but I also had the option (not at my hospital, but at a women's clinic) of having local.  I personally could not do just local because you can then hear everything going on and that would be unbearable to me. 

I'm so sorry you have to make this decision... 

[hildare]

oh, i am so sorry for your loss..  i've also had a blighted ovum.  it's such a disappointment.

i chose to have a d & e for several reasons:

i was far enough along where my ob thought it would be a passage of lots of material, which can be painful

my ob said it could be several more weeks before the actual passage of the material began.  i couldn't stand the thought of waiting for it to happen

i am older, and wanted to ttc as soon as possible.

i found the d & e to be super fast and pretty painless.. i was nursing my dd at the time, and i wasn't kept under long enough to disrupt or bother nursing nor did i take pain meds besides tylenol.  from what i hear from others, the natural m/c can be more painful, and physical recovery before ttc can be more lengthy in addition to waiting for it to start.

either way, i would NOT recommend using the drug that encourages the m/c to start-- i have known two friends who tried that and the m/c did not complete and they ended up with a d & e anyway.

your concern was that you feared the general anesthesia-- you're under such a short time, less than you would be for wisdom teeth removal.. there's none of that 'hung over' feeling you might get for a longer procedure.  i really felt no ill effects besides slight drowsiness later.  otherwise i agree with what your ob said, aside from #4.  LOTS of people (see the board recommendation i put below) have passed naturally and the worst thing that happens is that something is retained, leading to a d & e.  i have never read of anyone hemmoraging.

for support and other info, on mdc, i found the ttc after a loss group extremely supportive, for when you're ready to TTC again.  i love those mamas.  there's also a pregnancy loss forum where you can post this question and get maybe some more answers & lots of support. 

i hope you recover quickly no matter what you elect to do.  big hugs. 

[thecountrymouse]

I had a D & C this past week.  I was 9 weeks pregnant.  It was the right decision for me.  I wrote up my experience and posted it to the birth loss thread.  There are many miscarriage stories on that thread.  The stories might help you with your decision. 

[Milano]

I'm so sorry to hear your sad news, big healing hugs to you.  I, too, had a missed miscarriage, I only found out about it, though, when I had already started spotting, went for U/S and no heartbeat, so things were already underway.  I was 9 1/2 weeks along and baby hadn't progressed further than 6 weeks.  The spotting increased later that day and the next, nothing painful, just quite a lot of blood.  The following morning I had a sudden bout of cramps and then passed a large clot, spotted for 2 weeks, and that was it.  I don't like doctors and hospitals and am "glad" that i wasn't faced with your decision, it wouldn't be easy for me to choose, as I'm sure its not for you, either.  you've got some excellent advice above, all i can do is wish you peace and eventual healing.  It sounds like those that chose D and C have not regretted that choice and have been relatively comfortable through the process.   to you and for your little one.

[buggysmum]

I am so so sorry.  My heart goes out to you. 

Having tried this multiple times, I'd say go for the D&C.

Hugs,

Shelly

[mamanoish]

I'm so sorry for your loss. :-( Before this pregnancy, I miscarried in February on Valentines Day. It's likely that the embryo was never growing properly, maybe never had a heartbeat... I don't really know because I started passing everything 2 days before my first prenatal appt. I was 7.5 weeks. Since mine started naturally, obviously I went that route, but it was very painful. Somewhat traumatizing I think. It took me a really long time to get over it, and I can't say that I even am. DH and I started TTC right away and this baby is due early Feb, and all I can think about it hoping this baby can bring happiness to that time for me again. 

If I had another loss and hadn't started m/c naturally, I would go for a D&C. The waiting alone would kill me. I just couldn't wait for it to be over and get on with my life. 

[mrskatiekuj]

I am sorry. Had a missed miscarriage in December, and ended up going with a D&C after trying Misoprostol, which did not work. The D&C was quick and painless, but it didn't come without any emotional baggage. It left me feeling very worried about scar tissue, as well as just dealing with the miscarriage in general. I think because I was only 10 week along, I tried to convince myself that I shouldn't be feeling as sad as I was, and I ended up repressing a lot of feelings that kept coming back up.

I hope you are able to find some peace and make a decision that feels right for you. My best piece of "advice" is to really allow yourself to mourn the baby and take time to heal.

[MamaShannon]

I am so very sorry you are going through this. My heart aches for you.

My first pregnancy ended in a missed miscarriage. The baby did not develop passed 9.5 weeks, but I was nearly 12 weeks pregnant when we learned this from an ultrasound. It was devastating to say the least.

I waited two weeks and nothing happened. Finally, when I would have been 14 weeks along, I opted for a D&C, and I am so glad that I did. I went under general anesthesia and didn't have any problems. The procedure was over pretty quickly and I had very little bleeding afterwards. For me, having the D&C was healing because I knew I had been carrying this sweet little baby for so long after it passed away, and was just ready to get the next part of my healing process going. The waiting game was getting to be too difficult. And as far as fertility, we waited three months before trying again for another baby, and became pregnant the very first month we tried. I had a healthy baby girl 9 months later, so the procedure did not affect my fertility at all. 

I've never had a spontaneous miscarriage, but from what friends have told me, it is very painful, and can last over the course of a few days. I've never heard of someone hemorrhaging from a miscarriage, but I suppose it's possible. I have, however, heard of women retaining part of the pregnancy and then having to have a D&C anyway to remove the rest of the tissue.

I hope you are able to come to a decision that feels right for you. Everyone grieves differently. And I agree with Katie, allow yourself to mourn your loss and give yourself lots of time to heal. 

[Faither]

I had a D&C in November 2008. It was the best choice for us. Of course as soon as we found out there was no heartbeat, I started to bleed. But I think it was all wishful thinking. We conceived our DD four months (three cycles as recommended by the doc) later. She's almost 2 now. I have a friend who m/c the summer before and she didn't know she was pregnant. She said the cramps from that was worse then the 30ish hours of labor two years later. But it's all up to the person.

It never gets easier. But good luck with whatever you decide.

[Adaline'sMama]

I had a D&C only local, and I promise, you want the drugs. There is only one thing that has ever caused me that much pain, natural childbirth. I thought about the way that d&c felt when I was in transition with DD. Thats the last thing you want to be thinking about when you are about to deliver a baby in the future.

Im sorry for your loss mama. I wish you super fertility for the future!