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sensitive question about natural m/c and d & c

863 Views 18 Replies 18 Participants Last post by  simcon
Hopefully, this question will not be too painful for anyone. I also hope it's posted in the right place. This may be a sensitive question for some of you.

I honestly would like to know why some women choose to have a natural miscarriage as opposed to a d&c. I mean, I understand if you believe in natural remedies and the like, but I don't think, emotionally, I could handle it.

Just some background. I recently had a missed miscarriage of my dc that I conceived with some medical intervention. I started bleeding and that same day, I was scheduled for a D&E. I was scared, but knew that I would rather have this done and over than to prolong it. I'm still dealing with the loss, but I think I chose the best course for me. I am so glad that the dr. recommended that I not wait and just have it done that day, he was very polite and thoughtful about the suggestion and everyone involved was super sweet and caring.

Please help me to understand your choice to miscarry naturally.
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I would never consent to a d&c without medical reason. I understand why women would (for the emotional aspect) but I never would.

First and foremost- I believe it's a natural process. Same as getting pregnant, same as giving birth.

Second, and very important- a d&c can cause damage. Real damage. That would possibly compromise future pregnancies. I am not personally comfortable undertaking a physical risk for a theoretical emotional benefit. (if you're unaware of this possibility- it's quite common for d&cs to damage the cervix, and possible to damage or even puncture the uterus)

Third- the anesthesia risk. They are often done under general. ALL anesthesia carries a risk. General is the riskiest of all. Again, I am not willing to take a physical risk for a possible emotional benefit.

Physically, it's safer to let nature take its course if there are no complications. No question on that.

For me, emotionally it is as well. I understand if others feel differently.

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My doctor actually encouraged me to wait and try to let it happen naturally because of the risks of surgery and anesthesia. I realize there is a risk of infection with waiting but I am watching for signs of infection. I have a D&C scheduled for two weeks from now if it hasn't happened yet, but I don't know if I will go through with it or just try to wait it out. Hopefully I won't have to make that decision.

Emotionally...I guess it is harder this way, especially since I'm feeling very depressed right now and I think it's more than just the loss. My hormones feel really out of whack.

i'm sorry about your baby.

with my m/c in april my doc offered the same thing "if i just wanted to get it over with." i understand that sometimes there are medical reasons if the m/c does not complete on its own, but this reasoning made no sense to me. in my case it was not a medical necessity and the last thing i wanted at that time was to be in a doctor's office up in the stirrups and exposed. it just seemed like the obvious choice, given my belief in natural childbirth to also avoid unneeded interventions in this case. hope that makes some sense.
For me it is plain and simple that all surgery comes with a risk and I want to avoid that risk as much as possible. You can have problems with the actual surgery - scaring in the uterus, and you can have post op problems - infections. I don't want either and though they might be rare I would rather avoid them. They don't put you under around here for a normal D&C or E so it isn't an anethesia issue for me. Although if that was routine where I lived it would be another reason I didn't want the operation.

However, for me a miscarriage does not carry the same emotional issues that it does for some other people so I don't feel the need to "get it over with."

Originally Posted by alegna View Post
First and foremost- I believe it's a natural process. Same as getting pregnant, same as giving birth.
Yes - I figured if I couldn't have my natural birth, this was as close as I was going to get. While it has been difficult emotionally, I'm not sure having a D&C would have made it less difficult. To me, it's almost as if it's more OK to be miserable if there is a physical part to go along with the emotional one. All the waiting, while difficult, has helped me to develop more faith in my body's abilities. I feel like I'm getting the time I need to recuperate and hopefully be prepared for the next pregnancy. It's been so hard to wait, but this seems better than a D&C to "fix" it. If I'm still dealing with the emotional side, what's the difference if the m/c is complete?

Ever since I got pregnant, I've found more and more that doctors don't really have a clue. They tell you not to worry after the spotting... they tell you that if you are miscarrying, they can't do anything... they tell you that you *will* miscarry when they can't find a HB. Really, what good are they? I'd much rather be with my husband than alone in a hospital with doctors who may or may not be that supportive and the risks that they tend to minimize.
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Even though I've only had one miscarriage, I've kind of done it both ways. Despite the extremely intense pain associated with the natural miscarriage, I'd opt for that plan again.

To explain further, I miscarried this past March at 11 weeks while on vacation in rural Mexico. While I would have gone to the nearest hospital (2hrs away) if I was bleeding severely, I was very hesitant to go there unless I felt the need was dire--though we did travel the 2 hours to be near the hospital in case it became necessary to go. The miscarriage process lasted approximately 24 hours, with the most intense contractions happening every 90 sec to 2 min for about 4-5 hours. I really feel that the intensity of the situation forced me to process things as they were happening. I felt suprisingly OK by the time I got home to the US the next day. I felt like I was able to leave the experience there, though we brought the placenta and baby back home with us.

About 12 days later, I developed an infection from "retained products of conception" and had to have an emergency D & C and spend three days in hospital with IV drugs to fight the infection. I was not put under a general anesthesia during the D&C, but I agreed to whatever it was that they gave me to make me "not remember" anything and I also had a pain killer to eliminate feeling physical pain. My husband was with me the entire time and was particularly traumatized by the d&c, though thankfully I don't remember a thing. Apparently, throughout the procedure (which is only like 3-4 minutes) I kept yelling for the doctor to stop. (I wouldn't have wanted them to stop had I been "with it" since it was imperative that the infected remains be removed). The hospital staff was great, the care was wonderful, but the whole experience was terrible, awful and just plain sucky. Recovering from that experience erased any of the emotional healing I had been doing beforehand, plus I felt like crap physically.

According to the research I've looked at, and in conversations with my doc afterwards, only about 20% of people who miscarry naturally have problems. This is about the same percentage of people who develop problems after a d&c. The standard of care is usually, at least in the practice I'm part of, to let the patient decide the course of action as both choices have similar potential for complication.

Obviously, my situation is different that a simple choice between a or b. My miscarriage (part 1) was extremely painful and intense. But I feel empowered by how my husband and I were able to team up to deal with it. The hospital part left me feeling depressed, emotionally drained and just plain crabby. Maybe if I scheduled a d&c it would feel different, but in hindsight, I certainly prefer the natural part of the experience to the surgecial procedure.

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I miscarried at home in the bathtub with my husband present - after 12 days of waiting. The waiting was very hard on all of us. My whole family was standing by to watch our daughter, feed us, hang out with us, etc. I felt like I was keeping everyone waiting. BUT I didn't get a D&C because my midwife recommended waiting 2-3 months afterwards to safely conceive. I was scared of the procedure, the hospital experience, and the emotional of having yet another half naked "procedure" with basically a bunch of strangers. BUT, admittedly I was ready to throw in the towel after 12 days.

I also got to see the intact amniotic sac and the tiny fetus. My body missed the fact the the fetus died at 6.5 weeks and kept growing and supporting the sac and placenta. It was almost 12 weeks before I started to bleed. The whole experience gave me back some of the faith in my body that I lost when I found out that the baby had died. My body did what it was supposed to do, it just didn't care about my person schedule. I gave my body the chance to do what it was made to do. I got a much needed empowering experience at the end.
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Personally, I didn't realize there was a choice. I was far less enlightened then than I am now since joining MDC.
When I lost my first in 2005, it was so early, nothing was ever suggested to me -- that loss was at about 5-6 weeks. I never POAS with that, just had a beta done at the OB office on a Friday at end of business. On Monday morning they called with a "Congratulations," but I had already been bleeding for a couple of hours. Because I wasn't in distress or anything, they never suggested I may have been. They just had me come back in to verify my HCG levels were dropping normally, and they were. So that loss was natural without me ever realizing there were other options.

My second loss with Ainsley was at 8w5d. I called my OB with cramping and bleeding, and they said not to worry, but to come in to be checked. Immediately after the call, I passed an intact sac with baby floating inside, and then began literally hemmoraging. I bled so much and passed enormous clots -- I cannot tell you how much I bled. In retrospect, I seriously do not know how I survived. I had never experienced that sort of thing before, so even though I was freaking out from all the blood, I somehow thought everything would be ok. After I got to the OBs office, I lost conscoiusness twice and when the OB was finally able to revive me, he said an ambulance had been called, but I didn't have time to safely wait. I realized then things were worse than I thought. The hospital was across the street, and I didn't have time to wait for the ambulance. Four people helped me to my mom's car and she got me there. They wheeled me in, immediately squeezed bag after bag of saline into my veins to get my bp back up and made me sign releases to accept blood transfusions if they became necessary. Fortunately, my bp stabalized and I began to slowly regain color (evidently, I looked very gray). My OB was right there, and I was immediately wheeled back for a D&C. He said later there was still an incredible amount of tissue still inside, though I had been passing softball sized clots one after another for more maybe two hours by then. After my D&C, I had minimal spotting, and was able to sort of move forward and begin the healing process.

Zachary was not a miscarriage, but a second trimester birth that ended in demise due to extreme prematurity.

As for the decision I would make now -- if I conceived again, and had a missed miscarriage, I would opt for a D&C. I personally would wait a few days only to verify that baby truly was no longer living and have a followup scan or two, and then would go straight for the D&C. I had one that turned so bad and I believe nearly killed me that I personally wouldn't risk it again. For me, I was fine one minute, and things were really frightening in less than a half hour. I think the major risk associated with a D&C is the loss of a uterus, and in my opinion, I'd lose it in a minute rather than have my family lose me. I know there are anesthesia risks, but again, that seems far more controlled to me than the risk of hemmoraging alone.

Personally, I know I wouldn't like to handle the emotional pain that accompanies a drawn out miscarriage. I commend all the mommies who go that route. But that's a back burner issue for me. I did it once because I didn't know better, but if I had to do it again (which I pray I don't), I would choose the D&C.

Now, my situation is very probably unlike anyone else's. I have a progesterone issue for which I take supplements during pregnancy. I take very high doses, which is probably the cause of all the bleeding and enormous clots. On the one hand, that fun when I'm 8 weeks pregnant, and look like I'm 4 months. My maternity clothes get tons of use! On the other, it keeps me on my toes in an effort to prevent a repeat of that scary October afternoon.

I think the bottom line is that we each have to make our own decisions, no matter how hard they are for us or others to understand. No one wants to decide what method by which to have a miscarriage -- I think we'd all like to avoid them altogether -- but if they're imminent, I think the method by which you're most gentle with yourself is the best method for you.

I'm sorry for your loss...
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I couldn't bear the thought of my precious baby being thrown away into the medical waste
The wait for the mc to start was awful, but I just couldn't have a D&C

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As you can see from the responses above, miscarrying is an incredibly personal experience. There's no one right or wrong way.

We all have our reasons, and make the best decisions we can for ourselves.
it is very personal.

i miscarried my last baby in january at the end of the first trimester. (the baby had died somewhere around 10-11 weeks). i miscarried at home, in peace, and used the same visualizations that i used during labor with my two living children.

i passed the baby quietly and was able to spend time holding it and talking to it. we cried. the baby appeared perfect, beautiful, 10 little fingers and toes, just perfect. my husband was able to do the same.

we buried the tiny baby later in a special place in a special bag i had knit for it. my husband dug the hole and we had our own private time which gave us closure to our loss.

for me, a D&C was not something i could do - not without trying for a natural m/c first. and after being able to hold and see and bury our little baby - well, i know we made the right choice for us.

i understand why this isn't the *right* choice for many is personal. we make the best choices we can.
I found the waiting to miscarry naturally was very healing for me. I was aloud to process my loss, grieve and let go before my body expelled everything. The miscarriage was extremely healing. I trusted my body and watched it do the work of something so natural. Going through the motions was amazing. I had a c-sec with my dd after three days of labor. I had planned a homebirth and I so desperately wanted to birth my child naturally. My miscarriage pretty much redeemed the trauma I went through with dd. I know that my body can do it. I'm amazed.

I completely agree with Angela about the risks that are involved with a D&C. But that is for me. Everyone is different and I agree, there is no wrong away. It's just a super hard thing to go through.
When my DH and I started TTC, I knew that we were starting a journey that could have a happy or sad, I decided that in the event of a miscarriage I would stick to my convictions about natural birth as long as I was not in a life-threatening situation. So.........

#1 I wanted a natural birth at my house without intervention with my DH

#2 I didn't want deal with the risks of a D&C....scar tissue, anesthesia, weakened cervix, etc.

I also want to add that I felt empowered, even in the midst of grief.

Hope this is helpful!
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Although I ended up in the ER, I didn't have a D&C and am very thankful. I was able instead to experience the entire process and grieve my loss. It seemed much healthier to do it naturally - no chance of scarring. I miscarried 5 days after I was told that my pregnancy wasn't thriving. But I also have a friend that didn't miscarry 7 weeks after she was told the baby wasn't alive. D&C was very necessary in that situation.
I just found out my baby had died today. I probably having a d and c on Friday. My baby died and 7 and a half weeks and right now I'm (suppost to be) 16 weeks. My uterus is the size of a 16 weeks pregnant. I have not even spotted. I just don't know if my body has any plans to let go of this. And the longer I wait the more blood that will have to pass. I look pregnant and can feel my uterus just an inch or two below my belly button.
I agree with a lot of the reasons many of the PP's stated. I didn't want the risks involved with a D&C but mostly I wanted my baby to go in peace. I couldn't bare the thought of my precious baby's body going through the D&C process. Here's a bit of how it happened for me....

I started spotting at 11w6d on a Friday night. On Monday I had an ultrasound that confirmed the m/c and showed the baby stopped growing a little after 8 weeks. My OB gave me the option but was not pushy either way. He did say that I wouldn't "see anything" but blood and clots.

On Wednesday I woke up with mild contractions. One of my dd's was on the couch with me when the contractions become much worse. I stood up to go to the bathroom and felt a gush which was my water but it was also a lot of blood. I sat on the toilet (it was A LOT of fluid!) and cried. At one point I happened to look down to see what was coming out and saw my baby. I quickly grabbed her and sat there holding her (couldn't see the sex...just say her to make it easier and I don't like "it") in my hand crying. I told her how much I had wanted her, loved her, was going to miss her. She was PERFECT! I could see tiny ear buds, a mouth starting, arms, hands with fingers beginning, legs...just perfect. I feel so blessed to have held her.

We buried her with my brother who died when he was 16. I put her in a beautiful silver box with a picture of her family and a letter. My father read from the Bible and we prayed. My girls were there and they sang and played and told her goodbye.

I would have missed out on that goodbye had I gone with a D&C.
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Originally Posted by christinespurlock View Post
I just found out my baby had died today. I probably having a d and c on Friday. My baby died and 7 and a half weeks and right now I'm (suppost to be) 16 weeks. My uterus is the size of a 16 weeks pregnant. I have not even spotted. I just don't know if my body has any plans to let go of this. And the longer I wait the more blood that will have to pass. I look pregnant and can feel my uterus just an inch or two below my belly button.
I'm so sorry that your lost your little one, Christine.
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I would have chosen to miscarry naturally, and did try, but hemmorhaged and ended up needing a d & c and a blood transfusion. For me it's the risks of the d & c and also the sense that it should be a natural process that would incline me towards choosing a natural miscarriage. At this point, though, I would make sure I was never alone if I started to miscarry; I also passed out and would likely have bled to death (some of my vital signs wouldn't register when the paramedics came for me). This isn't common though (but I wouldn't have thought it would happen to me!)
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