sensitive question about natural m/c and d & c

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.

-Angela

Quote:
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.

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.

Jane

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.

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...

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

ND

When my DH and I started TTC, I knew that we were starting a journey that could have a happy or sad ending....so, 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!

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.

Quote:
I'm so sorry that your lost your little one, Christine.