Everyone's comments are proving infinitely helpful to me right now. At this point, I am living off of your support and that of my husband's. Thank you so much for your help. I am clinging to all of you right now to stay afloat in the pending storm.
Yesterday's visit with the doctor went pretty much as I expected. He laid out the risks and benefits of my options-the waiting game of a natural expelling, the chemical and technicolor pill route, and the "how could you do that to your body" method of the D&C. Clearly, he wants me to just go the natural way, and feels that there is too much risk involved in the D&C. He successfully scared the living crap out of Husband so that now he is begging me to reconsider my choice for a D&C. Husband finds the chemical version's risks more palatable. I really do understand his concern and anxiety about an invasive, surgical procedure that in his mind could be avoided by letting my body do what it needs to do on its own time.
But, here's the deal, at this point I don't have a lot of trust in my body. Pooter has left the building and now all I am left with is a fetus my body refused to support. My body had its chance and now it's time to step in and intervene.
So here's what I need some more of from all of you. Support and lots of it. Yes, I am a whore like that. I want to hear more of what you think of a D&C. I want to hear about your D&C's. The doctor filled our heads with all kinds of horror stories about how the procedure could cause future miscarriages. There could be fertility damaging infection. It will cause problems with my body not letting go of the placenta in future pregnancies. And on and on. Don't get me wrong, I love my doctors and appreciate their concern. He didn't fight with me when I made my choice either. Normally, I would be all over Dr. Google looking for information, but I don't know that it will help me right now. I need human perspectives, not just odds and statistics. This is hard and I am so very sad. I just feel so defeated, useless, beaten down.
Thursday, March 22, 2007
Subscribe to:
Post Comments (Atom)
45 comments:
Nicole-I have no experience with this. I'm just here to offer support and hugs. Hugs and support. Lots of both. I hope you can feel them.
I have never had the fortune of being PG, or the misfotrune of a still fetus, so I have no advice except to say that if it was me, I would probably go the D&C route. It's done while you're sleeping, and when you wake up it's all over. Many *warm hugs* from me to you.
I hope you get some useful advice from some of the other fabulous women out there.
Nicole, yes it is incredibly hard and very very sad. In my experience (3 m/cs) this period of grieving just has to be got through. There is no way to take away the pain and loss, the only way is through. Definitely take at least a week off work/college/any commitments. You need to give yourself and your husband time and space.
I've had 3 miscarriages, the first was a missed miscarriage (only found at scan at 9 weeks) and I had a D&C. No problems after the D&C. I felt the same as you, I wanted it finished. I subsequently had 2 further miscarriages and miscarried naturally on my own, so in my experience, it seemed like the D&C remininded my body of what it should be doing, ie letting non-viable pregnancies go.
I was never given the chemical option, so can give no opinions on that.
One thing that did reassure me with the D&C was that my consultant was very familiar with the procedure. Is your Drs reluctance anything to do with lack of frequency/familiarity with the procedure. Could he recommend a Dr who is very familiar with it if he isn't comfortable himself? You want someone who REALLy knows what they are doing - the D&C expert in your region.
If he's worried about infection, ask to be put on preventative antibiotics - they should get rid of anything before it even starts.
Just so that you are aware, even with a D&C you will bleed heavily for at least a week - heavier than an average period. The D&C doesn't take away all of the evidence, but to me, it was more bearable.
You are being very wise in asking for support - let other people carry you for a little while and get through this one day at a time. Us internets are here for you, so ask away, anything you like. Take care of yourself.
My first miscarriage was a missed m/c at 10ish weeks. Absolutely no bleeding, ever. The doc on duty the day I found out sat down with me and ran down my options for natural vs. D&C very calmly, giving me full pros and cons for each one, and then offered me the choice. She did not steer me in one direction or the other at all.
I had a D&C for my first miscarriage. It wasn't bad, I had no bad aftereffects. I went in the morning, they knocked me out so I felt nothing, and I was home that afternoon. I bled like a period for a few days afterward. I ovulated again about 30 days later. For me it was a huge releif. Walking around not knowing when it would happen, how long it would take, was just awful.
Since then, I've had two successful pregnancies and one additional miscarriage. My extra miscarriage was in no way related to the D&C. My pregnancies were ridiculously normal. It took quite awhile to get pregnant again after the D&C, but my hormones were out of whack, which had nothing to do with the D&C.
Honestly, my 2nd miscarriage, which started and proceeded naturally, wasn't *that* bad, either. But it was much, much, earlier. I didn't find that doing it naturally somehow led to some kind of special "closure" either. It was just over, in a different way.
YOu know how to get me if you want more details.
The one thing that worries me about this doctor being so adamant about not liking D&C is this: If he doesn't like them and doesn't want to do them - how good is he at them? Because skill level *does* make a difference. It really does. You want someone who is comfortable doing them and is in practice.
Frankly, his insistence in inserting his colorful opinion into the middle of the science bothers me a lot. He's right, there are risks, but he's overstating them immensely, to scare you. Which is pissing me off on your behalf. Which leads me to a suspicion but I won't rant about it because you don't need that right now.
I'll just say: The risks for all the things he talks about (infection, fertility) are greater after a C-section than they are after a D&C. I bet he does (or did) C sections. But because D&C's can be used for a procedure that is thought of as more "distasteful," they are being demonized by certain segments.
A quick search for a Cochrane review on the subject came up with this for you, which I know is a statistic, but I think it is very relevant:
No strong medical results argue for either approach. Information was very limited on mental health or future pregnancy.
Both waiting for the miscarriage to finish and having surgery are appropriate choices. What the woman prefers should be the major concern.
Review - Expectant care versus surgical treatment for miscarriage
Cochrane Database of Systematic Reviews 2007 Issue 1
I'm so sorry that this has happened to you, your husband and of course Pooter.
I've had two D&Cs: one at 15w and the other at 8w. I felt the same way as you and that was I did not want to be home alone delivering a blob (or not) and wondering what more there was to come. Both my D&Cs were uneventful (as D&Cs go). One was performed by my OB and the other by my RE.
Your doctor should not be pushing his opinion either way on you, but giving you the pros and cons to each and you, as HIS patient, should make the final decision.
No matter what is decided, it should be the decision YOU make. Everyone else needs to step off.
Nicole, I am so, so sorry! I've been sick for the last few days and only getting on line in spirts. Please know that you are in my thoughts right now.
I just had my first D&C last week at about 9/10 weeks. I was given the choice of natural or D&C but opted for the D&C because my doctor said it might take several weeks (6-8)for my body to start the process. I was still having some pregnancy symptoms, tiredness, heartburn, some nauseousness that I just felt I needed to be done with. I was extremely comfortable with my doctor and she has done the procedure many many times. The procedure itself was quick. For the first three days I spotted and felt fine. I thought I was getting off easy. Then I got some pretty intense cramps and heavy bleeding for about four days and just now it has tapered off and I am feeling more like myself. When my doctor inquired how I was handeling this emotionally I told her part of me just wants to be done as quick as possible to start trying again as quick as possible. She said that was a normal feeling to have right now. That made me feel good to hear that, I had some feelings of, I guess it was guilt, for taking the quickest way out. I am still very emotional but I feel like I am moving on. I don't think I could have handeled waiting. I have a sister who is a nurse anesthatist (sp?) and she has seen many of these procedures. She said they are typically quick and routine but it is very important that you have an experienced doctor to ensure 100% recovery. (Well, I guess that would be the case for any surgery.) In the long run I would have preferred natural but, for me, I just wasn't emotionally prepared to wait possibly two months. I also was expecting twins so there would have been two fetus to pass. I am so sorry for your loss. Everything about this just sucks.
Nicole - I have no experience with a D&C either; my only brush with pregnancy was bleeding heavily at 6w. So I'm afraid I can't give you any assvice.
But I want you to know that I am thinking of you, hon. And to quote you - I am giving the gods the finger as we speak.
xxx
I don't have any experience with this, but it seems like your doctor could have offered some kind of plan to put you at ease. Like, if you haven't completed the miscarriage within a certain period of time, to go ahead with the D&C or chemical intervention.
Whatever you decide to do, I'll be here supporting you. I wish I could offer more than just internet hugs.
No experiences to share, but lots of hugs whenever you need/want them. Thinking of you.
Nicole- I've never had to do this and mostly what I have to offer is more hugs. However, I do know that those risks your doctor's trying to scare you with are rare. Just make sure they give you antibiotics if you have a D&C?
I don't have personal experience with making this decision, but I agree with the other bloggers who suggest that you find a dr who is very skilled in D&Cs. There are so many women in the IF world who have had them and have not had any problems from them. A safe D&C sounds like the best option. The sooner that you feel you can move on with your life (including getting back on the Klonopin, the better.) Best of luck!
Okay, I had to walk away from the computer for a moment because I was gripped with a sudden desire to BEAT YOUR DR. WITH A BAT.
I have had 5 D&Cs and the risks of infection & perforation the Dr. described are only in connection to second trimester losses, or done by practitioners with limited experience in bad facilities or on women like me who have rare genetic clotting disorders. (None of which apply to you.)
As for the risk to future fertility, he is repeating a nasty myth told to him by certain activists who do not want anyone to get a safe legal procedure. Another way of blaming women for their choices. ie. "Look, its your fault you're infertile, because you had this before when you were young."
My D&Cs were done after later losses at 21 weeks, (for retained placenta after misoprostol...so much for his theory chemical pregnancy loss treatment is medically more efficient, I needed a D&C anyway!); after a 12 week missed miscarriage, and after a 16 week loss.
In the second trimester, there is a very slightly increased risk of cervical damage, and perforation which is why they insert laminaria before and take a long long time when you are under to gently dilate the cervix. It's why they always give antibiotics and why they use intraoperative ultrasound to check for retained placenta.
But you are only 9 weeks, and at your stage they barely use the curette. It's almost completely done by dilation and suction. The benefit of D&C for you is that they can check the chromosomes and the pathologist can look at the tissues and get you some answers so you can prevent a loss next time.
Look, Nicole if you were late in the second trimester, I would agree with him that chemically induced miscarriage in a hospital or clinic is the best way. Lots of painkiller, sterile environment, nurses to help, and a chance to say goodbye to my then visible child if I choose to. Instead, at 16 weeks I was under anesthetic for over an hour and a half in total, and the recovery was rough.
But you are barely over 8 weeks...there's nothing to see, 20 minutes under and your done, not to mention the mental trauma of either carrying a dead fetus around or being in pain at home...his assessment of your risks and benefits is incomprehensible to me.
I know I'm babbling, sorry, this is stupidly long...I'm just so sad for you...
YIKES! I just realized that I forgot to say how very sorry I am for your loss...
I am so sorry. :(. Sending you a huge virtual hug - you know the kind that I am holding you so tight.
I don’t have any first hand experience with D&Cs. Here is a story from a friend of mine (my memory of exact timing may be slightly off). At ~11 weeks they found that the baby didn’t have a heartbeat and was sized ~9 weeks. She decided to miscarry naturally, but the doctor told her that he would only give her three more weeks. After those three additional weeks, she still wasn’t bleeding. She tried to take the drugs to help her miscarry. And the drugs did initiate the miscarriage. Everything happened at home. She planned on burying the baby in her yard in a few days. A few hours after she thought everything had passed, she felt something strange and went to the bathroom. About 10-15 minutes later her husband went to find out how she was doing. He found her passed out in the bathroom. He called 911. She was rushed to the hospital and had to have an emergency D&C to remove a piece of retained placenta that was causing her to hemorrhage. She had to have ~4 units of blood because of how much she lost. Her husband is now reluctant to try to get pregnant again because he almost lost his wife.
I know this is a horror story. But if your doctor is telling your horror stories about having the procedure done, he should balance it out.
Addendum based on Sarah's story...
While I got absolutely no pressure (in fact, I said "What do you think I should do?" and got "You need to decide that for yourself.") to decide either way -after I did decide and called to make the appointment, the *nurse* said, "Honey, I'm glad. Many of the women who go naturally as far along as you are wind up having an emergency D&C anyway."
Now, that's just anecdotal, too. It's not like she was keeping tabs and stats across the whole practice - she only heard about the emergencies, probably. But like she said - there are horror storise both ways.
I am so sorry for the loss. I came here through Bumble.
I haven't had a D&C. The only complication I know would be Asherman's syndrome, but this is rare and usually happens after several D&Cs. The chemical option seems more conservative.
Whatever you decide, I pray for your strength to recover, physically and emotionally.
I had a D&C at 7 weeks and my partner had one scheduled at 9.5 weeks, but her body decided to naturally expel the fetus before the D&C occurred. Having watched her go through the natural m/c, I knew there was no way I would want to experience that. At 9 weeks, we did see the fetus when it came out - you could tell what it was very clearly - it was heartbreaking and an image I'll never forget. I totally preferred the sterile hospital environment and not having it be so personal.
I agree about maybe having another doctor do the procedure... something about your docs comments rub me the wrong way.
I'm so sorry you have to experience this...
Hey, sweetie. I just wanted to let you know that I'm thinking about you. I'm so sorry that you're going through this. And wanted to send a virtual hug.
I've never had a D&C because I've always expelled and it was always early (the latest was 8 weeks). Tina at My Many Blessings is a good person to talk to about it because she has miscarried both ways. You also read her write up about a D&C on my blog in those side bar links. And her email address is linked to that peer counselor list if you want to contact her directly.
Hang in there--just sending many good thoughts your way.
Nicole, I just checked in today and read your terrible news. I'm so, so sorry for the loss of your so-much-wanted little Pooter.
I had a D&C after I lost my daughter in 2003. I was induced with her and she was born vaginally, but a piece of the placenta remained in my uterus and then caused some hemorrhaging so I had an emergency D&C two weeks later.
I was also concerned about the impact the procedure would have on my body. As I already had infertility issues/PCOS and a newly-diagnosed incompetent cervix, I didn't want to do any more damage to that area of my body...but I didn't have much of a choice.
The procedure was straightforward. They put me out (not full general anesthesia--apparently I could follow simple directions and make simple answers in the OR--but I didn't remember a thing). I woke up and it was done. It significantly reduced my bleeding afterwards. I had no pain related to it that I can remember, other than a bit of cramping and I'd had that anyway. I managed to get pregnant 7 months later with our son...so it didn't cause any problems for us.
I don't blame you for wanting to go that route. I think it would be tortuous to have to wait for it to happen and then go through that process. Something you need to protect as best as you can right now is your mental health, and if a D&C is the best way to do that I think that's what you should do. Good luck. Thinking of you and your hubby.
I have had 1 d&c and 3 miscarriages (2 naturally, the first being a fetus that I delivered at 13 weeks and the second miscarriage at 5 weeks). The natural miscarriages were the hardest for me to deal with. The first one there was actually a fetus there to see and that vision has been burned into my brain forever. I will never forget what it looked like. I would never want anyone to go through the absolute horror of miscarrying where there may be identifiable products of conception. It is an anguish that I will never forget. Even when I miscarried the second time and I knew anything that I passed would be microscopic, I still was paranoid about flushing anything down the toilet (clots, etc) for fear that I was flushing the embryo. (dear lord I hope I am not giving you new things to obsess about). The d&c, while still heartbreaking, was over relatively quickly. My pregnancy symptoms faded quickly as well. I was sad for the loss of my pregnancy, but not traumatized by the experience of labor without a baby. I will not lie, there is nothing pleasant about a d&c. But I completely understand your need to get it over with. I hope this information was helpful and I am so sorry for you having to go through this. I found this website to be very helpful during my healing period http://pregnancyloss.info/
and this is my blog if you ever want to talk more in depth about my experience or what to expect with yours
darwinlaughing.livejournal.com
Take care
I just wanted to come back and say to Carey, that yes, I agree sometimes the fetus is visible at 9 weeks, I apologize if my earlier comment sounded dismissive.
I find first trimester losses difficult because everything is so small IRL, but of course, looks so large on the U/S screen. And some women only see undefineable tissue, and others like your partner and yourself, see more and it can be hard. I'm sorry you had to go through that.
Hi Nicole,
First of all I wan to send you my support. I've been there and I know how difficult it is to have our dream of motherhood stop cold like that. Fortunately, I did not have to make this decision. For me it happened naturally at 7 weeks. It was painful (more emotionally than physically). The good thing was that I healed very fast and ovulated 15 days later and got a normal 30 day cycle. Like you I’ve heard both sides about D&C and to be honest I don’t know what I would choose to do if I was in your shoes. I hope that you and your husband can reach a decision together that you both feel secure about it.
You will be on my prayers. Take care!
No experience with this, no advice. Just BIG HUGS and support. I'm so sorry. :´(
(((((((((nicole))))))))))
I can honestly say that I personally think that having the d&c is better than hanging around waiting for the inevitable. I've had 4 d&c's in the last 2 years and everything works fine- it's really a very minor procedure. I had the metho injection (biggest freaking scariest needle I've ever seen! and it HURT) and the stupid shit didn't work anyway, I just hung around waiting and waiting and waiting to miscarry, after 4 or 5 days I'd had enough of the tension and stress and went in for a d&c. In hindsight I wish I'd just done that in the first place. No doctor can identify with how you are feeling with the waiting unless they personally have gone through it themselves.
Much love to you babe x
I've never been PG, so can't chime in with any relevant experience. I am glad you like your doctor and that he didn't fight with you about your choice in the end. It's too bad he had to scare Hubby so bad though. The presentation of risks seemed a little skewed in one particular direction.
Only you know what's best in this situation though. I'm proud of you for sticking to your guns, and I'm sending many big bear hugs your way.
I've no experience with a D&C or with chemical route, but want to offer my support regardless. I'm so sorry for your loss. The best thing you can do is what feels right for you -- follow your instincts.
I don't have any real advice, as I have never been here before. I do want you to know I am thinking of you and Pooter.
You have to decide what is best for you. If I was in the same situation, I think I would opt for a D & C, because at least that way, you have some control over things.
Hi Nicole, how u holding up my friend? I've only ever had one D&C and that wasn't after a pregnancy, just to supposedly give me a good clean out and make me more "fertile" (snort). It wasn't bad at all. I had it at the same time as I had a lapscope and had no infections or anything afterwards. Maybe a few days of spotting afterwards. With my only pregnancy, I miscarried naturally, but I was only 5 weeks along so I didn't "see" anything. It was just hard to face it that every time you go to the loo, it took about 10 days, was like a heavy period and more painful than normal. You're much further than I was so I can only assume a natural will be more difficult for you. I'm so so sorry we're even talking about this. Hugs my friend. xxx
I've actually read that right after a D&C where RE's have found uteri are more receptive (yes, MORE!) to an embryo implanting. Something to do with the irritation that it causes? So there's a reason you can toss at your doctor that should be in your support.
I would be wanting a D&C too. I hope you get whatever it is that you need.
I am so so very sorry to hear the news.
My sister in law had a D&C in the late 80s, so I'd assume things are much better now. Anyways, she had no problems whatsoever.
Nicole, this is YOUR body. You follow your gut instincts. Whatever you decide, I'm here for you.
I am so sorry that you have to ask for this type of advice, Nicole. It breaks my heart that you're going through this. Please know that we are all there for you and are virtually holding your hand every step of the way.
I've had miscarriages at 11 weeks, 18.5 weeks and 10 weeks. The first happened "naturally", but there was nothing natural about it. It was one of the most horrific experiences of my life and definitely scarred me mentally. I know that sounds melodramatic, but for me it's the truth. No one (NO ONE) told me what to expect, not the ER doctor who coldly told me there was "no baby there - are you sure you saw a heartbeat at 8 weeks?", and not my OB. Plus, this "natural" miscarriage required a later D&C anyway, so I got two for the price of one. Nice.
Miscarriage number 2 was a D&E. I couldn't bear the thought of a labor and delivery (an option, given how far along I was). It was not an optimal experience (I bled too much during the procedure), but I was in a very competent medical clinic that handled the emergency beautifully. The doctor gave me both antibiotics (to stave off infection) and estrogen to guard against scarring and adhesions.
Miscarriage number 3 was a D&C. I had no desire to repeat my miscarriage number 1 experience, and scheduled it as soon as I knew (which happened, BTW, when we went in for a prep ultrasound for the CVS procedure).
All this leads me to say this - a D&C would be MY choice, but may not be yours. But you need unbiased, clear facts. If you have the option, speak to another doctor who does not have such a strong bias against a D&C, and can give you a more balanced discussion of the pros & cons. To put it nicely, this doctor's advice sounds so slanted against a D&C, that I worry about his objectivity and ability to provide you with sound medical advice. (To put it rudely, AURELIA, if you want to beat this doctor with a bat, I will hold the MF'er down for you so he can't get away.)
Please email me direct if you want to talk about any of this in more detail.
((HUGS)) to you, my friend. I wish I could make the pain go away.
my heart is breaking for you. i am not familiar enough on the procedure to speak to it.
: (
I'm sorry for your loss. I don't know what to say.
I've had two elective D&Cs at 7-weeks, 20-25 years ago. I went on to have a successful not-ART singleton birth and an ART (because of sperm issues) twin birth. If I remember correctly, the main concern is scarring with D&C's.
Just have major pain killers available. I think that the cervix needs to open open up which means major-cramping. I just want you to be prepared. There is no reason to add additional pain, during this time.
I am sorry but I have no advice. I know people that had it done and they were fine. If it were me I think i'd want it over. The idea of having to wait to have it happen naturally is cruel. I would however check around with doctors to be sure that guys hesitance is not becuase he is not good at the procedure.
we are all here for you hang in there
Don't have anything substantive to add. But I've been thinking about you. So sorry again for your loss.
I never had a D&C or a miscarriage, so I cannot truly give advice here.
You truly have to follow your heart...
What does your PDoc say about this? Would the D&C be too stressful for you, knocked out and all?
I would ask him or her about it as well.
Random lurker here. I am sorry for your loss and wish you well through your grief and recovery.
If you are willing try posting your questions in: http://community.livejournal.com/vaginapagina
This is an awesome safe-space women's health community and I have always received the best advice here. If you want to post anonymously, you can email your comment to the moderatorsvpteam@vaginapagina.com
Typo in the email address. It is vpteam@vaginapagina.com
Nicole..I had 3 m/c 1- 8weeks - on my own, 2-10weeks on my own...3rd - 18 weeks, delivered at home, by myself...check out blog...it gives more details...rushed to hospital was bleeding out and ended up with d&C to finish it. I really wish I had a d&c with one of the first 2, but the dr. didn't recommend it as I wasn't far enough along for it to matter...yeah right! I know that you are feeling that you just want over and that the d&c will finish...but you HAVE to deal with the emotions you are having. I think you might want to see someone else. I have never heard of it causing problems down the line. I had another d&c a year ago to remove polups(?) from my uteris...my periords have never been better! Yeah...and neither of ny dr.s ever said that there were risks for future pregnancy's. I think you are doing the right thing asking for advise...do what your gut feels...if you need to get a second opinion do it. The waiting SUCKS!!!! Love ya! Hugs!
I'm so sorry this has happened, Nicole.
I'd like to jump on the bandwagon here, I think you should try to find another doctor who can give you another opinion.
Sooo sorry honey. I really cannot add much. If you're feeling uncomfortable with your current doc and his inclinations, I would seriously suggest a second opinion at another local establishment. Couldn't hurt to just talk to another professional about it???
Fuck. Fuck, I am so sorry, hon.
I've had a D&C, I've had the pills (several rounds) and I've had zero intervention. They all suck, but--
Wait, before I go any further, can I borrow that bat for your fucking doctor, because he totally needs it. "Hey, I know! She's grief stricken and traumatized! What goes well with that? Oh, I know! Fear!" What a horse's ass.
Also, with all due respect to your husband and husbands everywhere, this isn't really his arena (or his uterus). YOU are the one who is going to have to experience this. Whether or not he's holding your hand, YOU have to do it, so it's YOUR call.
Pros for the D&C: Faster, better drugs, option to send tissue out for genetic testing, predictable scheduling. Cons: It's surgery, and not everybody knocks you out.
Pros for the pills: Fewer people up in your junk while you're unconscious. Cons: Doesn't always work, results can happen any time, anywhere, you may have to carry a dead embryo/fetus longer than you'd like.
Pros for doing nothing: Free. Cons: Same as the pills, plus...it can take a while.
Trust yourself to make the best decision for yourself.
oh goodness. i have just caught up on your sad news. i am quite late, had not had a chance to visit in a while. glad i looked before leaving for vacation.
here's my words of support: my very close friend had a miscarriage around the same time and had a d &c and it went fine and the happy ending is she is now traveling in italy wiht a 5 month old baby girl. i would totally go the same route as you. i had a d & c procedure when i had my abortion (due to being on poisonous meds) and i made sure they put me out completely. get the full anastesia. you don't want to be awake when they do it.
you will be fine and it is much less stressful than waitng around to miscarry which could be dangerous anyway. i totally support your decision. i'll now read ahead as you probably have already gone through with it. sorry so late...
Post a Comment