Ques on Miscarriage Options

TScalei

I just found out yesterday that I will mc again as they could not find a hb on the second u/s. This is my second mmc in 5 months. My first one I mc naturally right after the u/s so I didn't have make a choice on how I wanted to miscarry. This time I am still having pg symptoms and no spotting/ cramping. I asked my drs office if they would want me to have a d&c for testing reasons since this is my second mc but they said it wasn't necessary. They are not giving me any options and just told me that I would naturally miscarry eventually and want me to get my HCG levels checked. I was just wondering if anyone else's drs office did not give them a choice? I just find it kind of strange since it's my second one and kind of cruel as this could go on for weeks I suppose? My natural inclination is to miscarry naturally so I didn't really advocate too strongly for a d&c. But I just don't want to drag this out for weeks or pass up possible genetic testing that could shed some light as to what is going on? Any insight in this area would be greatly appreciated.

mjolk

I'm so sorry. Me personally, I would strongly advocate for a D&C. Waiting around for a natural miscarriage is complete and utter torture, especially if you still feel pregnant. I was gagging brushing my teeth up until my procedure. Again, those are just my feelings. I was constantly afraid if I went anywhere, I was going to start miscarrying, so I barely left the house. I only had a blighted ovum, though, so I just felt like everything was a really cruel joke.

It was a lot of work advocating for a D&C... I ended up having to get another doctor at the practice and I spent weeks tied to the phone waiting for calls, test results, etc. It was definitely the right decision for me though. I was also upset and flabbergasted they did not give me any options, other than keep going in for blood tests.

JAGinMI

My Dr immediately told me my options - wait it out and see if it happens naturally, take the misoprostol, or D&C. I was in the same situation as you with no signs of mc. I find it very odd that they didn't present your options! Maybe they are very big proponents of no intervention?? As for the genetic testing, they didn't talk to me about that at all. And, honestly, it never crossed my mind until all was said and done. So if that is something you might want, I would call your OB and talk about all of this. 

RiverSong15

I'm so so sorry you find yourself here again. My office did not want to test the fetal remains, but they did explain my options for completing the miscarriage.

After my miscarriage was confirmed, my OB talked me through the three options: waiting for a natural miscarriage, using misoprostol (Cytotec) to speed up the process, or a D&C. My OB felt that a D&C was "over treatment" at my stage and that the risk of scarring, although very small, was real and wanted me to weigh that risk. She was willing to do the D&C if I needed it for emotional reasons, but she did explain her thoughts. She recommended either natural or cytotec. I've heard that Cytotec can be pretty painful, and sometimes you need a second dose (if you go this route, try to see if your doctor will prescribe two sets of 4 pills for you to use just in case. And get a prescription for pain meds too).

Natural can take a while. It took almost 3 weeks from my first bad ultrasound for my body to get things moving. I spotted off and on for over a week beforehand too. I decided to wait it out naturally for a certain length of time and then I was going to use the Cytotec. The day I was planning on using the Cytotec is the day I started miscarrying naturally. It was a really hard few weeks emotionally. I didn't want to take time off work because I wanted to wait for the actual miscarriage when I physically couldn't work. But then things took so long that I was constantly wondering if and when it would start, and not making plans to do anything and wondering what to do about work. I think I wish I would have taken the Cytotec sooner, but at the same time, I'm glad my body finally did what it was supposed to do. It's such a hard choice, and I was definitely angry about having to make that choice. 

I would suggest reading up about your options here, and then calling your doctor back and asking to talk to them about options. You absolutely have the right to know the options for managing your miscarriage, and there is no shame in wanting to speed things along medically.

So many hugs lady. 

TScalei

@riversong15 - I kind of wanted to do the same thing and wait it out naturally but have an end time in mind to use Cyrotec or a d&c so at least I would know there was an end in sight. I was thinking I could follow up with them in a week and maybe if nothing has happened by then and they saw my levels were dropping they would be more willing to explore an alternate plan. Im kind of concerned about the scarring and your lining being thinned by a d&c.  And Cyrotec just kind of makes me nervous I handled the natural miscarriage fine last time but Ive heard that Cyrotec brings it on more quickly and more intensely, but at least you could plan when it could be.

Its just hard being in limbo. Im like you and not taking time off work now in case I need it later. Making plans and getting out and doing something made me feel better about everything after my last loss but I feel like I can't do that right now bec I don't know what is going to happen.

Its reassuring hearing what other people have to say about it and what their drs recommended.

RiverSong15

@Tscalei - think of the "love it" on your last post as a big hug. Limbo is truly awful, and I'm so sorry you find yourself here. If you ever want to talk, I'm here. 

beary67

@TScalei I was given the option of taking Cytotec or doing a D&C at first, but my RE strongly recommended against the D&C at first because the sac was so small and they were afraid they would miss it. So I took the Cytotec twice and it didn't work for me. Eventually, the doctor said I needed a D&C after waiting to miscarry naturally after the Cytotec. All in all, my D&C was exactly 4 weeks after I found out the pregnant was not viable. If I could do it all again, I would opt for the D&C right away. 3 weeks after the D&C I stopped turning positive pregnancy tests. 

I'm so sorry for your loss. My advice is to advocate for yourself if you think a D&C or even Cytotec is a better option than a natural miscarriage.  . 

weareturtles

I was definitely given the three options. I wonder if certain areas of the country are more up front about options compared to others. I live in a very liberal area, so I wonder if some other areas it's only acceptable to miscarry naturally...

nerdymama15

My doc gave me a pill. I don't remember the name but it was one they place inside you. It took two doses to get everything out. If it didn't work then a DC was going to be done. I had an incomplete mc so slightly different situation. I have read on here though and been told by my own doctor that three times is the magic number before they usually test Makes no sense to me as to why they'd wait til someone has suffered so much already.  So sorry for your loss.

RiverSong15

@nerdymama15 - it depends on how far along you were after two miscarriages. The American Society for Reproductive Medicine revised their definition of recurrent loss to mean two losses of a clinical pregnancy with no prior history of live birth. That is, two pregnancy losses after you were far enough along to see something on ultrasound (does not include chemical pregnancies). My OB did testing for me after two losses like this. There is an RE in my city that will also evaluate women for RPL after two clinical losses.