D&C or Natural Miscarriage?

katindy

I've only been following this board for about a week, but during yesterday's ultrasound, our worst fears were confirmed.  I should be 9 weeks along, but the empty gestational sac was only measuring 6 weeks, and there was no growth from our last ultrasound 10 days ago.  My doctor has assured us that there is no possibility that this is a viable pregnancy, but for some reason I just can't bring myself to schedule the D&C. 

He has left the choice up to me (for now), but I don't know if I should schedule the D&C or try to wait for a natural miscarriage?  This was my first pregnancy, and being 39, we'd like to start trying again as soon as possible.  Are there any risks in waiting?

simbajsp

I am so sorry for your loss, and I can completely understand everything you are going through right now.  I was in a similar situation in September.

 I opted for the D&C. I didn't want to have to guess when I would m/c naturally.  The D&C was relatively quick and easy.  I would recommend going the D&C route if you want to move on with your life and future baby making plans a little faster.  Also, physically the D&C procedure was not bad at all.  I have heard different things about natural m/c.  The choice is obviously yours, but I was happy with the choice I made to have th D&C.  GL and ((Hugs)).

jrhodes09

I am so sorry for your loss.

ownedby3

I also had a D&C and I'm glad I did it over natural.  It was definitely closure for me.  I agree with pp that the procedure wasn't as bad as I anticipated and am now on the road to recover and eager to try again (I'm 35).  We also are having the tissue tested to see if it was chromosomes, that you won't be able to do if you go natural.

Hugs to you, take care of yourself.  Time definitely heals.

DanceDeva4

I'm so very sorry for your loss. 

I decided to miscarry naturally, and even though I may end up having the D&E anyway, I'm really glad I chose this route.  For me, I have medical reasons to avoid the D&E, I also thought I'd feel more "at peace" with our loss if I chose this path and while I don't have anything to compare it to, I do feel that I made the right decision for us.  And, as stupid as it may be, the thought of spending our nursery money on hospital bills to get rid of our baby was horrifying to me. I know it is irrational thinking, but it really hit me hard. 

No one can tell you what is right for you, but I can give you my thoughts on my own experience.  I wouldn't have the D&E unless it was absolutely necessary and I know I did the best thing for me by waiting.  I also knew right away that I didn't want the surgery, however, there have been moments I wished I'd just done it and gotten it over with, but in the end I know it would have been emotionally harder on me had I opted for the D&E first.  I'm sorry again for your loss and I'm sorry that you are having a tough time with this decision; it's certainly not an easy one and I'm sending you hugs and strength to get through it. 

ssc2007

I had a natural m/c in 9/09; pg for a second time in 11/09 that ended in a D & C on 12/16/09.

With my first loss I scheduled a D & C for a week after my loss was confirmed but started to m/c on my own a few days later. I was really happy to do things naturally; it felt like my body was doing something right. The whole natural m/c process took about a week for me, with 3 days of on and off heavy cramping and bleeding. Not bad at all, but certainly a little unpredictable.

With our second loss I was just so devastated and felt the need to move on ASAP which is why I scheduled the D & C . Plus, I wanted to get pathology on the products of conception (which came back showing a chromosome duplication, and therefore explaining the cause of the loss).  I did the procedure in my OB's office and really it was not bad at all. I felt crappy 2 days afterwards, and bled for about 3 days, pretty light. I got my first AF on 1/17 and DH and I are trying again this cycle.

HTH. Thinking of you! 

Olive44

I had a d&c, which was a very easy procedure.  I only had light spotting the day of the surgery and nothing else.  No pain either.  If you are wanting to start trying again asap, the d&c would be the faster route I believe.

pepomntpat

I opted for a D&C and am glad I did. I didn't want to wait to move on. It was quick and easy and I felt that I could really start grieving and then move on.

Camicat

I'm so sorry you have to go through this. I opted to have a natural m/c and luckily things passed fairly quickly. I started bleeding the day after finding out. If a week had gone by without bleeding I probably would have changed my mind.

Everything is out in the open at work now and I am so surprised at how many women have had d&c's for loss. They were all happy they went that route. If time is an issue then you may want to schedule. Overall, you need to do what's best for you. It can be a tough decision to make. We are all here for you for support.

mdm2137

I was happy I went the D&C route. I don't think I could have handled the natural m/c. I am still spotting lightly but haven't had any physical pain. I'm sorry for your loss.

jenerally?

I had a d&c (actually vacuum) yesterday under general anesthesia (I have an allergy to a local medication).

It was very easy, completely painless, and today I have some cramping and spotting, but nothing severe (maybe that comes later?).

Everyone has the right to make their own choice, but I needed closure for myself and my family. 

Good luck to you!

bmp84

I have had natural m/c both times. It was physically and emotionally tough, but I felt like my body had been through enough without adding a D&C. If this m/c had dragged on any longer, I may have tried to the medications that help you m/c naturally.

::hugs::

I'm so sorry for your loss.

actgrl22

I chose to medically induce my miscarriage vs. having the D&C or waiting to miscarry on my own.  Although it was hard to "wait" to miscarry and the process was a bit slower for me than I have read others process was my OB did not recommend the D&C. He said it just has more risks than naturally miscarrying and although I took Misoprostol, the actual miscarriage was still natural.  I didn't want to risk anything happening with the D&C and prolonging me being able to get pregnant again.  It's really a personal decision. In hindsight I would probably do the Misoprostol (Cytotec) again but I completely understand why a D&C would be preferable to some women....you go in and get it over with.  I think the D&C is just riskier because instruments are being sent into your uterus.

grr_aargh

I had a natural miscarriage with my first - the sac measured 6w1d when it happened.  It was one day of cramping followed by 7-8 days of bleeding and a few days of spotting.

With my second, I had a medically induced miscarriage.  I was diagnosed with fetal demise at 8 weeks, measuring 6 weeks, but wanted to wait to have a natural msicarriage.  After waiting 17 days, we opted to induce with misoprostal/cytotec.  It was one intense evening of cramping with painkillers and I passed everything within 12 hours.  I bled/spotted for 8-12 days afterwards.

My third was a chemical, natural, no big deal physically.

My fourth was at 7w5d with a baby/sac measuring 6w.  I medically induced again with the cytotec -- this one took longer, my body wasn't as ready to let go of the pregnancy.  The miscarriage occurred over the course of 5 days but wasn't nearly as painful as the 2nd.

From the research I did, 70% of women pass a natural miscarriage within 2 weeks of fetal demise and 90% within a month.  You may be in for a bit of a wait if you wait to do this naturally. That's not necessarily a bad thing - it just depends on how you feel about it.  Of women who miscarry on their own, approximately 80% do so at home, some need to go to the ER for pain or bleeding management, and a small percentage (10-15%) need a follow up d&c for retained tissue or bleeding.

I couldn't wait any longer and used the cytotec.  My doctor said that a small portion of his patients choose this in order to avoid surgery.  Of those who choose it, according to him, about 75% would use it again.  In the research I've seen, it works the first time for about 85-90% of users, and upon a second dose for about 94% of users.  Of those in the study I read who used it, 84% would use it again.  There are some side effects - about a 1% chance of uterine rupture and a small risk of toxic shock syndrome. There are some side effects to the medication, though I personally didn't experience any. In the interest of full disclosure, the web is full of women with bad experiences with cytotec - I suspect they are more likely to discuss a bad experience versus a good one as I discussed this with many women who used cytotec and had a positive experience.  Of those who use the medication, the overwhelming majority do not need intervention, a follow up d&c, or to go to the ER (it's about 5-10% who go to the ER and about 6% who need a follow up surgery).

Of the friends I have who have had miscarriages, nearly all have had a d&c procedure.  NONE regret it.  A D&C has about a 96% efficacy rate - so the majority of women who undergo one will not need subsequent surgery or medications.  Many women experience little to no pain or bleeding.  I don't have personal experience with it but this is what I found in my research.  There's a small (2-6%) rate of scarring (Asherman's Syndrome), but for the most part women tolerate it well.

Good luck making your decision.  Mine was based on a need to physically undergo the miscarriage, an inability to wait, and a desire to avoid surgery.  Finally, I am sorry to hear of your loss.  I hope you can find an adequate answer for yourself.

katindy

Thank you all so much for the wonderful information and the emotional support.  It has truly helped my get through this tough time.  I'm scheduling the D&C for next week, but hopeful that it happens naturally before then. 

Best wishes to all of you experiencing this same loss, and I hope you too can find comfort in knowing you're not alone.