is there such a thing as a slow mc?

[gingerbreadmam]

hi. im just wondering if this is a thing. i discovered almost 4 weeks ago at an early scan due to spotting that my baby had stopped growing at 5 weeks. i would have been 13 weeks this thursday.

my hospital have new guidelines where they prefer not to interfere so i have been waiting to mc naturally although nothing is happening like all the mcs i have read about.

i started spotting last wkend, to look at a pad from the top there was barely anything there for a days wear but when turning it over there was more soaked into the pad i would say about 5cm in length but this is all ive had. no pains or none that are memorable, no gushes and no constant bleeding.

had anyone else waited to mc naturally and it been a long process? my epau told me to ring back thursday if nothing has happened and i dont know what to do.

[bakingtins]

It's a 'missed' miscarriage - your body has not recognised that the pregnancy has stopped developing so maintains the uterine lining. Mild spotting or brown discharge sometimes signals a loss (often the reason a scan is performed in the first place) but doesn't predictably develop into a full blown miscarriage, with the cervix opening and loss of the uterine contents. Often the sac continues to grow and produce HCG even though the embryo is not growing. I don't think it's acceptable to leave you in limbo (unless it's your preference to wait for a natural miscarriage) My understanding is the NICE guidelines that say try expectant management first apply to threatened miscarriage, not a missed one where there has already been a delay in recognition of the end of the pregnancy. In any case, if a short period (1-2 weeks) of expectant management does not result in a loss you should have been offered medical or surgical options.
If you choose to wait you will eventually miscarry, it's a question of how you are coping with waiting for that to happen. Very difficult to have that hanging over you and no control of the timescale.

[gingerbreadmam]

the hospital are aware it is a missed miscarraige as i had to have a rescan and it was at the rescan where we talked about options.

they said if i cant cope or if nothing happens in 2 weeks to contact them and we will then look at other options its just so confusing as when at the rescan we were advised that the new guidelines were in place as letting it happen naturally causes less problems than intervening and less future problems.

i know from reading these boards lots of people have medical or surgical intervention and go on to have many more healthy happy pregnancies but them saying that is the reason for the new guidelines has scared me a little.

thunk i will wait till thursday or monday next week and ring them. already had 3 weeks off work, 2 wks as advised by the nurse i saw at first scan as she was sure i would go home and miscarry then 1 wk following rescan because of the emotional side more then anything however did expect to miscarry as the scan showed sac had moved and though body would let go once knew for definite.

thank you for your advice obviously this has never happened to me before and i know ppl have different experiences and didnt know if you can just mc like that sometimes. thanks a lot.

[bakingtins]

The spotting/ light bleeding can go on for a long time, but IME and that of others on the board a loss won't be completed like that. At some point your cervix has to open which normally causes some cramping, and all the lining of the uterus and any pregnancy tissue comes out, which tends to involve heavy bleeding and some clots, though you won't necessarily see a sac. I would phone the miscarriage association and ask for impartial information on risk. I was under the impression that any risks were pretty much equal for all methods, with the addition of risks of a GA for surgical management. I suspect a lot of the leaving it to nature has more to do with budgets than patient welfare.

[gingerbreadmam]

the budget thing never even crossed my mind, wouldnt surprise me where i live i bet there are a lot of people that use the medical management route for other reasons.

i will ring miscarraige association my mam is panicking me saying it cant be healthy leaving it there getting it from both ends. so scared of intervention think thats why i keep putting it off because emotionally o feel destroyed.

thank you. i will certainly give them a call and get some advice in fact im going to do it now. thanks.

[gingerbreadmam]

thank you, you are so kind sharing that information with me

i emailed the mc association as easier because im at work. they gave me a leaflet somebody had already kindly passed me on mumsnet and although very understanding i dont know if they have helped me at all. quick response though which i was surprised at. they advised i join the forums to talk more.

on the link i dont know if i am getting confused but it says people who mc naturally or with medical management are more likely to need surgical management than those that opt for surgical management, have i understood that right? doesnt really make sense. i am so scared of an op...silly i know as if my pregnancy had been successful who would have known how giving birth would go. spose u dont worry about that as u know youll have a baby at the end.

the worst ive ever had is a wisdom tooth removed under local

[gingerbreadmam]

yes ive had that news for almost 2 weeks now and suspicions for almost 4 since first scan. assumed my body would just let go.

the surgical option does sound the easiest physically all providing nothing goes wrong and i know anything can go wrong with anything but this is my first pregnancy and it has made me realise just how important having a baby is to me i couldnt bare that to be taken away.

[IdaClair]

I had a missed miscarriage diagnosed in my first pregnancy with the baby stopping growing at 13.5 weeks along, I chose to wait for my body to get with the programme and it took a little over three weeks for it to begin the miscarriage, then a little over five days for the process to be completed, with a week or so of light bleeding after that. It was just about all finished by my 20 week scan date, I'd consider that fairly slow as a process however it did work fine physically and all done at home with no interference required. So that is a positive thing.

I am sorry you have to have this experience

[DayLillie]

I had this happen about 25 years ago.

I had bleeding, constant brown heavy spotting from 7 weeks. I had time off work, went to work, went on holiday, and it was pretty grim. I kept going back to the doctor who just said 'some women bleed, it will be all right'.

Eventually, at 11 weeks, after my low key holiday, I had a couple of cramps and lost some bright red blood and mucus, but that was all. I went back to the doctor and saw a locum who had just finished working on the gynae ward. He sent me straight in to hospital, where I met the horrible consultant who said the pregnancy was a 'dead loss' and had a D&C.

It all went pear-shaped after that, because they did not find anything at the D&C and the registrar ordered a blood test for pregnancy and a scan (I did not have one before!) to make sure it was not ectopic. So I had to stay in even longer.

I have no idea what happened. It was all a very, very tiring roller-coaster. It was my first experience of hospitals and doctors. It put me right off trying for a baby.

However, I felt much, much better after the D&C (I had got tired and spotty). I had a week off work to get over the GA and got pregnant 3 months later with DS.

There was no medical management then, so not much option other than D&C but it did bring the whole long slow process to an end well. I had little bleeding afterwards and had a period 4 weeks to the day afterwards.

[gingerbreadmam]

thank you for sharing your experiences ladies i do appreciate all the information. so sorry for your losses but lovely to hear you have since had hapoy arrivals.

i dont know what to do for the best. i returned to work yesterday and am really struggling. everyone around me talking about normal stuff and i dont understand why noone can see my grief. its awful. im mindful tho that i have taken 3 weeks and nothing has happened and when it eventually does or i have intervention ill probably need more time again.

i thought it would be over by now physically.

[gingerbreadmam]

also just to add my hormones are definitely dropping, boobs back to normal and spots as normal. i didnt have any spots whilst in the throes of pregnancy even though ive always suffered with them.

keep feeling hormonal too like pmt type but i dont know if thats just stress with everything going on. dp was eating peanuts lasnite the sound was deafening i could have launched myself at him sounds hormonal haha!

[GuybrushThreepwoodMP]

Sorry you are still waiting ginger.
To be cynical, budget is everything. I was told to couldn't have surgical management because it was 'too small'. They implied there was a medical reason for this but it is just policy. Surgery was then scheduled.

As you know I miscarried naturally but had retained products. When I had the scan, they told me that there was no way the surgery would be performed now because there was only 5cm left and I should pass it naturally. The consultant called me later having spoken to the epu and said she wanted to do the surgery as planned because that it how one should proceed for anything over 2cm. The epu seemed to be instructed to say anything they could in order to avoid giving me any treatment- medical or surgical. It was only when a consultant stepped in that this was changed.

What do you want to happen? Have you thought about medical versus surgical? My personal view was that medical sounded very scary. As I miscarried naturally and have described the process to you before, I still feel that medical wouldn't be for me. i imagine it would be as intense as what i experienced at home, but i would have to do it in a hospital. There is also a failure rate which means surgery could have been necessary anyway. The surgery was easy.

I think you should think about you want and be prepared to fight for it. I'm sorry that it might take a fight but a really feel that you should have this fine in The easiest possible way. Of they tell you they can't do surgery, what they mean is they DON'T WANT to do surgery even though it would be medically fine.

Sorry- this is obviously not the most objective post in the world! But wanted to give you some perspective. I want this to be over for you. Big hugs.

[GuybrushThreepwoodMP]

I was so scared if the general anaesthetic- never had one before. I was shaking all over. I cried and asked the surgeon to protect my uterus because I plan to grow another baby in there at some point. I asked the anaesthetist not to let me die.
I remember lying there feeling scared. Then I woke up. That was it- I just woke up- feeling fine. I knew exactly where I was and what had happened. No time had passed (actually if only been out for 20 minutes!). I had no pain and was just a bit groggy. The consultant came in and said it had all gone well. Half an hour later I was on my way home.

[gingerbreadmam]

i dont even know what happens when you have a general, how they do it or the risks. i suppose i have been putting myself off looking.

a part of me feels like medical is the next step from natural but i can see that there still may be a need for intervention after that and in that case i think may aswel just cut out the middle man. i suppose its nice if that can be a way to describe it to think of going to sleep for half an hour then waking up and its all over.

also where medical is concerned i am scared of the pain and the blood. my friend had a termination which i think may be the same process, pain wise she was completely fine but did have problems afterwards so that has scared me off medical too.

i actually just thought it would happen so tbh havent really thought very far ahead. guess i better get thinking.

[GuybrushThreepwoodMP]

It's a really hard decision. I struggled with it for days.
Ultimately there isn't a right one. Each one really has as many physical risks as the next so the most important thing to thing about is how your emotional health will be affected.
Just try not to let anyone put pressure on you. The NHS is utterly wonderful but I found that in this situation, the above I was getting want guided by objective medical knowledge or by consideration for what I might want. Instead it was guided by budget-based policy. Fuck that. This is your body and your miscarriage and you have a right to deal with it in the best possible way for you as an individual.

[gingerbreadmam]

thanks for your advice guy as ever. from what you have said and your experience as much as it scares me to death i am seriously considering the surgical option now if it comes to intervention.

emotionally im massively struggling just now, affects you in ways i didnt even imagine. so the sooner i get closure on it the better.

i hope you are ok today.

[bakingtins]

Just to throw a few more ideas into the mix, medical management doesn't necessarily mean staying in hospital. You take an oral tablet to soften the cervix, then 2 doses of vaginal pessaries 24 hrs apart ( you can insert them yourself, similar to a tampon) I had to stay for an hour to check for adverse reactions then was sent home, they take about 4-6 hours to cause 'contractions' and I did the second dose myself at home the following day. The experience of medical overall is quite similar to a natural miscarriage.
I haven't had an ERPC but I did have Ga to remove retained placenta after the birth of my son and the ga was absolutely fine, most posters seem to prefer this option as it's cleaner, but others feel they need to experience the physical loss to get closure
There's a similar failure (as in incomplete) rate for all three, requiring another surgical procedure. This is less for ERPC if they use ultrasound guidance - more likely to get everything out and less likely to cause damage or scarring, so worth asking about this.
No right answer, whatever you feel is least-worst for you. It is important that you feel you have choices and that your preferences are respected.

[gingerbreadmam]

i was swayed to medical management at first but i am worried how i will cope with the pain / blood. i dont particularly want to be in hospital either but know i will need to be for at least a couple of hours whichever option i choose. wish my body would just let go.

thank you for giving in depth information it really helps me in making a decision.

i dont know if i feel like i need to go through it as such and i would still get bleeding after an erpc so i suppose i can still see its happened. i just dont know what to do. its difficult.

i keep reading about ga and being over weight my bmi is 35 so thats scaring me too.

[mcsquigg]

Sorry you're having to make this choice, it's a horrible situation to be in. I've had surgical management twice and found it a relief to be honest - I'd had several weeks of spotting and bleeding so I just wanted it to end. I was very nervous of the GA the first time but it was fine and I was very well looked after. Recovery wise I was very tired for a week or so afterwards but was back at work within a week and had very little bleeding - by the next day or so I was just having to use liners.

Part of me wanted to wait for it to happen naturally but I have a 5 year old dd and wanted things to stay as normal as possible for her and didn't want her to see me in pain.

All the best with your decision, I hope it all goes as smoothly as possible for you. Look after yourself.

[mcsquigg]

Sorry, should have said that I had surgical management for two different pregnancies, not the same one - just re-read my post and didn't want you thinking they didn't do the procedure correctly and put you off.