MMC advise on medicated v surgical miscarriage

[AKP79]

That's it really. I had it confirmed Christmas Eve (following an unsatisfactory private scan on 23rd) that I've had a MMC. Sac measuring 9 weeks, lost baby at 6 weeks.

I've been given the choice of natural, medicated (tablets) or surgical removal for miscarriage and I've got no idea what to do next.

Worried about seeing foetus so I had thought surgical, but a friend of mine had surgical removal and suffered scarring which has left her infertile. I think this is rare, but how rare?

[sizethree]

I'm so sorry you're going through this. Awful at any time of the year, but seems extra cruel over Christmas.
I've had the misfortune to have 3 miscarriages, and have experienced all three ways of miscarriage management.
I found medical to be very painful, like a mini labour. I was 12 weeks but foetus measured 9, and it was very distressing to see. But there is a big difference between a 6 week sized foetus and 9 weeks and when I had a natural miscarriage (at 6 weeks) I didn't see anything resembling a foetus at all. So in all likelihood you'll be unaware of when you pass the pregnancy.
Medical management can sometimes not flush everything from the womb leading to it being repeated. This isn't very common but through it best to provide you with pros and cons (although there really are no pros in this awful situation).
For a natural miscarriage it can take a while for it to fully occur. If you haven't started to bleed, it can be a few weeks wait until the body starts to release the pregnancy and I know this can be distressing. I'd sjready started bleeding before the MC was confirmed, and I miscarried naturally within 48 hours.
The surgical management (called an ERPC or D&C) means you'll not really see any of the pregnancy (you'll have to wear a pad for a few days afterwards as there'll be some light bleeding) but you will have to have general anaesthetic, which I know is a deterrent for some. I think it is very rare what happened to your friend, but it is s rusk. The ductile and surgeon explain everything clearly prior to the procedure.
In my experience I found the surgical to be the least upsetting and physically the easiest to cope with. But everyone experiences things differently.
I gave thankfully had a happy ending to this and welcomed my little girl in November.
I so hope that whatever option you choose goes smoothly and fast and pain free as possible and you make a fast recovery. Remember to take the time to heal and be kind to yourself and surround yourself with people who get what you're going through.

[Bells2307]

Really sorry your going through this too. I suffered a mmc at 12 weeks, baby had died at 8weeks, size threes post is very good on her advice, I decided on the surgical eprc and have no regrets. My body was not recognising the miscarriage and I still had my pregnancy symptoms which I found hard to deal with mentally, I also wanted to be able to get over our loss and start trying again asap, so waiting for the miscarriage to happen seemed like it would be agony. By having the eprc I at least knew when things would be over, the staff at the hospital were incredibally supportive, gave me advice about my options and were brilliant when I went in for my op. I was in and out in a day and off work for 2 weeks, this was more for my mental health though than physical. I've not had the tablet method, but if you want to know anything more about eprc feel free to ask. Btw, I'm now pregnant again at 23 weeks and all is going well so don't give up if a child is what you both want. Good luck with your decision X

[Sourdough123]

I'm really sorry you are going through this. Exactly the same thing (mmc) happened to me this time last year and I ended up having surgical management a couple of days before Christmas. It was tough but happily I am now pregnant again and you will be too.

I was also really unsure what to do but wanted things over asap and I was showing no signs of miscarrying naturally. I ended up having a d&c, like the previous poster said there are risks (like any op) but mine went super smoothly. I went to hospital at about 8am and was home at 3pm. I then had a few days off for Christmas and then back to work before the new year. Virtually no pain and very little bleeding after I got home.

It is a difficult decision but ultimately the d&c worked very well for me.

Sending you hugs and best wishes for the future.

[Nectarines]

When I had my mmc, I opted for the surgery because I just wanted to go to sleep and wake up with it all over. I'd been through so much leading up to the confirmation that I'd lost my baby that I couldn't face any more.

I had a general anaesthetic, which actually gave me much needed oblivion for a few minutes. When I woke up it was done. Bled for about ten days, but of cramping but didn't even need painkillers.

Sorry you're going through this.

[Luckystar1]

I am very sorry that you are going through this. It's the most horrible experience and will never fully leave you.

I had a MMC a year and a half ago. I opted for the medical management as o too was frightened of scarring. I found it extremely painful (more painful than actual labour if I'm honest, but that's also probably because the outcome is not joyous)

If I were to have another (God forbid) I think I would opt for surgical.

I didn't see the baby, but I knew when the sac had passed.

I hope you can begin your grieving and recovery soon.

[April2013]

I'm so sorry you are going through this. I had a mmc, found out at 13 weeks but baby stopped growing at 8. Was going to have inpatient medical management as seemed best on the least risk of side effects and complications front but the night I found out i ended up having rare complications so had erpc that night - this rare complication meant the operation was necessary and an emergency. It was such a relief immediately afterwards that it was over physically but because of the recovery period afterwards which was significantly lengthened due to my complication, the physical side of the miscarriage dragged on for months afterwards for me, was very weak for 3 months (no bleeding though), i found this very upsetting. However even without the complication I heard from a nurse that the recovery period was 4-6 weeks of taking it easy after an erpc. So I'd find out about recovery periods for all the options and see which gave the best chance of feeling physically OK soonest. For me, i think I would only have one if medically necessary because of the recovery period afterwards, but everyone is different, it is good there is the choice but it is very daunting having to choose. I'm so sorry you are going through this.

[passmethewineplease]

Sorry you're going through this shit OP.

When I had my miscarriages I had one medical, it wasn't too bad, like a heavy period. I had another MMC and opted for the surgical route in the end, my body was just not recognising that I wasn't pregnant anymore so I didn't fancy hanging around waiting for the inevitable to start.

The surgery was fine, recovery was fine, no scarring or anything, I did lose quite a bit of blood but I seem to be a bleeder when it comes to medical things!

The only thing I struggled with was the cramps after, I found them really quite painful.

I'd go for the surgical route personally.

Again sorry you're having to think about any of this.

[Quodlibet]

I'm really sorry this is happening to you. I had almost exactly the same happen to me on Christmas Eve 3 years ago (suspected MMC diagnosed at 12 week scan). I had my ERPC on New Year's Eve.
The procedure itself was fine and quite straightforward, but I suffered from a high fever and violent shivering about a week afterwards and it turned out there was some residual tissue which led to an infection. I had a really horrible couple of days passing the residual tissue (and worrying about infertility!) but some strong antibiotics resolved the infection and my follow up scans showed a healthy uterus. I conceived again 2 months later and had a healthy and uneventful pregnancy.

Whatever treatment you choose, please make sure you give yourself enough time to rest, recover and grieve your pregnancy. I rushed back too soon which I think may have contributed to my infection.

[Nousername2015]

I'm sorry for your loss OP, especially at this time of year.

I had a mmc in March, I was 11+5 and baby had stopped developing at 9 weeks. I had inpatient medical management which was painful but did give me some closure on all of it. Unfortunately I also had a stuck placenta and ended up staying in hospital for a while due to the heavy blood loss. Hindsight is a wonderful thing, if I ever need to choose again I would choose surgical. There's risks with all the options but thankfully they are very low.

Give yourself the time you need and look after yourself. I suffered with panic attacks for a couple of weeks after, not saying this is a natural side effect though. I'm also pregnant again and due in 3 weeks.

Look after yourself

[Nousername2015]

I just re-read your post. I also didn't want to see the sac and let the nurses know. They dealt with everything very sensitively and made sure I didn't see it once it had passed.

[AKP79]

I'm blown away with everyone's support and for taking the time to share your stories, thank you. It's definitely helping me to get my head around things. Thank you x

[TheBubGrower]

So sorry to hear of your loss OP. I had a MMC with my first pregnancy in march at 9 weeks. I opted for surgical procedure because I felt like I needed to regain some sense of control over the situation and didn't want to wait for nature to take it's cause, either by waiting or through medical management. I think it's a completely personal choice though and have heard others say that passing the pregnancy out helped them to have a sense of closure. For me it was a relief to just go to sleep and wake up and have it all over with. Post surgery I recovered quite quickly - light bleeding and cramps for a few days. I took 2 weeks off work to deal with things mentally. Really do be kind to yourself and give yourself time, it's a grieving process as well as a physical turmoil and you need to allow yourself time to heal. I think what happened to your friend is incredibly rare. I got pregnant again within a couple of months and am now 30 weeks. It may seem right now like your happy ending is a long way off but stay strong and look after yourself and you will move on in time xxx

[Celen]

I had a natural MC last year and an MMC in September. For the MMC I opted for the surgical procedure - which was fairly quick and fairly painless but was completely unsuccessful first time round. I only realised as I'd been doing opks and hpts at the same time and the hpts were still showing as positive 4 weeks later.

If you have an ERPC then do keep an eye on the hpts afterwards, I was in the 5% that it wasn't successful for first time round.

[redstrawberries101]

Just though I'd share my experience for any future readers - I felt it really helped to read others experiences before making a choice.

I was 11 weeks 6 days when I went for a scan of my kidneys (I had an infection) and they kindly checked the baby too. The baby had died at 8+4. Absolutely gutted.

Couldn't decide between EPRC and medical as I knew natural wasn't an option for me, I wouldn't be able to wait and they wanted to act quickly as the risk of infection can increase if it's left for ages (it had already stopped growing for 3.5 weeks and I had no clue as I still had the symptoms).

I eventually decided for the medical route as the doctors were again worried about the risk of infection with the ERPC. I had my spleen removed a few years ago and was already in Hosp for urinary sepsis and last thing I needed was another infection. Had this not been the case, the ERPC was definitely the best option for me.

I took tablets at 4pm and period like pains started straight away. By 6pm I felt I needed to go and passed lots of blood and the baby. When I looked I instantly knew what it was, it was grey coloured so stood out and the baby was not in the sac. I didn't get scared or upset but instead felt amazed as it was properly formed with two eyes, arms and legs. The most amazing thing I've ever seen. I felt a lot better. However after that, the pain picked up quite a bit and I was pacing around, after which they gave me the next dose of the tablet as I hadn't passed the sac or placenta tissue. The pain picked up massively and twice I blacked out for a couple of seconds, had DH not been there I would've been on the floor but each time he guided me back to the bed from the loo. I did pass some tissue but still not enough and then was eventually given the third dose of the tablet. Again the same thing happened, very intense cramps and the feeling of being faint with the pain and exhaustion. I did pass a little more but still didn't feel like it was enough. It was about 2am now so the whole intense period lasted for about 10 hours, with the pain being at its peak for about an hour. The nurses were also unsure whether everything had passed and so I was sent for a scan the next morning which revealed 2 large clots measuring about 5cm each. They were sitting near the cervix so the following day, when it still hasn't come away naturally I was taken for an internal exam where they tried to pull them out. They did get quite a lot and were surprised that there was that much left but in the end they could still see some more. They are hopeful they will pass naturally now as they have least cleared the cervix entrance and I have been discharged from Hosp with an appt to go back in a few days for a final scan. The bleeding has tapered a lot and the pain is also much better.

I should mention that during this I was talking paracetomol, dihydrocodeine, ibuprofen and oral morphine.

My advice to anyone going down this option would be to take as many painkillers as you need, I think if I had taken the morphine before pain was at its worst I would've coped better so perhaps it took me a bit longer to get on top of the pain. Also - I don't think I could've done this at home and certainly not without my DH.

I was told that the process is like a mini labour and it is much more painful than going naturally as your body is being forced. Furthermore when you get to full term the placenta etc is already ready to come away whereas in this case it was fresh and going strong if you like as it doesn't even get used until the 12 week mark. Hence the pain for all that coming away is really quite intense.

It does depend on everyone's bodies and they are different. I had a pancreatic tumour a few years ago (that's when I had spleen removed) and I was on morphine at home for the pain so I do have a high pain threshold.

It wasn't a nice experience but the worst is over and I do believe I made the right choice for me.