To ask for advice re medical management or surgical management?

[TheCatsPaws]

I posted yesterday about my fourth miscarriage being discovered on a scan. I was supposed to have medical management today but I couldn’t bring myself to go to the hospital.

Last time, I had medical management and despite passing the sack and a very gory horror movie type scene, I still had retained tissue and had to have surgery. I also had a mild infection.

I have nightmares about that all the time, and sometimes even in the day, I have flashbacks about it and literally relive that scene. I’ve also started having nightmares about DS, my only living child, dying. I’m getting panic attacks before I sleep every night, and now that it has actually happened again I feel even worse.

My partner thinks I should just have the D&C because that way, we won’t kbow anything about it and I don’t have to literally relive that scene which is a fear of mine.

However they can’t book me in until next week and I don’t know how I can cope walking around knowing my baby is dead.

I honestly don’t know what to do. I feel like I’d rather someone just shoot me and put me out of my misery because I feel like I’m actually living out the fears that have been plaguing me ever since this happened before.

God you poor thing. What an awful ordeal. I don’t have any specific advice but do you think the GP might be worth talking to. I don’t know if there’s anything they can prescribe to get you through the next few days.

I’m very sorry for your loss.

I had surgical management and had to wait ages for my operation (the first one was cancelled at the last minute, so I had to be booked in again). As awful as it is, it sounds like you were losing your baby over several days with medical management and it would be the same with a natural miscarriage. At least you know everything should be removed in one go with surgical management and physically it is usually a very quick operation to recover from. It’s the mental and emotional side that takes so long and I think you have to weigh up whether waiting almost a week will make that much of a difference.

It would also be worth asking your hospital if you can go on the cancellation list as some women will miscarry naturally before the operation and so that space should theoretically become available.

I had three missed miscarriages and I would personally go for surgical over medical if it ever happened again. Sorry for your losses

Thank you both. Yes with medical management the main bit was over within hours but then I had weeks of pain and bleeding before they rescanned me and saw something “stuck”. The D&C physically was fine, painless even.

I might ring my GP today and see what they can do, and I’ll ask about cancellations.

I'm so sorry for your loss. I've had both medical and surgical management, and surgical was much less traumatic for me. I also had to wait nearly a week, and there is of course the risk you may miscarry naturally in the meantime, but the procedure itself was very quick and the physical recovery was also very quick. I found medical management quite distressing, although that may well be because I wasn't really told the truth about what to expect by the doctors. I think if you are at the stage of having panic attacks about miscarrying, surgery is the best way to go.

Ps you may be suffering ptsd. If so ask your go about counselling.

I have to say surgical. I’ve done both- the surgical, yes the wait is grim, but the actual process of medically or naturally was horrendous for me. I was very very ill, and the feeling of passing the products was worse than the wait for surgery.

Very sorry you are experiencing this.

I would and have opted for surgical over medical every time. I actually had no problem walking around still pregnant after I found out my baby had passed. I still felt a connection and wanted to hold onto her for as long as possible.

Kat I agree no one tells you what to expect. I was told it’ll be like a heavy period. That was true for my natural losses at 5 weeksish but not for that one. It was honestly horrific and it upset my partner too. I ended up just screaming over and over, covered in blood until my partner literally carried me out the bathroom. It was honestly horrible.

I think I might talk to my dr about PTSD. I have a history of anxiety and depression so they’ll probably refer me quickly.

So sorry for your loss. Me personally, I would book the d&c. I waited about 3-4 weeks after my scan for a d&c and I still think it was the best possible choice. This wasn't because they couldn't get me in, but because I wanted to wait for a natural mc. But nearly a month later, it still hadn't. When I finally made the decision, it was Monday afternoon. I went in for surgery Wednesday morning, so it was actually pretty quick (you may find they can get you in quicker than a week, you never know when a slot might open up). I was very torn about it as well as I really didn't want an operation (but I also really didn't want medical management either, I'd wanted to all to happen naturally).

But I spoke with a bereavement midwife in the EPU who was really lovely and I asked her if she was me and knowing what she knows what she would chose. She said 100% she would opt for the d&c as I would be more comfortable and likely to find it less traumatic. I definitely think she was right and I'm so glad we made that choice. Everyone was lovely on the day and I was really well taken care of. It was manageable, not too physically difficult and I am grateful now that I didn't have to go through the medical management experience. I feel like I escaped a lot of unnecessary trauma and pain and was able to grieve a bit better than I would have otherwise. It also didn't affect my fertility at all. I fell pregnant the next month and have had a lovely straightforward pregnancy after all that.

I know everyone is different, but actually having the extra time with my baby helped me to come to terms with it all. I didn't mind waiting and you may actually find it healing to have some extra time with your baby. I did. I felt like it gave me time to be ready to let go when the day arrived. Hope whatever you decide that it all goes as well as possible for you. I second the suggestion to maybe speak with a midwife or someone about what you've experienced.

I would opt for the dnc. I had medical management for my 1st mmc and it was similar to yours - I ended up hemmoraging (sp) and I think I have some form of ptsd regarding it. I opted for dnc after my 2nd and it was much easier to deal with - mentally and physically

So sorry for your loss

I'm so sorry for your loss.

In a similar situation last year, I opted for surgical management and felt that was the best option for me. From a physical point of view, it meant that it was 'over' very quickly with no future problems or complications as a result.

I had to be placed on an emergency gynaecological list as there were no available appointments and, luckily, a couple of days later I got a call to say that they had had a cancellation and could do it the following morning for me. Could you ask to be placed on a similar sort of list?

Take care of yourself x

I've had one mc with no management, four ERPCs (two for mmc and two for incomplete mc) and one medical management (which I chose because of worries about a fifth ERPC). I was lucky enough never to experience complications, but the ERPCs were fine in terms of the procedure and recovery. The medical management was quite painful but OK - it should be added that I had already been bleeding and this was about completing the mc. I am guessing with a mmc the likelihood of a less straightforward process is higher.

I do think that, all things considered, surgical would be less traumatic for you. Spend the week being very kind to yourself.

OP, I'm so sorry to read this, how awful for you. Please do contact your GP and if you can, tell them how you are feeling. I hope you have some good support around you, be gentle with yourself x

Thank you everyone and I am so sorry for everyone this has happened to.

I think I will book the D&C.