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Miscarriage/pregnancy loss

Why is medication not offered to women who have had a missed m/c

24 replies

KnittingRocks · 26/02/2011 21:43

A friend has just had her 3rd missed m/c. She is not showing any signs of 'losing' the pg yet and has been offered a D&C but doesn't really want another op.

Talking about it with her and another friend yesterday (all of us have had m/cs, D&Cs & natural in the past) we wondered why women who have had missed m/cs are not offered the so-called 'abortion pill'?

If this can be given to women up to their 9th wk of pg and she is only 5wks when she lost the baby why can she not take this? Why is it only D&C or wait and see?

Does anyone know if it is a rule of just a hospital by hospital thing?

Thanks.

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KnittingRocks · 26/02/2011 21:49

bump

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Blackkat · 26/02/2011 22:00

Hi Knitting, So sorry to hear about your friends loss, and your own.
I had a missed m/c at 12 weeks and was offered D&C, Natural or Medical, but was strongly advised to go for natural. Perhaps it's a hosp by hosp thing? HTH

juuule · 26/02/2011 22:03

I think itmust be a hospital by hospital thing.
I was given the choice of D&C, natural or medical when I had an early mmc.

KnittingRocks · 26/02/2011 22:11

Thank you for your responses - and your sympathy. I am so devastated for her as it had taken her such a long time to pluck up the courage to ttc again and she has to face this all over again Sad.

I will let her know that she could ask about a medical TOP as this may be her preferred option to avoid either a long wait or a GA.

Very Sad.

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daisytaylor · 26/02/2011 22:54

Hi knitt so sorry for your friends loss, she has a good friend supporting her. I had a mmc just over a year ago and was offered to wait it out but after weeks of heavy bleeding i was offered the pill rather than surgery. They did say it wasn't something they liked to do but will in certain cases. Mine being that i am overweight but recently had surgery for ectopic and wasn't offered anything else. So i guess it just depends on the hospital and the patient but worth asking about it. One thing i will say though just from my own experience the pill caused me heavy and painfull bleeding that went on for ages. But that might not be the case for her. Sorry i can't be of more help. All the best.

milkyway2007 · 26/02/2011 22:55

Hi, I have had 4 miscarriages - 2 natural and 2 missed miscarriages. I had an ERPC with the first one, as I didn't know about the medically managed miscarriage with the pill, and no one offered it to me in the hospital. It was all very point blank: "You will need surgery", and that's it.

My last miscarriage, last month, was also a missed miscarriage, and they tried to thrust the ERPC on me again, but I specifically asked for the "pill" method, and was given it. I was 10 weeks along when I had it, and baby had passed away at 7.

ERPC's arent confined to missed miscarriages, and I would think you can use the pill method at any stage - as I was given it at 10 weeks. I think its more to do with how long the baby has been carried since death - as the longer you hold it the greater chance of infection. Although one doctor has told me, that there is no great chance of infection, by carrying the baby longer until you miscarry naturally.
I think asking the doctor for specific treatment is the way to go, as they can't force any kind of treatment on you unless you ask for it.

scottishmummy911 · 26/02/2011 23:19

I have had 3 miscarriages. I was offered the pill method twice but opted for D&C as just wanted it to be over quickly.

Awful time and must be worse if you are unhappy with the hospital treatment.

GwendolineMaryLacey · 26/02/2011 23:33

Hi knittingrocks and sorry for your friend's loss. I had a mmc last month at 11 weeks, baby died at 6 weeks and I was offered surgical or natural with a strong hint towards the surgical, which I had. No one mentioned a pill and as the baby had died 5 weeks before and nothing had happened I didn't feel like I could wait for goodness knows how many more weeks for it all to end.

meliesmummy · 27/02/2011 08:18

Hi, I'm sorry your friend is going thru this but well done for being such a good friend to her.

I had a mmc 2 weeks ago at 11 weeks, baby had died at 8. I was offered the chance to wait, to have a erpc or the medical treatment and I chose the tablets (altho the 2nd dose is a pessary) bcos I didn't want to sit at home not knowing when it'd start and I didn't want an anaesthetic.

Basically she would be given an oral tablet to stop her producing progesterone and then 2 days later she'd have to go back for the pessaries and she'd stay in hospital for the day, altho I ended up staying overnight too. I bled a tiny bit after the first tablet, and it properly started a few hours after the second lot, it wasn't too painful and they were on hand with painkillers. It was messy tho, she would have to use a bedpan bcos they check everything is there.

I'm glad I took that route, and if your friend thinks it's right for her then it's worth discussing it with the hospital treating her, wish her luck and best wishes, x

KnittingRocks · 27/02/2011 14:30

Thank you for all your replies and I'm so very sorry to hear of all your losses - life can be so cruel.

The prolonged and heavy could be an issue for her then if she was to take the pill, but then I assume she could have this if she lost naturally too?

I will talk to her when I see her tomorrow and let her know it's an option she can explore with her doc.

Thanks again.

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KnittingRocks · 27/02/2011 14:30

Heavy bleeding I meant

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mummyabroad · 27/02/2011 14:37

Hi knittingrocks if you look at the NHS website you will see that there three options mentioned above are what is normally offered and it is the womans choice which to go with. However doctors should offer their advice as to which is best for the particular circumstances because there is less chance of the pill working the older the embryo is, and also if there has been a long time between the time that the heart stopped beating to when the mmc was detected there is a greater risk of infection (however taking antibiotics straight away and then taking the pill is an option too)

I hope your friends recovery goes well.

KnittingRocks · 27/02/2011 17:36

Thank you mummyabroad, that's v helpful.

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harassedinherpants · 27/02/2011 18:50

I had a mmc 6 weeks ago, my first mc. I was 10+1 and baby had died at 7 weeks.

I was offered erpc, medically managed or natural. I think they would much rather I'd had the medically managed, that was certainly how I felt. But on the advice of my mw and a friend who's a mw and had a mmc, I had the erpc.

It was the right decision for me.

I wish your friend a speedy recovery, she's lucky she has someone so supportive x

Ladybee · 27/02/2011 21:03

Hi knitting I'm currently awaiting an ERPC having discovered a MMC (my 4th MC) last week at 11weeks, baby seems to have stopped growing at 8+1.
I was offered natural or ERPC. I asked about medical and my consultant felt that it wasn't a good option for a couple of reasons:

  1. The size of the sac and embryo

2. The fact that due to re-organisation of services at my local hospital they no longer have inpatient facilities to care for women choosing that option.
I could have asked for it, but would have then gone home and experienced it all there.
3. The risk of it not working completely and then having to have an ERPC to follow.

I've previously had a natural MC at about the same stage a little earlier, which I found extremely painful and distressing to be having to cope at home (I have a DS 2.8 and he was home at the time, with my DH).
I've also experienced an ERPC, and although emotional difficult I found it physically relatively straightforward.

I hope your friend can make a choice that suits her.
wellieboots · 27/02/2011 23:31

I had a blighted ovum discovered at 12+2, but was given a general leaflet by my hospital which gave me 4 options - ERPC under GA, ERPC under local, medical or natural. They dissuaded me from natural as I'd gone for my 12 week scan without any bleeding or symptoms of an mc, so it was a case of how long was a piece of string in terms of when it would come away; and I felt dissuaded from medical management as I was quite focused on timescales and how quick can I get this over with, and for the tablets I just got told oh I'm not sure when I can get you the tablets. I opted for ERPC under GA, but I did take time to think about it (couple of days) and I was quite keen on tablets just because of the lack of an operation but not just waiting and seeing - seemed like a sensible halfway option.

I have heard that it can be quite painful though, that was the other reason I didn't go for it. Hope your friend feels that she gets enough support and information to go for whatever is best for her. Good on you fo being a supportive friend.

hairylights · 28/02/2011 22:49

Hi I have had three miscarriages. The last two were missed mcs and I was offered the pill on both ocasions. They don't call it the "abortion pill" bit "medical management". You don't want
to hear the word abortion when you much wanted
baby has died inside you.

KnittingRocks · 01/03/2011 13:34

Thanks for further responses.

hairylights, sorry for the use of that word. I had 2 mmcs myself and know how horrendous they are, I just didn't know the correct term and knew everyone would understand what I meant Blush.

My first mmc was twins and I did have an ERPC but they didn't remove everything and I went on to pass the rest naturally. It was horrific and I know which option I would choose in future were it ever to happen again.

Thank you all for sharing your stories.

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hairylights · 01/03/2011 16:29

No need to apologise.

I'm pro-choice!

Just pointing out that htey call it different things for different useage (although the medical term for miscarriage is actually 'spontaneous abortion')

Really sorry for your losses :(

KnittingRocks · 01/03/2011 17:04

Thank you hairylights, I've since gone on to have two beautiful boys but you never forget do you?

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hairylights · 01/03/2011 18:04

Lovely to hear that. I don't know if you forget or not, all three of my miscarriages have happened since last June, so it's all very raw. I don't think I will ever forget.

So lovely to hear that you can go on and have healthy pregnancies and children after Miscarriages :)

KnittingRocks · 01/03/2011 19:16

I'm so sorry to hear that. It is such a raw pain Sad. My m/cs were in 2006 but I think I hit my real low around the due dates in 2007 Sad.

I got pg again in the Autumn of that year and had my 1st boy in June '08, then 2nd one in October '09.

I well remember that feeling of helplessness and despair though Sad.

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hairylights · 01/03/2011 19:50

Yes the worst part is wondering if it will ever happen for you. Seems odd to say but I've had three in short succession and the second was the worst. By the time the third came, I'd learned so much more about how I would feel, and how to cope with that.

Two weeks later and I am feeling a load more positive, although there are still times when I feel quite desperately sad.

Am having some tests done now though, so am looking forward rather than back.

KnittingRocks · 01/03/2011 20:02

Yes, my second was the worst too.

I hope the tests help. My consultant (m/cs were IVF) advised me to take aspirin, which I did in my subsequent pgs. We'll obviously never know what made the difference but it made me feel I was doing something anyway.

Wishing you lots of luck.

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