Miscarriage, questions about treatment

[NotSpartacus]

I found out yesterday that I have had a miscarriage in the last couple of days. I'm a little over 8 weeks so it is early, but I had seen a heatbeat at 6 weeks so it is a bit surprising too.

Because I was having a private scan I now have to go to the hospital on Monday to get sorted out. Can someone please tell me a bit about what happens next?
If I have the ERPC is it a day case? I have a massive meeting on Tuesday and I am the only one in my team who has prepped for it. Can the ERPC wait until after then? (well, after Weds actually as I have to go to my daughter's nativity play).
If I have the drugs, how long would it take to start bleeding afterwards? I assume I am going to feel rotten, so presumably that is best left until after the play etc? And how long will I bleed for? Can I have the drigs when I have had c- sections before or will it do something horrible to my uterus?
If I start to miscarry properly before Monday should I still go to the hospital?

Thanks for your help. I just want this over now, but I am getting quite scared. I have had two ectopics before and this just feels like more of the same. I thought it was a brilliant stroke of luck getting pregnant without really trying this time, and now I think it was the universe's way of telling me to just bloody give up and be satisfied with what I have.

I'm so sorry you're having this experience.

Is it a 'missed' miscarriage, i.e. without any bleeding? Have you had hCG levels checked? If so, then yes, the ERPC can wait, unless there are any signs of infection (temperature, smelly discharge etc.). But you may want to consider whether you feel in any state to go through with the meeting. You and your physical and mental health come first.

Hospital may suggest you go for expectant management (i.e. wait to begin miscarrying) anyway. I live in a different country where they like to get ERPC done as soon as possible. I have accepted this in three of my four miscarriages for varying reasons. However, waiting to begin miscarrying and having a quick ERPC are all things considered about equal (although different) in risk - which is very low overall if you are keeping an eye on yourself, so don't worry.
An ERPC is usually a day case, yes. For mine I went in at 7am each time and was released between 2 and 4 the same afternoon. It is done under GA, though, so you will need someone to pick you up afterwards and won't be able to drive. After my first ERPC I felt well enough to walk (slowly and gently) home for an hour with dh and dc1 up a hill, whereas after my third one I spent the rest of the day knocked out on the sofa. In other words, the effect of the GA varies.

If you have the drugs you will probably begin bleeding fairly quickly and there may be pain. The bleeding will probably go on for several days (I've never had medical management so maybe someone who knows more can come along and correct me). I think medical management is safe for after a CS, as 'all' it does really (I think!) is induce the cervix to open and the uterus to contract - normal physiological processes, albeit for a very sad reason.

If you start to miscarry before Monday you should at the very least ring the hospital and see if they want you to go in. If the pain remains moderate and the bleeding manageable they may let you stay at home.

Again, I'm so so sorry. Miscarriage is a pile of shitty shite, and I'm not going to give you any of those pious lectures about being grateful you have a child. I have two and it was still beyond grim when I miscarried for the fourth time in total this summer. Perhaps, especially considering your history of ectopic, you might push for tests now? Despite not meeting the criteria for recurrent mc, my gynaecologist ordered tests after my last mc because of my history, and we discovered I have Factor V Leiden, which, fortunately, is treatable.

You'll be in my thoughts over the next few days.

So sorry that you are going through this. x

I only have experience of an ERPC (MMC discovered at 12 week scan). I had mine done privately (have private health care) so I don't know if things are a bit different with that. I was told that I could choose which days to have it, but I actually was able to have it the day after the scan. The only thing is that you might start bleeding before the ERPC if you choose to go that route? Did the scan show any signs of bleeding starting soon (with mine they said there was no sign of that at all)?

It is generally a day case, but I had to stay overnight. This was because my surgery was so late in the day (9pm or later iirc) that by the time I'd come round, eaten, been to the bathroom, had BP checks etc it was well after midnight. I couldn't see any pint getting dh and the Dcs out of bed to come and get me then.

Nil by mouth for 6 hours beforehand. 48 hours of feeling spaced out and not being able to drive or do much. I felt physically awful for 2 weeks afterwards, and not fully back to normal until 5/6 weeks post ERPC. The emotional side of things hit hardest on days 3-5 (when the anaesthesia wore off).

And if you do go down the ERPC route push for tests as to reasons for the miscarriage afterwards.

My histology discovered something rare (and potentially cancerous) that would not have been routinely picked up on by my local NHS hospital.

Thanks both. I'm not bleeding yet and the embryo was pretty much the right size when compared to my earlier scans, so I don't think this had happened long ago. I guess that means things might not start for a while if I wait. I'm not sure how long I would want to wait - I remember a friend waiting several weeks to miscarry, she was exhausted and it was awful. She ended up taking about a month off work just because it was all too much.

Does health insurance normally cover this sort of thing? I have it though work, but have never used it so don't know much about it.

I think I am more bothered about what I might see or feel if I don't have the surgery than I am about GA (i've had 3 before, I felt pretty crap but it could have been worse). I don't want to start bleeding suddenly or have loads of pain. Did you bleed lots after your ERPCs?

I'm not sure what tests they might do on me (the NHS did check my second ectopic for some cancer- related abnormality, I'm not sure what). The ectopics have stopped since I had my tube taken away, and at the age of 37 I guess one miscarriage is not completely unexpected. I wasn't really expecting to get pregnant tbh, so it feels like I've lost something I never really had in some ways...

My bleeding after ERPC was fairly moderate, period-like really, but did take a while to tail off completely.

Have you had an internal (transvaginal) scan to establish beyond doubt that the heart has stopped beating?
(I'm really sorry to write that. It's so hard on you).

I had no bleeding at all after my erpc, just some spotting on the day of my op. I was in 7-7 as after the op I was spaced out and everytime they took me off oxygen I drifted off again, physically you'll feel exhausted a few days, I waited 4 days between scan and erpc but if there's no sign of infection etc they may allow you to have an extra day or two grace.

So sorry your going through this :( its a year ago today my mmc was discovered. X

Health insurance may well cover it. Mine did (with AXA), other than the £100 excess. The consultant who did mine said the key thing when phoning them was not to mention the word 'pregnancy' as all things to so with that are rarely covered, but just to say in a matter of fact way - hard in the circumstances, I know - I've had a miscarriage and I need an ERPC. That's exactly what I did and they didn't even ask any further questions.

I had minimal bleeding after mine too. I did get a mild infection and antibiotics took care of that.

I passed a couple of clots at 3 weeks, and have more bleeding now at 6/7 weeks post ERPC but that may be a feature of my strange condition (partial mole) and almost certainly isn't the norm.

Evenif - yes, they did a transvaginal scan yesterday. It was at the fetal medicine centre too so I suspect their machines etc are good (and apologies to anyone who was there having happy scans while I was blubbing in the corner).

I will I think ask for another scan before we do anything else. I never asked them to re-check my first ectopic was ectopic (with hindsight I am sure it was, given that I had another) but I had nightmares for months that I had aborted a healthy child. Definitely to be avoided this time.

I was looking the scan report today. Everything was the right size, CRL, sac, yolk. There was a heartbeat ten days ago. The odds of miscarrige must have been so low for me, but I guess it just shows how random this can be.

Glad to hear there isn't much blood after an erpc. I don't think I could cope with that as well.

Thanks for sharing your stories and experience. I know it can't be easy.