Missed miscarriage - advice on next steps

[emsler]

Hi all,

We found out this week that I have had a MMC at around 9.5 weeks. The baby had only developed to about 6.5 weeks. We're pretty devastated but feel very lucky that we at least know that we CAN get pregnant and also that it happened within the first 12 weeks and we had lots of warning signs that the pregnancy wasn't going well (constant spotting, only mild pregnancy symptoms, delayed growth etc).

I wondered if any of you ladies would be willing to share your experiences of the next steps following a MMC. I have to decide whether to let it happen naturally, take the pills, have a D&C under general or an MVA (which I had never even heard of!).

I have a high BMI so am inclined to avoid general anesthesia if I can, but having had a very traumatic botched coil insertion the idea of an MVA terrifies me. I've read that the pills can increase the pain of miscarriage and make it happen quite violently. My instinct is to let it happen naturally but the midwife said this could take anywhere up to 2 months and I'm 32 so I want to start trying again as soon as possible. So I feel a bit stuck between a rock and a hard place and would really appreciate any advice or experiences you would be willing to share.

An added complication is that I don't get sick pay (I've been in my job under a year) so although we can afford for me to have a few days off, I do need to avoid having an extended period of time off - so if you could share how much time you needed to take off work I would be really grateful.

Thanks ladies.

Hi Emsler,
So sorry for your loss, I have just joined mumsnet to try & gain/share some experiences. First MC was natural at 5 weeks. Second we found out about a MMC at 10 week scan (had stopped developing at 6 weeks). Given lots of info and gentley tried to be persuaded towards medical management. Although personally I had a friend who has a terrible experience of that and ended up having to have the surgery anyway. I too was worried about the risks or surgery as BMI 40, but was insistent this was the best for me. as someone previously mentioned the anaesthetist basically said it's such a small amount of anaesthetic as the procedure itself only takes around 15 minutes. I had mine on 29 sept, bleeding has now subsided to a small pink when wiping & got a bfn today so body has recovered well.

Thanks mrstiff, that's much appreciated. I'm really glad you coped well and your body is recovering. Fingers crossed it will be similar for me. x

Good luck with everything. X

Just adding my experience. I hope it helps someone out there.
I had a MMC last Dec. I was 9 weeks. It's the hardest thing I have ever experienced. People's reactions ranged from "man up" "at least you know you can get pregnant" to "OMG that happened to me, it's so unbelievably shit"
I had an hcg of 72,000 so concern over a molar. It took a week or so for them to be sure I had a sac large enough to confirm the diagnosis. I had such bad morning sickness I wanted active management. I had two awful attempts at medical management by some fairly wooden staff at my local EPAU.
Both of which were enough to cause me massive emotional and physical distress but not actually deal with the problem. In the end I had an MVA under local anaesthetic which was fine (never going to be the most pleasant thing in the world) and did the job.
A bit uncomfortable. (Think vicious smear) but a couple of days of heavy bleeding.

The shining light in this sorry tale, was my GP. Rang me at home several times and immediately signed me off work for 3 weeks. I never would have had all that time off if left to my own devices. It's what I needed and what worked for me.

Sending flowers to anyone that goes through this.

My second miscarriage happened at 6 weeks and was a "late period" - still difficult emotionally, but was a walk in the park in comparison.

Just joined this morning as currently doing the wait and watch approach.
Firstly i feel like a fraud joining a group called "mums"net when I am no longer going to be a mum. Absolutely devastated.
Went for a scan yesterday as I had slight spotting when wiping. Meant to be 12 weeks pregnant and baby only measured 5-6 weeks.
Been sent home after being told I'm having a mmc and have an appointment to come back in 8 days time to check the progress.
What I don't understand is, if my baby stopped growing at 6 weeks and I've still not passed anything, what makes them think I will pass it? My body has kept it here for 6 weeks while not developing!
I am really scared for when it does happen, it seems people vary in the amount of tissue/blood they pass. In my case baby is only 6 weeks but my sac has continued to grow and was massive on the scan, I'd guess a sac big enough for a 12 week baby.
I just don't know when it will start, I don't want to go to work until it's over but it could take weeks?!?!

Feeling confused, worried and sad.

Morning baloothebear4
Firstly I am so so sorry for your loss,and secondly, no matter what you are a mum!
This is very similar to our case,I was 10 weeks & the sac kept growing with us but the baby stopped at 6 weeks. If you have already started bleeding they maybe think that's the start of things coming away. Did they give you some written information about your options to have a few days to think about?
Again in the same boat as you it's a scary thing when you have no idea if/when it will happen & felt practically housebound! You should take some time off work to process things, it's a huge emotional trauma & loss.
They gave us an appointment for one week later to see if anything happened naturally but I rang & said I wanted surgery & did not want to wait. They were all completely understanding of what I wanted and I was admitted that same day & had surgery the following day.
If they didn't give you information about your options, have a look on the Misscarriage association website as they explain things in a lot more details with regards to surgical/medical management.
So sorry your having to go through this, lots of love & hugs. Please feel free to message me if you want to talk. Xx

Thanks mrstiff
It was all a bit strange when we were told. I feel like we weren't really told much, just that I was going to miscarry and given an appointment for a week on Monday to check on things. She did direct me to the website to have a look.
The bleeding is so minimal, it's only when I wipe at the toilet I see a little bit. I'm actually terrified for when it really starts. I didn't realise you could choose to not wait the week, I just assumed as she hadn't mentioned surgery it wasn't something I could choose. I'm not sure what to do for the best.
Thanks for your reply.

I was lucky my EPU gave me lots of information about the options available.
Maybe ring them and tell them you want to speak to someone about the options if you don't feel that waiting is an option for you. You are perfectly within your rights to do so. Xx

I think I'll wait until Monday or Tuesday and if things haven't started I'll phone and discuss my options.
Thanks for sharing xx

Today 18:05 Crossmyfingerstoes

I to feel your pain. Monday just gone, me and my partner were skipping into our 12 week dating scan to see our baby, after seeing the heartbeat at 7 weeks we weren't expecting what happened. The baby had passed away at 8 weeks, so I had been carrying it for a while and my body wasn't realising it.
We were given loads of information and sent home to come back the next day to speak to a doctor. We chose The surgical (MAV) with local anestestic as I've had the medical way before and found it so traumatic at home. It was arranged for yesterday, I had to take 4 anti-bitotics Wednesday evening, then Thursday morning had to take two micro something and pain killers at 7am. The bleeding had started Wednesday night when I was asleep, and got heavier in the morning. My waters actually went and I saw them come out when I was sat on the toilet and I was stuck sitting on the toilet until I had to leave to go into hospital for the MAV. Then the worst experience of my life happened.
( Please be prepared for TMI and detail. )
When we got to the hospital about a 45 min drive, I walked into Maternity reception to just feel all warm all down my legs and bottom half, and a massive gushy feeling. I waddled to the toilet and everything just came out in one. I am talking the sac and baby. There was so much blood, I just started crying and screaming for my boyfriend who has been SO supportive, and a nurse came in. I was in a bad way and I think a lot of shock. The nurse was so nice and helped clean me up and took me into her office to find where I was to go etc. Then they done an ultra scan to check if it's all gone or I needed help. My womb had totally emptied its self and they said had done a good job. But there was lots of clots of blood stuck just above my uterus - I think - so I had to have a bit of help as they didn't want me passing this on the way home. I just lied on the bed and they inserted a septum thing to open my lower half and just helped clots and blood out. My boyfriend said a lot of blood came out. Then I had to stay and be monitored for around 40 mins and was allowed to go home and rest up, I got signed off work for a week, they did say two weeks but I want to get back to normal asap. I have had a pretty crap ride with it all, but I just want you to see my story and how everyone is different.
Also I am only 24 and my boyfriend is 29. Neither of us smoke or drink and both use the gym regularly and we had a missed miscarriage. sad sadly life sucks sometimes!
More than happy if anyone wants to PM and talk more. Xx

Thanks for sharing. And I feel your pain.
I'm still waiting. On Tuesday I'm meant to be 14 weeks and my baby has stopped at 6. Still nothing coming out and next appointment isn't until Monday. Why is my body keeping my baby for 8 weeks! I just don't understand it. I want it to be over.

Hi all,

Just wanted to come back and update as something I found really helpful when I was worried was threads where the original poster had come back and updated on their story, and I also found it very comforting to read detailed descriptions of the surgical procedure so hopefully this will be helpful for people in the future.

I had the procedure done last Monday. I was incredibly anxious about it and at first I found the medical staff really unhelpful and unfriendly. For example, they told me on Sunday that I would need to come in (in half an hour's time!) and stay overnight to ensure I got a bed. I suffer from anxiety and find it very difficult to sleep in new places, and really didn't want to be away from my husband the night before the operation as - as silly as it sounds - I was genuinely concerned I was going to die and it would be my last night with him. I stuck to my guns and said that I would come in and see the surgeon / anaesthetist etc but then would go home and come back first thing Monday morning and after doing my booking in appointment where I explained about my anxiety (I think it helped that I have a prescription for diazepam) and said that what would help would be to be with my husband and have everything explained clearly far in advance, they were much more understanding and were happy for me to go home. A massive relief for me, I genuinely don't think I could have gone through with it otherwise.

That evening I saw the surgeon who was lovely, a junior doctor who did my booking in appointment and the anesthetist who was just wonderful and so reassuring. I asked him if my BMI (35+) would be a problem and he practically laughed in my face (in a nice way!). He said that I'd only be under for about half an hour and even if it was longer, anesthetics are so safe nowadays and he has treated patients with much much higher BMIs so I didn't need to worry at all. This was a very nice change from the last time I had a general where the nurse weighed me and berated me for my weight for about 15 solid minutes and said "you know you're MUCH more likely to die during this operation than a normal person?" - probably explains a lot of my fear!

Anyway, I went back in at 6.30am on Monday morning after fasting from midnight - though I was allowed small sips of water until 6am. My husband was allowed to stay on the ward with me which was a huge comfort (to be honest, I didn't ask - he just sat down and we drew the curtain and nobody moved him!).

At about 8.30am I was given two mistoprosol and also took a diazepam (which was cleared by the anesthetist). They warned me that this could give me mild cramps. About 15 minutes later I had terrible cramps but they only lasted for around 10 minutes and I didn't need any pain relief. Then they settled to a completely manageable level and pretty much went away entirely.

About midday they came to take me down for the operation. They invited my husband to walk all the way down to the theatre with me which was great as he was able to keep me calm. (Again, I know it's silly, but I really was worried I would die!) After he had to leave the porter stayed chatting to me while the anesthetist did some checks. Then the anesthetist gave me the chance to ask any questions (I asked if I would be intubated, which I wasn't, and also if I would die! He was very reassuring as were the nurses!) and he then put in the calendula. This didn't hurt at all and didn't bruise either. I felt the anesthetic going in as kind of a cold slight sting but was then instantly asleep.

I woke up in recovery about 40 minutes later and instantly burst into tears of relief that I was still alive! I had an oxygen mask on and wasn't in any pain. It didn't take long to wake up properly and in fact I was quite bored as I felt completely fine but obviously had to stay in recovery. A nurse came over and told me that my husband was outside and knew I was okay (he had actually bumped into the junior doctor who let him know it had all gone well). After about half an hour the nurse from the ward came to collect me and I went back up.

I felt completely fine other than a bit sleepy and some tenderness when I moved about. The bleeding was quite heavy and I was desperate to get cleaned up. After about 2 hours they removed the calendula and I went to clean up and pee. Once I'd done that, they got the doctor to write me my discharge letter, gave me lots of ibuprofen and paracetamol and I went home at about 6.

Once I was home the bleeding settled down and the pain was really mild, totally controllable with ibuprofen. The nurse had told me to take the ibuprofen even if I wasn't in pain as it has a cumulative effect. I was totally fine for 3 days other than being a bit tired and the bleeding was light - I was changing my pad maybe twice a day which isn't bad at all. On day 4 I felt fine so didn't take any ibuprofen which was a BIG mistake. One thing they didn't tell me - which I've since discovered - is that everything can get a bit worse on day 4-5 as your uterus contracts back to normal size and expels anything that was left behind / sheds the womb lining. I had REALLY bad pain for about half an hour - the kind that has you rocking back and forward and getting breathless! - and (TMI warning) the bleeding suddenly got very heavy with lots of big clots. This lasted for 2 days but has now settled down and is very light but with the occasional small clot. I'm still taking an ibuprofen at night and one first thing but will stop once the bleeding does.

Emotionally I'm feeling okay but as the days go past I'm feeling more and more frustrated and ready to start trying again - which is good, but they advised I should wait one cycle before trying, so I'm feeling very impatient! I'm also very up and down mood-wise and can be "set off" by certain things (I went back to work yesterday and was greeted by the news that a colleague is pregnant which was obviously very hard, and I also found out that there will be a baby at a weekend-long party we're going to next week which I know I'll find difficult) but in general I'm okay. My husband has been unbelievably wonderful despite being unwell himself which has really helped. I took a full week off work and although I actually felt fine on day 2 and 3, I was glad because day 4 and 5 were SO horrendous! So I would recommend taking a week off if you can.

All in all, I'm very relieved it's over (and that I survived!) and having experienced the pain both from naturally expelling some clots and from taking the mistoprol I would definitely opt for surgical management again as it really was pretty painless and very easy.

Thank you to everyone who took time to reassure me in the run up - it was such a huge comfort and I felt really supported.

Thanks for the update, glad to hear it went well. Best of luck with TTC, I'm sure you'll catch again soon, it does seem like you're more fertile after a miscarriage x

Thank you for sharing that with us. I'm still terrified. I go in on Monday for my D&C and the waiting is killing me!
A few questions...did you get a pre op and what did they do?
Do you change into hospital cloak when you arrive or just before op?
When you come back from op and wake up do you have pants and a pad on or nothing?
All these things are causing me anxiety

Hi @balloothebear4, so sorry to hear of your loss. I completely understand your anxiety, I was absolutely terrified but I promise you it won't be anywhere near as bad as you imagined.

Pre-op: When I came into hospital the evening before I had bloods taken - this was a bit painful for me because I have rubbish veins and it took a few attempts but for most people I imagine it would be pretty painless. Then the next day, about 2 hours before the op I was given the medication as described in my message above. That was all, besides some discussions with the doctors and nurses.

Cloak: I imagine this depends on your hospital. They left me mine first thing in the morning and said they'd come and tell me when to put it on, so I was able to stay in my own clothes. However, they forgot to tell me to put it on so it was a bit of a rush when they came to collect me which I found a bit stressful! They'll tell you around when your op will be so I'd advise putting it on at that time, but over some leggings or something so that you can still move around if you need to without flashing your bum! Definitely bring leggings or pyjama bottoms, whatever you find more comfortable.

Waking up: I had a pad between my legs and a big pad underneath my bum but no pants on. To be honest I could have got up and put pants on as soon as I got back to the ward as I wasn't really in any pain but I chose to wait until they'd removed my calendula.

If you have any other questions let me know, I'm happy to answer as I know how much better I would have felt knowing the process in detail. And best of luck for Monday - you will be fine, but I completely understand your anxiety. Make sure you tell the nurses and let them know what will help (like being able to ask these sorts of questions ahead of time). x

Thanks so much for your reply. Every time one question is answered I have another!
I've got a pre op appointment today at 2.30 and back up tomorrow for bloods! Don't know what the appointment today will be for?
I feel sick the thought of waking up on a ward with no pants on and folk in the other beds.
How long before the op did you need to stop eating and drinking?
Sorry for all the questions x

Don't worry, I'm happy to help!

I'm not sure what your appointment today will be for as it probably depends on how your hospital do things. They might take bloods today as well so that they can measure the change in your hormone levels. Or it might just be to book you in and just be talking.

When you wake up you'll be in recovery. So you'll have your gown on and be under lots of blankets on a proper bed - there's absolutely no way anyone could see anything. Plus everyone else in there will also be waking up after anaesthetic and if it's anything like my experience you'll be the most awake person there as everyone else will have been under for longer. You really don't need to worry about privacy, but if it's a really big anxiety for you, talk to the nurses on the ward, they'll be able to help.

My op was in the morning so I fasted from midnight but was allowed sips of water up until 6am. If your op is in the afternoon I think you have to fast from 6am.

I woke from mine in recovery with a male theatre nurse looking after me one to one. He was lovely and did a fab job, he'd been there went I went in, he calmed me right down and was so solicitous.

Anyway I had just a pad and lots of sheets and didn't feel at all exposed, was well covered. They wanted to check my pad and he just called a female nurse, didn't even ask to do a check himself. They were very respectful.

Also, I had anxiety about the GA so was just glad irlt all went well and not too bothered about anything else when I came round, just euphoric to be alive! No doubt the effects of some drug or other.

AliBingo, I had exactly the same! In fact I burst into tears of joy and relief at still being alive!

Went for the pre op this avo.
They just asked health questions and took blood. Had a melt down in the reception though, I gave my name and she said oh your appointment was yesterday! I instantly burst into tears! Gave the poor girl a right fright
I'm almost 100% sure they said Thursday on the phone but with the way my head was I can't lay the blame on them.
They were amazing and found a nurse to take me within 10 mins.
Just the wait until Monday now.
Thanks guys for your support. X

Sorry for your loss.
I had a mmc 2 years ago and opted for medical management. It was long enough waiting 6 hours after so I can't imagine how some of you coped for longer.
I second what others have said though that after I finally stopped bleeding (3 months) I got pregnant within weeks and now have a wonderful little girl.
Keep positive my thoughts are with you all. It is such a hard loss but keep talking to others as that def helped me xxx