Post Miscarriage - Natural / Tablets /or D&C - Which is best ?

[Oblomov]

Advice would be appreciated re the pro's and cons or each.
I had a scan, a week ago, and they think I miscarried at 4-5 weeks. I have another scan booked for a week tomorrow.
I have not bled. I assume I still have a sac inside me and thus this is producing hormones telling my body that I am pregnant. This is casing havoc with my diabetes and making me feel ill.
So, if on tuesday, I have miscarried, it is in my interests, particularly diabetes wise, to stop the hormones / pregnancy asap.
I am thus assuming that natural, is probably not best for me.
I was in hospital for 5 days last week, whilst they stabilised my diabetes and did a scan.
So the thought of any more hospital doesn't appeal. But the tablet says one tablet, then two days later, admitted to hospital, whilst you have a number of dodses 3/4 hrs apart.
Maybe I would be better to consider a d&c ?
I know that this is a difficult decision, and I am only at the thinking stage, but I would really value others opinions and experiences.

bump

Sorry to hear about the possible m/c.

I cannot tell you wht the tablets are like, I had a D&C after missed m/c at 8 weeks.

I was given a sedative before being taken to theater, then GA. The procedure was straightforward and after monitoring I was allowed to go home that evening. I did not have a lot of pain, I think I took some painkillers the first day and then it was more like a normal period after that.

Where I live a D&C is standard practice, the docs here told me that it is better to "clean" the womb to ensure that an infection does not develop. I do not know if that is true or not.

If it is any consolation, I was also told that getting pg again after a D&C is often easier. I can vouch for this as it took me 2 1/2 years to get pg the first time and the 2nd time I fell pregnant right away.

Is there any hope?

Wishing you all the best for your scan.

Sorry to hear you're going through this.
I chose to have a D & C after I had a missed m/c at 10 weeks as I didn't want to have to deal with passing anything iyswim.
I had the d & C and was home at lunchtime and knew I didn't have to worry about retained product etc. It also helped me come to terms with what I had been through I think.

Thank you both. I will investigate d&c's more.

if you have the tablets, you are inducing a labour, which can be incredibly painful, you would also only be allowed to drink water as you may still need erpc for reasons like failure to induce or if doesn't all come away... so with your diabetes you would need to be on a drip.

if you have an erpc you again would need to be starved so you would need a drip, the operation is quick and you can go home the same day. period type pains are common afterwards.

i wish you luck for your scan, i'm sorry your facing this decision.

Thank you sarahlou. I need to talk to them to find out what would happen when.
I wonder if I could fast the night before, no breakfast, go in, be put on a drip and operated on, first thing in the morning ?
My hospital is Kings College hospital in London. I am there becasue they have a diabetic pump clinic.
But there is a big hospital, St Peters in Chertsey a few miles from my house.
I hope that a d&c could be arranged there.
It takes over 2 hours for me to travel to Kings, so I hope I wouldn't need to go there for the actual d&c.

I had a natural mc in August. I was sent home to decide what to do ERPC or natural but it was decided for me. Looking back I would have went for the ERPC, I had 2 other DCs to look after and the natural mc wasn't pleasant at all and took a lot out of me, at one point I was hardly able to get up (DP was there for 2 days so that wasn't too bad but had a job interview so wasn't there for the last day), the bleeding was very heavy sorry this may upset you, to the point blood was running down my legs inbetween towel changes and a towel lasted about 10 minutes. I also bled over the sofa and my bed which was quite upsetting especially for the DDs to see. I didn't see anything although a lot of the time I was sitting on the loo just letting it flow.

I didn't have the option of the tablets but have heard they can be pretty horrendous as well.

We have a mc support group mc supprt thread theres loads more people on there who have been through similar experiences.

I'm so sorry you're going through this Oblomov. I have had two missed mcs in the past 18 months and for both I chose to go home and miscarry naturally. Both my babies had stopped growing at around 6 weeks but this wasn't discovered in the first instance until 10 weeks and in the second at 8 weeks. Both times I started bleeding within a few days of being told I'd miscarried. I hope never to have to go through this again, but if I did have another mmc I would opt for letting things happen naturally again. After the trauma of knowing I'd lost my babies, I wanted to be at home and I wanted my hormones to return to normal as naturally as possible. The bleeding for the first one was very heavy and I spent about 10 hours in the bathroom because pads were getting soaked v. quickly (sorry if tmi), but the pain was bearable and I managed it with over the counter pain killers. I was lucky in that my DH was able to take a couple of days off work to look after DS and we told DS I had a tummy bug. For the mmc earlier this year I also had two very supportive calls from the midwife who'd booked me in the day before I discovered I'd miscarried. This is an awful thing to go through, especially as you have the added issue of your diabetes, and I hope you get good advice and support.

Thank you for your kind words bearsmom and sweetkitty.
I am all umms and aahhs about it all. I have to wait until tuesday before anything can be decided.
Maybe I will bleed before then anyway and the decision will be taken out of my hands. I think maybe a d&c would be good for me. How would they cope with my diabetes - I need to find out details.
Thank you all for your posts and support.

Hi Ob, hope it's not too late for you to read this. I've just been through this. Went in for a scan last Fri (I have two DC's already) and was told at 9 weeks preg that there was no heartbeat. I, like you, was given the natural, medical or surgical options. I was told that I'd probably miscarried at 7-8 weeks and to go through surgery would probably be a little heavy handed with a fetus so small. Risk of infection, damage to the cervix, etc. So I was going to leave things to happen naturally for a few days then consider the tablet scenario.

Got home that night and started to bleed. It was like a normal period on Saturday and on Sunday morning I woke with what was like bad abdominal pain and began passing large clots and quite a lot of blood. Couldn't leave the bathroom for around 45 mins then had to go reasonably often, but my DH was around to look after the DCs and it became managable quite quickly. Took nurofen and was OK, although felt pretty knackered. DH took the day off on Monday and I rested, then started to feel much better. I'm pretty much OK now, although I'm taking it easy.

God forbid this happens again, but if we were unlucky enough, I'd want the same, natural way. It really wasn't too bad - upsetting and not pleasant while it was happening, but far better for me being at home and not having to be pumped full of drugs in the hospital unless absolutely necessary.

GOOD LUCK!!

Loveverona, thank you for your nice post and I am sorry for you too.
I keep switching , every minute of the day - natural/ d&C - natural - tablets - d&C.
I don't know what to think.
I will see what they say on tuesday. Thank you for thinking of me.

sorry to hear about your mc, i had a mmc at 6 weeks and had tablet treatment as the thought of d&c terrified me. it was fine, i found it no more painful then a period and didnt see anything as apparently it was to small. they did have to check twice to see if anything was blocking my cervix and i found that the worst part (they dont all ways have to do this) my sis on the other hand has had 3 d&cs and prefers them as its over very quickly and your fast asleep. my doctor and nurse did tell me that they prefer the tablet option as its less invasive. what ever you decide im sure everything will be fine.

So sorry to hear you're going through this
I can't say which way is best, but I was told at 16 weeks that my baby had died and I was offered an induced labour (tablets) or and D&C. They also said I could let nature take it's course, but at 16 weeks they didn't advise this as the best route.
My gut reaction was "you're not taking my baby from me", it seemed unnatural and clinical so I opted for the induced labour.
It was painful and traumatic but it also helped me come to terms with things (as well as you can at that stage). I found out on Thursday and given a tablet before I went home. they told me to come in again on Saturday morning for another tablet and possibly to stay in. By teatime Friday I was in "labour", so went in, and by 8pm it was all over.
I don't regret my decision at all. Good luck with yours and again, I'm very sorry you're having to go through it.

I also didn't pass everything at once and had to have some tissue removed a few hours later, but this was done in the room I was in by a Dr, and I had gas and air for it, so it wasn't too painful.

I had a missed miscarriage at 9 weeks and baby died at 6 weeks. I opted for medical management as I thought it would be quicker than natural. took the tablet and ended up in a and e with the pain. pain was worse than my labour with my first child! would describe the pain as a forced pain. ended up with infection, probably from all the poking around the doctor did. test results came back I had bacterial vaginosis. another trip to a and e for antibiotics. after all this the tablet didn't work after 3 weeks and ended up having surgery management to get rid of incomplete miscarriage, there are quite serious risks for surgical management and if you get ashermans syndrome you can cause you to have infertility problems. surgical management was less painful than medical option. from personal experience my stepmum died as a result of a very routine operation to have her gall stone removed. there is always that rare chance of it being you.
from my horrible experience, don't rush into any options, every option is painful each comes with pros and cons but you cannot predict each option will be quickest/less painful as everyone is unique. nhs booklets give you minimal information and nhs staff also give minimal information. doctor didn't even mention ashermans syndrome when going through consent form. for example
if I have another miscarriage I will definatlely try the natural method, painful and unpredictable yes might take longer yes but I think researching into this there seems to be less risks involved in natural management. especially in the early stages. predicting it would be distressing seeing it come out of the toilet.

hope this thread is helpful to people not knowing what to do about a miscarriage.