Natural miscarriage v surgical management

[Sxp842]

Hi all

I went for a scan on Thursday after heavy bleeding and cramps, and was told that I am having a miscarriage (8 and a half weeks). I had a scan at 6 weeks which showed a heartbeat, but sadly it turns out the heartbeat stopped a few days later.

The nurse gave me the option of letting the miscarriage occur naturally or having a surgical procedure. Does anyone have advice on which way to go? (Apparently medical management won’t be of much benefit because I’ve already started bleeding)

im not great with pain. So far the cramps are bad at times but manageable, I’m just worried it’s going to get a lot worse. And I hate not knowing when it’s going to happen. The idea of surgery doesn’t freak me out and I’m leaning slightly more towards that option if it means the pain will be less and I’ll know when it’s happening. But I don’t want to do anything that will jeopardise my chance of having a baby in the future. We’d like to start trying again as soon as possible. The nurse said there is a small chance scarring from the surgery can affect ability to conceive, but everything on line says there is no greater risk from the surgical option.

does any one have any advice? The nurse has provisionally booked me in for the procedure next Wednesday but said I should take the next few days to decide

any advice would be much appreciated

thanks

I don't have the answer I'm afraid, just wanted to leave a note to say I'm going through the same thing and trying to decide between the two; ultimately I think I'd rather it was over and done with quicker than waiting for it to happen, so will go to with surgery.

I had medical management for an MMC in October in Spain at 11 weeks, and the hospital made me stay in for 4 days until it was all gone, which was traumatic at the time but in hindsight actually brilliant because I was constantly being monitored and scanned and when I left the hospital I knew that was that.

Often leaving it to happen naturally can end up with it not being 'complete', and you have to have the surgery anyway.

Thinking of you x

I had a mmc at 9 weeks.
I wanted to deal with healing and trying again as soon as possible.
I had a d and c the same evening. Was very straightforward and I went home the next day.
Sorry for your loss.

I had the surgery, was glad to have it sorted and recovery was fine. I can honestly recommend it.

I am so sorry you are going through this.

I had a miscarriage last year; start of December. I opted for surgical management because I felt I couldn't bear waiting for it it happen. I was terrified of passing something recognisable and felt I couldn't function in limbo. The surgery was very quick. I was taken down from the ward around 2.15pm and remember looking at the clock in recovery and noting it was only 3.25pm. My husband collected me around 7.30pm.

To reassure you (whilst remembering it is different for everyone) I then got a negative pregnancy test just over 2 weeks later (they ask you to test 3 weeks later to be sure all the hormones etc are gone but I felt a little ovulation pop that I'm familiar with so tested sooner. So that was just before Christmas. I then conceived in January and am now nearly 19 weeks.

If god forbid I were ever in the position of making that decision again I would without question choose surgical management again. I felt it gave me dignity and control at a time they were very much taken from me in every other way and let me begin to function and process the emotional aspect to what I was experiencing.

Sending you a hug xx

I went for the surgical management. Waiting around for it to happen is awful and tbh I was quite scared of what I would see. I was about 11 weeks and baby had stopped growing the week before. Surgical management was very straightforward physically and I think it was less traumatic than having to deal with it myself at home. If you do it naturally I think you have to kind of examine the tissue to see if it’s a complete miscarriage. I could be wrong. Someone more knowledgeable may know different though. Sorry you’re going through this.

I wanted to miscarry naturally and did so a few days after the scan, but it tripped into a serious haemorrhage. I would recommend surgery, although my understanding is that haemorrhaging is not usual so I don’t mean to worry you, simply feel it’s better to let someone make sure you’re ok.

Didn't want to read and run.
Firstly I'm so sorry you're going through this. It is utterly utterly shit. I've been there!

I found out about my mmc at the dating scan, baby died at 8 weeks. I opted for medical management because surgery and waiting seemed equally awful. I ended up having the surgery because I haemorrhaged at home. The surgery was fine, no pain, a little bit of bleeding after similar to a light period. Personally if I ever found myself in that situation again, I'd opt for the surgery.

Love and hugs to you xx

I chose surgery.
It wasn't great but 100 times better than being at home sitting on a toilet going through it all for days. It started at home, the pain was unbearable (I have a high pain threshold).

I was sore the rest of the day but didn't even need painkillers the day after.

Hi all

thanks so much for all of your responses, and I’m sorry for those of those of you who are going / have been through this. It’s horrible. even though I knew the odds i wasn’t prepared for how emotional it would be, and for the physical aspects. I didn’t think it would affect me as much as it has. Just reading through some of the threads on this forum has really helped.

It sounds like surgical seems to be a common choice, where there is a choice. I completely understand why. For those of you who opted for surgery, were you concerned about the risks of impact on future pregnancy or was this something the doctors talked to you about? So far, that seems to be the only potential downside to surgical, but I’m not sure how much of a risk it actually is and there isn’t much info online.

I can't remember being told there were any risks to future pregnancies.
I went on to have 3 successful pregnancies.

I think that risk is fairly low. I got pregnant again the next cycle and it was fine.

I also don't remember being told about risking future pregnancies - I imagine I probably was but it's all a bit hazy!

As I mentioned in my reply I got pregnant again first cycle and am now 19 weeks.

Remember they have to tell you every single risk no matter how low x

@Sxp842 firstly i'm sorry you are going through this rubbish time.
I had surgical last sunday and it was so straight forward, i was home by lunch time and apart from few light cramps and bleeding it's been fine. I had a natural back in October and it honestly was so traumatic, i didn't have much pain but the bleeding was awful, i could get off the toilet for hours and was passing clots the size of my hand. I ended up in hospital and it was just an awful experience. We always knew if we were in the situation again we would opt for surgical.
I was 10 weeks both times but baby stopped growing at 6.
Regarding risks I was just told very was a small chance of scaring but I think that's a tiny risk.I also know people who have had natural but then ended up having a surgical because it was incomplete.
xx

I’m so very sorry OP.

I would have the surgery. My friend was sent home to have a natural miscarriage and she said that what came out was shocking to look at. I’d rather the doctor sort that side of it out.

thanks for all the responses, it’s reassuring to know people have had a good experience (relatively speaking) with surgical and the risks don’t seem to be that significant.

To be honest I’m not sure if my miscarriage is over now. I passed what I thought was just a big clot on Friday (looked like some grey-ish tissue), then yesterday had some fairly heavy bleeding and more clots, and today some light cramps and fairly light bleeding and no clots. It feels like it’s coming to an end, but I also haven’t experienced the intense cramping pain and seriously heavy bleeding that people report/hospital warned me about.

I think I might go to the hospital for the pre-op assessment tomorrow morning and see if they can do a scan at the same time to check if I am still miscarrying or if it’s over. If it’s still occurring then I think im leaning towards having the surgery on Wednesday.

It’s so difficult not knowing whether it’s definitely over.

@Sxp842 so sorry you are going through this.

I have just experienced both in the last five weeks for the same pregnancy. On 1st&5th April found out it was mmc. Should have been ~9 weeks, it stopped at ~6 weeks.

Natural - I started bleeding on the 15th April, got very intense cramps over a few days, on and off pain, and I thought I had passed most on 18th with a 3 hr session on the toilet- lots of blood and stuff- I couldn’t leave the toilet. Passed more later that week. I had a delayed second epu scan on 25th to confirm mmc (delayed because I caught covid on the 12th April and thought I might not need the scan after I passed lots but they said to go). After the scan they said I still had stuff to pass but my body has done some of the work and it will likely pass over the next few weeks. I kept passing clots and mainly stringy blood during the two weeks after that and then it tailed off to light bleeding. So I assumed it was over…

3+ weeks after that scan I was still lightly bleeding and testing +I’ve (a feint test though). So I reached out to epau again. Had another scan last Thursday that showed stuff still there and it needed to come out so I opted for surgery for today-23rd- over medical for the retained products. Last Friday I had quite a bit more clots/heavier bleeding and mild cramps and wondered if I’d passed the last bits. I didn’t want them to waste a surgery if it wasn’t needed so I called to explain. They squeezed me in for an US yesterday and found it was still there.

I had the ERPC this morning, with general anaesthetic. The whole process was smooth. I got there for 7:30am, took two oral misoprostol at 8am to help soften the cervix. Agreed again to the anaesthetic process and the checks and details. Another blood sample because they only had one to confirm my blood type. Then they took me down at about 9:10-9:20am. I had GA and then next thing I knew I was in another area and it was all done. I have no memory in between. I was there for a short period while they took me off anaesthetic, gave me a pain killer and checked my vitals. I didn’t have any pain at that point, just felt shivery/cold. Then I was taken back to epau at 11ish. Had a cup of tea and a bit of toast. Managed to go to the toilet. My DH picked me up at 12 and I came home.

I am in some pain now, but I also haven’t taken any paracetamol for it yet. So it’s manageable and expected. For me it’s a dull constant pain- like a very full bladder pain might be the closest to explaining it but not quite. When I move/walk it’s slightly worse. This is only hours later though and their pain killer has worn off. So it’s expected.

Sorry that it’s a long post. Just thought I could explain both from my experience (albeit the surgery was for retained products rather than the whole embryo). Also everyone is different, you might have passed it all. Trying to ask for another scan is a good idea.

Good luck, I hope you are doing ok. There is an end in sight.

I’m so sorry you’re going through this.

Thanks for sharing your experience, it’s reassuring to know what to expect. I hope you’re doing ok, that’s a lot to go through.

i went for another scan today and found out that the baby has passed completely so didn’t have to go down the op route. Sad seeing that scan, but grateful it hasn’t been as drawn out as it could have been.

sending love to all you going through this xx

@Sxp842 oh no sorry. It’s good to know where you are in terms of it ending. But I know what you mean, it’s a sad moment seeing it no longer in there and/or being told it’s no longer there.

I hope you have a speedy recovery and good luck in the future if/when you try again. I really hope it’s better outcomes for us all.