What to expect from medical management?

[SRK16]

Third pregnancy, second miscarriage. The first miscarriage just happened on its own and didn’t need any treatment. I had a scan yesterday thinking all was going well, but there was no heartbeat. Huge shock as I really thought everything was fine. I’m going to need medical management. I’ve googled to see what to expect but wondering if anyone can share the reality? With my spontaneous miscarriage I had one night of very heavy bleeding and bad cramping and the rest wasn’t too bad (physically). I’m very focused on the practicalities of managing this with a very busy stressful job (worst possible timing for this to happen) and a clingy toddler.
thank you, and sorry to anyone who is also going through this or has been through it. It’s unbelievably shit 😞

Hi OP, I'm really sorry to hear this. I had almost identical scenario - had toddler, had 1 miscarriage that happened naturally and then a second as you describe. To be honest, it was fine. I went in to hospital, was out under general anaesthetic and when I woke up it was done. I was very emotional going in for the anaesthetic but the staff could not have been kinder, held my hand as I went under and were so supportive when I came round. As far as I remember I had little to no bleeding after. Felt a little bit tender but nothing regular paracetamol/ibuprofen for a day or two didn't sort. I hope it all goes just as smoothly for you xx

Thank you for sharing and sorry for your losses.
not sure if I’ve got the terminology wrong but I was thinking of the non surgical option (pills? Pessaries? Not sure). I’m worried that it’s going to be really painful/heavy and go on for a long time. We’re meant to be going away in two weeks and I’m worried about travelling if it’s not all finished. I googled but couldn’t see anything about travelling in this situation (ie whether it’s a bad idea)

I had this a few months ago. I went with the surgical option but just with a numbing gel at the area. I went to the hospital in the morning where they did another scan and and was given some medication for pain and to loosen the cervix. It felt uncomfortable for a very short period during the procedure and a needle with numbing gel was used at the area(felt a bit like a smear test) and the pills caused cramping which was uncomfortable but I was home by lunchtime. I bled for about a week and was in pain during that time but I have painful periods/get tired easily anyways and this was like a medium level period so not too bad. I've heard surgical management is a bit quicker and as I had a three year old I thought that was the best option for me and it was and also with the surgical management they did another scan at the end where they checked for retained products. I'm sorry for your loss. Hope it goes ok

Hi @SRK16
I’m sorry for your loss.

I have done the medical management. I was given a drug orally at the hospital (can’t remember name) to loosen the cervix then told to take the misoprostal orally (along with anti sickness drug) at home 48 hours later. After taking the misoprostal you should expect to have a heavy bleed after about 2-8 hours (but may be up to 48 hours). Then the bleeding should reduce and may last up to about 2 weeks.
So it sounds like it should be similar to your natural miscarriage. I had heavy bleeding and cramping for one night, then by 2 days later I was down to just light bleeding and no further pain. They also prescribed me codeine at the hospital but my cramps weren’t too bad so I just took paracetamol.
After the night of heavy bleeding where I was up a few times an hour I was fine to work from home the next day. The main thing I would think about is the timing to take the misoprostal and when to expect the heavy bleed - ie take in the morning if it’s better to bleed during the day, or late afternoon /early evening if you prefer it at night. I took the tablets at 2.30 and started heavy bleeding at 10.00 (which I think is slightly longer than average). At the time I thought it was really inconvenient planning as just going to sleep, but in retrospect I did sleep in between getting up so maybe it helped distract me so it was a good idea.
So except for some potential light bleeding I’d have thought from a practical perspective you should be fine for your holiday.
Oh the other thing to add is that the EPU told me to call them any time (24hours) so ok to phone them in the middle of the night to ask if it’s too much blood (it wasnt!)

Sorry you have to go through this, it’s really rubbish. Hope everything goes well for you.

Thank you both for sharing. Helpful to hear both experiences. I really just want this all to be over so I can move on. I felt better emotionally most of today but it’s just hit me that I’m not really pregnant anymore, I won’t be going on maternity leave in February… I just feel so sad 😞 and I tried so hard not to get carried away and overly hopeful.
I really hope I can get my prescription first thing and then get on with it 😞

Updating in case this comes up in a search for anyone else more than anything!
Took my first dose last might, started getting cramps quite quickly, alongside an upset stomach. Started bleeding a few hours later but it seems to have tapered off, so I’ve been told to go ahead with the second dose tomorrow. I’m feeling quite anxious about it, whether it will work or not and what happens if it doesn’t work properly again. I’m meant to be travelling the weekend after next and am worrying about whether that will be able to go ahead or not.

Hi there,
Im sorry for your loss - it’s just so hard when you find out there was no heartbeat.

The same thing happened to me and I’m a week on from taking misoprostol. I too would have been on maternity in Feb, I feel your pain as the reality starts to set in.

My bleeding stopped after 3 days and now just waiting for 3 weeks to do the pregnancy test for a negative. Hopefully you are the same.

If you are well enough in yourself I would think your holiday would be fine - just be kind to yourself and take care of both your body and mind. It’s a horrid time but you aren’t alone x

Sorry for your loss Kappi. You’re right, it’s just setting in. There’s a wedding in feb I assumed I wouldn’t go to as it wa so close to my due date… but I guess I will be going now. Stuff like that.

sadly the second dose has done fuck all. So I’m likely to have an ERCP within the next week. I feel so sad and so fed up. I just want it to be over. It’s been a tough day 😞

I’m the same, a hen do is now back On the cards - you just start to readjust to the new road ahead of you but it’s so tough shifting your thoughts/mindset.

gosh I’m sorry to hear that - it’s not a swift process and things like that add to the hurt.

What’s the ercp? Is that like a D&C?

thoughts are with you - we’re not alone x

Yes I think ERPC is like D&C. I’m booked in for tomorrow after spending the whole day waiting around to hear. I know it’s a minor procedure but feel quite anxious about it and generally very sad. It must be bad as I’m off my food which NEVER happens. Husband suggested a takeaway and I couldn’t care less about one.
I really hope the sadness settles down soon 😢

Oh that sounds so tough- I can completely relate to the sadness. Hopefully it’s all that you need and you can begin your journey processing - obviously at your own pace and in the way you feel you need. Each day is a step forward

It will get easier in time. That’s what I try to keep telling myself - just to give me something to work towards. I’m just hoping for the negative PT as for me that’s sort of a signal that the miscarriage is physically over.

I’ve not eaten much either - I would imagine that’s normal to feel no/little appetite. Especially in this heat!

Be thinking of you tomorrow x

I’m really sorry for what you’re going through, it really is so rubbish. Just wanted to say though that the ERPC procedure is nothing to worry about. I went in at 7am, there was a bit of waiting around, but once you’re in the theatre the next thing you know you’re waking up in the recovery room. I was home by 1pm and the cramping after was no worse than a mild period and was easily treatable with pain killers. I then spent the rest of the day laying on the sofa with chocolate and Netflix. Good luck x

Thank you both.
it was much better than I anticipated. I felt upset on my way up and was worried about waiting around, but I was taken down to theatre in just over an hour of arriving! Woke up half an hour later in recovery high as a kite, and then chilled in bed for a few hours. Almost no pain, which I’m stunned about when thinking how horrible the cramps were with the medical management and with my first spontaneous miscarriage. I’m exhausted but feel like maybe now it’s over I will be able to start moving forwards.

Woken up so sad. I think I just thought it might magically go now. I feel like now the physical side is done I’m going to be expected to just be over it. My husband has been amazing but he seemed perplexed by me crying this morning. I don’t think he felt it was our baby in the same way I did. I forget how isolating miscarriage is.

@SRK16 I was exactly the same, just kept bursting into tears at random moments. It will take a bit of time for the hormones to leave your body as well which doesn’t help with emotions. I found doing jigsaws helps (which might make me sound like a saddo but it helps to have something to distract me that I didn’t have to concentrate on, if that makes sense). My husband is a very pragmatic person. I would be wailing saying ‘why did this have to happen’ and he is very ‘it has happened, we just have to accept it and move on’. People deal with things in different ways I suppose. Just do what you need to do to get through it.

I’ve actually been on the PlayStation playing games as it’s a good distraction. My mum is kindly helping with our son today so we should both get some downtime which may help.