Natural management vs other options

[alex42]

Hi everyone,

I'd really appreciate some advice. I had a scan at 7 weeks which found that my baby stopped developing at 6 weeks, no heartbeat. This was reconfirmed with another scan at 8 weeks showing no further development.

It's now nearly 3 weeks since the pregnancy ended and I have no signs of natural miscarriage yet. The hospital gave me the three options - natural/expectant management, medical management and surgical. I originally was thinking I should give the natural option a go, but I basically have no signs or symptoms of anything starting - only faint cramps very occasionally and the lightest bit of spotting. As times goes on, I'm increasingly scared of the idea of miscarrying at home - my husband doesn't drive so I'd be trying to get a taxi or ambulance to A&E if anything went wrong.

I've also read online that natural management may not be 'effective' in 100% of cases. I don't really know what that means but I guess it means you miscarry but then some of the tissue remains and you end up going for medical management or surgery anyway?

Anyway - I'd basically love some advice from those of you who have been through this awful process before. What option did you choose, and how did it go for you?

[Headlightshome]

Sorry for your loss OP. I had a missed miscarriage at 10 weeks, awhile ago. I opted for medical management as I felt more in control. In reality this looked like taking pills under medical supervision then an overnight stay in hospital a day later, although I’m not sure if this is standard practice or not. I really appreciated being at home at the beginning, as it was fairly painful but found being in my own space comforting. I actually think I passed the embryo at home rather than at hospital, so being there felt ott.
Doing what feels right for you is important, if you’d feel more relaxed at hospital then could you ask for medical under supervision at hospital, share your concerns?

[CuttingMeOpenthenHealingMeFine]

Hi OP I am sorry you are going through this it’s utterly shit. I opted for an MVA last year as I just wanted a quick end to all of it. It was fine, as ‘fine’ as these things can be anyway. Wishing you the best, it’s such a hard thing to go through however you do it.

[Brookes19]

Hello, so sorry for your loss and that you are going through this 🩷 I found at recently at a scan at 10.5 weeks. I chose medical management and took the tablets at home, which worked and I passed everything that night. It wasn't a nice experience but not too painful and I found it comforting being at home with my husband x

[UrsulaSings123]

I'm kind of the opposite in that I have chosen surgical but they can't do it until next Wed and I find myself miscarrying naturally at home. I feel scared as to how painful it will be. So far it's just been blood with no clots or anything and fairly bad cramps that meant I couldn't drive or walk easily. This has been going on since Tuesday now. Personally I'd prefer to get it all done in one go rather than in the position I am now where I can't do my usual activities and have no idea how long it will go on for.

[alex42]

Thanks @Headlightshome @CuttingMeOpenthenHealingMeFine @Brookes19 @UrsulaSings123 - it really is a completely crap situation isn't it, with no appealing options on what to do. Thanks a lot for sharing your stories, and so sorry you've all been through this too. I phoned the EPAU back today and have booked an MVA for next Friday... but still not sure I'll definitely go through with it. The midwife I spoke to, and any of the midwives I've met so far, seemed to be encouraging me to try the natural/expectant option for as long as I can. I'm pretty terrified of having a horrible and painful miscarriage at home but I guess I'll give it at least another week (well, going to have to as next Friday is the earliest MVA), then make a decision.
Thanks again and hope your journeys to pregnancy, if that's still what you're pursuing, go beautifully from here

[zebrapig]

So sorry you're going through this. You just have to do what you feel is right for you. My first MMC I chose the surgical route as baby had died around 2/3 weeks earlier and no sign of it happening naturally. My second MC happened naturally and I found it slightly traumatic and would have had surgical again if it had been an option. I'm very much an over and done and move on kind of person though.

[Lemonvalley]

I’m sorry for what you’re going through.
I found out my baby had died at 12 weeks and was provided medication to bring on the miscarriage process on a Friday. I decided to wait a couple of days because I was unsure of what would happen and didn’t want to risk going to A&E on a weekend. But I got woken up Sunday morning by my own body having entered a type of labour. I’ve had an unmedicated birth before so I know what labour pain feels like and this was about the equivalent of how I felt at around 4cm. I hadn’t taken any of the drugs but my body had decided to clean house and it was a very aggressive process. Very heavy bleeding (much much more than the “heavy period” type bleeding I had been advised about), and eventually I passed the baby, sac, and placenta all in one after about a day. So I’m my case the miscarriage process was considered complete and I didn’t need intervention.
some people feel better about having their miscarriage managed by a medical team and they feel less out of control or ‘safer’. Whereas for me, I have ptsd about hospitals so avoid them unless I think I might die. There are risks with both medical and expectant management. Only you can make the decision as to which path you would feel most comfortable taking. It’s hard. Hang in there and best wishes

[alex42]

Thanks so much @zebrapig and @Lemonvalley for sharing your experiences here too. I'm so sorry you've been through this utterly crap situation too. It's really helpful to hear what approaches you took (or that happened naturally!) and what your experiences were. I hope everything turned out well for you if you continued TTC (or best of luck if you are still on that journey right now).

I am swaying back and forth on whether to go for the surgical MVA option or to keep hanging on. It's now 3 weeks since the baby died and I am finding it harder and harder to cope with as time goes by. I am terrified of having scarring or any sort of injury that threatens future pregnancies from the MVA but I know the risk is small... and I'm also keen to get back to normal and be able to TTC asap, as I feel like I'm running out of time (I'm about to turn 33 which I know is still quite young but I've got PCOS and it took us well over a year to manage to conceive this first time).
Urghhh I just wish I would wake up one morning with a clear decision in mind, rather than constantly swinging back and forth between these rubbish options and being unable to decide.

Anyway, thanks so much to all ladies on this thread for telling me about your experiences. Between this thread and the others in the miscarriage forum which I have been reading nonstop since finding out about this mmc, mumsnet has been a total lifeline at such a crap time. I have some really understanding family members and friends but no one really gets it apart from the ladies on here who have been through this exact situation. So to you all!

[ThelastRolo20]

@alex42 I'm recovering from my 2nd MMC in 4 months (what luck!) with the first it happened naturally the day after my 12 week scan - baby at stopped at 10 weeks. With the second I was 10 weeks but baby never really got going and I had an MVA.

Just wanted to say that both of my experiences were absolutely fine (physically), my natural miscarriage wasn't painful - I think it can be more so with tablets, and the MVA went really smoothly and in both instances my period returned exactly 4 weeks later. I'm taking a very reluctant break until April as we have a holiday booked but just wanted to give you hope that either option will most likely be fine. And if it isn't fine and you need further treatment, that can happen with either road too. I would focus on what will help you mentally - if you're struggling with the wait maybe book in surgery as an "end point" and be happy that you'd have given expectant management a really good go until then.

Always here to chat (ps. We share a first name if your name is Alex 😉)

[alex42]

Thanks so much @ThelastRolo20, that's really reassuring to hear. I'm so sorry you've been through this twice, never mind in such a short space of time. You're due some very good luck soon I reckon!! Hope your upcoming holiday is brilliant - although it's frustrating to have to take a break from TTC, it might hopefully be nice to just enjoy your normal life again for a little bit, it can be so all consuming.

Yes I think that strategy might work for me... maybe seeing Friday's MVA as the end date. That'll be just short of 4 weeks since the pregnancy ended. I feel like that SHOULD be more than enough time for my body to realise what's going on and get on with things - but no signs of that. And I read somewhere on another forum that often a natural miscarriage won't happen until the 12 week point (not sure how much truth in that) which would be another 3 weeks from now - not sure I can hang on that long. Having said all that, I was booked for medical management this past weekend with the same thought process (that that would be my end date on waiting) but ended up cancelling it!

[ThelastRolo20]

@alex42 I've heard about the 12 week point too, I think it's because that's when the placenta is meant to have taken over - until then your ovaries produce all necessary hormones. When the placenta doesn't take over your body then catches up.

I take a small positive in that hopefully it means our bodies are very capable of holding a pregnancy, just needs to be the right one! But I'll tell myself anything at this point... I'm very fortunate to already have my 2 year old daughter (who was a straight forward pregnancy) so I think this is just bad luck

[alex42]

@ThelastRolo20 exactly, let's take the wins/good news where we can find them, I agree it's quite encouraging in a way! Hoping for better luck next time for all of us

[zebrapig]

@alex42 Hope it goes ok whatever you decide. I booked my MVA (not sure what it stands for as it used to be called something else) and had to wait 5 days for it. As I was admitted for the surgery I started bleeding, it was painful and I was terrified as I didn't want to see/experience it. Luckily the surgery went fine and I was discharged home about 7pm that evening. Randomly found our neighbours cat hiding under the spare bed about 10.30pm, was such a surreal experience as I was still woozy from the anaesthetic and painkillers! They gave me codine for the pain but no/one warned me about the side effects and that was more traumatic than the surgery.

We successfully had DD after this (she's 9 this weekend!). After DD we had the second MC when she was 18 months. This MC was earlier than the first, I started bleeding and knew what was happening. Oddly I wasn't as worried as the first time and within a couple of days the sac passed naturally. I didn't really know what to do with it so after a quick look I flushed it away, then had to go straight to collect DD from nursery. Think the most I needed was paracetamol.

After the second MC we were lucky enough to have DS (now 6), although we had said that if that didn't end how we hoped then it would have been the end of our journey.

If you feel able please do be open about your experience with others, I've been very surprised by the number of people who will say they've been through similar when I've spoken about it and have been glad to have someone to share experiences with. Good luck with your journey after this, hopefully next time will be your rainbow baby.

[UrsulaSings123]

@zebrapig

@alex42 Hope it goes ok whatever you decide. I booked my MVA (not sure what it stands for as it used to be called something else) and had to wait 5 days for it. As I was admitted for the surgery I started bleeding, it was painful and I was terrified as I didn't want to see/experience it. Luckily the surgery went fine and I was discharged home about 7pm that evening. Randomly found our neighbours cat hiding under the spare bed about 10.30pm, was such a surreal experience as I was still woozy from the anaesthetic and painkillers! They gave me codine for the pain but no/one warned me about the side effects and that was more traumatic than the surgery.

We successfully had DD after this (she's 9 this weekend!). After DD we had the second MC when she was 18 months. This MC was earlier than the first, I started bleeding and knew what was happening. Oddly I wasn't as worried as the first time and within a couple of days the sac passed naturally. I didn't really know what to do with it so after a quick look I flushed it away, then had to go straight to collect DD from nursery. Think the most I needed was paracetamol.

After the second MC we were lucky enough to have DS (now 6), although we had said that if that didn't end how we hoped then it would have been the end of our journey.

If you feel able please do be open about your experience with others, I've been very surprised by the number of people who will say they've been through similar when I've spoken about it and have been glad to have someone to share experiences with. Good luck with your journey after this, hopefully next time will be your rainbow baby.

When you say you were more traumatised by the side effects than the surgery itself can I ask what you mean? I am booked in for surgery tomorrow.

[alex42]

@zebrapig thanks very much for sharing the details of your experiences, i can't tell you how helpful it is to be able to read these and get a sense of how the different options can go for people. I'm really sorry you have had to go through miscarriage twice but I am so so happy to hear you have your two lovely children, it gives me so much hope for the future. I rebooked my MVA for Friday 15th and have decided I am definitely going through with that if nature doesn't take its course before then. However just this evening I've started to get some (very very light but still) bleeding and a sort of dragging sensation in my abdomen which I think may be a sign that things are about to start happening soon. I just hope it is too painful or too scary to manage at home - my biggest fear is needing to go to A&E and having a nightmare finding a taxi to take me (taxi coverage is rubbish where I live, and DH doesn't drive - have been telling him he MUST get himself into driving lessons for the future hopefully much more successful pregnancies...!)

[alex42]

*ISN'T too painful or too scary

...just in case I totally jinx myself by failing to correct that typo...

[zebrapig]

I'm glad it's helped you both. It's not always easy to talk about but if it has helped to make it even a little easier for you then I'm pleased I shared my story.

@UrsulaSings123 Codeine makes me really constipated. The day after my op I spent an hour on the loo in tears unable to go, and ended up using my finger to help. That was almost worse than the op as I was so sorry and uncomfortable and embarrassed. I won't take codeine now; if I'd have known I could have had lactose to help but no-one thought to mention the side effects of the painkillers as they were too busy telling me about what to expect with the op & afterwards.
Hope tomorrow goes as well as it can for you.

[southerncrossconservative]

Sorry you are going through this

I had a D&C last week, after feeling similar terror at the idea of miscarrying at home (either natural or medically induced)

I had also had a traumatic termination in 2009 that resulted in cervix damage & psychological issues so I was also dreading the D&C

In the end the D&C went smoothly & I woke up with no pain

I feel my hospital / doctor was pushing me towards medical management so as to avoid paying for surgery but I am glad that I pushed for this option personally

All the best

[Lemonvalley]

@alex42 you are welcome, I just wish I was sharing advice or shared experience of something nicer than miscarriage. But like you, I found mumsnet a lifeline when I had mine, because the medical professionals either didn’t know or weren’t being honest about what I would experience and it was only by other women’s honest and frank posts on here with all the “gory” details that actually helped me know what the heck was going on. Eg, when I found out by scan that my baby had died, I asked the hospital if I would see a baby in the miscarriage and I was told no. But, I did. I wasn’t expecting it, but I can say that I felt better for seeing her. I can’t explain it other than it made her as real as I knew that she was. I don’t mean to waffle on here I am just sharing some of the details of what can happen with expectant management if you go through it at home. I actually felt safer in my own home than I do at a hospital. Try not to be scared if you end up going the natural route. It sounds like your body might be starting to get things happening now. Some important things- any more than filling one-2 maxi pads in an hour or clots bigger than golf balls you need to go to the hospital. I actually was in an out a couple of times because this happened to me and the doctor I last saw told me based on the size of the clots I must’ve passed the baby. She said I could be discharged and I passed the baby the next morning. There was a lot of pain when the baby sheared away from the uterus wall five minutes before I passed her. It’s different for everyone and I know it feels scary but try to trust your body and also your instinct- if you’d feel safer at the hospital, go. If you stay home but the bleeding gets too heavy then go, but know that your body is probably doing what it needs to do. If there is ever any bad smell that also means you need to go to the emergency because it can indicate sepsis risk. This is unlikely but best to know. Oh and no, I haven’t been able to fall pregnant since I lost this baby 8 months ago and it’s probably too late for me. I mourn the daughter I lost and the sibling she would’ve been to my first daughter but I am also grateful to have my one precious child. It’s such a shit thing to go through as a woman and I empathise with every single one of you ladies on here who has been through it. Best of luck OP, please let us know how you get on.

[alex42]

@zebrapig @southerncrossconservative @Lemonvalley - thanks all for your posts. It's really been a lifeline reading other women's experiences on here.

Just in case anyone else comes across this thread looking for advice/experiences at this incredibly crap time in life, I thought I should update with how things have gone for me.

In the end, nature did take its course (well, to be confirmed via a scan this coming Wednesday to check everything has passed). I had finally resolved to just give the natural management ONE more week and had rebooked my MVA appointment for Friday 15 March. The midwife told me that was a little longer than they would prefer given possible risk of infection rising over time, but she was okay to do it.

From about a week and a half ago, I'd started to have very light spotting each day - usually only for an hour or two each day. Then last week this increased to fairly steady spotting, light brown in colour, all day every day. I also started to get mild period cramps, but these would come and go.

Then Thursday evening last week, the cramps really started to kick up a notch. I'd been working from home and was just finishing up work around 5.30pm and the cramps started coming on me. Later that night I had more painful period cramps but managed to get to sleep with some paracetamol. Woke up at 2am with much more intense pain which I would definitely describe as contractions - waves of pain that had shorter and shorter gaps in between them. I couldn't stay in bed any longer and just had to walk around my flat, going to the toilet every so often, between 2-5am or so. I passed lots of small clots during this time but not much blood, which I thought was odd.

From 5am, things eased up and I went back to bed. I had some leave from work booked on Friday (was originally supposed to be going to a friend's hen do!) so could just stay in bed all day which was a godsend. I was tired and having moderate/strong period cramps all day - really hard to get comfortable but certainly bearable with just paracetamol. Again, not much bleeding - I was just continuing to pass small clots when I went to the toilet but nothing really in between; I barely had to change my pad all day. I called the EPAU and spoke to a midwife who told me bleeding can be really variable and that it was possible, given my pregnancy loss had happened almost 4 weeks previously, that my body had actually started to break things down and so most of the tissue might come away as clots rather than as liquid blood. I found that quite a comforting thought. I think I would have found heavy bleeding much scarier than the pain itself.

Then suddenly that evening at about 7.30pm I started to get the most severe pain I had experienced in my life - strong contractions - nothing like I've ever experienced before. I was crawling around on the floor at one point and couldn't stand up straight, I was doubled over any time I tried to stand. My husband had to help me to and from the bathroom. I took a couple of co-codamol and don't know how much they helped but I guess it would have been worse without.

This level of pain went on for just short of an hour, I was barely passing anything - just droplets of blood and small clots - and then suddenly I passed a large mass. I hope this isn't TMI but I think it helps to know what to expect - it was partly red and partly skin coloured, about the length of my palm but oval-shaped. The pain stopped instantly.

Since Friday, I've been more or less pain-free. Oddly enough, I have no symptoms during the day but each evening around 5pm or so I get period like cramps again - it's as though my body deals with this situation in the evening only, as my cramps and the miscarriage itself took place over two evenings. I've now got fairly steady blood flow like a heavy period - I actually soaked through my pad yesterday evening when I went out for a walk which I wasn't expecting, so the blood is definitely heavier than it would be with a normal period.

I feel like it is 'over', hopefully. The EPAU will see me on Wednesday this week to scan me and check that it's been a complete miscarriage so fingers crossed. My MVA is still booked for Friday as a back up as the EPAU don't want to cancel that until they're sure I don't have any remaining tissue.

Hope this helps someone - and thanks to everyone on this thread who offered their experience and advice, I so appreciated it when I was struggling, and reading mumsnet has helped me prepare mentally for what to expect.
For context - my pregnancy loss was diagnosed at a private 7 week scan, the baby stopped growing at 6 weeks. It took until 10 weeks for me to miscarry and during that time the EPAU said they thought my gestational sac and other tissue was continuing to grow a little, despite the baby having stopped developing.

Hope anyone reading this who is going through this awful experience gets through it okay, and that we all get our rainbow babies that we're hoping for.

[californiacooper]

@alex42 I'm so glad to read that you are through the mc now and out the other side, you did so well managing it yourself naturally.
-
My story is similar, if it helps anyone but I opted for surgical management as soon as they had available. I had MMC diagnosed at 8 week scan, baby died at 6 weeks. I had surgical management under GA at around 10 weeks. My symptoms of pg had slowed/stopped by then, I had no bleeding or cramping. The surgery was straightforward and everyone was lovely and kind because I was on my own and kept blubbing occasionally. I had some pain like a moderate period after for a few days. I'm now only using one liner a day and have a tiny bit of spotting only, I expect it will stop by tomorrow. For me, surgery was the best option and I would definitely opt for it again if I am in this unfortunate position. I feel like it's over and done with now and I can move on. I went in at 12.30, was take for surgery at 3.30, back in the ward by 4.30, and picked up at 6-6.30ish (was a bit woozy)

I hope this helps anyone in a similar situation ❤️‍🩹

[Lemonvalley]

@alex42 thank you for updating us on how you are. I’m so glad to hear you’ve come out the other side. Of course though, we know what this loss and experience is like, so although it’s a relief, it’s nothing to celebrate- I’m very sorry for you loss. I’m glad our posts helped a little to try and prepare for what was coming.
As women we can feel such a sense of solidarity with one another over this life experience, and like you, I’ve been grateful for other mums sharing their honest and frank accounts of their miscarriage process on here. Your post will help other mums in their own scary and confusing time that miscarriage is. Hang in there @alex42 all all the other ladies on here. I hope you all get your rainbows xx

[alex42]

Thank you so much @Lemonvalley

[Headlightshome]

So glad you’ve come out the other side OP. Now is the time for healing, look after yourself 💐

[Doralice]

Hi everyone, thank you so much for sharing your stories!

I had a very similar experience – They saw the baby stopped growing in my week 8 scan. I was diagnosed MMC at week 9, I went in for a surgical procedure three days ago at week 10. I made this decision after reading this thread, it was the best decision!

It was very quick, painful at the moment but it was literally like 2 minutes. Only ended up spending half day in the hospital. I'm still feeling a bit cramping now, but it's not as bad as I thought. Just wanted to thank you all for sharing, wish you all have your rainbows soon!