MMC - Surgical management question

[wellwellwow]

Hi all, could anyone give any guidance on surgical management under general vs being awake? I’m tentatively booked in for the procedure in just over a week’s time (need to wait for another scan first) and the nurse said on the phone today that being awake “is obviously much more painful” but I’ve been reading up on it this evening and it would be under local (is that right?) and most of what I’ve read describes it as uncomfortable rather than painful.

I have miscarried once before but it happened at home so I have no experience of hospital procedure and just wondered why people chose being awake over general, and if anyone could offer any thoughts having been through it. Appreciate everyone’s experiences will be different. Very grateful in advance

I had an MMC last year. I was able to wait it out. I was told that if I did go for surgical management that I'd need a GA purely because I've never given birth before and my cervix has never been stretched open, which is what happens during surgical management. I know it's not massively helpful, but I thought I'd give my thoughts. I'm really sorry this has happened to you 💐

I had some retained products so had the surgical management. I didn't have GA despite not having given birth before and while it was painful, with gas and air it was manageable and it meant I got to go home quicker which is ultimately what I wanted.

I had an MVA under local last months (was 7 weeks with twins). Wasn’t painful, just uncomfortable, and was over v. quickly (the procedure itself took about 10 mins, needed to take meds about 45 mins before and then needed to stay 15 mins after). I chose to be awake over GA as didn’t want to be put under, didn’t want to spend the whole day at hospital etc. I’m sorry you are going through this x

Sorry you are in this position @wellwellwow I had surgery 2 months ago under general. Was apprehensive about it but was totally fine. Had never been put to sleep before. Woke up with period type pain that they gave me codeine for and then went home a few hours later. Once I had been for a wee & they could see I was feeling alright I was discharged

Thank you all for responding, I really appreciate it

@wellwellwow I had Mmc and surgical management d&c nearly 3 weeks ago I was under GA I didn't get offered local? But I'd have gone for anaesthetic anyway. I was done by 11am and out by 2.30pm totally fine had coffee/toast biscuits before discharged and spent rest of day on couch at home.

After I got home after a few hours I did have stomach pains twinges so just took paracetamol/ibuprofen. And used a hot water bottle for pain after a week I felt so much better. Just needed rest.

Hello,
I had an MVA under local anaesthetic. I was “encouraged” to choose that over general as I was told Id spend less time in hospital and there was likely to be more waiting around for the theatre for general (as emergency operations would take priority).
I found it very painful but I understand many people don’t.

Sorry about your MC.
I had an MVA, just with local. My hospital don’t offer it under general unless quite special circumstances. I was able to manage without accepting the gas and air, just felt abit crampy like a really bad period. I’m sure you’ll get mixed reviews on the pain levels from others but I found it ok. Was fortunate to not have much pain after either. Maybe a day or two of feeling like I’d had a hard work out.

I was 9 weeks with first pregnancy (so never given birth before either).
Good luck whichever way you choose!

I had surgical management under ga in march, I didn't want to have to be aware of the procedure, or have any pain. I went in for lunchtime and was out by 6.

I'm 95% sure im experiencing another miscarriage now. I have a scan tomorrow, I'll choose surgery with general again definitely, unless it all happens too soon

Hi @wellwellwow
I hope you are ok. I feel the pain and am thinking of you. It just sucks.
I found out last week that I miscarried at 8weeks + 6 d and have also had to wait a week which I find agonising. I had a check on Friday and we opted for surgical but they couldn't get me in until this Saturday as was next available time. They advised I might go through the natural process in the meantime and sure enough, as soon as I got home on Friday, I think that has happened which was just as crap.
They booked me in for surgical on Saturday as it was the next available time, and they've told me it's a general and for me personally, I am so relieved as I have PTSD from trauma as a child in hospital, and I could not imagine going through this awake/aware of what's going on. I will have another check on Friday to see if there is anything still present, and I have a sinking feeling I'll still need to go through the surgical route to be on safe side, so as long as this is still under GA then I'll be ok.
I don't know if this all differs under which NHS trust we are receiving care, but all the information I have read has said it's normally done under GA but can be done under LA. But if I get to hospital on Friday for the pre-op and they push for LA, I will push back. I'm stressing about that at the moment, but hopefully I won't have any nasty surprises on this and it will still be done under GA. I'm really surprised to read that other ladies here who were encouraged to have it under LA, or only offered under special circumstances, as if this doesn't account for special circumstances enough as it is. I believe that we should be able to advocate for what is best for us, I am so mad at how we get treated. We are all different, but this is a truly painful experience as it is, so to be encouraged to have it under LA when all the literature I've read says GA primarily, it makes me nervous.
I hope you are ok, thinking of you and sending love, and to everyone on here who is going through this sh*tty experience. xx

I’m really hoping the scan showed positive news. So sorry you’re going through a worrying time

@kaia1982 thanks, I’m sorry you are going through this too. I’m booked in for the surgical this Friday and have opted for GA. I spoke to a friend who went through similar under local and she didn’t advise it. I know it will be different for everyone but I don’t want to risk adding any more trauma or awful memories. My hospital seems to have completely different booking slots for local and general procedures so I’d be surprised if they change your appointment on the day but absolutely stand your ground. Completely agree with you about choice. Will be thinking of you this weekend, I hope it goes smoothly for us both x

So sorry you are going through this. I had surgical management of mmc a few years ago. Similar options given. But the advice was to think about what felt manageable including emotionally. Personally I didn't want to be awake and aware of what was happening and had the ga.
Is it possible that the person you spoke to meant that it could be more emotionally painful?

Just saw your update - sounds like you are making the best choice for you. It's sad enough already without adding more traumatic memories.
Take care of yourself

I had mine under general. Local wasn’t an option given. I think it’s probably because it’s upsetting rather than particularly painful, I could be wrong.
It was all very quick and I had minimal bleeding and no pain afterwards ( I was 12 weeks baby 11 weeks). I got pregnant with dd2 next cycle. Hope it goes ok for you

Hi @timesogin and @Upinthenightagain Yes, maybe the nurse was talking more about the emotional side of things, I hadn’t thought of that. Thank you both for your helpful messages. Isn't it sad how many of us have been through it.

oh @CxCxTtc2024 - bless you, I am so sorry, I didn't see your post earlier, I am so sorry! I hope you are ok, please know I am thinking of you and sending love xx

@wellwellwow - and to you my lovely, my heart breaks for us all. 100% agree with you, I don't want to be aware either, I also spoke with a friend this afternoon who said the same thing, Fingers crossed for you, I hope it goes ok and I'll be thinking of you xx