Wanted to share my experience in detail for benefit of others. I have found a lot of useful information that gave me confidence through the process. I hope this helps one of you. You are not alone and miscarriages are common. Although I of course one would never happen to me…
The pregnancy was strange from the start. I found out I was pregnant when I started bleeding - this was meant to be my first period at 11 months postpartum due to breastfeeding. Something told me to do a pregnancy test and came positive. I was bleeding like a normal period, not just spotting. I had it over 3 days and went to A&E. They did some tummy check for ectopic and a blood test. Doctor didn’t suspect ectopic and said my HcG level is too low to be considered pregnant, hence most likely cheming pregnancy. He said to test again in a week and come back if it’s positive. It was so I came back. They did a transvaginal scan and they could see a gestation sac and it had an irregular outline. I was told to come back in 5 days. I did and the lady said she can see a normal sac and that it measures around 6 weeks. The scan report also said there is a beartbeat which the scan lady didn’t mention. The HcG blood test also showed the hormones growing as expected. I was happy and thought things would go well from there. This was all at Royal London Hospital.
I signed myself up for maternity care at St Thomas Hospital though due to their good reputation in maternity and because I delivered there last time by emergency c section due to failed induction. I didn’t hear anything from them for ages and had to chase to be enrolled with them which gave me a bit of anxiety. Finally midwives escalated for me and I got appointment for my 12 week scan and a midwife appointment.
I started bleeding the night before the scan. I didn’t have much pain, not even cramping. I was still hopeful, but found it strange how I was able to be sated with pregnancy. This was not the case when I was pregnant with my son when I could eat and still always have space for more. I was also a bit suspicious that I wasn’t showing more as they say you would be next time around. I did fool myself though that I was feeling some movements… I went to A&E in Royal London, but it was busy and after triage they told me I would wait 5 hours - it was 9pm in the evening and I decided to wait till my scan the next day as my symptoms were not strong and I knew I would most likely have to wait till the morning to get a scan.
I was meant to have two ultrasounds that day, first one at 9am for a urinary issue and the 12 week scan at midday. I went it for the 9am one in Mile End hospital. I was still bleeding. The scan didn’t show a 12 week fetus, on the bright side my kidneys and urinary tract looked ok… The lady said I would need to get a proper pregnancy scan. to confirm. I was sad, but not shocked and called my husband. He was still hopeful, but I wasn’t. Knowing from my 12 week scan with my son I knew you should be able to see a baby by now on a normal ultrasound.
We went to St Thomas for a 12 week scan, they did a normal scan and then transvaginal and confirmed that pregnancy must have stopped soon after it was confirmed, probably at 7 weeks. My husband looked so sad. They said they can see two sacs to and asked me to wait a week for another scan to confirm this is not a second pregnancy, which was a surprise. The next day I bled quite a bit with clots and had strong pain and cramps - not quite contractions - but was taking paracetamol and drinking wine to get through it (in full disclosure). At this point I knew there is no chance. I came back a week later and they confirmed a missed miscarriage and there there was retained product. I was offered a leaflet, but didn’t stay to chat to the nurses. Wanted to read about the options and make a decision myself.
At this point I was bleeding less and was afraid that this will either end up in infection or I will start having full on contractions to expel the rest - heard from other mums this can happen second and third week in. I didn’t want medical management as I had a bad experience with induction when giving birth. I called after a day or so and asked to be booked in for Manual Vacuum Aspiration (MVA) with local anaesthetic. They said they had a slot on Tuesday and to come on Monday for some checklists and more. I came in, they took my blood, a few waivers, asked what I want to do with remains… I was also told I will need to take misoprostol under tongue to soften / open cervix and a rectal painkiller few hours before procedure. I went it and was worried how bad it will be, but everyone was amazing. The team was warm and they listened. I had a great consultant doing my procedure. I asked to be able to do gas and air and I asked to be able to do it before the painkillers are applied and then injected in the cervix. I had experience of this being painful from IUD insertion in the past. Consultant was fine with that, kept me updated throughout and I felt like I was in charge. My husband was also with me in the room for support and another nurse. The procedure was longer than expected because my cervix was a bit too open so the suction did not work well. But I could have stopped it all at any point. It was not bad, got more uncomfortable as the drugs were off. The consultant checked with ultrasound 3 times and by the third she said she would stop now. There was still a bit of product left, but not too much. Hopefully this would pass naturally. She booked me for another ultrasound in 3 weeks to double check. The procedure wasn’t comfortable, but I would have given them all 5 stars, I felt really cared for and in charge of the process.
I came back to the hospital 2 weeks after due to greenish discharge and a bit of itching. I was prescribed antibiotics, altough the symptoms were mild.
The week after I had my scan to check and unfortunately still had remaining product. I got booked for next day for Evacuation of Retained Product of Conception (ERPC) under General Anaesthetic (GA). The procedure is the same like MVA but they can be more thorough and use stronger suction under GA. I was more scared of GA as I never had it done before. They did a bunch of tests - more than before MVA because of GA. I was asked if I had any family history of issues with GA so called my mum and dad do ask. Thankfully neither had any issues and both had it before. I was told to not eat from midnight and to take misoprostol in the morning again. I asked the nurse if it was common to have to have 2 procedures, she said it’s more common than people think. But that also she saw women who naturally miscarried with two days of bleeding and low pain. So I guess it really is a dice roll.
I went in the morning for the procedure. Spoke to nurse, surgeon and anaesthetist. They all had long checklists, but were nice and I felt well taken care of. I was told I would be under only for half an hour or so. I had to wait a bit because there was an emergency operation that came before me. My husband was able to wait with me. Once they were ready I walked with a nurse to the operating theatre. My husband was not able to come with me. In the room there was another nurse and anaesthetist waiting for me. The process was well explained and I was told when I will fall asleep, which I did. I woke up in post operation room on a bed. There was a nurse that asked me how I feel and said whenever I feel ready I am free to go. She gave me my phone back and I was able to text my husband. I stayed in that room for 20-30 minutes then they called a chaperone to come with a wheel chair to get me to a room when I would get change and wait for my husband. In that waiting room I was offered some snacks and tea and was told I will need to be able to pass urine before I am discharged. I was able to, so called my husband and left. The staff was all reassuring, but the process as you can imagine felt more clinical and impersonal with ERPC than it did with MVA. I had a bit of bleeding for few days but nothing major. I felt the worst the day after the surgery, like I was very hangover. Which I believe must have been caused by GA and dehydration. I would advise to drink lots of water - more than you think - post op.
My period came back pretty fast - Think it was 4-5 weeks. It was very light and I barely had any cramping. I have not conceived since yet. I think if this was not happen again the future I would just go for ERPC straight away, so get the process over and done with. But everyone is different. Maybe I was just unlucky.
I think losing pregnancy made me realise I don’t really care about baby gender. Which I thought I did at first. Life teaches you lessons…
I am thankful to NHS and especially St Thomas hospital. They have been great. But be aware being in the acute pregnancy unit waiting area is not nice a nice experience, so good to have a distraction. For me this was the ACOTAR series by Sarah J Mass… :)