Having termination as fetus can't survive... please help

[hopefullypregnant]

Following my nuchal scan and subsequent tests we know that my baby has severe abnormalities and wouldn't survive. I am having a termination (other option - to wait, but could take months before baby dies...) and seeing second consultant tomorrow. First one today recommended chemically induced termination via oral tablets. What will this mean, in practical terms? He said other option was surgery but this was more risky. Can anyone tell me their experiences? I know this isn't a miscarriage as such and so I feel awful posting it here, but I dont know where else to post it... and essentially this was the only decision it was practical to take. I feel devastated and shocked, still. I have a one year old who is still breastfed - just hope I can breastfeed through all of this - would that make a difference?
Thanks for your help...

I really, really don't want to be insensitive to you, but are you taking this decision because you feel it is the best one, or are you taking it because you feel you have no other option?

I have a friend whose baby had anencephaly, and she was under huge pressure to terminate, but chose to continue the pregnancy. Her baby was eventually induced, post-dates, and lived 3 hours, which was precious for my friend.

Having said that, I think that the chemically induced termination is pretty much like a miscarriage at the same stage. Hopefully someone who has been through either of those things will be able to give you some good advice.

I am so sorry that you are having to make a choice at all

From what I've read, the surgery is over more quickly, although it's more invasive (and whatever other risks). The chemicals means that you may be able to exprience most or maybe even all of the termination in private. The chemicals may be incompatible with breastfeeding, you have to ask.

My friend had surgery - she was 16 weeks.

I was also going to say, that i know i would want to see my baby, meet her, touch her...if the pregnancy could go that far?

My friend recovered fairly quickly physically. You will have to ask WRT BF.

Hi hopefully pregnant,

I am so, so sorry to hear your story. I am no expert, but my experience may shed a little light on the breast feeding question.

I had a missed miscarriage at 12 weeks, and had to take the tablet (think it was called Misoprostol?) I was breastfeeding at the time, (I have a 15 month old DD), however, the advice from the manufacturers of the tablet are that you shouldn't breastfeed for 14 days having taken the tablet. Due to this, I had to give up breast feeding. This isn't as bad as it sounds for me, as it turns out DD was more than ready. I am sure that if I had wanted to carry on after the 14 days I could have expressed and still had milk. After DD had gone 14 days though, she didn't miss it at all.

I think if you have the surgical option you should be able to continue breast feeding (unless you are given antibiotics, which I also was afterwards which again I could not feed at the same time as taking.)

It's a difficult decision to make. In my experience I found the medical management option very traumatic and if I had my choice again I think I would honestly opt for surgery.

The best of luck to you. I'm so sorry it's all ended this way for you, and best wishes for the future.

Message withdrawn

Thanks for all your comments and support.

I don't feel pressured into this at all - the consultant emphasized it was my choice and I can wait for nature if I like. But I've made the decision - I never imagined having to make this kind of decision - and I just want this over with. I know that sounds horribly cruel..

V worried about the bf thing now though as couldnt suddenly wean DD. Will ask tomorrow and if there is a 14 day ban, will ask for surgical intervention anyway.
I am sorry to hear about other people's losses; this is such a hard thing to go through, and thank you for taking the time to reply to me.

I'm so sorry

I've had both an ERPC (surgery) and medical management for miscarriages. I had Misoprostal, but by pessary, not orally. In my experience the medical management was preferable.

However, my situation was rather different. I had an ERPC for mc#1, and it led to an infection (always a risk with surgery) and a repeat procedure, which left me with a damaged and scarred uterus, so I was very reluctant to go through surgery again.

In a weird way I also felt that going through the physical loss helped me accept the loss of the pregnancy. It obviously wasn't nice, and was painful, but bearable. I actually found the ERPC more traumatic emotionally as it's so medicalised (going into theatre etc) and impersonal.

When I had the misoprostal for mc#3 I was about 10 weeks pg though - presumably you're a bit further on, so it might be rather more physically traumatic.

I'm not sure about bf for having misoprostal as a pessary - could you check? It might be that it affects bf only if taken orally.

So sorry.

Hopefullypregnant, as far as I'm aware, the 14 day no breast feeding thing was something the drug manufacturers advise as they haven't carried out any proper testing, so I think it's to be on the safe side. I'm not sure if it differs for the pessary, or if you can just have the pessary?

I know exactly how you feel about giving up breast feeding. I was almost as upset at the thought of that being forced upon me as losing the baby.

I only advise against the tablet and medical management as it went wrong for me, and I was left at home believing that it was all okay, when I should have been in hospital. So my advice if you do go down this route is too make sure you are monitored in hospital if you have any doubts at all about what is happening.

Hope this helps.

Hopefullypregnant: I am also sorry to read of your story. What an sad situation...

At first I thought that I would not have anything constructive to add to your thread but as I wandered away from the computer it occurred to me that I breast fed through two medically induced labours for missed-miscarriages.

I was 18 weeks in 2000 and dd1 would have been 19 months at the time and feeding quite often. In 2003, I was 16 weeks with twins meaning that ds2 would have been 27 months. He only fed 2-3 times in 24 hours at that stage though.

I am and to admit that I was in such a state both times that it never even occurred to me to ask about the possible side-effects for my breast fed toddlers.

Generally I don't even consider taking paracetamol or sipping wine whilst pg or bf...

I know that my anecdote is certainly not scientific evidence but both DD1 and DS2 are fit and healthy.

I have also gone the surgical route at the same stage as you because of a missed miscarriage so I could offer advice on that as well though I found it much better to experience the losses in my case.

One more quick thought:

I am confused about the manufacturers advice because I also have several friends who have had labour induced with this very medication and they breastfed their infants...

I fully understand that the manufacturer does not want the medication used for this purpose and I also understand why but it does happen (often in North America) and the mothers go on to breast feed within minutes of delivery.

This might well be a case of not enough research for the manufacturer to feel able to safely recommend continuation of breastfeeding.

(I am very sorry for how convoluted my post are. DD2 is crawling over me and the laptop is about to die.)

I really can't bear the thought of you having to endure weaning your 11 month old on top of everything else that you must endure if it is not really essential.

My thoughts are with you.

It doesn't sound cruel at all. We had exactly the same choice the first time I got pregnant. Have a termination or carry on with the pregnancy knowing that in all probability I would miscarry by 24 weeks. We took the termination.

And I know this isn't quite the same, but after having DS I had a D&C for a partial molar. I was still bfing DS and continued with without any problems. He just had to go without and have boring cow's milk while I was in hospital, which he was apparently very unimpressed with.

If it helps, I think you are making the right choice for you.

Depending on the gestation you will probably be given a tablet called mifepristone and then a tablet given vaginally and /or orally called misoprostal. However, im guessing that by you having a nuchal you are less than 18wks? If so, you will have pains and then bleed. It is safer than having a general anaesthetic and going through surgery, but i suupose emotionally more difficult as you are awake.

Im not 100% sure about misoprostal and bf as its not something ive encountered.

Good luck

I'm so sorry, hopefully.

I had a very late termination for similar reasons. Our experience was the hospital were very happy to make available any expert who might possibly be able to help us. If you have any questions ask your consultant, and even if it isn't their area of expertise they'll find someone who knows. And I would really recommend bereavement counselling at some point.

So sorry for you

I haven't got any advice to offer but regarding the breastfeeding issue, what about the Breastfeeding Network's helpline?

0844 412 4665

The link above takes you to the information page. I can't see anything directly relevant to you on their website section on drugs, but you may well find the people at the helpline can offer some advice.

Hopefullypregnant - what a horrible thing to have to go through, I'm so sorry. I know someone who had the chemical option after her baby died in utero. She decided she'd prefer to have the baby at home, took the pills, went home, laboured for a few hours and delivered the baby.

She then unfortunately went through the same tragedy a year later and went for the surgical option and said it was better in some ways because there was no waiting around to see when it would happen and not knowing whether she'd need to go to hospital for pain relief or help with bleeding etc.

Personally I would ask them to knock me out and just do what had to be done and let me get on with grieving.

I'm so sorry you are going through this. When I had my miscarriages I would hold my DD and cry and nurse her and that helped a bit. And I did go on to have another healthy baby, it can work out.

Hang in there, you have some really hard weeks ahead but you'll get through them.

Thank you all for your comments. I keep feeling guilty, even though I know I'm only preventing something that will happen later. Bereavement counselling is a good idea.

Cadmum, I am thinking I might ring the Breastfeeding Hotline and find out if it is unsafe. Then I might just not say anything to the consultant, if it seems it would be okay. Nobody yesterday mentioned bf and neither did I, in fact it was only because I have a terrible cough and was thinking about not being able to take medicine cos am bf that I thought, can I take these oral tablets and bf? My head is all over the place....

Thanks for other people's experiences of this, too. I am not worried about antibiotics and bf as I took them when she was 2 months and I had root canal.

I am 12 weeks and 5 days today, and surgical option can only be done until 12 weeks 6 days here, so unless they'd do it tomorrow, I guess it's oral or nothing.

I'll let you all know!

sorry you are going through this hp.

HP: I think that ringing the BF Hotline is a good idea. I don't think that anybody knew that I was still BF DS2 but I was thinking about the first time and the midwife actually asked the consultant to use a cervical gel instead of the first tablet and then 8 hours later I took the Misoprostal orally.

With the first experience I was at home with a midwife and with the second I was admitted to the hospital.

I would agree that it would be rather frightening at home on your own.

Again, I am sorry that you are in this position but I am here to answer any question as they occur.

Take care of yourself. You are not being cruel...

Hi everyone.

Have had my first tablet; miscarriage is to be induced fully on Friday - have to be in hospital all that day. I was offered the surgical option on Tuesday but decided I want this over with so there we have it.

I am just going to feed DD as normal as according to all the sources I've found it should be okay after a certain time, and she only feeds twice daily anyway.

Anyone else who has had this who has advice, please share what you did... the hospital have said they will cremate the baby in a service. At the moment I don't feel I could face going - they said we had the choice - and with DH we've discussed buying a sundial to remember this baby by. But might I regret it?

Thanks again.

hp: I am glad that you have some resolution and have 'chosen' the best solution for you and your family.

I wish you strength over the coming days. I will watch for your posts in case you have more questions.

DH and I opted to have a service with the twins that we lost because once they were delivered, I couldn't bear the thought of not having something done. I was four weeks further along than you are but that likely didn't influence my decision very much. I am also grateful to have pictures of three of the four little ones that are not here to be part of our hectic lives but I understand that not everyone would feel this way.

The good thing is that you don't have to make any decisions either way just yet. Just take it one step at a time.

Be kind to yourself and be patient with your DH as he might grieve differently.

I love the idea of a sundial.

Thanks Cadmum. I'm feeling really sick today and both dreading tomorrow and wanting it over with. I am so tired and struggling to eat; my sleep is haunted by nightmares. Did you find out why you miscarried several times?

You're right about taking each day as it comes. I think that might be the only way though it.

I haven't told anyone in RL about this so it does help to have support here.

Thanks again and I will let you know how it goes.

Hi there.
Really thinking of you and I hope tomorrow goes as well as it can do. We had a termination - chemically induced - in March at 18 weeks - like you we had been told our baby wouldn't survive. It is a very difficult time, but you will get through it, and gradually begin to feel better. It is the hardest decision I have ever made (it just felt so against instinct), but for us it was definitely the right one. I believe it made the suffering for all involved less than if we had waited for nature to take its course, which for us was likely to be term - as our consultant put it, I was like the baby's life support machine. For me, once we passed our due date, I felt even more like we had made the right decision.
I feel for you so much...
In terms of what to do afterwards, we met up with the hospital chaplain and went through the options. In the end we decided to have a cremation service which the hospital organised - it was just us and the chaplain. It was difficult, but I also found it helpful - particularly - like Cadmum - having gone through the delivery. But, we are all different, so just give yourself time to make decisions - I expect they will become easier to make once tomorrow is over.... For various reasons, our service was a month after the delivery, aso we were a little less raw, but my DH and I had a v special, slow day together - a long walk, a long chat and a long lunch after the service - it was v special.
I also highly recommend counselling - it has helped me hugely..
Thinking of you....

Hello Hopefully,
I'm so sorry for your loss. I hope today goes as well as it can. My baby died in utero at 20 weeks, and I had to deliver her using the chemically induced method that you are using.
I think the initial shock takes some time to wear off, and then you actually start grieving. You just have to give yourself plenty of time. You don't have to make decisions about whether you attend the service or not yet, or even when the service will be.
I was not keen on the idea, but my DH did want to do it. I think it is a chance for them to cry, because the rest of the time they are being strong and looking after you.
I don't regret having the service, and it was very well done, with just us and the vicar, quite early in the day before the more normal funerals start. Like SAMR71, it actually turned into a nice day that DH and I spent together, when he wasn't dashing off to work. We had our service 6 weeks after we lost the baby I think. I was hoping it would help me put an end date on my grieving (of course it didn't really, but each milestone like that helps I think, once you are past it). It also helps other people, like your family, to understand how serious a loss this is to you.
Sorry - it's a long one. Look after yourself.