erpc after miscarriage for first timers - try not to be too scared, here's what happened at mine.

[andrea10]

I've just come out the other side of a missed miscarriage and erpc. i knew zero a week ago, and i found all the threads so helpful, they made a huge difference and so i'm hoping i can help others with what, in the circumstances, was a positive erpc experience.

i had a viability scan at 10 weeks, and had had normal pregnancy symptoms (medium sickness, sore boobs, v tired etc). my DH and i got a total shock when the sonographer told us there was no heartbeat and the baby had stopped growing at 8.5w (I was 10.1w). we looked at each other and felt we were in another unreal world, couldn't take it in, couldn't believe it. it took at least 24 hours for the information to sink in.

the junior sonographer called in his boss who explained everything gently and clearly, and then the 3 options (wait for nature to kick in, medical mc and surgical mc - google these for more info). I'd had a natural mc 2 years ago at 7 weeks, and had been unlucky that it was beyond painful despite not too much blood, so this time i didn't hesitate to go for the surgical erpc/d&c. i was lucky that my health insurance covered it to do it privately, and waited from friday to tuesday. The worst bit was dreading nature kicking in over the weekend and the pain. It's also very hard carrying around your poor baby who's never to be, and I lived in a wierd limbo world till after the operation. Finding all our happy plans being ripped to shreds was in other ways the hardest part for me. But reading the threads helped me see i wasn't alone and how many other people get through their troubles so bravely gave me strength. The other hard bit was the fear of the operation. I'm normally pretty tough and unsqueamish, but i was still anxious and fearful despite telling myself it's a very simple routine op. Many people here have had to go through it several times, but waiting for the first time is still really scary.

I want to reassure other first-timers that my experience was so much better than i had feared. i realise that all our experiences can be very different, but i wanted to share my relatively good news story. the general anasthetic which most hospitals do for an erpc is brilliant and i'd do it again every time.

here's what happened to me: you arrive, register and give all your details, hang around for a few hours (so take books & mags, something to eat/drink for after the op in case they don't give you enough, comfy warm clothesfor while you wait, glasses if you wear contact lenses as you have to take them out for the op, i didn't know this, wished i had as couldn't see afterwards!). one bad bit is not being allowed food/drink for a long time before as your stomach needs to be empty for the anaethetic so you're not sick.

the nurse then comes to take swabs to check you don't have mrsa (just in your in your mouth/nostrils), temperature, blood pressure, and i had blood taken as we suspected i was rhesus negative which means you have an anti-d injection afterwards, in your hip/bum but it's fine( google miscarriage anti-d rhesus for more info).
then a few more hours waiting - get the nurse to tell you when you think you're going into theatre, best-case and worst-case timing, as i had to wait longer than i'd realised and i should have asked earlier. luckily i was prepared for the tough question i was asked, to sign a form releasing the 'remains'. google this - i found the rcog (royal college of obs and gynae) website very useful. difft hospitals have difft policies, or may not ask you at all. i think if you're in the first trimester, they don't make too big a deal of it. my form asked, was i happy for the hospital to dispose of them sensitively. i don't really know what this is, but was happy not to know and signed. google it to find out about your options as everyone feels differently.

so after all that, they give you gowns and slippers to change into and you leave behind all your clothes. i was given surgical stockings to keep blood moving in your calves, but kept me warm too! the anaesthetist came to say hi and check my details again. i wasn't given vaginal pessaries like some i've read about which soften the cervix. soon after, the nurse comes to get you and i walked down with her to theatre, got on a trolley and the same anaesthetist puts a needle in your hand for a drip, a bit painful but ok. then they drip in 'happy juice' to relax you, a dose of antibiotics to stop any infection later on, and then the anaesthetic. this all takes about 5 mins. they tell you when the anasthetic is going in and you try to count to 10 but barely get to 5. you go under really quickly and is painless, the key thing is to relax, be happy it's over soon and that you're in good hands.

next thing i knew i was in the recovery room, feeling like i'd just had a deep sleep. you have no idea what happened, apart from what you've read on websites. basically they use gentle suction to remove everything. without doubt, what you imagine is much worse than the actual physical experience which i found really ok.

i was back at my bed within the hour. i got wheeled back up to my bed, where the nurse checked i was ok. there was some bleeding on the absorbent mat they put under you but not as bad as i'd feared. i was given pads. the mustard coloured iodine they swab around you to disinfect the area looks dramatic but is nothing. i stayed there for 3 hours until i'd drank, weed, had a few blood pressure and temp checks and the anti d injection. i asked for a prescription for painkillers incase, and was given diclofenac, which is the same as voltarol, an anti-inflammatory and painkiller. DH got it from the pharmacy for me.

just a little light bleeding overnight and the next day, and light period type cramps, but nothing like i'd feared, and the painkillers helped.

so that's it, i'm relieved it's over,and am feeling more positive about the future as each day goes by. i'm 38, so that's a worry, but there are so many good stories out there that you have to hope it will all turn out ok. sorry for the very long post and if tmi, but it would have helped me if i'd read it last week. I wish you the very best whatever you're going through.

Andrea - think this is a very generous post, and hopefully helpful to others in the same boat.
I would like to echo much of what you've said - I had one at the end of August, and found it to be a very straightforward and well managed procedure. Like you I had minimal bleeding, and felt physically fine within 24 hours. Actually as I had been feeling dog tired and nauseous before (I was 13 weeks, baby had died at 11+6) I felt better than I had for weeks. Desperately sad of course, but physically much better.
I usually avoid "procedures" like the plague but in this situation I don't know why anyone would choose any other option.

Am very sorry for your loss, I am 41 and know what you're saying, but you have plenty of time (I had DS at 40)

Thanks for taking the time to write your post and so sorry to hear you've gone through this. I had an erpc last week and what you describe was pretty much word for word exactly the same experience I had!

My mmc was diagnosed on the 7th Sept, should have been 12 wks but the baby only grew to 8 wks. Four days later the mc started naturally at work whilst sitting at my desk

Had an internal scan on the 14th Sept and told it wasn't essential to have an erpc as most had come away. Light bleeding, two scans and four weeks later there was still too much retained product so opted for the erpc to finally get some closure.

Easy to say with hindsight but thinking I should have gone for that in the first place and I'm sure reading your post at the time would have definitely helped in making the decision. I was scared of the op and potential to have it repeated incase it didn't work first time.

I'm having very little bleeding now, feeling ok but still quite sore and feel like my period is about to start (would be happy if it did and for my body would be back to normal again)!

Glad to hear your feeling more positive each day ... wishing you every happiness for the future xxx

Hi, what a lovely way to share what is such a difficult experience. I wanted to add in my experience too as same as you when I was doing some searching when my mmc happened 4 weeks ago I couldn't find much explanations of what happened and I was very scared of ERPC and medical management. I did end up needing both!

I had a mmc discovered at my 10 week scan too, think the baby had developed to around 8-9 weeks. It was such a horrible way to find out at the scan. I was given the same 3 options, however, I was not keen on surgery, so I opted for medical management. I wanted to reassure anyone reading this too that although this option was not pleasant that it was not as horrific as I thought- the midwife described it in quite graffic, horrific terms that did frighten me (esp. the pain), although glad she did tell me (I did end up having later complications but I'm told that it is rare and I was unlucky).

I was given a tablet to take that stopped my hormones and had to go in as a day patient to a ward for the medical management 2 days after my scan and was given pessaries. About an hour later I started to bleed and was told to pass blood into one of those bedpan things and they could keep a check on it. I had envisaged loads and loads of bleeding and pain, however, I didn't really find it sore at all (just like period cramps really)- although I know everyone is different. It is a bit alarming the amount of large clots that come out (I just kept going to the toilet and they would come out) and I think you do have to be prepared for that and I did see the sac come out too, so that aspect is traumatic, but in fact I think I found it psychologically helpful to feel I had delivered the tiny baby and seen it come out my body, if that doesn't sound too weird (I previously needed an emergency section for my DS so in a way I was pleased to somehow "deliver" this tiny baby, if that's not strange). I then went home after about 5 hours of the bleeding starting. I wasn't quite prepared however that the bleeding (and clots still) would still continue at home and I felt faint and was sick (got a bit scared at being at home at this point). But all in all the medical management wasn't horrendous........

...now having said that and again unfortunatley mine was an unlucky case I'm afraid I did end up still needing an ERPC 3 weeks later as I started getting pain and continued bleeding and a scan showed too much tissue still inside. So there is that potential (I think midwife told me 5% of those with medical management need an ERPC later).

I can echo the OP that the ERPC was fine though, almost the same story about the procedure as described above. In retrospect now having gone through both procedures I think I would maybe opt for the ERPC 1st time now, it wasn't as scary as I thought (I was nervous of anaesthetic and surgery) and it was less physically traumatic way to miscarry.

So people have to make own choices. I did end up with further complications after surgery with infection, but I won't go in to them here as it again was unlucky (that seems to be my story right now).

I think the moral of the story is choose what you think fits best with you at the time, don't beat self up for making what feel might have been a "wrong" choice (I did feel I made wrong choice to have medical management as ended up needing surgery anyway, but now feel there is no wrong option). There are pros and cons of each option unfortunately and also things can go a bit wrong with each option too, as I found out.

But do what feels best at the time, and you will get through it, even if you feel you won't. It's amazing how we cope....

Sorry for anyone making those choices right now, thinking of you....