Dilation and Evacuation for missed miscarriage

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Dilation and Evacuation for missed miscarriage

Postby 80's Baby » Fri Mar 21, 2014 11:02 am

I didn't find much info on this online, so I thought I'd write down my experience.

I found out at 9w2d that my twins passed away (they only measured 6w5d). My ob/gyn ordered bloodwork that confirmed dropping hcg levels, and wanted me to come in right away for a D&C. My insurance won't cover it, but he wasn't willing to write a Rx for cytotec. So, it appeared that I'd be shelling out about $6500.
I decided to call the perinatologist that saw me through my VBAC a couple years ago. I figured, if he was willing to allow a VBAC, he might be willing to write cytotec and let my body do it's job.
He ran his own ultrasound to confirm the miscarriage, then told me to meet him in his office. He said, "I wish I had good news for you. Unfortunately, I saw two non-viable fetuses, and the gestational sacs are starting to collapse." I told him that I wasn't expecting a miracle, and I've pretty well done my grieving. Then, I explained to him that I don't want a D&C, and wanted to try cytotec instead. He asked why, and I explained about my insurance (or lack of).

He thought for a moment, and left the room. He came back with what appeared to be a reverse turkey baster. He said, "I can try this. Essentially, instead of a D&C, it uses suction to remove the tissue. If I start and it's not going smoothly, I'll stop and we'll try cytotec. If it goes well, it'll be done in 5 minutes." He must have seen the concern on my face. He said, "If I give you cytotec, I can't control the bleeding, and I can't guarantee that it'll work. Plus, I know you. You want to be done with this." I couldn't argue. He was right. I asked if I should get someone to drive me, and his response floored me - "I'm not going to drug you. You're tough. You can handle this." ... 'Tough' as I am, that terrified me.

He walked me into the exam room, and told me the nurse would be in to go over some paperwork, and then we'd get started. I love his nurse. I remembered her from my last pregnancy, and I was happy to see her walk in. She had a cup of water and ibuprofen. She said, "He likes to say nothing hurts. This hurts. I want to prepare you for what's going to happen. He's going to manually dilate you, and clamp your cervix. That's the worst part. Then, you'll feel some pressure, and some bad cramps when he starts the suction. Some women can handle it, but some can't. If you get to the point where it's unbearable, let me know and he'll stop. But, if you can squeeze my hand and bear it, I promise it'll be over very quickly, and you'll save about $6000." I signed the consent form, and read that this was called a D&E.

I stood, and took my ibuprofen while the nurse started prepping the area. This was scary to watch. She laid out absorbent pads on the table. And the step. And the floor. She looked at me and said, "This is not as bad as it looks. It's just a precaution." I nodded and sipped the rest of my water, trying to stop my hands from shaking. When she was done, she handed me a paper blanket and told me to undress from my bottoms. When they both walked in, I was a wreck. He told me to slide to the bottom of the table, and basically "assume the position" in the stirrups.

I started remembering my Lamaze breathing, and went right to it. There were a few moments that distracted my breathing. The clamp, as the nurse told me, was awful. But right away, the doctor said, "This will be a breeze. It'll be fast, I promise." Apart from a few bad pinches/cramps, it wasn't horrible. All said and done, it was over in less than 5 minutes. As I sat up, I expected to see a scene from WWII. Surprisingly, there were just a few drops of blood. The nurse told me, "Expect some bleeding and cramps for a few days. It can go longer, but shouldn't be worse than a regular period."
I was given a Rx for an antibiotic and Norco. Honestly, I didn't have a lot of pain. Maybe I was expecting something so awful that I was pleasantly surprised. I drove myself home (it's a 45 minute drive) with no problem, even stopped for coffee. I filled the prescriptions, even though I told my husband the painkiller would be unnecessary. I had little to no bleeding, and the pain was no worse than a light period cramp.

By 9pm that night, I needed the painkiller. The cramping was BAD. But still no real bleeding. I had a little when wiping, and that was it.
The next morning, I expected to wake up to a full/over-flowing pad. But still, only when I wiped. The cramping was pretty tame, so I took some Tylenol. Later, the pain got worse. Still nothing that required a narcotic, so I took ibuprofen.
Today is 48 hours after the D&E. The cramping has revved up, and real bleeding has started. It's more like a real period now.
*Update* - day 3 after d&e - Last night, the stabbing pain woke me up. Ibuprofen didn't help much. I basically just had to go to sleep to make it stop.
Today, the pain is continuing, and I'm passing large clots (about the size of a bic lighter). I broke down and took the Norco.

I know this was long, but I'm hoping it will help some women know what to expect. From what I had read, D&E is usually reserved for 2nd trimester loss. I was nowhere close to that. It went very well for me, and I feel better knowing that I can move on.
Last edited by 80's Baby on Sat Mar 22, 2014 12:31 pm, edited 1 time in total.
Me- 29
DH- 28
DD- 11/2007
DD- 02/2012

TTC since March 2013 - Dr. found 2nd degree uterine prolapse
July, 2013 - :angel:

BFP - January, 29 @ 9 DPO
Twins :angel: :angel: - missed miscarriage - D&E@ 10 weeks

August 19 - bfp @ 9 DPO! TWINS!
October 1st - Baby A - :angel: Baby B - Heartrate 162
November 24th - It's a girl!

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Re: Dilation and Evacuation for missed miscarriage

Postby care327 » Fri Mar 21, 2014 12:18 pm

80s im so so sorry for losses <3 thank u for explaining ur experience so that it may help others. thinkin of u xoxo
Me: Carrie 34
DH-35
DSS-16
DSS-14
DSD-12
DD in Heaven Faith Marie
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Fur Baby- Snoop Dogg 5
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Fur Baby Bizzy Bone 10 months

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TTC #1 Since May 2012
BFP feb 17, 2013
M/C march 11, 2013 @ 6w3d
Officially diagnosed with PCOS October 2013
January 2014- New SA shows very few sperm (7) =(
April 2014- Dr. Confirms we need re-do of reversal or IVF
October 14 2014- Surgery semi-successful. Tons of healthy sperm alive n swimming!
December 2014- SURGERY SUCCESS!!!!! 89 million spermies =)
Jan 5, 2015- BFP
Jan 13, 2015- MC
March 20, 2015 BFP!
Faith Marie born into our hearts 6/24/15 at 16 weeks.( triploidy) RIP babygirl

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Re: Dilation and Evacuation for missed miscarriage

Postby Sunshinetex » Fri Mar 21, 2014 2:00 pm

80s. So sorry you had to go through this. Thank you so much for sharing your experience.
Me - 41
BF - 39
TTC #1 - Sept 2012

Hsg October 2014 - blocked tube. Straight to ivf
Ivf #1 - feb 2015 - bfn
Ivf #2 -may 2015 -
5/7 - 10 eggs retrieved, 9 fertilized
5/12 - et. 5 day transfer - 1 blastocyst and 2 morulas - bfn
7/2 - surgery to remove/repair tubes - tubes cauterized
Ivf #3 - sept 2015
9/10 - 13 eggs retrieved, 10 fertilized
9/15 - et 5 day transfer 3 blastocysts....
9/24 beta 152 9dp5dt
9/28 2nd beta 248 13 dp5dt
9/30 beta #3 468 15dp5dt
10/3 beta #4 1672 18dp5dt
10/9 u/s 1 baby
10/19 u/s 1 baby with heartbeat of 140. Due June 3, 2016.
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Re: Dilation and Evacuation for missed miscarriage

Postby BichonFrise » Fri Mar 21, 2014 7:26 pm

80's thank you for sharing your experience. I am glad this is all behind you now and you can start the healing process. Best wishes for your next TTC cycle. I hope you will get your rainbow baby soon :hugs:
Me (39) DH (41)

TTC #1 since June 2013. Married for 10 years.

BFP #1: 10/01/2013 MC: 10/15/2013 (7 weeks)
BFP #2: 12/24/2013 MC: 01/01/2014 (5 weeks 1 day)
BFP #3: 02/08/2014 Ethan was born 6 lbs 9 Oz on Oct 17th, 2014.

TTC #2 since November 2015

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Re: Dilation and Evacuation for missed miscarriage

Postby B Michaelson » Wed Mar 26, 2014 6:11 am

Thanks for sharing 80's. knowing someones most private and heart wrenching moments makes us feel closer to each other.

I imagined you going through the process and started to tear up as I recalled my own. It's always scary when you have to go through a medical procedure in addition to a loss.

My heart goes out to all of you ladies. Having these boards for support over the last year and a half has been invaluable.
Me - 36
Hashimotos, JHS/EDS, ANA negative, 1 Fallopian tube
DH - 41
TTC #1 Aug 2012 - May 2014
DS - Born Jan 2015
TTC #2 since Aug 2016
May 2017 :bfp:

:angel: Our Angels :angel:
2004 - 7.5 weeks
Oct 2013 - 6w6d ruptured ectopic
Jan 2014 - Chemical

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