D&C · grief and loss · missed miscarriage · pregnancy loss

On D&C

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I elected to have a D&C for my missed miscarriage. My rationale for this decision was mainly that I didn’t want to wait it out and deal with the emotional toll of being pregnant with a baby that had died (and potentially the surprise of things starting at an inconvenient time in my workday) and then having to go through the trauma and pain of watching my baby be born; and I was concerned that taking medications to induce at home would include all the above elements (except the surprise) and that I could risk it being incomplete and having to have a D&C eventually anyway.

I went in under the assumption that I would be sedated…which would essentially eliminate most of the pain and the trauma. In light of this assumption, I didn’t eat anything all day (which will play into the story later).

Our particular health care network does not typically do D&C’s under sedation. I did not know this. I suppose I could have changed my mind yesterday when I found it out during the initial evaluation, but we were already there, we’d already taken time off work, and I guess I figured maybe it wouldn’t be that bad.

———-

I cried a lot on Thursday. It suddenly got very final; obviously now I’ve known for a week that the baby is gone and the pregnancy will not continue. But reading up on ways to prepare for the surgery made it real and I began to grieve anew the loss of the baby that we had wanted so badly.

I cried a little more on Friday morning for the same reasons; just not wanting to go through with this but also knowing it was the best option since what I really didn’t want to go through had already happened.

We made it to the first appointment, the ‘pre-op’ appointment. Blood pressure check, then a repeat ultrasound to confirm the status of the baby. No change. No hidden twin that decided to show up healthy on another side of the uterus (the tiniest sliver of hope). Doctor reviewed our options again, then explained the procedure. She starting talking about having to take some norco an hour beforehand for the pain; then explained that she’d numb me ‘down there’ and give me an additional shot just before. I then realized that it wasn’t being done under sedation. I confirmed this with the nurse as well. But again, we were already there so we proceeded.

We were sent down to the pharmacy to collect cytotec (to take immediately), norco, and doxycycline (both to be taken about an hour before). I started sobbing again as I held the cytotec in my hand; just not wanting to actually have to start the process of making my body deliver this precious baby.

We waited around outside for a couple hours; I started to get pretty uncomfortable once the cytotec kicked in and I felt a gush of fluid the first time we got up to change seats.

We returned to the office; I was taken back again for a repeat blood pressure and the shot of toradol. I asked if my husband could come in with me (as I wasn’t going to be sedated I really wanted to have him there) and the nurse said we’d have to ask the doctor. While waiting for them to prep the room, the tears started again. They didn’t stop until well after everything was finished.

I was taken back to the procedure room and left alone to get undressed and onto the table. The basin below the table with the red biohazard bag did not help the tears. I just held my hand over my belly and told the baby that I loved it so much.

Doctor came in, and said that my husband couldn’t be in the room. Nobody had even thought to tell him that I was already being prepped and the D&C was starting; I had to ask them to send someone to tell him (he’d basically already figured it out by that point and he was furious at both the lack of communication and their refusal to let him be with me since I had to be awake for it).

It started out mostly just uncomfortable; thankfully the numbing shots were not as bad as I had anticipated. More of my pain was emotional at that point. One of the nurses came over and held my hand, which was very sweet of her. Once the doctor actually started the D&C the pain got really bad. Again, the emotional aspect of hearing and being aware of everything that was happening (without my husband being able to there) did not help my perception of said pain, but it was definitely intense.

Finally it was over and they let my husband come in. He held me and I sobbed for several minutes more.

I got dressed, we went back to one of the exam rooms for discharge instructions. Pain was still pretty bad but improving at that point, so after she finished, we were allowed to leave.

We’d almost gotten home when the pain got really severe again; I think that combined with all the medications and the lack of any food in my system made me really nauseous and I vomited in a cup; I legitimately thought I was going to pass out in the car at that point as well.

Once we got inside I went to the bathroom, almost fainted and almost puked again; then managed to get into bed. My husband tried to get some food in me I was in so much pain I couldn’t even eat or sit up; finally was able to take more norco and naproxen and after another 30 minutes or so the cramping finally eased enough for me to eat (all of which came up an hour later when another round of nausea hit).

By the time our friends came over with dinner, I was feeling a lot better (just super sleepy) and was able to keep some food down and visit with them for a while.

I went back to bed after they left, took one additional norco and a sleeping pill and woke up Saturday morning feeling almost completely normal again.

I still had a couple gushes of blood when using the bathroom overnight, but the bleeding had almost entirely stopped by the end of Saturday and there was no more cramping. Even the intense emotions had subsided some; strangely enough having everything be done gave it a finality that is enabling me (us) to just grieve the loss itself instead of the combination of the loss and the anticipation of the loss. Saturday night I did get pretty sad and tearful again; but I don’t expect those moments to just stop. This was our baby; we loved it, we wanted it, we rejoiced to see and hear it’s little heart beating; and even though it was early it is still an unfathomable loss.

——-

I wish I’d known ahead of time that I would not be sedated. I also wish I’d known how painful it was going to be without any sedation (and I also think I wouldn’t have had the severe pain/nausea that I did at home afterwards since I would likely have still been in post-op recovery under some degree of sedation). Knowing all that now, I would have likely chosen a different option; I wouldn’t have risked all the possible complications to still have to experience all that pain and trauma and intense grief.

So hopefully this informs someone else; just be sure to find out how your provider typically performs D&C’s before making a decision.

 

 

after miscarriage · baby EL · D&C · grief and loss · missed miscarriage · pregnancy loss

Happy birthday, little waterbear

March 29, 2019 at approximately 2:30 pm…our baby was born.

I had a D&C. It is done. I am no longer pregnant. (I will probably write another post on this experience later; it was rough)

My pregnancy lasted 54 days. I knew I was pregnant for 43 days. I thought I was pregnant with a growing baby for 35 days. Our baby lived for 37 days.

Numbers. I guess they don’t mean a whole lot. But they are all I have for this little one.

Little waterbear. One of my pregnancy apps let us pick the ‘size’ comparison and we were primarily using ‘strange but cute animals.’ At four weeks, baby was the size of a “waterbear,” which is a tiny, strange, resilient little creature that apparently can survive in the vacuum of space. The cartoon drawing of said waterbear was extremely appealing to my husband and from that moment on, it was our little waterbear even though the animals changed each week.

2/3/19-3/29/19.

Too soon a memory but forever in our hearts.

We love you.

Happy birthday.

 

after miscarriage · baby EL · grief and loss · Infertility · journal entry · missed miscarriage

I am having a miscarriage.

(Sensitive content to follow-also a rather long post)

I am having a miscarriage. Again.

This is so surreal and heartbreaking. And the minute we saw that heartbeat for the first time I knew that if this happened, it would be infinitely harder than before.

Miscarriage number one was a chemical pregnancy; no question now. Of course we still grieved…with any pregnancy loss it’s a loss of dreams and hopes and of knowing that this is a life you won’t get to know.

This one…we had a baby growing, we saw our little one with it’s precious heartbeat. And then it was gone. It is gone. I can’t even quite wrap my head around the depth of the grief right now. It’s easing just the slightest as the days pass; but I know on Friday when we have the D&C that the intensity will return.

——-

I keep replaying that office visit in my head. I was so nervous for days before that something had gone wrong; and that fear was present in the waiting room but mixed with the excitement and hope of getting to see that everything right on track just like everyone else was so confident about. And the first part of the visit was so normal; blood pressure, history…then into the exam room where the NP went over genetic screening options and breastfeeding, diet advice, and telling us that we could visit the hospital ahead of time to be able to see the maternity department.

Then she went in. I think I knew almost immediately; she could barely find it and when she did it was clear the sac was too small and the baby didn’t look like it was supposed to. I’d seen enough ultrasounds of babies at 8.5 weeks to know approximately what the shape should be. She mumbled something about ‘well, it’s definitely in the uterus,’ then a moment later said, “I’m not finding a heartbeat.” I think I still had a sliver of hope that maybe it was just the machine or her technique, but then she measured the baby. When I saw the 7w2d I knew it was over. 9 days behind and no heartbeat could only mean that the worst had happened.

I don’t remember much after that, just that the tears started and she talked for a while about what the next steps were (while I was still in the stirrups with a ultrasound wand inside me…); then she left us alone. I cried hard for a while and my husband just held me; when I was composed enough we went downstairs to have blood drawn and repeat ultrasounds in the radiology department. In this interval I texted my mom and my manager (to alert her I’d need some immediate time off); husband texted his parents as well.

Both of those ultrasounds were silent and cold and all the while I just cried silently; I couldn’t see the screen from my angle and ultrasound technicians aren’t supposed to comment about what they are seeing even if they know (so I didn’t expect it). My husband thought he knew when she was looking/listening for a heartbeat and even he could tell that there was nothing there.

I got dressed again and we went home. The NP called a few hours later to inform us that the results indeed showed that there was no heartbeat. She repeated our options, and advised we take the weekend to think about them. (or she simply told us that it would be okay to take some time after I said that I honestly had no idea how to proceed in that moment).

———

We spent the afternoon attempting to rest; telling additional family and a few close friends…all of this interspersed with quite a few breakdowns on my part. Deleting all the pregnancy apps on my phone brought a fresh round of tears; somehow it felt like I was erasing all evidence of this child but I also knew that I wouldn’t want to keep getting email notifications about ‘your baby today’ when it was no longer relevant.

We headed out later that evening to spend the weekend with my parents. Husband had an interview in their area the next day so he was already heading up; and he just seemed to know that I needed to be there. My mom has become the most amazing person in a crisis; she just seems to know when to listen, when to talk, when to distract, when to be present, when to excuse herself. Just being there (and away from the house) allowed the reality to sink in a little more gently.

Woke up Friday morning crying. Cuddled with my husband for a while and that helped, but this made me realize that mornings bring fresh reminders of this new and painful reality. Going to bed each night was hard too because then the distractions of the day faded and the emptiness sets back in.

Saturday night we got home; and there were flowers from an out of state friend and a care package from my sister-in-law (almost an exact copy of the things I left for her when she had her miscarriage). Husband had to run to his parent’s home for some medication, so I came up alone. Walking back inside to the emptiness of our home (for a season, anyway) in addition to seeing these thoughtful but unwanted gifts (I mean, I don’t *want* flowers and bath salts and tea…I want my baby to still be alive) brought a fresh round of tears. After sobbing on the floor in a fetal position for a while, I texted my sister and we talked until I calmed down a little bit.

Sunday morning we went to church; it was hard but good and definitely where we needed to be.

The rest of Sunday was just spent relaxing. Both of us dreading going back to work but also not wanting to just sit around at home all day not doing anything either; both of us completely drained and sad and confused. We both managed to get through our work days today; and now he’s at the gym so I’m making use of the time to attempt to get some of my thoughts and experiences down on “paper.”

——-

My primary thought is: “this is not fair.” We’ve already had one miscarriage, we’ve struggled to conceive for over a year, we’ve had to spend time and money and energy on some level of assistance….and then we finally get to rejoice in what seems to be a healthy pregnancy and we finally start to get excited about the future…and then it’s ripped away in a moment. Miscarriage by itself is hard enough; miscarriage after infertility is even worse.

I am sad. I feel empty, I feel like I (currently) have no purpose. I spent the last 5 weeks being so careful about what I put in my body and how I took care of myself…and now suddenly none of that matters and my womb is (essentially) empty again. I am confused…and hurting…and jealous (of those who haven’t had to experience any of this).

I believe that God is good, that he is sovereign, and that somehow all this is part of his plan; I take comfort in knowing that even in this he is faithful and we are not alone. But it doesn’t mean that I can even begin to understand why he chose this to be our path.

——-

In terms of our options, I have chosen to proceed with a D&C at the end of the week assuming the process has not already started (and given how far along I was I really don’t expect that natural process to begin for a least a few more weeks). I hate that I have to have a surgery to remove my baby from me; but I also know that I can’t take the emotional toll of waiting on a natural miscarriage with the knowledge that my baby is dead inside of me. Taking medications to induce the miscarriage at home was the other option; but that will mean that I still experience all the pain and bleeding and emotional trauma of being reminded of the loss every time I use the bathroom…and there’s a risk here of the process not completing and then we’d have to have a D&C anyway.

Our infertility doctor recommended that we get the baby’s DNA tested for chromosome issues; it is highly likely that there was a chromosomal abnormality that would have been incompatible with life and that is the reason for this. If so, then hopefully such a thing won’t happen again. If it’s not the baby, then she wants to do a workup on me to evaluate why my body can’t seem to sustain a pregnancy.

If we are able to know the baby’s gender, I want to know. I want to give this little one a name. It made me a mother, and by giving it a name I am acknowledging that gift and choose to thank God for the blessing that it was to have and nurture this child even for 5 short weeks. I hope we get to have a child (or several) living earth-side…but even if somehow that is not in God’s plan…I am a mother.