If you’re ever threatened with miscarriage (not able to tell if the pregnancy will remain viable,) or have been told by your doctor that you have indeed, lost the pregnancy, you will have many questions about what happens next.

This is part two of a series of posts covering the different methods for clearing the uterus of a failed pregnancy, to make way for the next cycle. (FYI, this post is a little graphic.)

As I mentioned in my previous post, I have had three miscarriages. For the first two, I chose to have the fetal tissue surgically removed from my uterus, by D&C. (Please see previous post for information regarding surgical evacuation.) The first miscarriage was treated by the OB staff like a hangnail. Everyone told me, “It happens all the time,” and not to worry. After the second miscarriage, I had more tests run to try to determine the causes, but nothing in the results showed a problem with my reproductive parts. So, after the third baby’s heartbeat had stopped beating in utero, the OB wanted pathology run on the fetus. In a D&C, the uterine lining is scraped, and the fetal tissue is suctioned out of the uterus. The fetus is no longer in tact. So, for pathology purposes, I had to let the third miscarriage go it’s own way, so that the fetus would be expelled “whole.”

I had the choice of using pills to help the uterus contract and expel the fetus. This is called medical management and the drugs generally used are RU 486 and misoprostol. All this does is speed up what the body would do normally, which is expel the contents of the uterus. I chose to let my body go at its own pace, and this is called the expectant method.

Now here’s where the major emotional differences lie. With the D&C, it was very cut and dried. You went in to the doc’s office with fetal tissue and you left without it, a few hours tops, and you were drugged the whole time. There was some bleeding and cramping, but it was done in a day. With medical management, it can take a few days for the tissue and clots to pass; and with expectant, it can take weeks before the body completes it’s own evacuation. You will see tissue and clots each time you use the restroom, (you can’t use a tampon,) and you are walking around with major stuff coming out of you for what, emotionally, seemed to me, like a long time. For me, it was a constant physical reminder I could have done without.

And if you are in the unfortunate situation (like I was) of needing to “catch” what came out of your vagina each time you went to the bathroom, it’s even worse. I had to use a bedpan every time I went to the bathroom, and when I finally passed the fetus, I had to put it in a container (like the kind you use for urine tests at the doctors office) and take it to the lab for pathology. It was horrible. I still bled for days afterwards, passing very large clots. I finally had to go back to the OB for an ultra sound to be sure I had passed all the tissue. If I had not, I would have had to go back in for a D&C to remove all the tissue that hadn’t passed naturally. This situation (not passing all the tissue naturally) is common. If this happens and it is left untreated, it can cause infection in the uterus.

It turned out that the fetus showed no abnormalities. It wasn’t until later that it was discovered that I had a blood clotting disorder, and that my perfectly healthy babies were not getting sufficient blood and oxygen after their 10th week, and that’s why the pregnancies failed. It was devastating to know three healthy little babies with heartbeats died in my womb, but the problem was correctable with blood thinners and strict bed rest. I now have a wonderful 6-year-old boy.

- Lee