***Just a Warning. This is a very TMI and graphic post. Don’t read if you’re triggered by pregnancy, child loss, grief or biological functions. I’ll reiterate: this post is not for everyone. If you need information on miscarriage, cytotec/misoprostol, Methylergonovine (Methergine) maleate and/or pregnancy loss, this post is for you. ***
Well. Here my family is again.
After March’s miscarriage we waited about four months to try again. We got our first positive pregnancy test on August 1st. I was due April 13th. The pregnancy was touch-and-go in the beginning. I actually tested negative after my first positive, leading me to think that I had a chemical pregnancy. After numerous blood draws and progesterone supplements, everything seemed to even out. I was tired, nauseated, irritable and bloated–but happily, gratefully and cautiously pregnant.
Still, like last time, I just had a…feeling. From the beginning. I let it slide, telling myself that, as usual, I was being negative. But a few days before our first ultrasound and appointment I just knew. Clear as a bell, in my head, you need to prepare yourself. I brushed it aside. After awhile I did start to imagine the worst. Let myself stew in it a bit. Just in case. Better to be happily surprised than bushwhacked.
The morning of the appointment I said to my husband, “I’m so nervous!” What I really meant was, “I’m having a miscarriage. I know it.”
Sure enough, the ultrasound revealed a large, empty 7-week sac. I was supposed to be approaching 10 weeks.
The midwife came in, and bless her heart, wanted me to wait it out. I understand the position. Cytotec, or misoprostol, is not an easy drug. But it had already been almost 3 weeks. I have a job now, and a toddler, and a husband who can’t take more sick days. I’m glad that I have a choice in how to manage it.
I searched Google for women’s experiences with Cytotec, but only found one blog (link). However, that post’s comment section has about 200 stories of medicated miscarriages. Since this is only *my* experience–and atypical–I’d check that out. It was a comforting resource before I started the process.
***Don’t read if you’re squeamish or triggered by this stuff. It is all TMI. This is here for women and partners who need/want to hear the story and know the information.***
Disclaimer: I’m not a medical professional nor do I pretend to be. This is just my experience. As always, consult your care provider if you have any questions.
Preparation (for you or your partner):
- If you can, arrange a three-day weekend. Get a doctor’s note from work if needed.
- Have an adult with you. One, there might be an emergency. Two, you need the support. If you can’t have an adult, discuss other options with your care provider. I really cannot overstate the important of NOT BEING ALONE.
- Go grocery shopping. I stocked the pantry and fridge with easy to eat and make food for my husband and daughter. Also, have something easy to eat around: saltines, digestives, bananas, coconut water, ginger-ale, etc.
- Light cleaning. Make sure your home isn’t gong to stress you out. Dishes, a bit of laundry, etc.
- Ask for help for the week after. Whether it’s your best friend, mom, coven-mate, whoever–if you’ve trusted someone enough to tell them when you’re early pregnant, ask them for a meal or two.
- Prepare your bathroom. You might be spending a lot of time there. Clean it, fix a nice stack of towels, make sure you have pads. Some have even recommended a pack of Depends for the really heavy bleeding.
- Gather entertainment. Laptop, kindle, movies, magazines. You might want distraction, you might not, but it’s better to have it than wish you did.
- Make sure you have a pain management system in place. A couple of ibuprofen might not cut it, so if you didn’t receive something with your Cytotec, call your doctor and ask. If you choose to wait for the miscarriage to happen naturally, I’d still fill a script of pain meds just in case. My natural miscarriage was much, much more painful than this one (even heavily medicated).
- Eat a good meal an hour or two before you begin. Drink lots of water, Gatorade and/or coconut water.
Friday, 7:00 p.m.: Took 1st pain pill
Friday, 8:00 p.m.: Took 1st Cytotec dose, suppository style.
Friday, 10:00 p.m.: Light cramping, no discharge yet. Took 2nd pain pill.
Saturday, 12:00 a.m.: Another dose of Cytotec, suppository style. 3rd pain pill. Went to sleep.
Saturday, 1:45 a.m.: Woke with cramps. Medium bleeding. Almost lost a Cytotec pill. 4th pain pill. Have strong, burning contractions that come in waves.
Saturday, 4:30 a.m.: Wake up because I feeling…nothing. Pass a few clots. Take next round of Cytotec orally, as I lost a Cytotec pill in the toilet. Take another pain pill.
Saturday, 5:00 a.m.: I’ve been in bed trying to sleep, but now I’m in the living room sitting cross-legged and watching Hot in Cleveland. I’ve eaten a little something, and I get up every few minutes to walk around and do some squats. I’m just not feeling much at the moment, not even the fuzzy feeling I get on Vicodin. Light period-like cramps. I’m beginning to worry this might not work, but I still have another 12 hours worth of Cytotec doses.
Saturday, 6:00 a.m.: Discover that another Cytotec pill didn’t absorb. Frustrating!!! No wonder this seems so easy. Take one orally to make up for it. Larger clots passed.
Saturday, 8:20 a.m.: Nothing. Happening. I’m really trying to be patient, but it’s been 12 hours now. I know it can take longer than the usual (6 to 12 hours), but damn. I just want this done.
Saturday, 8:40 a.m.: Take next dose of Cytotec orally and another pain pill.
Saturday, 1:00 p.m.: Take last dose of Cytotec vaginally.
Saturday, 10:00 p.m.: Alternating between sitting cross-legged, baddha konasana and bouncing on the exercise ball. Some very, very mild cramping.
Sunday, 12:30 a.m.: Have some cramping. Still bleeding, passed a tiny bit of greyish matter. Also, have noticed that my breasts are hot and engorged. Fucking disturbing–I’m miscarrying at 10 weeks and milk is coming in?! Fuck you, Whoever.
24 Hours Later…
Monday, 9:30 a.m.: Call the doc. This obviously didn’t work the first go around. Have an ultrasound and check up to discuss “options”. Found out through the Almighty that a D&C can cost up to $15,000 out of pocket. Am terrified. While we have personal insurance, in the state of Texas that does not include maternity. And while we have the resources to absorb this, fucking America. Where you can go bankrupt because of a tragedy. It’s almost a cliché now, right?
Monday, 3:00 p.m.: Well, that’s a relief. No D&C. Everything is emptying fine, but I do have the beginning on an infection because some tissue got stuck. OB prescribed antibiotics and another type of induction medicine–Methergine–to expel the rest. She said the miscarriage should be completely over in 24 more hours.
Also, when the OB did the physical check she cleared out a lot of tissue. It didn’t hurt at all, mostly because the u/s showed that it was unattached to the endometrium. Which is a good thing that she could do so (no D&C) but also bad that it didn’t expel, so now I have the beginning of an infection. OB sounded optimistic that it would be easily treatable.
Monday, 7:30 p.m.: The Methergine cramps are a lot sharper than the Cytotec cramps, but so far, all is well. I’m just ready for the physical part of this process to be over.
Pain Management Advice
A miscarriage is labor. If you haven’t had children before, there are few pain management tips to keep in mind.
- Don’t fight the pain. If you tense, clench your jaw, make fists, curl your toes that will make the pain worse. I know it seems counter-intuitive, but one of the first things they teach you in med-free birthing classes is to relax. Let the pain come. If you find yourself clenching, curling, whatever–actively undo it. It’s hard. I know. But it will help the pain.
- Breathe. This is where yoga and meditation help. Ujjayi breath was extremely helpful to me during labor and during my first miscarriage. Inhale deeply, exhale fully. Concentrate on the breath.
- Have a mantra. As a yoga practitioner, I’m most familiar with some of those. But any prayers or chants that bring you comfort can help.
- Visualization. This technique helped me the most throughout my long (72 hour) labor with my daughter. I visualized myself as an ancient redwood being buffeted by a wild storm. Any thing will do–calm oceans, rainforests, vast plains, whatever–just anything to take you into another state.
- Hot or cold temperature applications, depending on your preference. Cold–wash cloths in water, ice packs, frozen bottles of water, frozen rice socks. Hot–warm wash cloths, hot water bottles, heating pads, hot rice socks. [Make a rice sock: take a man’s tube sock, fill it with rice, knot the end = done].
- Stay on top of your pain meds! Begin them before you start the Cytotec and take them as your dr. recommends. You might even want to ask for a script for Zofran, an anti-nausea medication, as nausea can be a side-effect of Cytotec.
- If you are directed to take the pills vaginally and/or you are collecting tissue for testing, I’d recommend buying a sitz bath to do your business over. You can purchase them at a pharmacy for less than $20. Basically it’s a little tub that sits in your toilet. It’s meant to fill with hot water for pain relief of hemorrhoids and after child birth. However, it’s really handy for retrieving lost Cytotec pills and so you don’t have to fish the tissue out of the toilet (if you’re collecting it). If you bleed a lot, it will be messy, but it worked for me.
- If you feel any tenderness, are running a fever, your discharge smells funny, or your bleeding is letting up but you don’t feel like everything (i.e. the sac) has passed, call your doctor. Better safe than sorry, always.
- Print out a page with your OB information, allergies, important phone numbers, what medications you’re taking, your insurance information, etc., so that on the off chance you pass out or need to go to the ER you have this information prepared.
Miscarriage sucks. It just does. No matter which way you go through it–expectant management, medically induced, D&C, D&E, whatever–it’s just like something out of a horror movie. And if you’re reading this and you’re going through it, know that I get it, and you’re not alone.
Also know that as terrible as this is, some of the horror can be mitigated by making yourself as comfortable as possible. Know what to expect. Hope for the best, prepare for every eventuality. Don’t stress over it–but be prepared, and in being prepared, take comfort.