Miscarriages aren’t easy. Having a miscarriage means different things to different people. Having a miscarriage means different things to men and women. When a woman becomes pregnant – she starts imagining kindergarten graduation, her child’s birthday parties, high school graduation, her child’s wedding…..many men don’t realize what a pregnancy really means until they are changing their first diaper. This is a huge over generalization just to show that pregnancy and miscarriage are do not mean the same thing to all of us. There are some men that grieve more than their female partners who are suffering from miscarriage. There are some women who don’t grieve at all.
Some women grieve as if it’s the death of a living relative. They remember the date they miscarried and remember the date every year and remember the date their child would have been on that day, referring to them by name.
The way you choose to grieve during over the loss associated with miscarriage is the right way. Everyone is different. Physicians need to realize that every patient is different as well and some women need longer to cope with the news than others.
We grieve differently, and we also want different things when it comes to how our miscarriage gets handled.
If you’ve recently been diagnosed with a miscarriage, depending on how far along you are, you have choices. No woman should be told that they should just go home to miscarry. Not in today’s world. For the most part, you don’t need to make your decision the day you receive the news that you have miscarried.
This what I tell my patients and this is what you should know.
There are three options in terms of managing someone who has recently been diagnosed with a miscarriage in the first few months of pregnancy.
The first option is called expectant management which means do nothing but wait.I offer all of my patients pain medications so that if you find yourself with severe cramps at home, you will have something to take and you won’t have to go to the pharmacy at 2 AM looking for someone to fill a prescription for you. You may experience heavy bleeding and cramping for a few hours followed by bleeding similar to a heavy period which will become lighter.
The second option is called medical management. Medical management means placing several pills vaginally (misoprostol is the name of the drug) that causes the uterus to contract and release the pregnancy tissue.
The third option is surgical management which involves a surgical procedure which can be done (depending on your doctor’s set-up) either in the office or in a hospital setting. The surgical procedure is called a dilation and curettage or suction D+C. The procedure involves slowly dilating the opening to the uterus which is called the cervix in order to allow placement of an instrument that will remove the pregnancy tissue.
What you need to know is that with the first two options, you may still need a surgical procedure if you have heavy bleeding or if all the tissue doesn’t leave the uterus.
If you choose option 1 or 2 you can still bring the pregnancy tissue into thehospital (discuss this with your doctor ahead of time) for a chromosome test of the tissue.
Depending on how far along you are in pregnancy there are benefits for each of the choices above. Having a surgical procedure puts you at risk for uterine scarring also known as Asherman’s syndrome. But at the same time – if you’re someone who wants to try right away, having a surgical procedure will be the quickest approach in terms of getting ready to try for pregnancy again.
Dealing with miscarriage is tough. Knowing what your options are will help you deal with the situation the way that you want.