Deciding what to do after pregnancy loss
A natural miscarriage, medication or a D&C
When we found out our angel baby wasn’t okay, our hearts broke. We’d had what is called a missed miscarriage—when baby’s heart has stopped beating but your body doesn’t know that and keeps acting pregnant.
After receiving news of a missed miscarriage, parents might have a choice: wait for a natural miscarriage (which could take days or weeks), take a prescribed pill to initiate a natural miscarriage, or get a D&C (surgery). In some cases, a natural miscarriage or the medicated route may lead to a D&C anyway (not to scare you).
There are pros and cons to each of these three options. Everyone experiences pain differently and may be given different recommendations based on the situation.
Diagnosed with a missed miscarriage
We were diagnosed with a missed miscarriage following our baby’s first-trimester screening. During the routine ultrasound, the technician called in a colleague and they revealed that they couldn’t find our baby’s heartbeat. We were instructed to go home and wait for an update from our midwife, who called later to tell us that when a baby is at 11 weeks gestation with no heartbeat, it means that the baby has passed away.
We were heartbroken. Our midwives wanted to support us, so they set up an appointment for a week later at a hospital clinic for early pregnancy loss. I also read a lot online about how others made this decision, and I talked to a loved one who had faced the same decision in the past.
What we chose to do after our first miscarriage
In my case, I made the decision based on a recommendation from a doctor. A week after my husband and I found out we’d experienced a missed miscarriage, we attended a meeting at an early pregnancy loss clinic in a hospital. Our midwives had arranged the meeting and we understood that someone would explore our options with us.
This was not the case. During the meeting, I felt super nauseous and was reaching for a ginger cookie when the staff member we met with warned, ‘It’s important to have an empty stomach before surgery.’
An empty stomach...surgery?!
I have long held a fear of medical procedures, including some anxiety around needles. I was also feeling heartbroken over our angel baby.
My husband and I revealed that this was news to us and requested—even insisted—on another ultrasound. I knew not to hold onto hope that our angel baby was okay after all, but we wanted to be thorough.
Our request was (possibly reluctantly?) granted. As my husband and I waited elsewhere in the hospital for the ultrasound, I went into zombie mode, which I later realized was something my body and mind did to help prepare me to do something I was so scared to do: undergo an operation.
My husband kindly called my parents to update them and they came to join us. I was called back to the clinic section of the hospital to speak with an OB-GYN, who explained to me that at 11 weeks of pregnancy—almost the end of the first trimester—our baby was a bigger size and the risk of bleeding during a natural miscarriage was higher.
She also told me that my HCG levels were abnormally high (it ended up taking several months for them to return to non-pregnancy levels), which I think suggested that my body would not initiate a miscarriage soon and might be why I had actually started to feel even sicker after we found out we'd experienced a missed miscarriage (I had started to throw up more often and sometimes spontaneously).
The doctor assured me that choosing a D&C meant being surrounded by medical professionals who could help reduce bleeding, and that if I chose to the D&C that day, she would perform the operation herself.
I literally paced the hallway trying to make a decision. I’m very big on “natural” and was fortunate to have never had any invasive medical procedure beyond a blood test. At the same time, I understood the risk of waiting for a natural miscarriage and am the kind of person who tends to face my fears head on and want to “get them over with”.
My husband told me he supported whatever my decision would be. I appreciated that and knew that if I was going to a D&C, I’d rather do it then and not have to worry about it after that day.
Throughout the D&C procedure, the staff were extremely supportive. My husband and I waited and waited in the waiting room, and eventually—maybe because I was the last patient—it was okay for my parents to wait with us too.
The D&C was physically painless, beyond a small painful feeling as the IV was inserted into my hand.
When I was in the recovery room after the D&C, surrounded by my husband and my parents, I was so happy that the procedure was over and I vowed to do what I can to help anyone else who goes through this. I thought of that when my husband first proposed Parent Ink to me; the idea of writing here to hopefully help others felt right.
If you would like more information about D&Cs, you can learn more about my experience and D&Cs in general in this article I wrote for Today's Parent in 2021 entitled Everything you need to know about D&C procedures.
What we chose to do after our second miscarriage
Our second miscarriage was a natural miscarriage, which means that my body started bleeding and the miscarriage was already happening, so there was no choice to make between a natural miscarriage, medication or getting a D&C.
But there were other choices to make. This was now our second miscarriage. We did not want this to happen again.
I had heard that in Ontario, Canada, additional medical assistance is provided after three miscarriages to help support the next pregnancy, but we did not want to risk another miscarriage, so my husband and I decided to advocate for ourselves. We expressed to the pregnancy clinic that we would like to ask for help before our next pregnancy and they encouraged that idea. We then asked my family doctor for that help, and she agreed right away.
I expected to be referred to a fertility specialist (at the time, we felt confused about the term “fertility”—I had gotten pregnant twice in one year, so was this really a fertility issue? The term is more complex than it might seem) and when my doctor understood my surprise, she assured me confidently that the OB-GYN she was referring us to was a great choice for the knowledge we were looking for. It turns out he is amazing!
One of my loved ones reached out to recommend a fertility specialist and I decided to meet with her as well. The first time we met, she encouraged me to share as much as possible about my health and she came up with a theory and ways to support a healthy path to pregnancy. It turns out she is amazing too!
If you went through this or are making this difficult decision now, I hope these resources are helpful to you. I’m here to listen if you want to talk or have any questions at all. There is a supportive community here.