Missed Miscarriage with Awake D&E / D&C


I am sharing my story of a D&E with local anesthetic only because I haven't found much on here (or the internet really) about the type of procedure I had.  For me personally this was the best course of action, but it was painful and kind of traumatic and I want other women to know the story to inform their decision. 

For the record: This was my first pregnancy and as such, my first experience with loss and a D&E (my hospital/doctor's office used suction evacuation).  

I went in for my first prenatal appointment when I should have been roughly 10.5 weeks along in my pregnancy.  Sadly, after an ultrasound, we learned the baby had stopped growing at 8w1d.  It was only 1.7cm from crown to rump.  We quickly had decide how to manage the passing of the embryo. I ultimately decided that because I had no symptoms of a miscarriage, that I should go with the D&E.  I wanted to start moving on as fast as possible as well    My pregnancy symptoms had faded, but not entirely disappeared, and it had already been 2.5 weeks.  The next available appointment was literally 24 hours from my first appointment, so we took it.

As a side note, I've had 3 surgeries in my life where I was put under general anesthesia and I received conscious sedation for removal of my wisdom teeth.  All 3 times I had to be restrained upon waking from the anesthetic, and during conscious sedation I screamed and cried the whole time until I was put fully under.  Knowing this, I opted for the procedure using local anesthetic in the doctor's office as opposed to general anesthesia in an OR.  My midwife told me prior to the procedure I would only receive 600mg of Ibuprofen and I would take doxycycline as a precaution.  No pills to soften the cervix (they would inject lidocaine to numb it), no pills for anxiety or remaining calm.  I fully understood this and went ahead with the procedure.

(Also for the record, my primary care and OB/GYN are outpatient offices a Massachusetts General Hospital - one of the best hospitals in the country.)

My procedure took all of 10 minutes.  My appointment started at 9:30am and my husband was helping me into the car at 10:45am.  The team was one nurse, one doctor, and 2 medical assistants (1 was being trained). They were absolutely amazing.  My husband stayed with me and held my hand the whole time.  The nurse held my hand, rubbed my shoulder, and massaged a warm pack on my lower abdomen while talking me through the entire procedure.  She coached me on breathing so and told me how amazing and strong I was, and how great I was doing throughout. After the procedure the doctor also told me how I was so amazing and such a strong woman.  My husband just kept telling me to breathe like the nurse said and to squeeze his hand and that I was an angel.  I felt so supported through the whole process.  Like amazingly supported.

That being said... It hurt.  It was so painful.  It was not like a 'really bad period.'  It was more than a bad period. And I got bad periods as a young woman (missing school because I couldn't walk type bad periods). The lidocaine injection in my cervix was actually the least painful part.  I felt my cervix being dilated.  It took 90 seconds, but it felt like forever.  The cramps were something I never felt before.  Then cramping I felt during the suction - that was the worst part.  I could barely keep my feet in the stirrups.  I was trying my best to stay still, but it was so so so painful.  From injection to suction stopping was literally 5 - 7 minutes, but it was the longest most painful 5 - 7 minutes of my life.  My body was being forced to do something it wasn't ready to do and I felt it. 

Also I cried. I cried the entire time. As soon as they they started moving the table into position I started to cry and didn't stop till well after the procedure was over.  First it was sadness for what was happening, then it was pain, and then it was sadness for what happened.  I swear without my husband and that nurse talking me through everything and the doctor telling me I was so amazing, I couldn't have done this.  

After the procedure was over the nurse put an ice pack on my neck and kept massaging my lower abdomen.  She got me water and then left me and my husband to be alone for a little while.  I laid on the table with my husband rubbing my arm and wiping my tears for about 20 minutes.  I was able to get up and dress myself and we left maybe 30 minutes after the procedure. I walked out on my own, in pain, but on my own.  The cramping yesterday was not the same as a period, but it definitely got better as the day went on. I took a few more of the 600mg ibuprofen through the day and used a heating pad. It was painful but got more like the level of pain that I could compare to a bad period, though the feeling is different. I woke up this morning and felt ok physically, but I was still lightly cramping. As for blood, I bled like a regular period after and it turned to a light period overnight. 

It's now about 36 hours later and my uterus just feels sore (I'm barely spotting now).  It's an odd feeling.  I've never had a sore uterus.  But it's definitely sore.  I'm hoping by Sunday (it's Friday) all feels good again.

I'm sorry this is so long, and if you made it to the end, Bravo.  I just hadn't seen any D&E / D&C stories like this so I wanted to share my experience.  If you're facing this decision my heart goes out to you.  For me this loss has been isolating, and there's nothing anyone can say to change that, but I do take solace in knowing that there's an army of us out there who have felt this and are fighting their way through or who have made it through to a rainbow on the other end. ❤