So I wanted to share my experience in the hopes it gives someone some reassurance or guidance in making a tough emotionally-fraught decision. Sorry it's a bit long!

For background, I have had 2 previous pregnancies, both carried to term and I was still nursing when I got pregnant the third time. However, when I went to my 8 week scan, they only saw a gestational sac measuring 5+4, no yolk sac, no fetal pole. As I'm still nursing they said it's likely my cycle is irregular and perhaps I ovulated later than I thought, otherwise it's possible it's a blighted ovum. I was not <a href="https://play.google.com/store/apps/details?id=com.glow.android">tracking ovulation</a>, just my periods, so they could be right, except that my positive pregnancy test had been over 3 weeks prior, making it very unlikely I had ovulated as late as they were saying. They drew beta HCG that day (10500) and would repeat it in 2 days. Leading up to the appointment, I'd been having very small amounts of brown and pink-tinged spotting. I was told it was likely nothing, maybe a small subchorionic bleed that was resolving. No cramping during any of that.

Two days later, before my next lab draw, I started bleeding some bright red blood and a decent amount of it (It was off and on that day and the next, but always bright red). I knew then my pregnancy wasn't going to progress. I went for the follow up blood work to confirm what I felt and it had dropped to 9000. I got a call from my doctor the next day confirming I was going to miscarry and he offered me two options: wait and see if I pass it naturally since I had already started bleeding some, or if I wanted to assist it along, I could take a medication to help. As it was the weekend, I opted for the medication so that I wouldn't have to experience losing my pregnancy at work.

I was prescribed two doses of 400mcg Misoprostol, to be inserted vaginally. I had read some pretty terrible experiences and was quite anxious, but still would prefer to have everything happen at home while I was off. I took the first dose around 4pm and laid down the following hour to make sure they had stayed in long enough. I took 600mg ibuprofen at that time too. I then went about the house a little, trying to distract myself. I was told I should start experiencing cramps and/or bleeding and if not, to repeat the dose in 4 hours. Nothing happened, so I repeated the dose around 815pm (with another 600mg of ibuprofen). Same thing, laid down for an hour, then got back up and just tried to relax on the couch as best I could. I stayed up for the 4 hours, expecting some kind of something to happen and still nothing. I went to bed with the plan to call my doctor in the morning that it hadn't worked.

I woke up around 815am, needing to pee and when I went, I felt a large clot evacuate as well. It had started. I still had no cramping whatsoever. For the next 6-8 hours, I continued to bleed pretty heavily, passing large golfball sized clots. As my sac was only measuring just over 1cm, it was likely in one of the clots I expelled, but I didn't go digging to confirm. The bleeding started to taper off in the early evening and the large clots stopped, replaced by just a few small ones at a time (~1cm in size). By the next morning, I was just mildly bleeding, like the end of a period bleed.

Throughout the experience, I had very mild cramping occasionally (1 out of 10 pain), but nothing like the experiences I read about with women experiencing labor-like pain or anything like that. For me, this went as well as I could have hoped, much more manageable than I expected, and I was able to be in the comfort of my home throughout. I ended up going back to work the next day (I needed the distraction) and apart from some mild (1/10) cramping and some minor bleeding, I got through that day fine- physically at least.

Anyway, I hope this experience can help reassure some people, that it's not necessarily going to be the worst pain you've experienced. I don't know if it's the dosing (I've read sometimes people will use 800mcg per dose instead of the 400mcg I used) or the fact that I took Advil simultaneously, but I firmly believe I made the right choice to use medication to assist my miscarriage. Good luck to all you other mamas, I wish you the best on your journey 🩷