Home » FET#3 » Natural, Cytotec, or D&C? That is the Question.

Natural, Cytotec, or D&C? That is the Question.

The RE’s office called today to tell me officially to stop my meds. The radiologist took a look at the ultrasounds and called it.

I didn’t speak to them. In fact, my cell phone didn’t even ring. They sent it directly as a voicemail. Motherfuckers. Clearly, they weren’t interested in entertaining any questions. They just reiterated that I had three options: miscarry naturally, take Cytotec, or do a D&C.

Option A: Miscarrying naturally sounds the gentlest of the three options, but it could take weeks for my body to initiate this, and weeks for it to fully complete the task.

Option B: Cytotec/Misoprostal freaks me out a bit, as I imagine it’s basically Option A condensed into a violent and short period of time. I’ve read of women opting to bleed it out at the hospital for the access to effective pain killers, you know, the good shit. Getting it done with in a predictable amount of time sounds attractive to me. However, sometimes remnants remain and you end up utilizing Option C anyway.

Option C: D & C is the one most people fear initially. It involves dilating the cervix, and then either scraping or vacuuming out the contents of the uterus. It is often scheduled, and while women often report some moderate pain afterwards, it isn’t usually as painful as Options A and B because you’re under general anesthetic. With this option, you can be sure that all of the remnants are removed, while with the other two options, sometimes large clumps of endometrial tissue and the gestational sac have a difficult time passing through the opening of the cervix, which prolongs the bleeding and cramping (trying to flush it out).

Right now, I’m leaning towards Option B, because I don’t think I can emotionally handle waiting for the inevitable. I also need my HCG to go down as quickly as possible so that we can start trying again with our last embryo. I have heard that this can take WEEKS, even MONTHS, for women with levels as high as mine are right now.

Anyone at around 8 weeks miscarry naturally? How long did it take to begin the process, how long did it last, and how badly did it hurt?

Anyone with HCG around 40,000 know how long it will take to return to <5?

And finally, pain control: what works for the labour-like cramps and contractions?

Thank you for helping me mentally prepare myself.

32 thoughts on “Natural, Cytotec, or D&C? That is the Question.

  1. Have your read A Calm Persistance’s blog on option b? She has gone through this multiple times and used all options I believe, she just made a blog post on option b and I think it would be a good one for you to read considering. I’m very sorry you have to make this choice.

  2. Words can’t express how truly sorry we are for your loss. </3
    My last cycle I was eight weeks and one day (September 20th) when we found out that the baby stopped growing about a week prior. (September 14th according to measurements) & on September 22nd I began bleeding. On the September 26th i passed everything at the same time. To be honest it was really strange. One minute I would feel stabbing HORRIBLE cramping pains that would literally make me cry and the next minute I was fine. This lasted about an hour and then I felt it come out, we were driving home so i couldn't do anything about it but we already knew what was happening. My wife & I ran to the store when we got back in town and she got me some heavy duty pads. I could feel that the tissue was literally just stuck half in me and i was freaking out. When we got home we both went into the bathroom and it fell right out. I bled for a few days and that was it. I can't remember the cramping being extreme or anything but it for sure wasn't great. I am glad that I did it the natural way because the idea of a D&C which we had originally planned to do really scared me. And I've heard taking the medications is super painful. I'm not sure how long it took for my levels to go down because our next cycle kept being delayed due to two separate complex cyst I had got. Sorry if this is too detailed but I hope it will help you to chose whichever method will work for you. Ultimately you & your wife should chose the plan you are most comfortable with. We will keep you in our prayers.

  3. I might be in the minority but I’m so happy I chose to miscarry naturally at 6 weeks. I felt like the pain helped my healing process. So sorry you have to make this choice

  4. I’m sorry you’re facing this right now. My heart goes out to you. I chose naturally, but the doctor had me come back for blood tests to make sure my hcg was dropping, and then my RE had me do a sonohysterogram before starting to try again (and took one full cycle off) so they could be sure there wasn’t any remaining tissue. I believe at that point if there had been any remaining tissue I would have had to do a d&c. I heard not many good things about risk of further future fertility issues following d&c so I wanted to avoid if possible. I’m glad I was able to.

  5. I’m just so sorry for you loss. I am at a loss for words for you. I just want to pull you both in my arms and give you a big hug. If I lived closer, I would take you both out and get you ice creams! ((HUGS))

  6. I chose a D&C but ended up miscarrying naturally the weekend before my Monday appointment. For context, this was the beginning of week 10, and I had learned at the end of week 9 that the embryo stopped growing at 7. Once I knew I wanted it done as soon as possible, so I’m in the camp of not waiting for the uterus to catch up with what the head already knows. I chose D&C because the drugs seemed scarier–excruciating pain with no guarantees (my mother had them and still needed the D&C after). But as I said, my body had other plans (a good 3 weeks after the growth stopped). The bulk of the passing was very crampy but only marginally worse than a really painful period. That part was a few hours but surrounded by off and on bleeding over two days. The last bit of the miscarriage (about 24 hours after the really crampy bulk of it) was excruciating but over in an hour. My HCG went down quickly and was back under 5 within a month–almost like the miscarriage was an actual period. I think it started around 100,000 if I’m remembering correctly (though I may not be). Oh, and I took ibuprofen. It helped.

    Let me know if any iof that didn’t make sense or you have further questions. Bottom line? If you have a gut feeling, go with that. I am so sorry you have to make this choice.

  7. I echo so many others when I say, I’m so sorry you have to make this decision. A good friend of mine chose Option b. It worked quickly, though she did have quite a bit of pain.

  8. I am truly sorry that you and your wife have to go through this…again. I hope time passes quickly and the healing can begin no matter what you chose. Holding you in my thoughts and prayers ❤

  9. Hi, I’m a new follower but just saw this and thought I’d share too as I’ve had two natural MC’s. The first was very spontaneous at nearly 12 weeks so the details won’t help much. The second one I was 11w, 4d but I had a tiny little bit of blood so went for a scan and they told me the baby had stopped growing at 8 weeks. It was on the Friday. I went for acupuncture on the Saturday morning with an experienced woman who did points to bring the MC on. (I believe it’s the same points they use to bring labour on.) I also went to my naturopath and she gave me a foul tasting herbal concoction (including black or blue cohosh) which also was supposed to bring on the miscarriage. I started bleeding on the Sunday night I think and then lost the baby on the Monday. I had pretty sore pains early on the Monday morning but had been studying hypnobirthing techniques and so just breathed through them. For me it was more traumatically sad than painful. I didn’t even tale a panadol (aspirin type painkiller) till later that day and that was for some cramps I had then. Like someone else said – I wanted to actually kind of embrace the pain as with the first one I felt like I had literally ‘lost’ the baby – with it just suddenly almost falling out of my body. The shock was awful. So for the second I wanted to be closer to the experience in some way. I did not want a D&C for two reasons – one that I was worried it could do some damage and I was worrying enough about ever being able to carry a baby to term. Secondly – in our culture the body (and body tissue etc) is sacred – especially anything to do with birth. So I wanted to take the foetus and the placenta and bury it with the other one. The (f#*King stupid) young female doctor was horrified when I asked if I had a D&C could I take the foetus away. She replied – ‘but it will be all macerated!’ I was so upset and swore that I would not do that. The induced option was not ideal but I would have done that if I had to.
    I wish you well with whatever option you choose. Keep reaching out to your community – we are all here for you.

  10. I truly wish you didn’t have to deal with this. But to provide you with my perspective, since I’ve done all 3 I’ll try to be brief about each experience.
    My first miscarraige was a natural one and occurred at about 5 weeks, so it was relatively easy. Bad cramping, but really just a bad period.
    Misoprostol/cytotec – I’ve done it twice and both times I was the 20% of the time when it doesn’t work properly. My second pregnancy was my first time using the drugs and it resulted in extreme pain, but virtually no bleeding. I ended up having to go the ER at the hospital and had an emergency D&C. It was not fun, but the D&C itself was not that hard. I had some blood pressure issues afterwards, but for me it wasn’t that bad. But, I think it was really hard on my husband as he was stuck waiting through the surgery. My fourth miscarriage was the second time I took misoprostol/cytotec also did not work. I had stronger drugs (Oxycontin), thankfully. I was monitored daily by my RE, and after 4 daily doses (max that my clinic will give), it did not work. Bleeding, pain, but I never passed the sac. I spent about 2 full weeks on very powerful pain drugs, and I was virtually useless. It took 29 days, with multiple in-office procedures to suction pregnancy products out of my uterus, before my body expelled everything.
    I’ve also had a medically required abortion which is the same surgery as a D&C – my third miscarriage. You can read all about that horrible experience in this post – http://wp.me/p4qQfg-8X. Whatever you end up doing, please, please be very aware that if you start having any green discharge you need to get the hospital immediately. It’s unbelievably rare to have a septic miscarriage, but it was one of the hardest and scariest situations I have ever been through.
    The last thing I’ll add is that I found the D&C the easiest for me – it was virtually not painful for me – or at least not compared to my misoprostol experiences. But, the D&C was also the hardest on my husband. And, now my RE will not let me have another surgery because of the high risks of scar tissue developing with multiple D&C’s. So, now if we have another miscarriage, I will only be able to take the drugs.

    Anyways, I hope I wasn’t too blunt about all of this. If you do have further questions feel free to ask me – myperfectbreakdown @ gmail.com. And, honestly, whatever you choose will be right for you. And, honestly, I find that the actual physical miscarriage is always easier then the emotional side of it.

    I wish you the best of luck getting through this.

  11. I miscarried at 8 weeks but heartbeat stopped at 7. They gave me the same options, but as you know I took two rounds of cytotec to no avail. Both times I took it I laid around with some mild to moderate cramping, and did pass some significant tissue, but when I went to the doctor most of the tissue was still left inside. My mother thinks the cytotec didn’t work because I’d been on progesterone. When your body thinks you’re pregnant and you’re giving it extra progesterone support, it doesn’t know to excrete the pregnancy, much like how your HCG was still increasing (according to my midwife mom). Our fertility clinic would’ve charged us $3,000 for a D&C (?!) so we went to our regular doctor, who ended up doing a vaginal u/s, confirming tissue was still there, and scheduling an MVA which is a manual vacuum procedure. I had to wait three more days, which was awful. You just want it over. An MVA is the same thing as a D &C but less invasive and you’re awake for it. I don’t think I could to through it again because it was too medically traumatic. A D & C would be my preference because you’re not awake for it and it ensures your uterus is completely empty in case you want to do another cycle.

    My reaction to miscarriage is still that I can’t believe so many couples have to go through it; it’s horrible. I’m so sorry that you’re having to face this again, and this time with your own body. It will get better, especially after the physical part is over. Sending you love.

  12. Oh, and when I took the cytotec they gave me codeine, which made me sick and wasn’t strong enough. After the MVA I had Vicodin which was better for intense cramps. Ibuprofen is absolutely necessary too, as it’s best with muscle pain. I hope this helps. And I think your doctor’s office is mean and impersonal. They should call and check on you and talk to you in person; not cool.

  13. I’m so sorry 😦

    My last MC story is very similar to what you just described. Bleeding started a few days after the US. It was not bad at all, I only remember having bad cramps once or twice. Use a heating bad, and keep yourself on a regiment of ibuprofen. I only ever passed “stuff” when I was using the bathroom really. Take care of yourself ::hugs:: Thinking of you.

  14. I know that no words I can say will help right now but please know that you are both in my thoughts and prayers and if there’s anything I can do from a distance, please, please let me know. Hugs for you both.

  15. Hello, I see you’ve chosen a natural MC but saw your question re: HCG level dropping to 0. At my MC, my last beta was 56,000. After taking cytotec and after all was passed, I had a beta drawn and it was ~600. The drop from 600 was slow – maybe 4-5 weeks. I think about 8 weeks from learning there was no heartbeat I got my period. So very sorry you’re going through this.

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