Miscarriage Options
Natural Miscarriage vs. D&C
I will be completely honest with you, in the end it really comes down to personal choice and you should not feel that anyone (medical professional or friend) has forced you to go either way. With that said we will look at these two choices a little more closely.
A Natural Miscarriage basically just means that you wait for your body to take care of things in it's own timing, without intervention. Many women choose this option because they are able to go through the very personal and emotional process of a miscarriage in the comfort and privacy of their own homes. Another big reason that women choose to go the natural route is the margin of error that undeniably exists in the diagnosis of impending miscarriage. Thousands of women every year are told that their babies were not going to make it, only to end up holding a beautiful and perfect baby in their arms months later. We have to keep in mind that ultrasounds are not 100% accurate and that even lab results can be misleading. Personally I knew I couldn't intervene in the ending of my pregnancy as long as there was ANY lingering thought in my mind that my baby could survive- I could not let myself wonder down the road about what would have happened if I had done nothing.
The last thing I would like to mention in support of natural miscarriage is that you are in complete control of the remains of your baby. Some hospitals and medical professionals feel that it is traumatizing for the mother to see the tissue and so they do not allow her to have it for burial, or even see it in some cases. This is an issue you would have to speak directly to your health care professional about if you decided to go the D&C route.
The downside to natural miscarriage is that you don't know when it is going to happen. Sometimes it takes days and other times it takes weeks, during which you can't really plan much of anything because you don't know what each day will hold. One of the problems that can develop is that sometimes your body does not expel all of the tissue, which can lead to infection. Most of the time these infections can be cured with a round of antibiotics if the tissue does eventually expel itself, but it is a risk to consider. If the tissue does not expel itself, those women typically are put on medication to aid in the process or end up having a D&C. Another problem that can arise is that sometimes a woman's body does not detect that the baby has died and so therefore it does not pass it- this is called a missed abortion or missed ab, meaning that your body "missed" "aborting" the unviable tissue. In this case the woman would most likely end up needing to have a D&C.
A D&C (dilation and curettage) procedure allows you to take matters into your own hands and essentially get the miscarriage "over with." Many women choose this route, solely for the reason that they don't like the thought of waiting and not knowing when everything will be said and done. AmericanPregnancy.org has to say the following about a D&C procedure:
"D&C, also known as dilation and curettage, is a surgical procedure often performed after a first trimester miscarriage. Dilation means to open up the cervix; curettage means to remove the contents of the uterus. Curettage may be performed by scraping the uterine wall with a curette instrument or by a suction curettage (also called vacuum aspiration), using a vacuum-type instrument."
AmericanPregnancy.org goes on to say that for many women, especially prior to 10 weeks gestation, a D&C is not always necessary. There are some definite risks associated with this procedure that you should be aware of. The following are some of the risks identified by AmericanPregnancy.org:
-Risks associated with anesthesia such as adverse reaction to medication and breathing problems
-Hemorrhage or heavy bleeding
-Infection in the uterus or other pelvic organs
-Perforation or puncture to the uterus
-Laceration or weakening of the cervix
-Scarring of the uterus or cervix, which may require further treatment
-Incomplete procedure which requires another procedure to be performed
You can find more information regarding D&C on the AmericanPregnancy.org website, including how the procedure is performed.
Midwife vs. Doctor
Perhaps one of the biggest differences you will see in the care you receive during a miscarriage depends on if you are seeing a midwife or a doctor. By nature, midwifes typically trust your body more and allow such events to run their course unassisted. Another advantage to having a midwife is that you generally meet with them in a much more comfortable environment- either their home or yours in most cases. When faced with a traumatic life event, such as a miscarriage, many women find it difficult to have to enter a very sterile environment, like a hospital or doctors office. Perhaps the most important aspect of being under the care of a midwife is the personal relationship you have with her. In many cases a midwife will sit and talk with you for more than an hour, discussing all of your options and the emotions you are encountering.
Sadly, most OBs just don't have the time to sit down with you and discuss how you are feeling for an hour. The care most women receive under an OB is typically very one-sided- the medical side. A doctor tends to look at the physical issues at hand but ignore the deeper emotional ones that are very much in play during a miscarriage. Also, many doctors these days, not all mind you, are working off the bottom line and it is more financially beneficial for them if you undergo a procedure to have your miscarriage "taken care of." Many other doctors are simply trying to cover their backs. By giving you a D&C they are essentially "doing all that they can for you," which doesn't give the patient a chance to sue them in case something (like a hemorrhage) were to occur during a natural miscarriage at home.
All of this is not to say that there are not some wonderful doctors out there who are willing to listen to your concerns and work with you through your pregnancy loss. You just need to be aware of what you may be facing if you are under the care of an OB. Keep in mind that your defenses are down when you are in such an emotional state and you are far more likely to do what the doctor recommends just because they said so, even if it is not the best route of care for your personal case. Don;t make any rash decisions while you are at the office. Go home and do some research for yourself so that in the end you can feel comfortable with the outcome, knowing that you were able to make informed choices for yourself.
