Illustration by Sam Woolley/GMG
“I’m sorry, there’s no heartbeat,” my doctor said to me. She didn’t sound very sorry, leaving the room so quickly—ostensibly so I could pull up my underwear—that she couldn’t hear me burst out in tears.
There are many ways to lose a pregnancy—from the traditional bleeding in the toilet, to a missed miscarriage where you don’t even know that you miscarried, to a blighted ovum where the baby never started growing at all, to an ectopic pregnancy, where the fetus implanted in the wrong place. I’ve had most of them—they all suck, let me tell you—and I’ve learned the important ways to deal with a miscarriage.
Chances are you were told in school that you could get pregnant any time you have sex so don’t have …
First, you will probably be in shock. No matter how nervous you were about becoming a mom, no matter how skeptical you were of the pregnancy working out, you will be disappointed times a million. And as awful as this all is—sad and frustrating and emotional—the first thing you have to do is figure out how to start or complete the miscarriage process.
There are a number of ways to terminate a failed pregnancy (and I’ve done most of them).
This means you just let nature take its course. You wait for the bleeding to start and for the pregnancy to pass. For very early pregnancies, like chemical pregnancies which never registered a heartbeat, this is often the recommended route. My very first miscarriage—where I didn’t really know I was pregnant until the prior day—passed this way, and it felt like a really late period. (Had I not taken three pregnancy tests, that’s what I would have assumed it was.)
Some women prefer to do the natural way no matter how far along in their first trimester they are, but the downside is that you could be waiting a while—which totally creeped me out in my second miscarriage, knowing there was a non-living fetus inside of me. Also, it could be super messy (ditto on the creepy). And it can also be incomplete, sending you to surgery anyway (see #3).
2) The Pill
There is a pill that can help the miscarriage proceed faster—especially if it already started. Misoprostol, which induces labor (and for miscarriages is often given together with Mifepristone) also can be messy and from what I’ve heard, extremely painful. I was advised not to use this because you often end up in surgery anyway (see #3).
As you can see from my previous two conclusions, I am a big fan of the surgical procedure to terminate a failed pregnancy, specifically the D&C. I am not a doctor, so I can’t give any medical advice except to tell you there are risks to every surgery.
But as a patient, by my third miscarriage, I preferred this method of removing the contents of the uterus, usually under general anesthesia. (There is a surgical procedure called “aspiration” which involves a vacuum and no general, but I found it awful to be awake, making conversation and watching everything happening.) An ectopic pregnancy must be surgically removed.
Here’s why I preferred the D&C:
Your pregnancy is terminated quickly and painlessly, for the most part.
You don’t have to witness any of the sad bloodshed.
It is the most effective way of making sure everything is removed and to get you ready for your next pregnancy.
MOST IMPORTANTLY and I can’t stress this enough so I’m going to give it a separate headline ... 4) Get It Tested
If you have surgery you can get what is medically called “the products of conception” tested. That means they can chromosomally test your fetus and see what, if anything, was wrong with it. For older patients, patients undergoing IVF, or in my non-medical opinion, any patient, it is a great comfort to find out that something was wrong with the fetus, which is why it didn’t make it. On the other hand, if they find out that there was nothing wrong with the baby—that it was chromosomally normal—you can investigate other solutions to prevent it from recurring.
In fact, I’m such a fan of this method that by my 4th—and final—miscarriage—I scheduled it right away so I could make sure not to lose my chance to test the products.
It’s only after you’ve dealt with ending the miscarriage that the real loss may hit you: you’re not pregnant anymore. The sadness of this will be accompanied by actual physical symptoms, such as a drop in hormones— those happy-making chemicals that buoyed your bump. I myself often experienced a palpable gut-wrench from the drop, as well as a weight gain that no doctor had warned me about.
Look, I’m not going to sugar coat this: There was no good thing about any of my miscarriages. And most people didn’t have any good things to say about it either, like, “At least you can get pregnant.” (Thanks a lot).
But maybe the one good thing that can come out of this is that I suffered through indecision and different procedures so you don’t have to. Hopefully you can get through the physical part, so you’ll be free to focus on emotional healing and hopefully, get started trying again.