Most posts on this blog are written to archive our family’s history or to show off pictures of Soren for the grandparents. This one? Not so much. When I was searching the internet for information about misoprostol for miscarriage, I found other women’s experiences, posted on forums and personal blogs, so so helpful. So I’ll add another story to the world wide web, in hopes that it’ll help some other searching soul who is preparing for her own miscarriage. (A separate post describing more of the background on the miscarriage can be found here.)
Oh, and warning: Slightly graphic content ahead. Dad, this post is not for you.
On the day I learned, via abdominal and vaginal ultrasounds, that my pregnancy had “failed,” my midwife wrote me prescriptions for misoprostol and oxycodone. She advised me to wait a week for a confirmatory ultrasound, so it was strange to have the prescriptions and two-page miscarriage instruction sheet sitting on my dining room table for seven days while I waited, waited, waited.
After the follow-up ultrasounds showed the fetus was, in fact, not viable, I met with my midwife again and peppered her with questions about what the physical experience would be like. Tim and I had read five or six detailed accounts online of others’ experiences with misoprostol for miscarriage, and each person seemed to have a very different story. Among other questions, I asked if I would be awake all night if I inserted the pills at bedtime, as she recommended? How painful would it be? How much bleeding is too much? Or not enough? Would I know when I’d passed the fetus? What if I didn’t feel like I could flush the toilet? Should I eat a lot in advance in case I’m nauseous during the process and can’t eat then? Should I consider scheduling a D&C instead? How will we know if it’s successful? Would I be able to travel by Christmas?
I felt fairly confident in our plan to go forward with the misoprostol, and Tim and I decided we would get the miscarriage party started around 5 or 6 p.m. — late enough that I’d only have a couple hours on my own (while Tim would take care of Soren and put him to bed) but early enough that we’d have a good four or five hours before our own bedtime. As 5 p.m. approached, I started feeling really nervous, and a little anticipatory nausea hit me. And then we realized we needed to tend to other really important things, like dinner. Tim somehow convinced me that a Chipotle salad bowl was the perfect pre-miscarriage meal — not too heavy, but substantial enough to carry me through whatever blood loss and pain might come my way. To be honest, that dinner kind of hit the spot. But it did push our plans back by a bit.
7:15 p.m. I placed a towel on my side of the bed, then laid down with two bottles of pills and a glass of water by my side. I placed the four misoprostol tablets, one by one, as far into my vagina as I could reach. I popped one oxycodone pill right after. (I’m generally pretty against pain medication, antibiotics, etc. I birthed Soren completely naturally, I had a cavity filled a few months ago with no numbing, and I rarely turn to Advil for headaches. But in this instance, I didn’t hesitate to take the strong stuff. Doctor’s orders.)
And then, the waiting began. I was in the middle of reading The Bishop’s Wife, which was kind of fascinating, so I welcomed the forced bed rest. My instructions were to lay flat for at least four hours after taking the miso, so I considered myself ready for bed.
8:45 p.m. I started feeling super drowsy. Nap time. Figured it’d be good to rest up now in case I was awake a lot during the night.
9:30 p.m. Super weird dreams brought me out of my semi-slumber. My book — and the oxy — must have had some influence, because I was having crazy visions of abusive men trying to kill their wives. I woke up feeling a tiny bit dizzy and a little nauseous, but mostly normal. The mildest of cramps started to come on right around then, but they were so slight I wasn’t even sure I was feeling anything. Time for more waiting. We watched an episode or two of Parenthood — fun date night!
11 p.m. Nothing’s happening! I was expecting full on cramps and bleeding at this point. Since I was pain free and feeling totally normal, we decided to call it a night and turn out the lights. I had no trouble falling asleep, and most of my nerves had been settled by the oxy.
12:30 a.m. Woke up in an absolute panic that someone had entered the house and was standing next to Soren’s crib, ready to snatch him up. I startled Tim awake to have him check the monitor. Safe and sound. Must be the drugs.
1:30 a.m. Woke up to the feeling of warm blood — finally! This might be working! I went back to sleep, figuring I had some time before I’d need to change my pad.
3:30 a.m. Woke up again and felt like I should go to the bathroom to see how things were progressing. Tim insisted on accompanying me, which was a really good idea. As soon as I stood up, I felt a rush of blood come out, along with a very large clot — possibly the embryonic sac itself. Because it fell into my pad, I was really interested in looking at it. It was around three inches long and definitely looked like more than just blood. Not wanting to flush the possible fetus down the toilet, I asked Tim to save it. I sat on the toilet for a little while, figuring it made more sense to bleed there instead of quickly filling up another pad while laying in bed. I started to feel lightheaded and weak, so I leaned forward against Tim, who was standing in front of me. And then I guess I passed out. I’ve fainted probably five other times in my life, but it had been a good 10 years or so since the last time, so this caught me by surprise. And it really freaked Tim out. He caught me from falling off the toilet and cracking my head open, then eventually I jolted up, still totally out of it. The next thing I was remotely conscious of was someone saying my name, over and over. In real life, it was Tim, but in my passed-out state the voice sounded completely foreign — and I remember feeling like I was intentionally ignoring it. Strange how our bodies/minds do things like that. Eventually, I came to but felt pretty confused about what was going on. Tim escorted me back to bed, and I felt absolutely wiped. And Tim was terrified about my ghostly white face. He fed me apple slices with peanut butter to get some protein in me, and then I took a second dose of the oxy. I still hadn’t felt any pain to this point — and hardly any discomfort — but I was nervous I’d get hit if I didn’t keep ahead of the pain with the meds.
5 a.m. Of course Soren began crying and whimpering, “I want mama” from his bed. I swear he knows when something is going on that makes me unavailable. Luckily, he quieted quickly, and we all fell back asleep until 6:30 a.m., when Soren gets up for the day (his choosing, not ours).
6:30 a.m. Tim force fed me a bowl of cereal with strawberries, letting me know I was still super pale and was not allowed to make my way to the bathroom until I had some food in me.
7:30 a.m. 12 hours in. Realizing my pad was full, I crawled to the bathroom — so four hours since the last time I’d changed my pad. Another enormous clot came out, but this time it went into the toilet and I didn’t feel the need to fish it out for saving or inspection. After making it back to the bed, I was exhausted. I tried to read Soren a story while Tim showered, but halfway through the book I had to put it down — my arms couldn’t handle it!
8:30 a.m. I finished my book and took another dose of oxy, just in case. But realizing the drugs might be what was causing my lightheadedness and dizziness, I decided to make it my last dose. I still had felt no pain, so I figured I could move to Tylenol if cutting off the oxy led to some discomfort. Also to combat my weakness and complete lack of energy, Tim was practically pouring juice down my throat to keep me hydrated. He made an excellent nurse.
10 a.m. Started feeling really hungry, so I snacked on blackberries and a Cliff bar. (Note that this is all still taking place in my bed. I didn’t feel quite ready to get up and walk around.) I was so thrilled to realize I had felt normal about hunger and eating through all of this. I had been so worried I’d be too nauseous to eat, but that never was a problem for me. I’d read plenty of accounts where people vomited throughout the experience, so I was really pleased with my situation so far (minus the fainting incident). It all seemed a little too easy, which made me nervous the whole things wouldn’t be successful.
11:30 a.m. Another accompanied trip to bathroom showed a super full pad (again, a four-hour span) and a few decent-sized clots. I lunched in bed, then laid back down for a nap. Eating and reading sure was exhausting.
3 p.m. Another pad change, but it wasn’t incredibly full. No more pain meds, and still no pain.
7 p.m. 24 hours in. The bleeding really let up by the 24-hour mark, and the only discomfort I felt was a headache, probably due to all the crazy hormonal changes happening. I was feeling really worried that it hadn’t “worked.” But my body was definitely feeling the blood loss. I felt pretty drained and void of all strength. A good friend delivered a Vietnamese feast to us, so we had a family picnic in my bed. I didn’t even have enough energy to care that Soren was dropping noodles and peanut sauce all over our “picnic blanket”!
It was the perfect night for takeout!
Day 2: Not much action during the next 7 p.m. to 7 p.m. period (Saturday). I slept alright, but felt pretty exhausted in the morning. Bleeding was light most of the day. I took a shower, which felt incredible. Tim hovered in the bathroom, terrified I’d pass out again. I took a few naps here and there, and in the evening I made it outside! I walked the short distance from the house to the car, then we drove around to look at Christmas lights, sharing a Rancatore’s frappe among the three of us. Nice to be outside, but really nice to get back home to bed.
Day 3: On Sunday, after 48 hours in, I woke up with an incredible headache. Anytime I tried to stand up I felt like I’d been hit by a truck. I napped while Tim and Soren went to church. Around midday I could feel a lot more blood coming. I took a shower, and blood was just streaming out of me. Through the afternoon, I had to change my pad a few times in quick succession, and there were a few more large clots. By evening things slowed down again. This gave me hope that things were happening as we’d wished!
Spending hours upon hours in bed got old really fast. Soren didn’t seem to miss me too much. He did come join me for lots of cuddles, though.
Day 4: On Monday, I headed for the doctor’s office, where my blood work showed that my hCG levels had dropped from 88,000 (the day before the miscarriage) to 11,000 — a good sign, but not conclusive. The midwife recommended returning in a week for more bloodwork. Today was the first day I started to feel a little more “normal.” Still weak, still tired, but capable of picking things up around the house and doing a little more than just laying in bed.
Days 5, 6, 7: On day 5 the midwife said we were clear to travel for the holidays, so we jumped in the car and spent the next 10 hours traveling from Boston to Virginia. My body was feeling pretty good, and the bleeding was light enough that we didn’t need to make more than a couple stops to fill the car with gas and to get dinner. The day after we arrived, though, (day 6) I was spent. I wouldn’t have expected a road trip to take it out of me, but I was completely drained. My mom and husband ordered me to stay on the couch while they pumped me full of water, iron supplements, and food. The next day — day 7 — was Christmas, and I felt a little closer to normal. A little stronger, no headaches, and very little bleeding.
From there, things have gotten better each day. On day 18 I returned to the doctor’s office for another hCG check, and the results showed my levels had dropped to 586. A huge drop, but not quite low enough to mark this whole thing as “finished.” I’ll go back in a week for another check, but I feel optimistic that we can call it a day — now that it’s been a month since I first got the news that the pregnancy was not viable.
All in all, I think my misoprostol for miscarriage experience was incredibly ideal. I felt no physical pain, and I was fortunate to be among the 80% of women for whom it works first try. Although doing a D&C in the hospital might have guaranteed successful results more quickly, I’d go with misoprostol at home every time after my experience. Now we’ll just hope I never have the need to choose again!