Is This Really a Miscarriage?
QUESTION
Dear Midwife,
I am about 8 weeks pregnant on 02/23/. I had some minor bleeding during the day on 02/22/ and returned home for some rest. At 1830 I had a sharp cramp like pain and some bleeding. Cramping got a little worse and the MD on call suggested I went to the ER to be checked out.
At the ER we sat there for an hour and half before being seen. I had yet to soak through a pad. Cramping had near enough stopped and was thinking about going home when they called us back.
After blood work, they sent me down for an ultrasound. I knew I had a retroverted uterus so I informed the US tech of that. I did not have a full bladder when they attempted the trans abdominal Ultrasound. Then a trans vaginal ultrasound was performed. At this point and time I was not allowed to see the monitor or anything. She was just taking pictures and asking if I had passed any clots. With the answer being NO! She kept asking me like I wasn't telling her something.
The blood was never really DARK red, more bright. The ER Doctor then came in to do a vaginal exam. Nothing like I have ever had done. He was like 'yep, there is your cervix.... okay I am done' and walked out.
Sometime later he came back and said I was having a miscarriage and to take some Motrin when I get home for pain if I needed it.
We get home and are DEVASTATED! We have lost the baby.
I get up in the morning and there is minor blood. Nothing like a normal period. No cramping or anything. I had a few cramps (nothing worse than I get with menstrual cycle) during the day with bleeding (red - pinkish).
I called OB/GYN and find out blood levels are in the high 8000 but the Ultrasound said nothing was found so therefor diagnosed with a miscarriage. (ER did not provide us with any of this information, just the diagnosis)
Bleeding stops that night and started back up again today 02/24/ while at work.
I have yet to pass ANY significant clots or large amounts of blood. (or what I would think was a large amount, I get more on the menstrual cycle that I do right now) Bleeding is still redish-pinkish.
I have an appointment scheduled for Friday with OB/GYN for a 'problem' checkup.
Should I be in more pain or experiencing more cramping/bleeding if I am miscarrying? How long do the symptoms for a true miscarriage kick in? I heard the cramping pain is unbearable.
ANSWER
I am SO sorry all this is happening to you and that you had such a poor experience at the E.R. These are times when it is great to have a supportive midwife on your side. Anyway, if there is nothing in the uterus at 8 weeks, then you have indeed lost the pregnancy.
It can take a long time for the products of conception to either be expelled or absorbed, and for your pregnancy hormones to disappear. Basically, you have three options:
1) surgery (a dilation and curettage or D&C) to scrape out your uterus;
2) medication that will increase the cramping and hopefully expel everything; or
3) let Mother Nature take care of it.
As long as you are not hemorrhaging or getting a fever, IMHO you have all three options open to you--it's your decision.
All of this should have been explained to you in the E.R. and if not there, then on the phone by the OB/Gyn's office. Hugs, and know that we understand how loved your baby was and is.
-- Cynthia, CNM. PhD.
Cynthia Flynn
Cynthia Flynn, CNM. PhD, is the General Director of the Family Health and Birth Center which provides prenatal, birth, postnatal, gynecological and primary health care to underserved women and their families in Washington, D.C. Recently Cynthia served as Associate Professor of Nursing at Seattle University. There she not only taught, but remained in full scope clinical midwifery practice at Valley Medical Center where she cared for pregnant and birthing women, and practices well-woman gynecology, family planning, and treatment of sexually transmitted diseases.
Cynthia founded Columbia Women's Clinic and Birth Center, where she took care of pregnant women and infants up to two weeks of age and attended both birth center and hospital births. Before Cynthia earned her CNM, she worked as a registered nurse in labor and delivery and postpartum and is a certified Doula and Doula trainer.
