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What to Expect When You’re Miscarrying

Photograph by Twenty20

I was typing on my phone—some urgent work thing—barely paying attention to the ultrasound, when the doctor said to me, "I'm afraid there's no heartbeat."

"What?" I said, dropping my hand. It was a 10-week appointment, after we'd already seen the baby's heartbeat the month before, and celebrated. I hadn't even had my husband come along.

"I think the baby has stopped growing," the doctor said. She told me I should go to another place which had a more detailed machine, just to be sure. And then come back.

RELATED: The Many Ways to Miscarry

I was sobbing unremittingly as she left me alone to get dressed, call my husband and wait for him to take me to the other office, where a more kindly ultrasound technician confirmed the initial result. The baby had stopped growing at eight weeks.

There is nothing quite so horrible as losing a pregnancy. But one of the worst parts—to add insult to injury—was having to decide what to do about it. Because it was a missed miscarriage – the type where you don't bleed or show any signs, where the fetus simply stops developing – I had to decide how to get rid of it.

First, though, before you do anything, you have to be absolutely positive the pregnancy has terminated. (Some women have a tilted uterus and a doctor can't find the heartbeat, but it's there.) Then there are three options: Let it occur naturally, take a pill to expel it or have a procedure to remove it.

To be honest, even though it's natural, the thought of allowing a miscarriage to happen on its own creeped me out.

Although I went home that day doing everything you're not supposed to do during pregnancy—eating sushi, drinking wine and going into a hot tub, all to try to induce bleeding, after all my experience (with three more miscarriages) I highly recommend that for any pregnancy beyond six/seven weeks, you should have a procedure.

To be honest, even though it's natural, the thought of allowing a miscarriage to happen on its own creeped me out. You don't know how long it can take. Some women still carry their fetus for a few weeks. Second, once it does occur, it can be very painful, bloody, and long—not to mention incomplete. Meaning, you'll have to go for surgery anyway in the end.

Although taking a pill (misoprostol, cytotec) to terminate is quicker than waiting for a spontaneous end, again, as above, it can be bloody, painful and incomplete—and often ends in surgery anyway.

The first time I opted for a procedure, I was afraid of anesthesia, so I opted for a "aspiration," which used vacuum aspiration to remove the fetus while I was awake. It was a horrible sight.

RELATED: How to Support a Friend Coping With Miscarriage

The next time, I overcame my fear of going under, and had a D&C, "Dilation and Curretage," removing the contents of the uterine and scraping the lining, which many believe is good for future pregnancies. Physically, the pain was minimal. Emotionally,it was devastating.

No matter what your OB-GYN says, I highly recommend everyone with a miscarriage after six or seven weeks have a procedure done and test the "products of miscarriage." This will determine if the fetus was chromosomally normal or abnormal, which will determine your next steps. Especially if you've had a miscarriage before.

It's a horrible experience all around, but if it happens to you, these are your options—and sometimes knowing what's ahead is a comfort in and of itself.

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