miscarriage at 13 weeks

I feel it's really important for me to post how my miscarriage went. When I found out there was no heartbeat and that I would eventually miscarry I searched quite a bit on how the miscarriage would go and found a lot of the time at 13 weeks people have a D&C. I'm sorry if some of this is graphic but I want to give as much detail as I can.

Saturday I started getting cramping around 9pm. I was laying in Lauren's bed singing her to sleep when the pains started. They were fairly mild mostly just annoying. At 11pm I noticed it was a pattern. The pain would come, wrap around my stomach and back, last 10-15 seconds then go away for a few minutes. I took 2 tablets of paracetamol then tried to get some sleep. I woke up at 2am in a lot of pain. This is when I realized that I was actually having contractions. It wasn't early labour contractions it was full on active labour contractions where I had to grip the bed and breathe through them (my jaw is still sore from clenching). We called the nurses line because I wasn't sure if this was normal as my miscarriage at 10 weeks was nothing like this,  I also wasn't bleeding very much just blood when I wiped. They asked Dan I bunch of questions and then said to go to the hospital because the blood was liquidy like there was discharge with it. We got to the hospital around 3:30 without any of our insurance information. They told us it would be $90 for a consultation and if I was admitted $1770/day. We said that was fine and they sent us in to check my bp, temp and get my information. The nurse said that the contractions seemed pretty close together (3-5 minutes apart) and that hopefully I would pass the baby soon. I told her that my contractions were always 3-5 minutes apart, even with my daughter's labour. We were placed in a room and left there until a doctor came to see us. The doctor came in to get my history and find out what was going on. He also took some blood and got the IV set up in my arm incase it was needed. While he was there I had a couple contractions and felt like I passed something. He ordered morphine (and gravol when I mentioned morphine made me sick with Hailey's labour) and sent in a nurse to check what I'd passed. I went to the toilet and it turns out I was just bleeding heavily but then there was a plop in the toilet and I passed something in there but you couldn't see it because there was so much blood in the toilet and the light to the bathroom wasn't working. She flushed the toilet and said hopefully it was the baby and now the contractions should start to die down. She then came back to give me the morphine at 5:30am. Yes they made me go 2 hours with the contractions before giving me anything for them! The morphine helped and we were left in the room on our own with a call button if we needed anything. At around 6:30 I felt like I passed something so got up and caught it in paper towels. I asked Dan to call the nurse and when she came in she said it was just a clot (about half the size of my palm) so I flushed it down the toilet.
She came back in at 6:45 and asked how I was doing. I told her I thought the morphine was starting to wear off and she said yes it probably was and would I like more. I said I would but asked for something other then morphine as I didn't like the way it made me feel. She told me she'd go get something similar that I could take orally and it'd last 4 hours instead of 2. While she was gone the doctor came in with another doctor (a female) and said they were going to check my cervix and see if it was open and check if they could see any products of conception. The female doctor did it as the male doctor I'd seen had only been with the hospital for 2 weeks and I'm pretty sure was only a resident. She explained and showed him what she was doing. They checked my cervix for products of conception and pulled out a few clots. She then did an exam and said that both front and back of my cervix was open and that I should be allowed to miscarry naturally at this point without the need for a D&C. Because I had to take off my underwear for this I bled quite a bit over the bed and they had to change the sheets. I put on a new pad, was given the pain killers and said that the doctors and nurses where switching over to the day shift. At 8:30 a new doctor came in and said she'd requested a gynaecology consult and they wanted an ultrasound done. I wasn't allowed to have anything to eat or drink at this point incase a D&C was required so they gave me a litre of fluid through IV in 30 minutes. I went down for the ultrasound at 9:45. By this time I checked my pad and the bleeding had stopped and the pad I'd put on at 7 still looked was almost new.

To be honest when I went for the ultrasound I was still hoping she'd say that they'd made a mistake before and that the baby was alive and well. Of course this was not the case, we weren't sure if I'd passed the baby into the toilet earlier or not. She did a pelvic ultrasound first and said that the baby and sac were still there and the baby was measuring 9 weeks with no fetal heartbeat. She then said that she'd have to do an internal ultrasound to confirm no heartbeat as sometimes you can't see it abdominally and she'd hate to be wrong if I ended up with a D&C. Of course there was no heartbeat vaginally either and I was then sent back to my room in the ER.

I finally saw someone from gynaecology around 12pm. She told me that since my cervix was closed I'd need a D&C. I told her I was confused because when they did the exam at 7am my cervix was open. She told me that the ultrasound showed my cervix was closed but she'd do another one herself to confirm. She went to get the portable ultrasound and confirmed that the baby was still there and that yes my cervix was now closed and this is probably why the bleeding stopped. She told me that I'd need a D&C but they don't do them on Sunday's unless you're bleeding heavily and at risk of dying because it costs the hospital 1000's of dollars extra (there's penalty rates for working on Sunday's in Australia) so since I was stable at the moment she was going to schedule me for one Monday. I said that was fine but my only concern was that my insurance doesn't cover related issues after I've been discharged. Basically we were unsure if my policy would cover a D&C as it just states it's covered if "medically necessary" but it has to be done the same day or same time I'm admitted to hospital. I was worried if I left the hospital I'd no longer be covered for pregnancy related issues. The OBGYN said that it's a stupid policy (which I agree) and asked us to call the insurance company to see if they'd let me go home as I was currently stable but check if I'd still be covered to come back the next day to be readmitted and also check if anything happened overnight if I would be covered. She told me that if they wouldn't allow me to leave they would admit me to a ward if need be. I got Dan to phone them (I didn't need the extra stress) and they agreed to allow me to go home and come back the next day. They asked us to keep them updated if my situation changed and I was readmitted overnight. So I was sent home with pain killers and asked to return to admitting at 8am the following morning (the D&C would take place in the afternoon).

The Sunday afternoon was uneventful. I was in pain so took 1 tablet every 3 hours. I was supposed to take 2 every 6 but found it only helped with the pain for 3 so I switched to 1 ever 3 and it worked better for me. Around 10pm I started bleeding lightly. I woke up at 12:20 in a bit of pain and although I knew I couldn't eat or drink after 12 I went down and had a tiny sip of water and took 2 pain tablet (hoping it'd hold me over until 8am) then went back to sleep. I woke up at 3am in A LOT of pain. I asked Dan to go down and get me another tablet but it really didn't help. At around 3:30 while sitting on the toilet my water broke during a contraction then at 3:45 I passed the baby. It didn't come out like a clot it come out when I wiped. I wasn't sure what to expect as I hadn't googled what an 8 week fetus looked like but I could tell that it was definitely the baby. It was translucent and had eyes. Dan wasn't convinced that was the baby so we googled pictures the next day and I can say those pictures are pretty accurate. I said my goodbyes to the baby then handed it over to Dan as I couldn't bring myself to get rid of it. I left the room then Dan flushed it down the toilet. I continued to bleed fairly heavily and passed clots for the next few hours. I was so exhausted from lack of sleep the previous night that I fell asleep and woke up numerous times. I'd fall asleep for maybe an hour, wake up, go to the bathroom to pass clots then go back to bed and start the whole cycle again.

I woke up at 7:20 and the bleeding and clots had slowed down quite a bit. We quickly got dressed and headed to the hospital. We went to admitting and spoke to the admitting nurse saying I wasn't sure if I needed a D&C anymore since I was fairly certain I had passed the baby. She said I should speak to a midwife so she phoned and asked for my file then walked me down to the clinic attached to the hospital. We waited in the waiting room and saw the midwife just after 9am. She went over my history then said that because I looked very pale, was still bleeding and passing clots she didn't feel I was stable and they only see stable patients so I'd have to see a doctor down in ER. She called over then walked me down and handed over my file to the nurses there. We waited in emerg and finally saw a doctor around 10:30. We explained what was going on and he said that I'd need another consult with gyno and they'd want to see where my HCG levels were since it hadn't been done the previous morning. He took my blood (they also did a CBC) and asked if I'd had previous HCG's done with this pregnancy. I told him yes at 4 and 6 weeks and that I could access them online. I printed them off for him and we waited for gyno to come.

We had the consult at 11:30 and she said that since I most likely did pass the baby I probably wouldn't need a D&C at this point. She said there was no point doing an ultrasound since it would show there was still stuff in there. She said that if I wanted I could still have the D&C or we could wait it out and see what happens. I asked what the risks of waiting were and she said basically just chance of infection as well as heavy bleeding.  She said normally what they'd do is wait a week and compare the hcg levels. If they weren't going down fast enough then I'd need a D&C. I said since I would be home in a week anyway we'd wait it out, keep an eye out for sign of infection and if needed have a D&C when I get home.

We got copies of the ultrasound results done the previous day as well as the blood results and were sent home. Just as I walked out the door of emerg I felt I passed a couple clots so quickly went back inside to the bathroom. As soon as I sat down a few clots came out but then I felt one stuck. I tried pulling it out but it wouldn't move. I tried pushing and the clot slowly moved out but just kept getting bigger and bigger. After 5 minutes of trying to pull and push the clot out I pulled up my underwear and pants then went out and told the nurse that I didn't know what to do but I had a clot stuck that I'd been trying to push and pull out. They said they'd page the doctor for me and I told them I'd go back to the bathroom and when the doctor did come to just come knock on the door. After a few minutes of sitting on the toilet, pushing and moving around I did manage to get the clot out. I'm actually pretty sure it was the placenta based on size and texture. It was the size of my hand. I went back and told the nurse it was ok I'd managed to get it out. They asked if I wanted them to page the doctor again and I said no it would be ok and that I was fine now. We then left the hospital. At home we called the insurance company to update them saying I'd had a natural miscarriage at home, had a consultation with doctors that morning at the hospital and no longer needed the D&C at the moment. They asked if I needed a follow up visit or just wait and see if anything else happens and I said just wait it out. I didn't need to see another doctor unless something went wrong. They said thank-you for the update and sent paper work for me to fill out via e-mail.

Today (Wednesday) is the first day that I haven't taken any pain killers. I still have mild cramping but after passing the placenta the bleeding has died down to a normal period and the clots are small and rare. I've gotten back to doing our normal activities for the week (except swimming since I can't wear a tampon). I'm looking forward to getting home and getting back to our normal lives. We will try again when the time is right. I'm thinking we will just not prevent for a few months then start properly trying again after 2 cycles. I asked my mum to cancel my Monday appointment with the midwife and make an appointment with my GP. I see her on Wednesday so I'm planning to go to a walk in clinic Sunday (we get home that morning) and ask them to do an HCG so she has the results there when I see her. I expect everything to be fine and no longer need a D&C.

I was surprised at how different this miscarriage was from the one I had at 10 weeks. I don't know if it's because my body thought I was in the second trimester but I never expected to go into labour. I was worried my milk would come in since my boobs grew while pregnant and I went into labour but so far it hasn't and I think it won't if it hasn't by tomorrow. Emotionally I'm sad and frustrated but I keep in mind how painful it was to lose Hailey later in pregnancy and I don't want to have to do that again.