Dilation and Evacuation

One of the things that gave me hope these past couple weeks was talking to other women who have had late missed miscarriages. Apparently that’s the term for what it is we went through… ‘late’ refers to happening after the first 13 weeks of gestation, and ‘missed’ refers to the medical team not being exactly sure how or when the baby died.

While it made a huge difference for me to hear stories shared by any woman, the stories that resembled mine closest were the ones I clung to for hope and solace.

Unfortunately – and fortunately – late missed miscarriages are pretty rare. Miscarriage is fairly common, but most happen within the first 13 weeks. Of course, a loss at any stage is incredibly difficult, but hearing mamas talk about their 6, 8, or even 12 week miscarriages honestly made me envious. I wished our baby could have passed before I felt her movements every day. I wished I could have even had the choice of doing just a D&C on Maui rather than having to do a D&E on another island. I wished I had the option to just ‘pass the baby naturally and start trying again immediately’.

Pretty shitty thing to be jealous of, right?

The truth of the matter is that loss is loss, regardless of when it happens. And in the same way that I could never know the grief of having to choose a D&E due to medical reasons, I could also never know the grief of what an early miscarriage feels like, either.

Nonetheless, because there are so few stories about late missed miscarriages, and what the D&E process is like first-hand when baby has already passed, I want to continue putting my story out there. I hope it helps someone feel less lonely or scared.

[This may be too raw for some people to handle.]

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We found out that we had miscarried on Tuesday, September 1st. My OB sent us home that day, shocked, and said to think about our options. I called the next day requesting a D&E. I was aware that it needed to be scheduled on O’ahu. They contacted us on Friday saying they could schedule the procedure for the following Thursday, September 10th. I continued going about my every day life – going to work, attending trainings, crying in bathroom stalls, waiting.

September 9th || Dilation

Finally, on Wednesday, September 9th, I could do something. We went in for the dilation part of the D&E procedure, which I had heard would be the most uncomfortable part of the experience. It did not disappoint. My OB wanted me to come in at the end of the day because I’ve given birth before and he didn’t want to give me too much time between the dilation and the evacuation procedures. My OB let me know that he’d insert as many laminaria (dried seaweed sticks that soak up liquid and dilate the cervix) as he could possibly get in.

I was grateful to finally be able to get the process started, so I did my best not to squirm through the procedure. I only have one thing to say about the laminaria procedure – it’s painful. There’s no way around it. I hear some doctors give a numbing shot, but some don’t. I didn’t have one. The doc uses a speculum to hold the vagina open, then needs to use another tool to keep your cervix from moving. For me, that was the gnarliest part of the procedure. Whatever that tool was that kept pulling at my cervix – it was not fun. Every time the doc had to put in a laminaria stick, he’d have to pull the cervix to keep it still. I couldn’t tell what hurt more: the pulling of the cervix or the laminaria insertion.

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Laminaria: Large on the left; Small upper right; Medium lower right.

My OB placed two large laminaria, followed by a medium, and then a small. I used relaxation and (ironically) birthing techniques to keep calm, but by the fourth, I wasn’t able to hold back the pain. The doctor said that four was excellent and he was glad I ‘didn’t even flinch’. I immediately felt intense cramping and discomfort, then was sent to the pharmacy to get some Motrin.

That night, I laid low and watched a movie with Ben. Between the cramping and the meds, my stomach hurt and I didn’t want to eat much, but I was able to choke down a bowl of cereal before midnight, which was my cut-off for food and drinks. I slept well.

September 10th || Evacuation

The next morning, I took an antibiotic upon waking, then a cervix softener a couple of hours later. Not eating that day wasn’t a big deal, but my thirst was outrageous.  All I wanted was water. Ben and I jumped on the 8:30 flight to O’ahu and then walked around the Honolulu Airport for a while before catching a shuttle to the hospital there. Aside from some cramping, I wasn’t too uncomfortable.

My procedure was scheduled for 1:20pm. We checked into the hospital on Oahu around 10:30am , then checked in with pre-operations. And then we realized we still had a couple of hours before anything was going to happen. Ben and I walked around the six-floor hospital and laughed and cried. We went to see the birthing center on the top floor and I thought about being there under different circumstances. We found the cafeteria so that Ben would know where he could grab a bite to eat during my procedure, we stood on the upper level and people-watched from above. And then we found the meditation room.

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It was a simple room hidden in an obscure corner of the hospital. It was quiet and plain and empty. It was exactly what we needed. We shared our fears (my biggest fear was that something would go wrong and render me unable to have any more children). We said our goodbyes to the physical and all I could think was Everything Is Going to Be Okay. 

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At 12:30pm, pre-op checked me in, took my vitals, drew blood, had me change into operating clothes and inserted an IV. This was the first surgery I’d ever had, so I was most nervous about the IV, but my nurse was amazing and I barely felt it. The operating room was backed up a bit, so we waited longer than expected in pre-op, but I was so grateful to have Ben next to me the whole time.

My OB came in around 2pm and asked if I had any questions/concerns. We talked for a few minutes and I apologized that she had to do such an unpleasant procedure. She looked at me like I had two heads and said her only concern was Ben and my well-being. I liked her.

My doctor and two nurses wheeled me into the operating room at 2:15pm and I moved over to the operating table. I remember huge, bright lights and a freezing cold room. Then they said they were giving me some medicine and started blowing warm air into my gown. The last thing I remember telling them was, ‘My son would LOVE this!’.

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I came to in another room and immediately felt cramping. There was a male nurse sitting next to me who asked how I felt on a scale of 1-10, and when I told him “7”, he said he was going to give me some meds. He said, “It’s 3:00. The surgery went well.” And I fell back asleep for a few minutes before the pain came back. He gave me more meds, and then I felt just fine.

He said he wanted me to be a little more awake before I could go into post-op and see Ben, so I pulled my shit together, woke myself up and said I was ready. A few minutes later, I was in post-op and they were calling Ben in.

Ben said it all went so quickly and smoothly on his side, too. After saying goodbye to me, he grabbed some lunch. As soon as he got back to the waiting room, the doctor was calling his name. She said the procedure went very well and that the baby’s tissues looked pretty old, but she couldn’t tell anything aside from that. She said they’d send the tissue to the lab, but not to expect anything of it.

After Ben came into the room, the staff made sure I could stand up and go to the bathroom. There was a lot of blood that first day, but after that, I’ve hardly had any bleeding at all.

Physically, my body felt pretty normal almost immediately. After the procedure we went to dinner with my God daughter, nephew and close cousins. I ate a lot and held my baby nephew. The only things I felt that day, after holding a dead baby in me for over a week, were relief and resolve. I was grateful for my safety and for such a positive experience after all the waiting. I was grateful for my medical team, for my family, and especially for my husband.

That night, I cuddled with my son and then with Ben. I thanked the Universe for all my blessings, and I went to sleep with an empty womb, but a full heart.

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4 thoughts on “Dilation and Evacuation

  1. Pingback: Moving On |

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