March 16, 2020
A part of pregnancy for some is loss Sometimes, a baby passes in utero, for various possible reasons. I am going to talk about some of the options one has after the misfortune of miscarriage/spontaneous abortion occurs. Once baby passes and loses fetal tone, they can take a bit to dispel. In this time frame, we have options! More options than your provider will likely share with you. This is why research on OUR part is most crucial. Keep in mind their suggestions come from a place of financial gain. They will not gain business/revenue when you do nothing, so something, usually of cost, is suggested. Let's talk about those options!
Misoprostol
Some may suggest to give Misoprostol, which is actually a stomach ulcer medication. The medical establishments often use this for abortions, hemorrhage, inductions, and miscarriage, as well. It can be taken orally, sublingual film, or used vaginally. For early pregnancy miscarriage, the most commonly used regimen is a single dose of 800 µg of vaginal Misoprostol. Misoprostol is often used for miscarriage in women at 12 weeks or less of gestation; for both alive and passed fetuses. The success rate is approximately 85%, as long as at least 7 to 14 days is allowed for completion of expulsion. A second dose of Misoprostol is considered for initial failures. One of the more common risks of Misoprostol are gastrointestinal issues. This can complicate your digestive system/GI tract, look into this prior. You can also obtain this pharmaceutical *WITHOUT* a medical provider; on your own.
https://pubchem.ncbi.nlm.nih.gov/compound/misoprostol https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4664101/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2760893/
MVA & EVA
Manual Vacuum Aspirator uses manual aspiration to remove uterine contents through the cervix. The tool is long, plastic, and about $50 online. It is similar to a Del Em, if you ask me. This is an invasive, but common option. The woman would need to have her legs spread wide open, with the provider gazing into her vagina, then inserting a cannula tip through the cervix, into the uterus, to suck out all tissues that will come with. Pretty invasive, but it is said to be a safer option than a D & C (will be discussed later) or other invasive options.
https://www.ncbi.nlm.nih.gov/pubmed/25404439 https://www.ejog.org/article/S0301-2115(16)30617-0/fulltext https://www.ncbi.nlm.nih.gov/pubmed/2076683
Electric Vacuum Aspiration
EVA is similar to a MVA, but is performed in the operating room with an electric suction device and a rigid curette and typically involves general, intravenous, or spinal anesthesia. EVA is done with a machine vacuum aspiration system. The cannula is passed into the uterus, through the cervix, the pump is turned on, and the tissue is forcibly removed from the uterus. The procedure takes about 15 minutes to complete. This method is more invasive, and in study has proven to have more risk than manual vacuum.
https://www.ncbi.nlm.nih.gov/books/NBK75875/ Manual versus electric vacuum aspiration for first-trimester abortion: a systematic review. https://www.ncbi.nlm.nih.gov/pubmed/18053098
Methotrexate
Many providers will suggest this option as an injection as a way to terminate ectopic pregnancies, as well as miscarriages. Methotrexate is used in chemotherapy to stop rapidly growing cancerous cells from multiplying. It is more often known as a cancer treatment medication, but also used to dispel a human that has passed, or is in ectopic. This drug comes with a slew of complications. It is stated that when completed before 7 weeks, injected methotrexate is effective in 92 to 96 out of 100 cases.
https://www.cardiosmart.org/healthwise/tw12/77/tw1277 https://www.verywellfamily.com/treatment-of-ectopic-pregnancy-2371468
Expectant Management
This would be waiting for the baby to pass on their own. Choosing not to evict your baby, but allowing them to arrive when they are ready. Medical establishments state that baby must pass within one month on their own, if not, medical help is needed. This is not fact, but suggested. I have seen women in the unassisted community waiting over 2 months to dispel baby. If there is no sign of infection or excessive bleeding, there really isn't much concern. This is the most hands-off approach to loss. If you ask me, this a more so respectful way to allow your baby to pass, as well as more private, without strangers in the room when your baby is born. I can also add this route is FREE. There is not often a price tag to follow physiology.
What would I do?
I would stay home, PERIOD. My baby will pass when they are ready. My baby joined my womb at the exact time they needed to, and I trust they will leave when they need to/ are ready. I will respect my baby's time frame. I do not feel my desires trump my conceived child's. I would not evict anything from my womb, unless I had to, due to complication. If complications arise, I would handle this alone myself if at all possible. I would start with herbs. If needed, I would obtain Misoprostol, without a provider and use it. (Yes, you can obtain Miso without a provider. We have choices, ladies!) I’d use natural antibiotics as needed in this time frame.
A surgical removal, or removal requiring a provider, would be an absolute last resort for our family. I am not okay with the uterine scaring or emotional trauma I would be taking home. The risk in future pregnancies increases if I go the medically assisted route; knowing this, I would pass.
Waiting for the fetus to pass on their own is the option of least risk, if you ask me. Paying attention to your body, looking for signs on infection, while avoiding intervention. Many choose other means because they just want to get it over with, some are eager to try again, many have no idea they have a choice or the true risks at hand. I personally would choose to wait; honoring my baby, their form, and their timing to leave my womb. Same as I would if they were overdue; I would not inflict my desires on them without absolute emergency.
Management of First Trimester Pregnancy Loss Can Be Safely Moved Into the Office https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3100102/ (Medical study on multiple options in one place)