My Experience with Misoprostol for Miscarriage

We found out the news about two weeks ago. Our baby had stopped growing at 5 weeks 5 days. We never found or saw the heart beat. My doctor allowed me to see if it would pass naturally and if in a week nothing had happened, she would give me a choice. A medicinally-managed miscarriage or a D&C. Not a decision that anyone should ever have to make.

A week went by and my doctor's office gave me a call to check on me. During that week nothing had happened yet, so they presented me with the options.

I opted to go with the less invasive version. While I don't know much about D&C's, I just didn't feel like it was the right option for me. As much I wanted to just wait it out for a natural miscarriage, I knew that the stress from waiting was only going to make me more stressed. So, I chose the medicine to induce it.

This is an account of my experience using Misoprostol/Cytotec to miscarry. Please note this is my own experience. Growth stopped at 5 days 5 weeks and this week would have been the 9th week.

It's about to get real. If things make you queasy, this is your warning to turn back now.

----------------------------------------------

I went to pick up the prescription for Misoprostol as well as the painkiller Tylenol #3 (with codeine) for pain management.

I was pretty nervous about it. The nurse had told me that I would be receiving two doses. I would take one dose at bedtime and if nothing happened, I would repeat the dose the following evening.

And of course, what do you do when you're about to take medication that you've never taken before and the nurses can't predict what your personal reaction will be? You take to the internet, of course! I'm really thankful for the couple of personal accounts I found of other women who chose to take Misoprostol to miscarry. It made me feel less alone, more prepared, and at least have some idea of what was going to happen.

I was instructed to insert four misoprostol tablets vaginally before bed. I was also given the option to take two Tylenol with codeine for pain management - I opted to take them.

I consider myself pretty lucky that I rarely ever get menstrual cramps before or during my regular periods. That being said, I was nervous about what was going to happen.

12:00AM - At about midnight on Saturday night, I took the two Tylenol #3 and then inserted the four (total 800mg) Misoprostol tablets. I also set myself up with a pad just in case bleeding started in bed. I also laid out a towel on the bed under me. I got into bed and we watched a couple episodes of The League on Netflix. I didn't feel anything quite yet.

1:05AM - I started to feel slight cramping, but nothing too bad. I got up to go to the bathroom, and nothing yet on that front.

3:30AM - The cramps were getting stronger and starting to feel uncomfortable. I got up again to use the bathroom and there was some spotting. I figured that was a good sign.

5:25AM - The cramps continued, I tossed and turned, and then when I turned over one more I time, I felt the feeling like when your period starts. I got up to go to the bathroom and whoa...there was a lot of blood.

5:55AM - More cramps, more feeling of bleeding, get up again. More blood.

6:15AM - Get up again. Cramps feel worse. I go take one tablet of Tylenol #3 since 6 hours had passed. Try to get comfortable in bed.

6:30AM - Get up again, go to the bathroom. Still passing clots, pass what looks like could be the embryo (grey material with the clot).

6:50AM - Get up again. When I lay back down, the cramps are feeling unbearable. Can't get comfortable.

7:05AM - Get up again, this time I leaned at the foot of the bed face down, hoping that position would be more comfortable and bearable. When that wasn't working, I got up again and wandered around the bedroom, hoping to get things going.

7:10AM - Then I suddenly felt a clot or large amount of blood coming, and before I could sit down, SPLAT, looked like a toned down scene from Dexter. I passed a large clot, perhaps the sac.

7:15AM - After that last bathroom run, I feel much better and can finally get comfortable in bed.

7:45AM - Get up again, pass more clots, but the volume of blood is significantly less from earlier.

7:50AM-10:15AM - I'm able to sleep for the most part comfortably.

In about two hours time, I went through five pads, that were FULL and soaked.

The cramps finally subsided completely by about 12:00PM, so a full 12 hours after inserting the Misoprostol.

Now, my nurse had told me that if nothing happened from the first dose that I could do a second dose the following day. Since I felt like all my insides passed, I wanted to know if I needed to take the second dose or if just taking the one was okay.

I called my doctor's service and well, I have to take the second dose. I'm sure that just to shake out whatever is still left...though I feel like there's not much of anything! (Gotta keep a good sense of humor when dealing with gross things).

I'm really hoping that round two is less intense than round one. I'm hoping that since I've passed most, if not all the tissue, that the bleeding is a lot less and the cramping is hopefully not as severe. But who knows?!

In spite of the pain, I'm still glad that I chose the medicinal option over the D&C. Even with outpatient surgery, that still kind of freaks me out because I do know they have to put you under in some capacity.

Have you ever taken Misoprostol/Cytotec for miscarriage? What was your experience like?

Updated after second dose of Misoprostol:

The second dose of Misoprostol wasn't bad at all. I experienced the slightest cramping, but nothing in comparison to the night before. I was able to sleep through the night.

The thing they don't tell you (or at least doesn't seem too important) is that after you have bled out what feels like half your body volume in blood (okay, being dramatic), you continue to bleed for days after the event. It's kind of like having a normal period. And just when you think that you're done bleeding, things have reduced to spotting, you get a random bit of blood here and there. Like heaving spotting. It's annoying more than anything given the circumstances.

How to prepare to take Misoprostol:

It'll depend on how your doctor's protocol works, but if you're instructed to take it at night, here are my recommendations.

1. Eat a good dinner, but nothing that might upset your stomach.
2. Stock up on pads. Considering the amount of blood that gushes, tampons are not recommended.
3. Lay out a towel on your bed, just in case.
4. Keep a glass or bottle of water accessible.
5. Wear whatever makes you feel most comfortable, and easy when you need to run to the bathroom.
6. A heating pad - I did not use one, but I have heard that this can help with the cramps.
7. Decent toilet paper. Like, you don't want the thick, fancy stuff clogging up your toilet, but you also don't want 1-ply because you'll be bunching that stuff up like crazy anyway. A good, middle of the line toilet paper will do. 
8. Netflix or other distraction - if you can't sleep, I'd recommend finding a distraction - Netflix is always a great option...watch something funny.

When being right is the worst thing ever

I've been trying to process how to even write this.

Attempting to collect my feelings and thoughts and emotions into a coherent paragraph.

Tuesday, we had our follow up sonogram after last Thursday's sonogram. Last week, we were told that there had been no progress since the previous week. Basically, the sonogram was looking about the same, where there should have been growth.

On the bright side there were only five days between our appointments instead of the full seven. It felt like several long days of being in limbo. Not knowing the outcome. Not knowing what lay ahead. Only knowing that it could either be really good, or really bad.

We went in for our appointment and our RE did the ultrasound herself. And in just a few minutes, our futures were permanently altered. Decided. Changed. And not in the result that we were so fervently praying for.

I'm going to have a miscarriage.

Those words just feel ominous and haunting.

We opted to let things progress naturally, and then next week if nothing has happened, we'll talk about medication or a procedure.

I guess I feel like I was slightly prepared for this prognosis because of last week's appointment. But I don't think that you're ever fully prepared to know that the life that was once inside you is no longer.  There's a much more crass way I could put that, but I won't.

It's so crazy how you can go from pure, amazing, overwhelming joy, to utter, complete devastation...in a matter of weeks, a matter of minutes, a matter of seconds. The little world I had cautiously constructed, from baby blogs and registry lists, pregnancy apps and countdown calendars...shattered, obliterated, all came crashing down.

Perhaps the hardest part for me has not been accepting the facts. The hardest part has been the idea of having to tell family of what happened. We didn't tell a lot of people that we were expecting. We only told our immediate family. But still, having to tell them that our exciting news turned to tragedy just breaks my heart into a million pieces.

Maybe it's the disappointment? Maybe I feel like I'm disappointing them? I'm mad and sad and disappointed in myself. I feel like I should blame myself. I know that I shouldn't. I know the facts. I know that about 20-25% of pregnancies end in miscarriages - with most of them happening before the parents realize that they were even pregnant.

The thing that I didn't expect throughout all of this was the immediate bond I felt with the little life that was developing inside of me. Previous to my own personal experience, I didn't really understand why or how a miscarriage under 12 weeks was a big deal. I know how insensitive that sounds. But I didn't get it.

Now I get it. It was like the moment that we saw that pregnancy test, that we heard our beta numbers, that we were "for real" pregnant....that I was forever bonded with the little nugget. That little life was real.

I have such an appreciation for what a miracle life is.

So many people take it for granted. Dumb teenagers get knocked up "by accident". Irresponsible one-night stands result in two pink lines. Unplanned pregnancies. Surprise babies.

I feel like when you are in the trenches of infertility, you learn to appreciate that making a baby is a freakin' miracle. It's not an accident. It takes work. Sometimes it takes tests, medications, procedures, and lots of prayers.

Honestly, I was so excited about our positive pregnancy test. But part of me felt slightly guilty that we got pregnant naturally when so many others have such a hard time. My fears got me too. I was afraid of having a miscarriage, of something going wrong, of it all not being real.

But now it's just too real.

And since I haven't physically miscarried yet, I just feel like I'm in between again. Not pregnant, but not empty...if that makes sense. I understand better why some women opt for medication and/or the procedure right away.

I have no idea how long this grief is going to last. I have no idea when we will get pregnant again. But I have faith that there is a plan for us, that we're ultimately not in control, and we just have to trust that it'll happen in the right time. That's the last thing that I want to hear, but I know that it's the thing that I need to hear.

Have you ever been through this?