When the doctor says, "It looks like this pregnancy has failed," your first thought probably isn't about what happens next.
If anything you will be looking backward—wondering if you could have prevented this miscarriage, wondering if you should have known that something was wrong. But miscarriage occurs in 1 out of every 5 pregnancies, most often due to a chromosomal abnormality. There was nothing you could do and no way you could have known.
Not every miscarriage involves bleeding or an immediate loss of tissue. When my first pregnancy failed, I had no inkling of a problem until the initial ultrasound. Turns out, even after learning that you've lost the baby, there's still the matter of actually losing the baby.
Depending on your circumstances, you usually have a few options for removing the fetal tissue after a miscarriage:
1. Let nature take its course
You can wait for your body to expel the fetus on its own, potentially avoiding any surgical or medicinal options. But sometimes the waiting process takes too long, and many women end up choosing another route.
2. Induce with medication
Take a medication that essentially puts your body into early labor. You can do this at home, but the process might last hours. This option is often painful and messy.
3. Undergo a medical procedure
Dilation and curettage (D&C) happens in a hospital setting, with general anesthesia to put you to sleep. Manual vacuum aspiration (MVA) is essentially the same process, but in a clinic setting, without general anesthesia. Instead of putting you to sleep, the clinic might give you local anesthesia to numb the cervix area, as well as some other medications to make you drowsy.
I opted for an MVA.
Plenty of resources online explain the MVA from a scientific perspective. But here's a description of what you can expect from the procedure on a more personal level:
MVAs tend to take place in a clinic rather than in a hospital. My own procedure occurred in a room like any other normal exam room, except a bit larger and with more surgical instruments. They dimmed the lights, closed the blinds, and turned on soothing music to help me relax.
Your level of awareness will depend largely on what kind of medications the clinic uses. In my case, I took a few pills that put me into a haze but kept me semi-functional and semi-aware—I felt more lucid than I actually was, though I do remember bits and pieces of the procedure.
Despite the local anesthetic, you might experience some sharp cramping throughout the MVA. And on top of the pain, you will likely feel disoriented.
While I certainly felt strong discomfort and intense cramping, it was comforting to have my husband present, holding my hand. A sweet nurse also stood by to rub my stomach and offer support. Consider bringing a loved one—or asking a nurse—to sit with you during the experience.
Your physician will probably prescribe antibiotics, and maybe a strong painkiller. But in the days following my procedure, I was able to manage the pain just fine with over-the-counter medications.
You will want to relax for a few days, and you should expect some bleeding. Again, consider asking someone you trust to stay with you for a short time after the procedure, for moral support and for help around the house.
Of course, each individual will experience varying amounts of pain and varying side effects during medical procedures. If you ever have to make this difficult choice, consider your personal needs before settling on a specific route.