Re: Benefits and risks of D&C after MC - doctors, please

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Not a doctor here, just a midwife, but will give it a shot...

With a D&C there are the attendant risks of surgery, such as infection and any anesthesia complications. Also, additional scarring which could potentially (not usually) cause complications in future pregnancies.

Without the D&C there is a somewhat increased risk (although this may largely depend on how far along you are) of infection if the process doesnt completely expell uterine contents, plus heavier bleeding. These risks are more common the farther along you were plus the longer the process takes. Also, the cramps associated with a naturally occuring miscarriage can be quite intense, sometimes approximating labor contractions such as you might feel early on in labor. If there is a complication such as heavier bleeding, you may end up in an uncontrolled setting such as ER with the same process rather than being able to plan and prepare for it. If you opt to go naturally, I would strongly recommend you not be alone, or that you have people readily at hand that you may telephone.

The emotional side is one that only you can answer. For some, waiting for the process to complete naturally is very traumatic and difficult. For others, that waiting time gives time for reflection and coming to grips with the loss. Some find that the D&C is an option that they cannot take with a correlation to abortion, even though in a miscarriage it is a different reason, though not necessarily a different technical process. This does color the decision making process for some women.

I speak from 'professional experience' as well as personal. I have had five miscarriages, two with D7C, three without. One of the times that I did not have a D&C I *should* have and suffered serious complications such as a severe uterine infection. I recovered but am mindful that my fertility could well have been permanently affected by the infection and I never cease to be thankful that this did not occur. One of the things that I have done that helped greatly was to request one more scan immediately before the proceedure so that I could see, yet 'one more time' that there was no hope.

I am so sorry, this is a hard process in many ways.

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