diary of a miscarriage - warning this is VERY graphic

For those of you who have never experienced a miscarriage, I thought I'd give you a little play-by-play of what the physical side of it is like. (What happened to me in the past 72 hours - no exaggerating.) My experience is admittedly a bit extreme, because I endured more than most people do. A lot of miscarriages simply plop into the toilet or have a bit of bleeding and are done. I have not been that lucky. That being said, I still feel like it has been easier on my body to let things progress naturally (even if it takes a bit longer) than to opt for surgery. Recovery is easier - waiting is harder. Not an easy decision to make.

A disclaimer: If you get queasy easily, you probably do not want to read this because I am going to get into the nitty gritty graphic messy details of miscarriage. And much of it is just plain gross. And there are pictures. If you're still curious, read on. And my apologies that it's so long.

Saturday - 11/1/08
9 am - Wake up to contractions. They progress throughout the morning, more often and more painful.

2 pm - Lay down to ease pain and try take a nap.

3:30 pm - Wake up to a gush of blood. Remove clothing and prepare to hang out in bathtub. Ten minutes later, pass the 10-week-old baby and what appears to be tissue. Very little pain. Lots of blood. Try clean off with the handheld shower while hubby puts a little space heater going. Kids are banned from the bathroom.


4 pm - Lay on towel on bathtub, trying desperately to get comfortable, yet maintain a laying position so blood loss is decreased. Pass a large softball-sized clot, along with occasional trickles of blood. Hubby finds a bucket to toss the clots in since they will not make it down the drain. Take cayenne pepper capsule along with some food and water to try stop/decrease the hemorrhaging. Bleeding tapers off after an hour, but does not stop altogether.

5 pm - Stomach starts churning. Puke up the cayenne pepper and pass another clot all at once. Lay in tub in own vomit and blood, while nose burns incredibly from the cayenne puke, thinking to self, this is about as low as it gets. Strangely the smell doesn't bother me. Realize it's a good thing my towels are red.

5:15 pm - Finally rinse off self and tub. Hubby pushes water, Dr. Pepper, candy anything on me to get me to drink fluids. Sip on water as often as possible.

5:30 - 7 pm - Continue to lay in tub, extremely uncomfortable on hips and shoulder, even with the folded towel underneath me. At some point realize I'm going to have to get on the toilet or I'll have another stinky mess to clean up. Manage to get out of the tub and poop. I recall leaning over the side of the seat, almost falling into the tub, but not quite out. Plop back into tub and wait some more. Pass a few more smaller (golf ball-sized) clots, with minimal bleeding in between.

7 - 9 pm - More laying around, pain pain pain on my poor hip. Bleeding seems to have slowed to small occasional trickles. Cover naked body with another towel because am feeling cold. Day dream of my bed. Hubby won't let me out of the tub until I can sit up without getting woozy. I manage to do that and crawl out of tub and toward the bedroom. He tells me later that I passed out on the way, but I still don't believe him.

9:15 pm - Throw up in bed into a beach towel. Think the towel was Boy #2's, but what he doesn't know won't hurt him. So much for trying to drink liquids. Am now feeling very uncomfortable with cramps that start in lower abdomen and radiate to my lower back.

9:30 pm - Inlaws come to pick up boys in case we need to go in to hospital. Hubby doesn't think we'll need to go, but I am feeling differently, although I don't tell him yet. Try to keep sipping water and am starving. Eat a piece of toast with grape jelly. More cramping.

10 pm - Puke up the toast, part of my droolings and dribblings are on hubby's tshirt and his pillow. He is thrilled. Cramping is getting worse. Bleeding still hasn't stopped.

12 am - I can't relax enough to sleep because the cramps are so painful. Can only lay on one side or the cramps are worse. Cannot lay on back as the bleeding seems to increase. Finally tell hubby I can't do this anymore and that we need to go in.

12:15 am - Lay on floor while hubby puts on my socks, underwear and a ratty pair of pajama bottoms. Crawl down stairs because I don't want to stand and pass out. Crawl to front door after hubby helps me put a sweatshirt on. Jam shoes on and limp out the front door 10 feet to the van.

12:30 am - Finally make it out the driveway. I am sweating profusely, ears ringing, tunnel vision - all from standing up - no blood in head apparently. (Not that there ever is.)

12:45 am - Make it to ER entrance. Try to walk in, but collapse once inside the door. Hubby picks me up like a sack of potatoes and the pressure of his shoulder on my belly makes me cry out - "Oh my stomach!" I am plopped into a wheelchair that is thankfully parked next to a wall so I have something to lean my head against. I cannot see anything around me and remember feeling sweat drip down my forehead. I hear hubby behind me giving the intake person my date of birth and some other pertinent information. A nurse comes behind the wheelchair and tells me, "Kara, sit up! We have to go." I mumble that I can't and she picks me arm up (that had fallen to the side of the chair) and plops in on the armrest. It fell back down. She starts to push the wheelchair and I have one foot dragging along and my head tipped all the way back because I couldn't hold it up. I remember thinking to myself, "Why is she being so mean to me?" Two nurses help me into a bed and pull off my sweatshirt and t-shirt. I tell the one nurse, who is banging on my arm to find a vein, that she is going to have a hard time getting the IV needle in because I know I'm so dehydrated. The other nurse starts typing into the computer and asks me, "So, what seems to be the problem?" By this time, I finally feel coherent and tell her I had a miscarriage and that I've lost a lot of blood and have been throwing up. Almost immediately I notice a change in her and she comes over and puts her hand on my shoulder and tells me she is sorry I've had to go through this.

I find out later that when the intake nurse asks hubby what the problem is and he tells her about the miscarriage, her reply is: "Oh! I wasn't expecting that!" (We figured with the timing of our arrival and my physical symptoms, everyone probably thought I was either drunk or high or both.) Can't say that I blame them considering what I was wearing and how I probably was acting.

1 -3 am - I am examined by a doctor who looks like he's 17. Still bleeding. Still have cramps. But after about a half hour I finally get some morphine - thought my head was going to blow off. I also got two doses of some anti-nausea medication that did not work. I was wheeled to radiology for a vaginal ultrasound. The ride there and back was torture - had I had anything in my stomach to throw up I would have. Then came a pelvic exam which was a real fun experience - I lost count of how many cotton swabs the doctor went through. I do remember another gush of blood and perhaps another clot when he pushed in my belly to check the uterus. I was still in a fair amount of pain, so was given another 1/2 dose of morphine.

3 am - ER doc talked to the OB on call who decided I should be given a blood transfusion because my hemoglobin levels were so low (and I think they assumed I'd have to had a D&C in the morning as well).

3:30 am - I sent hubby home to get some sleep and the transfusions began. It took about 90 minutes to complete each unit. (I had two units.) I got a little sleep in between each 20 minute blood pressure check, all the temperature checks because apparently a body can have some sort of reaction to donated blood. I was told to call the nurse immediately if I noticed any wheezing, itchiness or difficulty breathing. (Was I praying after that!) No complications.

7 am - ER doc decides that he would rather send me up to the OB department than send me home yet. So I endure yet another nausea-producing ride. I am the only patient in that unit - ironic, considering I have no baby. Doc also tells me that the ultrasound technician and the radiologist confirmed that there was nothing left in my uterus. Bleeding has slowed. Pain from cramping has decreased. I am exhausted.

7:30 am - Call the inlaws to let them know where I was and tell them what happened. Accidentally hung up on mother-in-law when nurse came to check on me. Decided to wait to call hubby so he could get some sleep, but he showed up about two seconds later, looking very nice in a brown pullover I bought him last summer. How sweet of him to come check on me - early - and how sweet that he couldn't sleep. Unfortunately, he did not bring me any clothes to wear home - a slight problem since my pj's were pretty much toast and the nurse said she wouldn't let me out of the room with my granny panties showing. Hubby made a few phone calls and I rested. I wasn't peeing enough so the nurse gave me another IV bag (I think that brought the total up to five) and hooked an antibiotic dose as well. I was too tired to argue.

9 am - Hubby decided to go home and get my clothes and let me sleep. I wasn't holding up my end of the conversation anyway. I immediately conked out and didn't wake up until the doctor came in.

10 am - OB doc said I wouldn't have to have a D&C, as the uterus was empty, bleeding was minimal and my cramping was tolerable. He wouldn't let me go until I peed more and could keep some food and fluids down. He reminded me of someone, but I still can't place who it might be - a little bit like Gil Grisam from CSI maybe.

10:30 am - Sister-in-law stops by after church and visits. Her ER experience immediately clues her in to my paleness - my hemoglobin level was still only 8.7, but that was an improvement. We chat for awhile and I eat crackers and apple juice.

11:30 am - Finally peeing on my own and get the go ahead to get out of dodge, but no clothes and no hubby. Finally call him, thinking he fell asleep at home. He is at work, filling out his time sheet. Eat a piece of jelly toast and keep it all down. Pretty proud of myself.

12 noon - Going home. Yay. Kids are staying at Grandma & Grandpa's another night. Peace and quiet is so nice.

1 - 4 pm - Take a nice long nap after texting immediate family members about the ordeal.

4 pm - Watch NASCAR w/hubby. Sad. Then cramping starts again. Was told to take ibuprofen for pain, but didn't think it would be necessary since I don't usually have any post-delivery cramping with live births or miscarriages. Not this time.

5:30 pm - Finally succumb to the pain and down the Advil. Watch Extreme Makeover Home Edition and go to bed.

Monday - Cramping continues much of the day - need more Advil. This sucks. Still bleeding, although not a lot. Trek in to the clinic to relive the events with OB doc. He decides not to put me through another pelvic exam, saying I've been through enough. I have more blood drawn to check hemoglobin levels and test for some possible miscarriage causes. Go to bed taking another dose of ibuprofen, just to sleep.

Tuesday - Get up feeling pretty good, although bleeding still hasn't stopped.
10:30 am - Go to the bathroom, wipe and feel something funny. At first think I'm really swollen for some strange reason. Get out a mirror and about die. There is something sticking out of my vagina and it doesn't look good - dark red thick tubular mass. I panic and yell for hubby, picturing cows on the farm with their uteruses hanging out. He doesn't want me to touch it but to go in immediately. I choose to call my OB's nurse. She says to try tease it out and call her back. It takes nearly 10 minutes of bearing down, pulling, wiggling, etc. to get it out. I realize it is not part of my body because I cannot feel it when I touch it. I finally get the mass out and it is the size of a baseball in my head, heavy, red and fibrous. It is the placenta and I have just passed something about 2 inches in diameter. And I hurt bad. The cramps immediately disappear. The bleeding, which was darker red blood before, turns to a lighter, thinner red. I am freaking out wondering how an ultrasound technician could miss this and what would have happened if I wasn't at home, etc. Call the nurse back and she says to save it and will talk to Doc when he comes in at 2 pm. The adrenaline from this ordeal has exhausted me and I have to lay down. Plus, I'm just a little grossed out.



12 noon - Try to sleep, but can't. Lay in bed until nurse calls back with instructions to come in as soon as possible w/the placenta.

3 pm - Take a shower because I realize I'm still wearing the clothes I went to the clinic in yesterday.

4 pm - Have hubby drop me off at emergency room so I can take the placenta in to sister-in-law since she's working. She is amazed (and not grossed out, which is pretty impressive.) Tell her the plus side is that I just lost a pound.

4:15 pm - Receptionist ushers me right back to Doc - who is mortified at the size of the placenta and that it wasn't caught on ultrasound two days ago. "Gonna have to call down to radiology and see how they missed a placenta the size of a big Mac in a gal who weighs 80 pounds soaking wet." (That was nice to say, although I haven't weighed 80 pounds since junior high.) I don't think he was too happy and was upset with himself for not doing a vaginal exam yesterday, but neither of us thought was necessary. Hindsight of course tells me that the cramping should have been a huge sign for me, since I never have that. But, that's what hindsight is - not valuable for much else. Go through another vaginal ultrasound which shows nothing in uterus but a slight spot of lining that should slough by itself. Bleeding is minimal. Pain is gone. Horrified feeling still present. I am told to come back in two weeks to check if cervix is still open and to go over results of blood work.

So, there you have it. Two days of a very interesting experience I wouldn't really care to repeat. But for several reasons, I'm still glad I did this at home. My body was then ready and knew it wasn't pregnant anymore. (D&C was really hard last time because I bled for six weeks and my hormones were raging because my body had no idea what had just happened.) I got to see the wee little one and (surprise, surprise) it was another boy. And I'm glad we went in when we did, because I got some pain killers, fluids and a transfusion, and I don't feel as tired as I would have without all that. I'm also glad the doctor got to see the placenta, because apparently it was much bigger than it should have been for as far along as I was. It has been sent off to pathology.

I hope this diary doesn't freak anyone out, or discourage anyone from trying to pass the baby at home. My experience is not even close to the norm. Most people will have some cramping, some bleeding, but I believe it's generally over in 2-4 hours, with minimal risk to mom. There are of course horror stories from both ways (at home or in hospital), but knowing what happens to my body because I've experienced it both ways, I was still more comfortable doing it naturally. I had to wait two weeks for the baby to pass, which isn't pleasant. But other than being a little tired right now, I feel like myself, something I could not say for at least three months after the D&C with the last miscarriage.

I hope you're not too grossed out by this and I pray that this diary will help someone, someday. Or help others to understand what a woman can go through during a miscarriage.