After the Miscarriage: My Experience with a D&E

(You can read about our miscarriage here.)

While it's still fresh in my mind, I want to write about the day I had a D&E (dilation and evacuation) to remove our little girls whose hearts had stopped beating around 15 weeks of pregnancy.  Not that it's an experience I want to re-live but because if I can help one person, then it's worth it.  Writing also helps me process experiences and is very therapeutic to me, so here I am.

My procedure was scheduled for 1pm on Thursday, April 29 with an 11am check-in.  I couldn't eat in the 8-12 hours leading up to check-in, and couldn't drink for two hours prior.  Truth be told, I didn't have one sip of water all morning.  I took a shower and threw up while brushing my teeth.  A reminder that I was still, in fact, pregnant, but with babies who were no longer alive.

We checked in at 11.  I got a wristband, paid the $50 deposit towards our final bill, and we were sent to the surgery waiting room.  I was doing fairly well emotionally (albeit hungry and needing coffee) until a waiting room attendant checked in with us.  Her job was basically to move around the waiting room, prep the patient and family (one support person per patient due to Covid) with information about his or her procedure (she told us mine would last about 30 minutes) and give updates on whether things were running on time, etc.  We asked if Craig was supposed to go back to pre-op with me once my name was called.  She said they would allow it, given my procedure, even though Covid prevented most others from having support with them.  This, of course, opened the flood gates.  I cried then and there, not knowing or caring who was watching.

Going into the procedure, I was equal parts sad and hopeful.  Hopeful because I knew it would give me some closure and allow us to move forward.  It was hard being "pregnant" with dead babies.  At the same time, I felt extreme sadness because although the babies were not alive, they were still with me physically, and that was, in a way, comforting.  The procedure would physically eliminate the babies forever, leaving us with only memories, which was a hard truth to accept.

I honestly have no idea what time we were called back.  But I do remember crying as the employee called my name, crying some more as the nurse introduced herself and told us how sorry she was, and crying even more as I was prepped for surgery.  As we were leaving the waiting room, I also remember someone telling Craig he couldn't go with me, and someone else telling that lady it had been approved for our situation.

Craig stayed with me for about an hour.  I put on a hospital gown, met a ton of medical staff (KU is a teaching hospital so lots of med students...they were all amazing), talked with both the anesthesiologist and OB, and got hooked up to an IV.  I hadn't had anything to drink (or eat) for over 17 hours so it took awhile, several pokes, a vein light, and a second nurse to get the IV in place.  Did I mention I hate needles?  The IV was always my least favorite part of giving birth.

The first medication I took was a pill that went under my tongue to soften my cervix.  It did not taste great and left a grainy, gritty taste in my mouth (with nothing to drink to wash it down).  It also gave me period-like cramps.  Then they started me on antibiotics (standard during surgery to prevent infection) and pain meds.  I had a stress + lack of caffeine headache (plus the cramps) so I welcomed the pain meds with open arms.  Similar to some women in labor, I got the severe shakes.  The nurse assured me it was normal; thought I can't remember which medication caused it.  They piled on the blankets to give me some comfort.

Craig eventually headed back to the waiting room and I sat watching doctors and nurses come and go.  People-watching in a hospital is kind of like people-watching in an airport.  So many stories and experiences inside those walls.  Happy moments.  Sad moments.  Scary moments.  At one point, the nurse asked if I wanted my curtain closed and I declined.

I have no idea what time they finally took me into the OR, as I had given Craig both my phone and watch, but I do know it was a lot later than the 1:00 time it was supposed to happen.  The last thing I remember is moving from the bed on wheels to the operating table and a new nurse introducing herself and telling me they were starting some meds to relax me.

I woke up a few(?) hours later wearing a breathing mask while being wheeled down the hallway to the ICU.  I remember nurses telling me bits and pieces about what had happened.  "Blood loss, fluids, ICU."  I remember seeing a clock and it was near 6:00pm.  I was so confused.  And so cold.  The next hour is a blur.  At one point, I was reunited with Craig, but I barely remember the moment he showed up.

From what I have pieced together, the procedure went well.  However, the IUD had apparently implanted into some blood vessels (as it had shifted into my uterus during pregnancy) so I started bleeding when they attempted to remove the IUD.  I lost over two liters of blood, which is over 40% (a normal adult body has five liters) and required a blood transfusion.  The doctor also had to embolize the blood supply to my uterus through an artery in my groin (I woke with several more IVs than what I went to sleep with) and also placed a balloon in my uterus (with a tube coming from my privates) to keep the bleeding at bay.  The blood transfusion also required pumping me full of fluids so I also woke to a catheter.  The fluids went to my lungs (normal), and I found it hard to breathe; hence the aforementioned breathing mask.

Craig said one of the first things I asked about (once coherent) was Rhett.  My procedure was supposed to be an outpatient thing so we planned on being discharged by 4:00 and in plenty of time to get Rhett from preschool.  Luckily we had a backup plan and one of our neighbors grabbed him.  The other boys were given dinner, carted to practices, and looked after by our amazing neighbors, who have become our Kansas City family. ❤️

(Note: Craig told me later that he asked the doctor if I was going to be okay cognitively because I could only nod or speak one-word replies.  He thought the blood loss may have caused some permanent brain damage. 🥺)

At some point that evening, I asked my nurse how long I had to wear the oxygen mask.  You think Covid masks are bad...they ain't got nothing on oxygen masks!  I was "lucky" to swap the mask for a nasal cannula, which was also not ideal. I hadn't eaten in over 24 hours and I was hungry, but on a "nothing by mouth" diet so I couldn't eat or drink until the next morning.  

Note: I had a box of Crumbl cookies at home (delivered that morning while fasting) calling my name.  I had been looking forward to eating one (or four) so badly after my procedure was complete.

My parents did not plan on coming...mainly because I wanted an empty house to recover and relax in, but once they heard the procedure had gone amiss, they hopped in their car and made it to KC in record timing.  I think they arrived around 8:30 that evening and took over care of our boys.  Just in time to clean out our refrigerator that had, ironically, stopped working earlier that day.  I wish I was kidding.

Craig stayed with me in the ICU.  I knew his bed (aka a chair) would not be comfortable, but I couldn't bear the thought of him leaving me alone all night.  The nurses did mention I was the healthiest patient in the ICU, but it was still the ICU.  Outside of having babies, I have never been hospitalized, so this was an all-new experience.  Sometimes it's just nice to ask your husband for a favor over a nurse.

I didn't get much sleep that night.  Vitals around midnight.  Balloon removal around 1am.  More medical stuff that I can't remember between 2 and 4am.  I finally slept from about 4 until 6 in the morning.

Around 7am, we met with the doctor.  I was looking and feeling more like myself.  I had taken pain meds consistently throughout the night and wasn't in much pain.  They removed the catheter and told me I needed to pee on my own before I could be discharged.  I also needed to be breathing on my own (sans oxygen) and maintain oxygen levels of 90 or higher.  I was still hard to take a deep breath due to the fluid in my lungs.  The nurse suggested I get out of bed and move to the chair, but when I tried, it was too painful to stand up straight, so back down I laid.  I was finally given permission to eat the below-average hospital food.  The highlight was when Craig got me a Roasterie latte.  


Peeing on my own proved to be a challenge (especially given the swing out toilet in the middle of my hospital room...the things you take for granted!), as did maintaining the >90 oxygen level.  But finally, around 2pm on Friday afternoon, I was discharged.  The sun had never felt so good on my face.

In the day or two following, I learned a lot more about what had happened and how it all went down.  I don't know how near death I was, but Craig said he feared for my life and for single dad life for awhile.  (Google says one can die from losing half to two-thirds of their blood...that's about where I was.😨)  I don't like to think about that.  The doctors also told Craig that had I chosen to induce and deliver the babies (as opposed to the D&E), it would not have ended well.  I don't know what that means exactly, nor do I want to.

Craig had to sign off on the fact that we will likely never be able to have more kids.  Not a huge deal, as this pregnancy was not planned and he's since gotten a vasectomy, but it's still hard when someone else (semi) makes that decision for you.  (Since they cut off blood supply to my uterus, it's possible for me to get pregnant, but the pregnancy itself would not be viable.)

I am so, so grateful for the doctors' quick thinking and fast plan of action.  I'm thankful for meds and anesthesia that kept me under the whole time (I don't do well with needles and/or pain).  I'm thankful for a husband who has been so supportive throughout this entire process (7+ weeks of surprises), and for our family and friends who rushed to our assistance in the hours and days following.  More than anything, I am thankful to be alive.

Although I continue to bleed (similar to after having a baby), I am not in pain like I expected to be.  I assumed I would experience a lot of cramping, and with the exception of that first night in the ICU, I have not felt much of that.  My wrist and hands were swollen for a couple of days afterwards, and the bruises (from IVs) are intense nearly a week later, but the physical side effects have been minimal.  I am going on six days of wearing a sports bra 24/7 to eliminate and dry up any milk that may come in...a normal aftereffect of a D&E.  I'm hoping my lack of luck with breastfeeding in the past does me some favors here.

Losing a baby is hard.  Losing two babies is hard.  Losing babies that were not planned is hard.  It's comforting to know there were two of them and they are together.  They will forever and for always have each other.  We are beyond blessed to have our three healthy boys and we know that.  This would have been more devastating had we planned more kids since embolization has eliminated that option.  We feel lucky and loved given all of the support we've received since.  Truly, we can't thank our family, friends, neighbors, coworkers, students, and random Internet strangers enough.  They have provided for us...and then some!

People keep telling me how strong I am.  I'm just doing what I my life.  I have three kids and a job to take care of.  It's not like I can give up on life and sleep for 10 days.  I've certainly been emotional, but I also want to do my best to move forward.  It's ironic...I cried for a week when I found out I was pregnant.  And now I've cried for a week because I'm not pregnant.  But I find myself playing the "It could be worse" game.  We didn't watch them suffer.  It's not one of our living (on the outside) children.  I wasn't 35 weeks pregnant.  And in the end, I am healthy and happy.

We opted to do genetic testing on the babies to see if that gives us any answers.  However, in chatting with the OB before the procedure, it seems like it was less about a genetic issue and more about how the umbilical cords were attached.  She and a team of specialists had reviewed my ultrasound images from Children's Mercy and, in their expert opinions, they think that because the umbilical cords had formed/attached so closely to one another, the babies were almost competing for nutrients.  They were able to grow for 15 weeks because they were small enough and didn't need much.  However, there comes a point when a baby can't survive if he or she isn't getting the proper amount of nutrients, and that was likely around 15 weeks for our babies.  That is also semi-consistent with the previous findings from both Advent and Children's Mercy.  Does that help us move forward?  I don't know.  I think the hardest part is understanding why God gave us these babies and then took them away. 

We were lucky enough to get footprints of both babies.  They are itty bitty, about the size of my pinky fingernail.  Physically, this is all we have to remember our twins.  I have already ordered a necklace with the prints engraved so that my girls can always remain close to my heart. 👣💕

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