Post Op Appointment!!!!!

I had my post-op appointment today for the D&C two weeks ago. I don't know if I am more disappointed or angry. My darling husband had to take most of the afternoon off work to take me to the doctor's office. (I'm still on a learner's permit for driving and we only have one vehicle anyway, and he works a 40 min drive from where we live.)

The whole thing was a total waste of time. I got to the office and as I check in I am informed that the doctor has gone home to stay off her feet as she is pregnant and I will be seen by the nurse practitioner instead. The receptionist also processes a co-pay as she doesn't realise it is a post-op appointment. DH leaves me in the waiting room so he can go and vote in the State Senate Election that is going on today. After about 10 minutes I'm taken to a consultation room. When the NP comes in she obviously hasn't even read my file yet. She asks me how I'm doing and then proceeds to give me a lecture about not getting pregnant again straight away. She also notices that there is no pap smear results on my file (the file is 2 weeks old!) and asks me when my last one was. I inform her I've never had one and that the miscarriage was my first contact with a doctor since arriving in America. She tells me I need a Well Woman Check where they will order a mammogram, pap smear and check my cervix to make sure it is recovering correctly and it should be done in four weeks time. She then takes me back to reception to make another appointment for four weeks time. The receptionist then asks her what they are billing this visit as. Another nurse overhears and informs them both that this is a post-op appointment. The receptionist then realises that there should not have been a co-pay for this and has to refund the money.

I was under the impression that the post-op appointment was important because that was when they would check to make sure everything was returning to normal. I never even got my blood pressure taken, never mind a physical exam or hormone levels checked, nor did she do anything to check that there was no undetected infection. I asked if I should be concerned about anything and all I was told was don't get pregnant again until after we have checked everything at the next appointment. I was in total shock as I left that nothing was actually done at this appointment, other than to make another appointment. I won't be going, and I certainly won't be asking my husband to take anymore time off work to take me anywhere near that doctor's office again.

Now I am over the shock and beginning to feel angry. Everything I know about what has happened to me over these last few weeks I have found out by doing my own research. I have never had anything explained or told what to expect next. As I have been thinking about this tonight I realise I shouldn't be surprised. The doctor didn't even speak to me in recovery. She spoke to my husband immediately after the procedure, but she never came and spoke to me in the few hours I was still in the hospital recovering.

Well my rant is over. Hopefully I can get some sleep now. I do know I will be staying as far away from doctors as I possibly can for as long as I can. The health service doesn't seem to be about medical care, just about making money.

Miscarriage Details

Having just gone through a complicated miscarriage during weeks 12 & 13 of pregnancy I wanted to record the experience. The most difficult part of the process was not knowing what to expect, and not knowing if what was happening to my body was normal. While I know that every miscarriage is different, I felt that describing what happened to me might help someone else faced with this terrible situation.

Be warned this account is purposefully explicit. It was the lack of concrete details in my internet searches that made it difficult to know what to expect. Do NOT continue reading if you are not emotionally prepared for the detailed description.
Thank you for taking the time to read and share in our journey.

I started with a missed miscarriage. I was 11 weeks and 3 days when I noticed some mucus slightly tinged with pink blood after using the bathroom. I thought enough of it to be concerned enough to tell my husband and to stay off my feet for the rest of the day. The following day there was a tiny amount of brown spotting after being intimate with my husband, but no discomfort and no continued spotting. I mostly stayed off my feet the next day as a precaution. A day after that (11weeks & 6days) there was another little show of brown spotting during the day, but then as I got ready for bed I noticed a tiny amount of fresh red blood when I used the bathroom. I was concerned enough now to contact our midwife. After speaking to her for a few minutes she suggested we listen for the heartbeat with the Doppler. We drove to her as she only lives a few minutes drive from us and it was 10:30pm. She couldn’t find a heartbeat, but was not too concerned, as from her vast experience this was not completely unusual. Sometimes the heartbeat won’t be heard until 13 weeks with the Doppler. However as I was having slight bleeding she suggested an ultrasound for our own peace of mind.

We went for the ultrasound the next morning, at which point I was 12 weeks exactly. The midwife had asked for a “wet reading” which meant they would send the results to her immediately. We were taken back to the waiting room, then a few minutes later told we could leave and to call our midwife for the results. We decided to drive home before calling our midwife. We were about halfway when she called us. The results were not good. There was no sign of a heartbeat and the baby’s growth indicated that it had stopped growing at 9 weeks and 3 days. We were advised to prepare for the miscarriage to start. This was on the Friday afternoon. Our midwife did say that if nothing had started happening by Monday we needed to go into her office to discuss our options.

I started cramping that evening. It was just mild cramping, accompanied by the passing of small blood clots. This continued throughout the night, leaving me with very little sleep. This continued on and off all through the day. It was uncomfortable but not truly painful. It eased off late Saturday evening, allowing me to get a little more sleep than the night before. The next day the cramps eased off for a while, and then returned stronger, with increased bleeding. That evening the cramping had definitely become painful. The blood clots also increased in size. As the evening progressed so did the miscarriage. The cramps had become contractions, and steadily increased until they were only a few minutes apart. Just before midnight I finally passed the placenta, and just after that the contractions stopped. Thankfully I was able to get a full night of sleep. With no pain or cramps returning, and with an end of bleeding I thought the miscarriage was over. I spoke briefly with our midwife that morning, and she seemed satisfied from my description that we were indeed finished miscarrying.

Just after lunch, about twelve hours after the pain ceased, the cramps returned. They were immediately back to the intensity of the night before. I went to bed to try and get some sleep, but I was in too much pain. I finally called my husband, who had gone to work that day, to ask him to bring more pain killers home as the pain had returned. I dosed a while during the contractions, and within a few hours my husband was home. He didn’t feel right about me being home alone in my condition, and so had come home early. My contractions continued to increase in intensity and frequency. After five hours I could barely cope with the pain. My husband phoned the midwife and in less than 15 minutes she was at our house. She confirmed that I was in full blown labour, something that can happen when a miscarriage happens this far into a pregnancy. Knowing that was somehow comforting, despite the pain I was in. I was however becoming very tired from the almost constant pain, lack of sleep and lack of food. I was helped back to bed by my husband, where I continued to labour, mostly curled up on my side. Both my husband and the midwife kept up the conversation while I tried to breathe through the pain. By now each contraction was bringing with it a gush of blood, not all of it clotted either. I tried joining the conversation when I was not contracting, and after eight hours of full labour the contractions, pain and frequency began to reduce, giving me some much needed rest, but as the midwife was sure the miscarriage was not yet over, it was not good news. Another two hours and the contractions had once again stopped. This time however the bleeding continued.

The next morning our midwife made an appointment for us to return for a follow up ultrasound. There it was confirmed that the miscarriage was incomplete. From the report that was sent to the midwife it appeared that there was only a small amount of fetal tissue left inside my womb, and that it was sitting just inside my cervix. The midwife did not think it was very likely that I would finish the miscarriage naturally, and recommended that I have a D&C to reduce the risks of further complications. She gave us the choice between going to the local ER, or arranging to see a doctor she had worked with previously. We opted for the doctor she knew, but after trying to contact him for a few hours, she called us back to say it would be the next day at the earliest before she would be able to even speak to him. So we decided to visit the ER instead of waiting yet another day.

The staff at the hospital were all very polite, and we were seen within 20 minutes of arriving. The duty doctor asked if we had an OB-GYN, and when we told him we only had a midwife he seemed to think this would make the whole process easier, as he could just contact the on-call OB. We were left in a room by ourselves while he spoke to the OB, and returned to inform us that she would see us in her own offices the next morning. I then had some blood taken before I was discharged, so they could do a blood count. Once the results of the blood test came back I was discharged with instructions to call the OB office to make an appointment for the next morning. As soon as we left the parking lot I called the OB’s office to make the appointment, which was scheduled for 11:30 the following morning. We went home thinking the whole thing would be over the next day.

At the OB’s office we had to fill in all the registration paperwork and were then left sitting in the waiting room for what seemed like forever, but in reality was about 45minutes. We were then taken to a consultation room where I was given instructions to prepare for the doctor, and we were again left alone. Another ten minutes and the doctor finally arrived. She did an internal pelvic exam (my first ever one) and then confirmed that I did indeed have an incomplete miscarriage. She then gave us the option of waiting longer to see if it would complete on its own, and as such we could set any given date to follow up. Anxious to now get this over with and disappointed that I was once again going to have to wait longer we informed her we wanted it over with as soon as possible. She then contacted the hospital to schedule an operating room for the next morning. We went home a little deflated, as we were both under the impression that the D&C was going to be performed on that first doctor visit.

I went through pre-admitting by telephone that afternoon and given all my instructions for preparing for the surgery. My check in time was 6am, as I was scheduled for surgery early on in the day. Again all the staff at the hospital were very professional and compassionate. Several of them tried to be encouraging saying that once this was over we would soon be able to try again for another child. The biggest complication for the surgery was that I had to be treated as a “full stomach” by the anaesthetist as I was over 12 weeks pregnant. This meant I had to have a breathing tube while I was under the anaesthetic. Fortunately I have no recollection of this, but I was left with a sore throat afterwards. Also because I was given a general anaesthetic I have no recollection of the procedure. The OB did speak to my husband after the surgery, but I did not see her again. She did mention that there was a lot more fetal/placental material removed that she was expecting. It would seem that the ultrasound had not shown the extent of how little I had miscarried on my own.

After I was taken back to recovery I was not allowed to leave until I had successfully used the bathroom. I was told I needed to rest for a few days, and was given two prescriptions. One was to prevent excessive bleeding from my womb, and the other was an antibiotic. I was also given instructions to make a follow up appointment with the doctor for two weeks after the surgery to make sure I was healing correctly.

In hindsight I am glad was made the decisions we did. I am also glad we pushed for a quick surgery considering how much tissue was still inside me. We learned a lot about how the US healthcare system works, and that in future I need to be much more forceful in asking questions if I ever end up in the system again. For both my husband and I the greatest frustration was the lack of information we were given, and that nothing was ever explained to us in advance. At the same time our midwife was truly amazing, showing great care and following up with us at every stage of the process. Even our midwife was surprised at how long it took once we hit the system. I do know that if we get pregnant again we will definitely be using the midwife for all our prenatal care, and delivery.

Bye bye Mordecai

Sorry I haven't updated earlier. But it hasn't been an easy weekend.

We went for the ultrasound on Friday, and the results were sent straight to our midwife. All we were told was that we needed to give her a call. So we decided we would drive home first and then call our midwife. A few minutes later as Rob was driving she called us. It was not good news. They couldn't find any sign of a heartbeat, and from size our wonderful baby had stopped growing just over two weeks earlier. We had what is termed as a missed miscarriage. Our midwife said to go home and wait a few days to see if the miscarriage would complete on it's own. If nothing had happened by Monday we would discuss the alternatives.

We had lunch and then I suggested to Rob that he went back to work. It seemed pointless for us both to be waiting around in a somber mood. I called my mum in Scotland after Rob left and had a really good chat with her about it. We called Rob's mum on Friday evening to let her know as well.

Late Friday the cramping started, showing that my body was trying to complete the miscarriage on its own. Just before midnight last night (Sunday) it was finally over. It has not been the most fun weekend in my life, but I am glad my body was able to do this by itself, so that I don't have to go near a hospital. We are also rejoicing in the fact that Mordecai is with the LORD in heaven, and we will one day get to meet him. Although we only had Mordecai with us for ten short weeks we do very much love him and will never forget him.

Thank you to every one who has kept us in their prayers since Friday. We both have really felt sustained by God, and although we are sad we can also rejoice at the same time.

Dedicated to
Mordecai Conrad, born Sunday July 19th at 10 weeks gestation.