“What were the results of the ultrasound, Doctor?” Gina asked.
She had called the office two days ago because she noticed that It’s there she was having a brownish discharge and that she wasn’t experiencing nausea and breast soreness anymore. Although she knew that all pregnancies were different, there was something radically different about this one. She called and told the receptionist what was happening and she booked an ultrasound for her. And now, here she was facing the doctor after she had gotten dressed, her heart racing.
“Gina, the ultrasound showed that you had a missed abortion.”
The color drained from her face. “A missed abortion?” she exclaimed. “How is that even possible?”
“A missed abortion is not an elective abortion. We use the term spontaneous abortion to refer to miscarriage. A missed abortion is named such because this type of miscarriage doesn’t cause symptoms of bleeding and cramps which usually occur in other types of miscarriages. And this can make it difficult for the woman to know that the loss has occurred. These types of miscarriages happen in the first trimester.”
She sat there in a daze. “Do you know what caused it?”
“The causes of missed abortion are not fully known. About 50 percent of miscarriages happen because the embryo has the wrong number of chromosomes.”
“But, I don’t understand. I’m eating well and exercising. My husband and I haven’t had sex in a while and I’ve been under some stress but–“
“Gina, in a missed miscarriage, the embryo simply stops developing and there’s no clear explanation for why this happens. Things like stress, exercise, sex, and travel do not cause miscarriages, so it’s very important that you don’t blame yourself.”
Her hands trembled as she adjusted her shirt and finished buttoning it. “What happens now?”
“There are several ways to treat a missed miscarriage. You can choose or I could recommend a treatment which I feel is best for you. There is the expectant treatment. This is when the embryonic tissue will pass and you’ll miscarry naturally. This is successful in more than 65 percent of women who suffered a missed miscarriage. However, it isn’t successful, you will need medication or surgery to pass the embryonic tissue and placenta. You may choose to take medication called misoprostol which helps to trigger your body to pass the remaining tissue to complete the miscarriage. You can take the medication here or at the hospital and then return home to complete the miscarriage or you can have the medication inserted vaginally. Your third option is to have the D and C surgery immediately following a miscarriage or later if the tissue doesn’t pass on its own or with the use of medication.”
“Could-could you explain what the D and C surgery is?”
“It’s a minor surgery which dilates or opens the cervix. The cervix is the opening to your uterus or womb. After dilating your cervix, the doctor uses a spoon-shaped object called a curette to remove tissue from the inner lining of the uterus. You can have the surgery done here in my office, a women’s health clinic, a day surgery center or at a hospital.”
“What do I need to prepare for the surgery?”
“You need to avoid eating or drinking on the day of the surgery; get a physical exam to make sure you’re healthy enough for the procedure; visit the place where you’re going to have the surgery done the day before so they can apply a gel to start the process of opening your cervix; arrange to take one or two days off from work; make sure you have someone to drive you home after the procedure. I will give you written instructions and a pamphlet with all the information you need to know about D and C procedure and the other treatments I mentioned before you leave. I don’t want you to make your decision right now. Go home and sleep on it. Call me when you’ve decided what you want to do and we will proceed from there.”
She nodded. “Yes, Doctor Alvarez.”
“You should probably talk this over with your husband.”
“Yes, Doctor Alvarez. Thank you.”
“Are you all right getting home on your own now?”
“Yes, I’ll be fine.”
“All right. Here is the information on all three options. Read them over carefully before you make your decision.”
She took them from him and stood up. “I will. Thanks, Doctor Alvarez.”
“Goodbye.” She grabbed her handbag and walked out of the office.