Medical Management

The doctor helped us today determine what our next steps will be. There are three types of management for a missed abortion:

1. Expectant: waiting for the miscarriage to naturally occur
2. Medical: using Cytotec to induce a miscarriage
3. Surgical: Dilation and Curretage (D&C) to surgically remove the pregnancy remnants

They all have the same risks, except that surgical has some extra risks over the other two (scarring and possible puncturing of nearby organs), the common risks of the three being hemorrhaging and failure to complete.

Since we have been technically in the expectant management stage for a minimum of four weeks (perhaps as long as six), we were both pretty ready to move past that stage and create a miscarriage medically. Also, since we are planning to travel next Friday, we would both like this to be over with by then. So, we received instructions on a medical abortion. Actually, we received the same instructions as someone who did not want their fetus and was aborting it, with a few lines crossed out by the doctor with the instructions on how to medically kill a fetus (since ours is long dead and not even present). Basically, 800 mg Cytotec (normally an ulcer medication) is *ahem* taken vaginally and then the miscarriage should happen over the next 24 hours. I will take mine at 1 pm tomorrow, to safely fit within Jonathan's schedule, since he will need to be present in case of a hemorrhaging episode and has a meeting at 11 am tomorrow and 1 pm on Friday. If nothing occurs within 24 hours, or if I continue to hemorrhage at that point, we have to go in to get the D&C anyway.

The cyst on my left ovary is probably what is keeping the pregnancy alive, and will probably go away after the miscarriage. But, they will watch it, and I have to go back in three months time to make sure it isn't something else.

You can be praying for us from tomorrow (Thursday) at 1 pm until Friday at 1 pm. This really, really sucks. But I hope it works the first time, because I don't really want surgery on top of everything else.

Oh, the really good news (is there really good news?) is that since the baby didn't develop too far we only have to wait for two cycles after this whole mess, and then we can try again.