calling all L/D nurses for help PLEASE

  1. I have a question for all of you L&D nurses, I recently miscarried at 9 wks, it was complete had my sonagram yesterday, my H & H are getting kinda low, anyway my question is should I have a
    D&C or not, my doc said it was up to me, but he would prefer me to have one, (shoudnt he tell me yes or no) I am totally confused about all this I have had a D/C in the past after a miscarriage,so I kinda know what to expect, needless to say emotionaly I am having a hard time dealing with this. Bosses dont want me too b/c I would have to miss work, yada yada yall know the drill. I am a little scared okay I admit it alot scared. please help and give me some info. love to all kelli
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    About stressedlpn

    Joined: Jan '02; Posts: 251; Likes: 3


  3. by   mark_LD_RN
    I am very sorry about your loss.

    as far as if you need one or not it is hard to say just from the info you have shared. it is often required especially if the bleeding continues or increases. there may still be some produces of conception inside the uterus. He should give you his medical advice and let you decide. if in doubt go to another doc for a second opinion.

    from what you are decribing i would think it is probably a good idea. also you might consider taking some iron and vit c supplements to get H&H up.
  4. by   melissa24

    Sorry...not an L & D nurse, and have no advice to offer. Just wanted to say I am very sorry about your loss, and I felt like I needed to give you a hug...


    And the last thing you need is more stress from an employer who doesn't want you to miss work...You do what YOU need to do!

    Take care,
  5. by   Q.
    Sorry to hear about your loss.

    If it were me, in your same scenario, I might opt out of the D&C *for now* and take a more conservative approach, kind of a wait and see.

    If you doc doesn't think it's necessary, and it was a complete, there might be no need to go ahead with an invasive procedure just for the sake of posterity, especially at 9 weeks.

    Since you've had a D&C before, you know what to expect. This should help guide your decision.

    Why not wait, check your H&H again in 4 days, watch for bleeding/cramping, etc and if it continues, have the D&C as then it will be necessary. I am really against unnecessary medical procedures, especially invasive ones. Again, this is my opinion, but I feel perfectly capable of figuring out if I am still bleeding and not doing well, enough to need a D&C. Don't forget, either way there are risks, so really, there is no wrong answer, just a different one.

    Good luck and take care.

  6. by   SmilingBluEyes
    I am So sorry for your loss! I, too, miscarried in March, almost 8 weeks. I opted out of D and C, and did very well. I never hemorrhaged, but bled quite "heavily" for a week or so. The cramps were KILLERS, I felt a lot like I was in labor.

    If your dr is fairly certain all the parts of conception are passed, he/she probably feels confident in your not having to have a D and C. Often, in early m/c, the conservative approach is being reduce chances of infection and further complication this way. However:

    If you are saturating pad after pad, and passing large clots, bigger than quarter to halfdollar size, however, you need to keep an accurate pad count and call your doctor or go to ER. Keep up on fluid intake; this is VITAL! What do I mean? About 3-4 liters of water a day if you possibly can. If you develop fever over 100.4, this prompts a call to your doctor, as well. The H and H may drop quite low and you still do well... young women's bodies can mirculously function on very low blood counts. I have seen patients go home with VERY VERY low H and H's after delivery or csection and do ok. But they are ordered to TAKE IT EASY! This is partly why I emphasize fluid intake. I would also emphasize continuing w/your prenatal vitamins and iron, if they were prescribed. They will also help you build back up and heal. Eating foods high in B-vitamins and iron, sure cannot hurt, either.

    Just take it easy, don't rise from bed or a chair rapidl ( you might feel dizzy if you do), and REST REST REST. You have been thru a major loss, even if others do not see it this way. It is significant to you and if you need time off, TAKE IT! The world will not stop (and neither will your work) if you take much-needed time to heal physically and emotionally. I feel your pain, and know what you are going through right now. The saying time heals is true, you will, but you need to take that time for it to do so!

    I also have the name of a wonderful book I read after my m/c that put into very good words how I felt and also how my patients do, after such early losses. Too often we are dismissed with well-meaning words ("at least it was early; you can have others.." yada yada). If you want the name of this book and ISBN, let me know by PM or here. I wish you well and am here if you need support! Meantime, take that time and be very good to yourself!
  7. by   stressedlpn
    thank you all so very much for the advice I posted this topic last night when I was feeling really low. I have a friend in the lab who is monitoring my H/H qday. I knew that the folks here could help me, I promise to be careful and safe, thank you again, It has taken me awhile to write this cant hold back the tears. love to all, kelli
  8. by   Brownms46
    (((((((((((((((((((((stressedlpn)))))))))))))))))) ))))))

    Sorry to hear of you loss.. I had two miscarragies, and didn't have a D/C after either. So you will probably be ok...following the advice you have already received. Take good care of yourself..
  9. by   SmilingBluEyes
    Don't hold back your tears. let em flow. I cried ALL night after my m/ was horrible. You will get better...slowly. I wish I could be there for you. But you take it easy now.
  10. by   sharann
    I'm sorry too, and have been there myself. As for the bosses feelings(is that what they call them), ignore them. You might just want to take a few days off regardless of having a D&C. Just to rest and deal with your feelings. Get a doc's note if you MUST, and rest up.
  11. by   nakitamoon
    ((((( stressedlpn ))))))))))

    I was told 17 years ago after miscarriage then d&c,,, would never be able to concieve again,,,,, took many years to come to terms with this and accept it,,,,,,, two and half years ago,,,,, Pregnant,,,, omg!!! found out at 12 weeks,,,, passed out!,,,, miscaried at 17 weeks,,,,, Have had a really difficult time,,, with this one,,,,, seems like cruel joke,,,,,

    I digress ,,,,,, I agree with waiting and taking it day by day,,,, feel you should of had more input from your doctor,,,,,,

    I had a d&c immediately after both miscarriages,,,, this last one,,, was terrible,,,, prior,,,,, waiting in er,,,,for or to be available,,,, cramps were like contractions,,,,,though my cervix was completed closed back,,,,, bleeding was in copious amounts,,,,, I was in agreement with gyn,,,, needed the d&c,,,,,, physical symptoms better,,,,,

    There are days still dealing with mental aftereffects,,,,,