D&E: What to expect when you’re no longer expecting

This is my own personal experience, it may or may not be what you’re going to face or what you can expect. It may be difficult to read, please keep this in mind. I am writing this for those just discovering that they’ve had a second trimester pregnancy loss or anyone contemplating having a D&E procedure.

I minimized my great desire to Google search “D&E” or “Dilation and Evacuation” procedures. I knew the basics, it was all I needed to know. I strongly suggest you don’t Google further. You don’t want to know.

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I was given two choices with how to deal with our great loss. They were as follows:

• – Dilation and Evacuation (D&E) procedure under general anesthesia
• – Labor induction and delivery

I went with the first option. The second option was only barely whispered to me. I’m sure the pain in my eyes spoke loudly for me. I wanted to move forward. I wanted our Leo out of my body. It was not fair to either of us. The second option seemed incredibly painful for me to imagine. For me, laboring and delivering my dead son would be too much to bare. I want to remember him as he could have been and within the protection of my womb. Not as the tiny little being that he would have been in my hands. I wanted to preserve the sanctity of birth for myself in due time. This may not be what you would choose or would have chosen, but, it was right for me. For us.

Very quickly after we were diagnosed with Fetal Demise at 18 weeks, the attending Perinatologist (Dr. DM) made a call to my then-OBGYN Dr. J. He told her that they didn’t perform the D&E procedure in his office, I also assumed they didn’t perform it in the hospital that I had planned on delivering our son, either. Who knows, I was glad I didn’t have to see Dr. J’s face ever again. They referred me to a Dr. K. Late on Monday, August 12th, someone from her office called me to start preparing me for what to expect. They told me it would be a two-day procedure beginning on Tuesday and the D&E would happen on Wednesday. At the very end of our conversation, she told me that I had the option of having Leo cremated. It, too, was only a fleeting whisper, as she wasn’t sure I wanted to even talk about that. I’m SO very glad that she did, otherwise, nobody would have mentioned it to me at all. I just remember the words Neptune Society.

Tuesday:
Went in for my appointment, I filled out my medical history paperwork and the standard HIPPA notice. I was then given an Ibuprofen pill and a Valium. This was the first time I’ve ever been given Valium. Within about 15 minutes, I was lead-legged and dopey. Whoa. I think I barely listened to anything anyone said to me beyond that. I was then given an exam and had Laminaria sticks inserted into my cervix and was packed with gauze. These are sticks made of seaweed that gently dilate your cervix over several hours and prompt labor. The main purpose of this is to prep your cervix for the D&E procedure. I was given lots of prescriptions for pain medication, antibiotics and medicine to stop heavy bleeding (if needed) for the next day and days. I was given thorough warning on what to expect. I could expect cramping and pain as my cervix began to dilate. Thankfully, I really didn’t have any. I could expect for my breasts to engorge and produce milk in the days proceeding and was given instructions on how to prevent that.

I mostly rested the most of the day. Then, we went to our counseling appointment. It was perfect in timing as we prepared for the D&E the next day. We discussed the option of cremation. We hadn’t really thought about what would happen to Leo if we just left him at the hospital or lab (pathology). We discussed that he would more than likely be discarded as medical waste. I’m glad we had that frank discussion. It was then a no-brainer that we would have him cremated. I could not imagine him just being thrown away. We walked away feeling strong enough to face the next day.

Wednesday:
Thankfully, our procedure was moved up to 9:55 am instead of 1 pm. We walked into the hospital and registered with outpatient surgery. I gave my husband a list of items to do while we were at the hospital, including trying to get paperwork completed for my medical leave. I did this because I know my husband would be sitting in anxiety for well over an hour and I didn’t want to think of him as being in fear for me. I wanted to give him something to occupy his mind.

I was called back and my husband stayed with me the entire time. I had to change into a hospital gown. At first, they had given me a Bair Paws gown, but it proved to be quite itchy for my already-sensitive skin. I was wiling to suck it up, but the nurse offered a regular cloth gown so that I could be comfortable. My vitals were taken and they prepped me for an IV. They took more blood to be tested and then we waited for the doctor to arrive and be walked to the operating room. But, before I forgot, I told the nurse that we wanted our son’s remains to be cremated. And she said, “Oh, there was nothing in your chart. Let me go grab you the paperwork you need to sign.” So, she did, and I signed a document asking for him to be held and be released to a mortuary. This is VERY important if you wish to have your child cremated. ASK! It appears they don’t volunteer this information.

Dr. K was waiting for me, as well as a nurse and the Anesthesiologist. Dr. K is a chipper little thing. I also told her that we wanted Leo cremated, and she told me she was glad I said something, because she didn’t know. She then talked to me some more about my PCOS and got to know me a little bit, even though she had barely met me the day before. She goes on to tell me that she was delivered by Dr. Michael Leventhal, made famous by the discovery of what was at first called Stein-Leventhal Syndrome, later PCOS, later Metabolic Syndrome. I found this fact fascinating and I stopped to think about it for a small little moment before I felt quite heavy with sleep and then I was OUT.

I woke up while being wheeled out to the recovery room. I was having a coughing fit. Someone, I can’t remember, comforted me and told me that the cough was normal and that I’d be okay. I was in some pain, with cramping. I was told this was normal, for they had started giving me Pitocin to help the muscles of the uterus contract and reduce bleeding. Very shortly afterward, Dr. K. came back holding Leo in a container. She told me “I have him.” She went out to speak to my husband while I recovered and eventually was wheeled into my own private recovery room while they continued to administer fluids and Pitocin. My husband was brought into the room to sit with me. I couldn’t be MORE comforted by his presence. The rest is just standard recovery stuff after your procedure. You will have bleeding. You will feel icky. You will feel a little sore. Your throat will hurt. You will be hungry. Most of all, you will feel sad. You will feel empty, as no longer having your 18 week old baby within you will feel like a void. Where your bump once was, it will be drastically reduced in that moment.

It was finally time to be released. My husband went down one last time to try and get my medical leave paperwork signed. And, thankfully, our Perinatologist, Dr. EM was around to personally speak to my husband. He talked to him and gave him a hug. He said that he knew we had lost our son, but he had no idea that the procedure was on this very day. He asked where I was and then he was off after signing the paperwork. I was then sitting waiting for my husband to send me a text that he was downstairs waiting so that I could be wheeled out. Instead, the door flung open and it was Dr. EM! I started to cry the moment I saw him. He sat down with me and talked to me about how sorry he was for my loss. That we would figure this out and we are almost there with “tuning up” my body. That he’s confident that we can do this again and I can have the family I so desire. He gave me a hug. He told me physically the recovery will not take as long as my emotional recovery process. That perhaps I should let the word slip about our loss at work, so that people know. He told me that well-meaning people will say stupid things. WHAT? Naaah! 😉

He stood up and hugged me.

I was wheeled down to the car and my husband drove us home as we both cried.

XO, Isabel