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03/26/2003

The best of three bad choices

A miracle did not occur. We were not surprised.

Today's ultrasound showed that the gestational sac had grown, but it was still about a week behind where it needed to be, with no yolk sac, no fetal pole, and obviously no heartbeat. If you don't have most of those things at 6 weeks 5 days, you're just not going to get them.

It confirmed what we already knew. I felt a dull sadness, a background version of the more turbulent feelings I've been having for about two weeks now.

My doctor offered three options.

I could wait to miscarry naturally. As far as I was concerned, this wasn't an option. On the one hand, you know beyond a doubt that the pregnancy is really and truly over. On the other, that could take weeks, and could happen in the supermarket checkout line. At this point, haven't we gone through enough without imposing more uncertainty on ourselves?

I could have a D&C. I briefly considered this, but decided I'd like to avoid that if possible. I worried about the pain of the procedure, and I worried that I'd have to wait for an appointment. I wanted it over.

I could take misoprostol, a drug that induces miscarriage. (It's usually used in conjunction with mifepristone, but in IVF patients the other drug is unnecessary.) It's taken vaginally, and it causes your cervix to soften and dilate; the ensuing contractions usually empty your uterus of the products of conception.

I decided on the misoprostol because it will cause a predictable miscarriage that I can endure at home, properly medicated, without surprises. I'll be inserting the tablets tomorrow, after which I intend to spend the weekend feeling hideously, operatically sorry for myself.

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