TFMR: My D&E

In the days leading up to my D&E I did a lot of research on what exactly the procedure entails. Unfortunately, I struggled to find the detailed information I felt I needed in order to calm my anxiety. For that reason, I want to provide a detailed, step-by-step, account of what the process looks like. I will start by saying that the emotional and mental aspects were more difficult than the physical experience. As I mentioned in my previous post, I struggled with what was going to physically happen to my baby during the D&E. I also dreaded the emptiness I expected to feel once Archie was no longer inside of me. While I had never felt him kick, I would often place my hand on my stomach, especially after we found out he would not survive. It provided a sense of comfort, knowing that I was “touching” him as much as I would ever be able to. But, soon my body would be void of his little life. And, then what? I was caught in this place of wanting to get the procedure over with, and trying to treasure every moment I had with Archie before he was gone forever.

The D&E procedure is a two day process, but I did not have to stay in the hospital overnight. That was a huge relief. On Wednesday, May 17th, V and I went to my doctor’s office where I underwent what essentially felt like a more intense pap smear. It was not pleasant, but also not unbearable. It was definitely worse than the actual procedure the following day. I won’t pretend to understand all of the medical ins and outs of what exactly was done. But, basically my doctor started the process of dilating my cervix on Wednesday morning, in preparation for my procedure on Thursday morning. I did receive two injections (I think into my cervix, though I could be wrong on the exact location) to help with the pain. These injections felt like a tiny pinch. Again…uncomfortable, but not unbearable. My doctor then placed five dilators into my cervix. My understanding is these dilators work similarly to a tampon - they expand once they are inserted, thus slowly dilating your cervix. I took ibuprofen around the clock for the remainder of the day to help manage any cramping, pain, etc. I also used a heating pad. The “pain” really just consisted of period-style cramping. Again…uncomfortable, not unbearable.

I had a 7:30 am surgery time. So, we had to be at the hospital at 5:30 am on Thursday morning. I was not able to eat or drink anything after midnight, with the exception of a gatorade that I was told to drink right before I walked into the hospital. I was advised this would help with recovery. I had also been prescribed two tiny pills that I was to put under my tongue before I entered the hospital. After 30 minutes, I was allowed to have a little bit of water to wash the pills down. These pills helped to further soften my cervix in preparation for surgery. We arrived at the hospital and checked in. We were then almost immediately sent to discuss payment for the procedure, which felt like very poor timing. *If a hospital tries to charge you the full balance on the day of your procedure, ask to make payments instead. This was not an option that was offered to us, but once we asked we were advised that was fine and asked how much we wanted to pay that day. *I will also note that it is very important to contact your insurance prior to scheduling a D&E. My doctor’s office was able to provide me with the billing code for the procedure, and I was then able to confirm that my insurance would help to cover it. Had they not, I was advised that Planned Parenthood would have been a cheaper option. Once done with the financial aspect, we were sent to a second waiting area where we waited maybe 15-20 minutes to be called back. I was incredibly uncomfortable during this time. I had not taken any ibuprofen since the day before, and was not able to take any that morning. I was in quite a bit of pain - heavy cramping. I wasn’t sure if I would have to pee in a cup before the surgery. So, I was scared to pee, but I couldn’t wait. *You will not have to pee in a cup before this procedure - I assume because they already know that you are pregnant? Shortly after I got back from the bathroom we were called back by my pre op nurse.

I cannot adequately express how amazing every single person we encountered after that was. My nurse was so kind and reassuring. She walked us back to the pre op holding area where we had a bed and a chair, located behind a curtain. She then stepped out long enough for me to change into my hospital gown. When she asked if I was nervous, I told her I was terrified. She advised me not to worry and assured me that we were going to get through this. Just her saying we as opposed you was so comforting. She also told me that she had had two previous D&Es. This was SO comforting - to know that the person taking care of me before my surgery knew exactly what it was like to be in my shoes (or hospital socks in this case). I had never had any type of surgery before - not even wisdom teeth surgery. I’d never gone under anesthesia either. So, I really had no idea what I was walking into. Honestly the worst part of the procedure (physically) was the IV. The nurse had told me this would be the case. It was quite a bit more painful than having blood drawn. I can’t watch this kind of stuff, but V confirmed it was a big needle. I just remember being so incredibly thirsty at this point. I would have done just about anything for a cup of water. I was told that the IV would help with that feeling, which I guess it did. I was also advised that pain medication would be provided through the IV, as I was very uncomfortable (cramping). I asked if I could be given something for anxiety. I’m not sure what they gave me, but I received something through my IV to help with that, as well. I was also able to take a Xanax the morning of the surgery, which I was SO grateful for.

I was so incredibly nervous and then to make matters worse - I got very nauseous all of the sudden. The nurse had stepped out, but V was with me. I asked him if there was a trashcan in the room and thankfully there was. He handed me the trashcan and I immediately vomited several times - essentially losing all of the gatorade I had consumed shortly before. My doctor had arrived by this point and told me that I could blame her for getting sick. Apparently the pills I had taken before walking into the hospital can cause nausea/vomiting. The anesthesiologist had also popped in to introduce herself - literally the kindest human ever. I had been told that I would be able to breath on my own during surgery. However, since I had gotten sick, the anesthesiologist advised that she would prefer to insert a breathing tube (no idea if this is the correct terminology) into my throat just to be on the safe side. I confirmed this would take place after I was asleep, so I wasn’t worried about it. The anesthesiologist’s assistant and a resident doctor, both of whom would also be in the operating room, stopped by to introduce themselves as well. I was honestly just blown away by how kind and attentive everyone was. They all reassured me so much and made me feel so safe. Each one of them was seriously the biggest blessing.

When it was finally time to be taken back to the operating room, V and I were both pretty emotional. My nurse stayed with him and the anesthesiologist’s assistant and resident doctor rolled me back to the operating room. The resident doctor made sure I was okay and assured me everything was going to be fine. Once in the operating room there is very little I remember. I was transferred onto the operating table and the anesthesiologist’s assistant asked what type of music I would like to listen to. “Taylor Swift.” That’s the last thing I remember. The procedure itself lasted less than an hour. When I woke up in post op a different nurse was there. She sent for V and gave me some apple juice while I waited. I was nearly immediately overcome with emotion. I cried the entire time I was in post op. I felt so empty. Archie was gone. He was no longer in my stomach. He was no longer alive. It was the lowest feeling. My parents had come to wait with V while I was in surgery. So, I asked V to have my mom come back. It was just one of those moments that I needed my Mama. Shortly after she poked her head from behind the curtain, and held me as I cried.

I was surprised that I was essentially free to go after that. The nurse told me I could leave whenever I felt up to it. I finished my apple juice, and then V helped me get changed back into my clothes. I was so grateful to see a wheelchair - I just didn’t have the mental capacity to walk out on my own. Physically, I honestly probably could have, but I guess that isn’t allowed anyway? The gentleman who escorted us out waited with me while V went to get the car. Again…SO kind. I was bleeding quite a bit initially, but otherwise I felt pretty normal physically. Mentally and emotionally, I was beyond broken.