a misoprostol miscarriage

My first clue that miscarrying would hurt was the second prescription I received along with the misoprostol: acetaminophen with codeine, also known as Tylenol 3. Looking back, I’m surprised none of the medical professionals I encountered along the way warned me about the pain or offered coping strategies, because one could easily have been blindsided when the contractions set in.

I was fortunate to find this wonderful blog post by a woman who had a misoprostol-induced miscarriage a few years ago. Her meticulously documented account prepared me for what I was to experience and inspired me to record my own story to help others the way this stranger from 2008 helped me.

When I was in law school, I studied quite a bit of health law, especially reproductive and sexual health law. I know misoprostol well because it has tremendous potential to end unwanted pregnancies in populations that do not have much access to health care, so it was a topic of discussion in many of my classes. I did a clinic project for Human Rights Watch on the off-label use of misoprostol (which is actually an ulcer medication) in countries where abortion is illegal, but there is still some sympathy for women who are so desperate to stop their unwanted pregnancies that they turn to something approximating the stereotypical back-alley doctor with a coat hanger. The word “misoprostol” rolls right off my tongue, I have said it so many times.

How funny life can be. Misoprostol, once associated with rescuing impoverished women from dangerous abortion methods, has twisted itself into the ugliest of words without changing a single letter. It now sat on my bathroom counter in a vile yellow vial, literally with my name on it.

I planned to take the medication in the morning so that I would be rested, and so that I could keep on a normal sleep schedule, as I knew I wouldn’t be sleeping through the pain. On Saturday morning – yesterday – I woke up around 8, drank an enormous fruit and vegetable smoothie with extra protein powder, and took some Floradix, a liquid iron supplement. I also drank lots of water, which turned out to be critical as I was incredibly thirsty for the rest of the day.

At 9:20 am, I pushed four pink, diamond-shaped tabs, one at a time, into my vagina. I marvelled at how something so small can contain so much life-altering power. I also took only one Tylenol 3, despite the instructions saying one or two can be taken every six hours. I should have taken two. My heart was pounding against my lungs, increasing the speed of my breath, as I returned to the couch to wait for the unknown to change everything.

For a couple of hours I felt very little other than some light cramping. I got up periodically to check my pad, but after some initial bleeding, there was nothing to see. I even suggested to my husband that we go for a short walk, but by now the cramping had increased enough that I was more comfortable sitting still with a heating pad. My lower back was also aching, as it tends to do before I get my period.

Around noon, I ate vegan poutine that my husband picked up, one of my ultimate comfort foods. I wanted to eat before the pain got much worse and eating was the last thing on my mind.

By 12:30 pm, I couldn’t quite get comfortable on the couch, which always has to be shared with at least one cat, and we moved into the bed where I could stretch out. (The cats came too.) My husband set up his computer so we could watch The Office to distract me from what was happening, and he filled the hot water bottle so that I could lie with the heating pad beneath my lower back and rest the hot water bottle on my pelvis. But its modest weight was too much then, and that is when I took another painkiller.

Around 1 pm, I could no longer concentrate on anything other than the cramping, and I couldn’t get comfortable lying down. I got up to move around and found myself moving from position to position as I breathed and groaned through the unbearable cramping. I walked, I crouched, I rocked on my hands and knees, I held onto anything I could. My hooded sweatshirt felt like it was choking me, so I tore it off in favour of a long-sleeve shirt with a scooped neck. But then the waistband of my sweatpants was intolerable against my abdomen, so I put on a flannel nightgown. I just couldn’t get comfortable.

And oh, I was so thirsty. I guzzled and guzzled water, and it was never enough. I was thirsty well into the night.

Around 1:30 pm I took another painkiller – my third – and moved into the darkened bathroom where I could labour over the toilet, hanging off of the towel rack, and leaning over the sink. I asked my husband to bring me water, but before I could drink any, I knew I was about to throw up. The entire contents of my stomach gushed into the toilet in five full heaves. I drank more water. I took another painkiller to replace the one I had just lost.

The vomiting gave me some relief, and I managed to lie back down on the bed, easing myself from vertical to horizontal in blocky, awkward stages. Now I could focus on breathing slowly and deliberately. When meditating, it is hard to concentrate on one’s breath without drifting off on a chain of thoughts. But pain commands one’s full and diligent attention. I breathed in and relaxed into the pain, I breathed out and relaxed into the pain. I repeated to myself that pain is housed in the mind and I could think my way out of it: “The pain is in my mind. The pain is in my mind.”

But soon no amount of breathing or mental tricks could help me. Around 2:30 pm, I felt a sensation like I had the worst gas in the world and I needed to relieve the pressure. I moved to the bathroom, but the pressure wasn’t from gas and it couldn’t be relieved. Now I was yelling, crying deep low sounds alternately of pain and frustration. I couldn’t stay still but I couldn’t get comfortable. The pain was inescapable but I wanted nothing more than to escape it, and I tried and tried.

This is when I asked my husband to find that blog post I linked to above and tell me how much longer I had of this. He could tell from her post and from watching me that I was in the worst of it. I told him I felt like I was dying, although that wasn’t really true. I told him I never wanted to have children if this is what labour was like, but that wasn’t true either. I considered calling 911 and demanding morphine. I took another painkiller.

The cramping was so overwhelming, so consuming, that all I could do was reposition myself from horribly uncomfortable to less horribly uncomfortable. My husband called a pharmacist to see if I could take ibuprofen along with Tylenol 3 and got the green light, but I didn’t get a chance to do this.

As I stood writhing around my tiny, dark bathroom, I felt a sensation like a bubble moving along my vaginal canal and asked my husband to pass me some toilet paper – quickly – because I couldn’t move out of the “S” shape I was contorted into. He couldn’t possibly have moved quickly enough, though. I reached my hand down and caught the bubble as it rose (dropped) to the surface of my vagina, to the outside of my body. Blood gushed out too and I stood over the toilet, dropping the contents of my hand into the bowl. I could see now that I had caught the sac that contained what I once thought would become my beloved son or daughter.

“I think that’s the sac. Is that the sac?” I chattered to my husband, my rapid, rolling voice sounding foreign. He looked. He asked me if I felt relief. It was only in response to his question that I noticed that the pain had entirely stopped. Labour was over. It was 3:30 pm.

Now my body was mine again and I could sit on the toilet as we cleaned up the floor and the spattered white towels that I had been using as cushioning for my knees. I felt amazing. I had survived. The worst was over and we had only a bright future ahead of us, whatever it may look like. I was like, “I JUST DID THAT,” euphoric from relief, and we high-fived. We really did.

I bled an enormous amount for the next couple of hours, filling up a pad in less than an hour, and sitting on the toilet pushing out warm clots. The bleeding dropped off to a normal period-like trickle after those few hours, and I felt woozy from the blood loss but not dangerously so. I napped a little, took more Floradix, and ate a daiya grilled cheeze with sauteed iron-rich spinach – another ultimate comfort food – that my husband lovingly prepared. I curled up with the heating pad and we talked to our mothers, who were incredibly worried about us and were suffering as if the loss was their own, and it was in a way, as it was their first grandchild. But now I understand that a mother’s happiness is inextricably linked to her children’s happiness, because I was so close to motherhood that I felt how it will feel.

Today the bleeding is so light, I could probably use a pantyliner. I am not cramping at all and I feel as energetic as ever (which is to say, moderately so). My optimism remains; I feel surprisingly confident that we will have our viable pregnancy in no time. Perhaps my confidence is a defence mechanism against what could otherwise be despair, or perhaps I have just finally accepted that although the worst can always happen, the odds are overwhelming that they won’t.

This experience has brought me to my knees with humility. Our bodies are nothing short of miraculous. Miscarrying was one of the worst things that has happened to me, but it has tested my strength and I have stood my ground, and learning that this is within me has made the experience, in its own way, beautiful.

***

Today I asked my husband if it was hard to watch me in that degree of pain. He said that it was, but that when it was really bad he knew that it was almost over so it was okay. Worse was watching my emotional pain the day before, because that was long term, not a discrete pain with a foreseeable end.

The emotional pain is certainly more amorphous, and it will no doubt reappear in subsequent pregnancies. But I’m not too worried. I will breathe through it and remind myself that “the pain is in my mind.” It is okay.

***

If you are going to have a misoprostol-induced miscarriage, I offer you these tips, based solely on my own experience:

  • Learn some pain management tips. Read about labour-coping methods. For me, this meant allowing myself to make noises – keeping them low – and moving around as I felt the need.
  • Do not start in the evening unless you are normally a night owl. If you start in the morning, you can miscarry and recover over the course of the day and be in bed at your normal bedtime – at least, this was true for me.
  • Eat around the time that you first insert the misoprostol. You won’t want to eat later, and you will need your strength.
  • Eat iron-rich food and/or take an iron supplement. I like Floradix because it is easily absorbed and doesn’t cause constipation. You will lose a lot of blood and the iron boost will help make you stronger, sooner.
  • Take the maximum amount of painkillers that you can. If possible, get something stronger than Tylenol 3, like Percocet or Vicodin.
  • Have someone with you. Whether it is your partner, mother, or best friend, having someone around will be both practically helpful and emotionally comforting.
  • A heating pad helps with the cramps before and after the pain is at its worst.
  • Wear a nightgown, or nothing at all. If you’re like me, you won’t want anything touching your abdomen.
  • Remember that when you think you can’t take it anymore and you just might die, you are almost done.
  • Above all, remember that your body is doing just what it should be doing – it contains the wisdom of the evolution of our species. You will get pregnant again and you will have a (another) baby.

I wish you safety, optimism, and a swift recovery. You are not alone.

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34 thoughts on “a misoprostol miscarriage

  1. Noelle says:

    You are incredible for writing this, and your attitude towards all of it is truly inspiring. I have no doubt this post will be a great source of information (and comfort) for someone considering her miscarriage options.

    I hope recovery continues to be smooth for you and your husband.

  2. stayingsarah says:

    I agree with the above comment 100%

  3. Deb says:

    Thank you so much for writing about your experience. I have just started the medication for my third miscarriage in 18 months. The first two were treated by D&C but I couldn’t handle a third one.

  4. haijin amin says:

    My wife just took miso this evening. She hasn’t started additional cramps/bleeding, but we know it’s coming.

    Right now, she is sleeping. It was yesterday we were told our unborn baby is dead. Today, she had to go back to the ER. The fetus is still there. That’s the reason for the pills.

    Keep us in your thoughts.

    Steven

  5. Gabriela says:

    Thank you for writing this. I was beginning to think that I was the only one who went thru this. Everyone I read about has had wonderful experiences. The worst for them was the feeling of a heavy crampy period. I was pure agony for me. Mine started 1 hour after the pills and lasted 2 hours. This happened yesterday. Your so right, it does test your strenght and you realize how amazing we women are.

  6. Chantal says:

    Thank you so much for writing this post. I read it last night as I was waiting for the misoprostol to kick in. This is my 4th MC, but the first missed MC. Your outlook is inspiring. I do not feel alone, and I too have hope that my body can be a welcoming place for a baby some day soon.

    • Oh Chantal, I’m so sorry. Four miscarriages is devastating. I hope you’ve been able to find support for recurrent miscarriage. I hope that your next pregnancy brings you the beautiful baby you deserve.

  7. Ashleys1010 says:

    I am so happy to come across this because I too thought I was the only one. The pain for me was absolutely, 100%, THE worst pain I have ever felt in my life and not even my doctor – no one in fact – warned me about the pain. Because of this I thought “Ok, heavy cramping like a bad period, I can handle it.” But no way, not at all! Tylenol 3 and even Morphine didn’t touch the pain. Now after reading this I wonder if I should have toughed through it, but in my case I ended up going to the emergency room for pain meds because my husband didn’t know what to do for me any longer. I’ve only had c-sections so I believe this was very similar to actual labour and I am very curious to find out. I was 13 weeks along but my little baby died at 9 weeks.

    Thank you for writing this, I only wish I saw it sooner and I am very sorry for all our losses. ❤

    • I’m not surprised you ended up in the ER – the pain is really scary, and without warning it definitely feels like something is very wrong! Now that I have been through med-free labour, I can say that miscarrying was very close to as bad as transition contractions (and worse than most of labour).

      I’m sorry for your loss.

      • Ashleys1010 says:

        Thank you for the reply and letting me know otherwise I’d always wonder! Sorry for your loss too and your new little one is absolutely precious 🙂

        Ashlee

  8. alaina says:

    thank you, thank you, thank you. i read through your blog yesterday while i was in my own misoprostol hell, and i can’t say enough how this helped. my experience was very similar to yours – down to watching the office, which my husband put on to distract me and make me smile.

    this was my second miscarriage – the first one last year happened naturally, and i was terrified of taking misoprostol this time. it was every bit as terrible as i thought it would be, and i had every symptom in the book. at one point my husband was in tears out of concern for me, wondering if the pain i was going through was normal. but after reading through blogs like yours, we were reassured.

    i read you just had your baby – congratulations. i hope i have a story like that of my own to share someday.

  9. Octavia says:

    Thank you so much for your posting. It helped me go through my own miso miscarriage yesterday. The specialist didn’t tell me how painful the experience would be, but women should know that these are in fact labour pains. They don’t last as long as full term labour pains but they are painful and intense. Our bodies are incredible and we can get through it with love and support (and painkillers). I wish you all wonderful, happy future pregnancies, and these miscarriage experiences will be a distant memory.

  10. Perla says:

    I wish I would read this before my experience with Misoprostol. I had mine last Thursday, and I honestly thought I was going to die. I took Ibuprofen 800 mg when the cramps started, about 2 hours after I inserted the 4 pills, and I don’t think it helped at all. I have an ultrasound in 3 days to see if I passed everything. I’m so afraid that I didn’t and that I might need another dose of Misoprotol, that the only thought is making want to throw up.. I don’t think I can handle the same pain all over again. Thank you so much for posting about yout experience. God bless you.

  11. Mandi says:

    I just found out we miscarried yesterday and was googling tips about the medication. This blog was the first link. You’ll never know how comforting this has been (I’ve read it 3 times already) I just took my second dose. So far just light cramping (I take 3 pills every 4 hours 12 pills total) thank you so much not only for your advice but your comforting words. I thought immediately I can’t try to conceive again I couldn’t handle this again. You made me hopeful again!

  12. Dana says:

    Holy crap my experience was exactly like yours – even to the point of learning in college about misoprostol as an option for women who didn’t have access to abortion – and we are vegan.

    Except I climbed into the shower for mine – I don’t know if this really helped but it was a distraction and at least helped me not worry about bleeding everywhere. Our doctor’s office has a 24 hour hotline and the on-call doctor was able to talk my husband through the worst of it.

    I didn’t actually start bleeding much till about an hour after the pain stopped. I’m still really crampy and muscle sore three days later like I ran the worst marathon in the world.

    I have found your blog to be a huge comfort.

    • ewokiddo says:

      This is my blog… I hope it’s ok that I linked back to yours. I’m relatively new to this blog thing, so not sure the etiquette. Your blog was an incredibly helpful resource for a bad situation. Thanks for posting!

  13. khush says:

    hi, I had 4 pills of mistrovix (misoprostol) into my vagina and after 5-6 hours and I had a uncontrolled pain and found heavy flow of blood and its was too much. after this, I felt normal but next day we have again checked with Strip pregnancy check but it was showing positive. so, I couldn’t understand what is happening so, could you please advice.

  14. Babeinheaven says:

    Thank you so much for sharing your experience, helped me to face mine starting out positive. This was my first pregnancy and miscarriage at 8 weeks and a day.I’m 28.
    My husband inserted five diamond shaped pills vaginally on Friday night at 11.30 pm.Previously I ate dinner by 10.30 pm and took one Advil pill right after it.
    As per my Docs instruction I lied down for two hours after insertion of pills.My cramping started off by 1.30 pm , very mild.At 3.00 pm however it was another story entirelyThe cramps got terrible, I was unable to lie in bed so I paced up and down the room.Checked my pad and there was some spotting.I began crawling on the floor.Went to the toilet and had a bout of diarrhoea. I tried lying in bed again but around 4.00pm I felt a gush of water and check my pad (overnight size) to find it soaking wet with blood and water.I went to the toilet and passed some clots.When I tried to get up and return to bed I almost blacked out and called out to hubby for help.I asked him to give me another advil which I downed with some fruit juice all the while cramping in pain.Within minutes of taking the Advil I felt a sense of relief and fell asleep after changing pads.I woke up at 8 am to a very soaked pad and what I can only believe was the fetus on the pad.I wasn’t able to discern much but that was tge largest tissue I passed since .I wasn’t cramping anymore.O returned to bed and had breakfast later at 11.30 am.All seemed to have ended quickly and the bleeding was minimal the rest of Sat and Sun with very mild cramping.Come Monday however and the cramping got worst, I passed some more smaller pieces of tissue and few blood clots.I had to take an Advil to control cramping pain for Monday evening as it was getting worse.Tuesday I experienced mild to moderate cramping and bleeding, did not use a pain killer and had my Docs appt.for ultrasound in the evening. She said to my utter relief that most of the uterus looks empty with still a bit of placental tissue and blood clots remaining.This she said should find its way out through the bleeding.I have just returned from that appointment and truly happy that I won’t have to go thru d and c.Hope all goes well from here on.May God be with us all as we go through these hard times and may we all be blessed with our sunshine soon.

  15. Jules says:

    Thank you so much for writing this. I just had my fourth miscarriage and this was the first time I opted for misoprostol rather than natural mc or D&C. I wish I had found your post before taking the misoprostol, because my experience was almost identical to yours and I had no idea what I was in for. Miscarriage can be a very lonely experience–it’s somewhat of a taboo subject that most people aren’t comfortable talking about, so it’s comforting to hear about others’ experiences, and to read your reassuring words about moving forward after this. I know I will get pregnant again. My doctor has promised that he will do everything in his power to “keep me pregnant” next time, so I have faith that it will happen!

  16. Anonymous says:

    Remember that everyone reacts differently to these drugs. I did not experience as much pain, I took 600 mg Ibuprofen and I was not really ever in pain, but I am used to cramps with my periods. For me the scariest part was the blood, but my doctor said the more blood and cramping the better, so I embraced it and took it as a good sign. I bled heavily for several hours and past a lot of large clots type things. I ate a lot throughout and drank lots of water. I didn’t want to pass out or something from the blood. I had diarrhea in the beginning but it went away quickly. The next morning I passed something that looked more tissue like. I had stopped bleeding heavily for some time and then started again next day and passed what I believe was the last of it. And this was after I had gotten back from the doctor who said my uterus was clear, so expect that you may still pass things even after doctor says you are clear.
    Get a heating pad
    Drink lots of water and eat a lot
    set yourself up on a couch with comfy blankets and movies, but at some point I was bleeding so much I had to hang out in the bathroom to avoid the back and forth of running to the bathroom to change my pad.
    Set yourself upright otherwise blood will run down your back.
    Good luck! I found this a much better alternative to d and c and if you are like me and experience really no pain, it is a less invasive alternative.
    Hope I will get pregnant again and have a good pregnancy this time! I found out at 12 weeks that there was no heart beat but baby stopped developing at almost 9 weeks.

  17. Laurie Merrill says:

    Thank you very much for sharing your experience. I appreciate how you kept a detailed account of everything. I was deciding between a D&C and taking Misoprostol for an nonviable pregnancy. After reading your account and a few others, I felt prepared to do this in the comfort of my home, rather than the expense and coldness of a hospital. In such a trying time, we could not of made a better decision. Your account also armed us both with knowledge, as my provider did not provide me with much and was not even going to prescribe me with painkillers. So thank you so so so much for putting yourself and your story out there and bringing comfort to me and many others during such a dark time.

  18. Allison says:

    I had an experience almost identical to yours this week. I thought I was going to die, the pain was so terrible. I was actually praying I would die because I couldn’t escape the pain. Thanks for sharing this. It helps to know I’m not alone. I had read about other peoples experiences and they talked like they didn’t have much pain. That’s hard to believe but I guess every person is different. Like you, I wish I would have known to take the maximum amount of pain medicine immediately. Maybe that would have helped. Thanks again for sharing.

  19. Jen says:

    I’m so sorry you had to go through this. I had a similar experience and felt like passing out from the pain. Two other techniques that really helped me with the pain was stretching my legs and getting my husband to massage my lower back as they both caused a sensation somewhere other than my stomach which was distracting.

  20. Cmc says:

    It is almost 2 o’clock now and I took my pills at 8 AM I’m really hoping this is over soon but reading your blog has given me a little bit of hope that it’s almost over. Thank you for sharing. I commend your honesty and bravery and it has helped me through what I feel like is the worst day of my life.

  21. mc914 says:

    Thank you so much for your post. It helped me through the entire process and what to expect. I was really nervous coming home from the hospital and opting to do this but so glad I came across your blog and so glad I didn’t opt for a D&C! Thank you so much!

  22. Sarah says:

    No words to express how appreciative I am to you for this blog! It has given me so much strength during this utterly shitty time. I’m so sad to see you blog posts stop after bambino…I so enjoy your humor. Here I am waiting to have a miscarriage and misoprostol kick in and you have me LOLing. I want to hang out-want to be my friend? Ha… Anyhow do more blogs! You are so talented in the way of words and funny to boot. Bless you for making such a kick ass resource for all of us strangers on the interweb. Much love-Sarah

    • Melissa says:

      Thank you so much for sharing your experience. My first pregnancy just ended in am incomplete miscarriage and I am taking the pills now. I appreciate hearing from other people who have gone through this horrible time. ❤

  23. Melissa says:

    Thank you so much for sharing your experience with everyone. I am currently taking the medication to end my first pregnancy which ended in a miscarriage after 8 weeks. It’s a pretty lonely experience to go through even though my husband is with me, so I really appreciate reading about what other people went through.

  24. MommaV says:

    Thank you

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