Looking for information about second-trimester abortion

November 19, 2009 8:12 PM

I am looking for information about therapeutic abortion in the second trimester.

I am 18 weeks pregnant and just got back an abnormal result on my quad screen. Today I went in for a level II ultrasound, which showed massive hydrops, pericardial effusion, and several other markers for a chromosomal abnormality. We are waiting on amniocentesis results, but the consensus among several doctors was that this baby would die well before term. We are probably going to have the pregnancy terminated. I am looking for any experiences anyone has with late pregnancy termination, e.g. what the procedure is like, recovery afterwards (both physical and mental), etc. Anyone who doesn't want to post here can email me at [e-mail]

posted by anonymous to health & fitness (10 answers total)

I haven't gone through this situation myself, but there have been a few threads on MetaFilter which have dealt with the topics of doctors (like George Tilley) who dealt with difficult cases such as this, but generally, even more extreme/further along. I'm posting them, not because I think they are going to have direct answers for you - the situations these doctors dealt with and you are dealing wtih are not completely similar - but because you might identify some leads on clinics, places, or people from here that you'd like to MeMail to see if you can speak to, since a few people did comment in the threads about their own experiences.

Sorry they're probably difficult threads to read right now, though. 1, 2.

And you have my support, as well.
posted by Miko at 8:53 PM on November 19, 2009 [1 favorite]

We are terminating a planned pregnancy at 16 weeks due to test results, how can we prepare emotionally and what should we be thinking about?
posted by LobsterMitten at 8:55 PM on November 19, 2009

I'm so sorry. More than words can possibly express.

Mrs. Liquado and I had a stillborn child at about 31 weeks, which was obviously far later than your scenario. We went in to the hospital because of reduced movement, and discovered there was no heartbeat. Labour was induced using pitocin (hard, hard labour), and she was 5lbs 12oz when born.

Realize that you are making the *right* decision, IMHO; we discovered that the cause of Olivia's death was congenital heart abnormality, likely from exposure to a fairly common flu-type virus during pregnancy. Even if she had survived, she would have endured much pain, many rounds of surgery, and a very, very low likelihood of survival. It doesn't make it much easier, but I believe that your decision is still acting as a parent; you're taking on the pain so your child doesn't have to, even if there was a chance for survivability.

Please make sure you take time for yourselves afterwards; we were zombies for weeks following, which was especially hard, given we had a 2.5-year-old in the house, and live far away from family. The extraordinary sense of loss is profound, and wrenching; actually, while writing this, I went back through the emails I got from friends after we sent out an announcement about her birth, and cried the whole time. If you've got family/friend support you can lean on, do so. If you have time you can take from work, do it. Grief counselling can do wonders, or it may not be your bag. My partner did grief counselling, I didn't, but we both came away from it okay, after time.

Feel free to Mefimail if I can possibly offer anything else.
posted by liquado at 10:06 PM on November 19, 2009 [9 favorites]

When I found out I have a disorder that can cause infertility, I started reading infertility blogs. A few are written by fabulous, brilliant women who have had miscarriages and abortions for similar chromosomal defects or fetal death. Among the best are Here be Hippogriffs, Uppercase Woman, Uncommon Misconception. All three have written about their experiences in moving ways and have a lot of both practical and emotional wisdom to share. All also made it through to the other side and have healthy children. You'll probably be able to find the relevant posts by searching the archives of the sites, but if you'd like suggestions, please mefi mail me.
posted by mostlymartha at 12:08 AM on November 20, 2009 [2 favorites]

In the second trimester, you generally have to go in the day before to have the cervix dilated. This is slightly uncomfortable. The procedure itself should be performed under general anesthesia, but be prepared for the possibility that all the fetal tissue might not be removed the first go round. I can't speak for your own mental recovery, but the physical recovery is like a very heavy period.

I'm very sorry you have to go through this.
posted by Ruki at 12:53 AM on November 20, 2009

I'm so very sorry for your loss.

A very good friend of mine discovered at about 20 weeks that her in-utero daughter was anencephaletic. She and her husband chose to deliver early. Their experience was not like those of therapeutic abortion, in that she actually went through labor and delivery - her choice. However, the end result was the same, a tragic end to a very much wanted pregnancy.

I just want you to know that there's light at the end of this. My friend and her husband got through it. It was sometimes hard, but they've come through it. You will, too. Lean on everyone you can, accept every offer of help you get, and take care of yourself.
posted by cooker girl at 5:06 AM on November 20, 2009

I had pretty much exactly the same diagnosis as you've just received.

I was induced 4 or 5 days later. My best advice would be to have someone (the father, your mother, a close friend) glued to your side from the moment you enter hospital, just to be there quietly and hold your hand. Checking in to the hospital was crushing for me, but then going through the process of labour and delivery was strangely therapeutic. Intensely sad, but time to reflect, to say goodbye and come to terms with the reality that this particular story has a different end than the one you had planned.

The drug they use to dilate your cervix is administered every couple of hours. It grew gradually more uncomfortable with each dose as the drug can be irritating and they did not use lubricant. Ask if they can - there was some difference of opinion between doctors on this point - and it certainly makes the application more bearable.

I had no real pain (except when they were checking my cervix) until about 20 hours in. I had expected much more cramping. Once the labour pain really kicked in, it was over in a couple of hours.

I could occasionally hear babies in other rooms crying, and this was agony at first. I didn't think I would be able to stand it. But by the time it was over, the cries would make me feel....not happy but almost proud for them... like "good work, little guy. you made it" There are so many people in the world that we forget how massively improbable the whole process of pregnancy and birth is - I can't imagine a more complicated process.

They asked beforehand if I wanted to see the baby, and I opted not to - largely on the advice of my family who were concerned for my mental state. I don't know if this was the right decision but the nurse who took the baby away took a cast of her tiny footprints and gave them to me when I was discharged. It was extremely and almost overwhelmingly emotional to receive those at the time but - I treasure those footprints and I'm endlessly grateful I have them.

Of course, you know your own situation best, but I would suggest that something you think you may not be able to stand at the time can be an immense comfort to you later, like those footprints are to me. There is no right or wrong answer - be gentle with yourself because this is hard.

You've been dealt an unfortunate hand and now you have a job to do. You are saving your baby the pain of being born into a body that cannot sustain them. Remember that.

I'm sorry you're finding yourself in this situation. My heart goes out to you.
posted by Kappi at 1:15 PM on November 20, 2009 [7 favorites]

Reading what Kappi said, just a quick add-on: We did have a chance to see and hold Olivia, I immediately after her birth, and Mrs. Liquado the next day. As hard, hard, hard as this was, I don't know that I'd trade it for the world. I know that my SO would agree, even though she did so against the advice of the nurse.

But, everyone has to do what works for them, so don't let anyone convince you what's right for you. Either way is completely okay.
posted by liquado at 5:19 PM on November 20, 2009

Another thing that might be useful to mention, as far as recovery: I felt like I made a number of enormously weighty decisions during that week. When I came home from the hospital, I really couldn't handle making even the simplest decisions for a while.

It sounds ridiculous, but if someone would ask me whether I wanted a salad or a sandwich for lunch, I would just break down. I felt like I had used up my decision quota and had nothing else to give. Having to choose between two options, no matter how trivial, was enough to cause a mild panic. I never would have anticipated that.

Everyone reacts to situations differently but perhaps have someone close prepared to take the reins and steer you through daily life for a week or so after you're discharged?

Consider finding a task that is mindless but requires some element of concentration while you recover - for me it was doing one of those paint-by-numbers pictures. Not at all taxing but still required me to pay attention to what I was doing.

I hope this helps. Above all, remember that there are a lot of other people out there who have been through this very situation - you are by no means alone. They get through it, and you will too.
posted by Kappi at 12:51 PM on November 23, 2009

What helped us was reading books about perinatal death, pregnancy loss etc... Information pertaining to these subjects has always had a positive effect on our mood and also, of course, on our understanding of what happened. This page contains many useful links. These advices are noteworthy.
posted by nicolin at 11:12 AM on November 24, 2009