Post D&C Recovery: What to Expect & When to Worry

Question
Hi.  I'm a registered nurse as well.  I work in the O.R. and have no idea about ob/gyn issues.  I do know what I've went through these past 3 months have been abnormal.  My husband and I found out were were pregnant August 10, 2007.  We were barely 3 weeks along.   We lost the baby at almost 9 weeks.  The ob/gyn did a D and C on September 18, 2007.  I didn't bleed for two days and then it was horrible.  Clots and horrible cramping that 800mg of Motrin didn't touch.  I called the doctor.  About 5 days later I went in to have him tell me it was normal and I was fine.  The bleeding lasted another two weeks.  At this point I took a home pregnancy test which came back positive, so I knew that something was wrong.  I called the doctor and insisted on a CBC and HCG test.  Which he did.  That's when we found out my HCG was still 592.  Then I had an ultrasound.  They found retained tissue and 4 corpus luteum cysts.  (2 on each ovary that measured 3cm each).  So the next day on October 20th I had my second d and c.  Felt perfect afterwards.  Here's the problem.  As of Thursday I had a a small amount of brown blood or discharge when I wiped.  Nothing else.  I went the rest of the evening Thursday and all day Friday with out anything.  Then another small amount on Saturday of pink discharge mixed with clear.  And now nothing again.  My husband and I like idiots had unprotected sex on Nov. 3 and 4.  I tested before the discharge for pregnancy on Thursday and it was negative.  I'm just curious if this is normal at this point.  I just want a normal period and get back to normal.  Please if you have any suggestions just let me know...thanks

Answer
Dear Amanda,

Most often after a miscarriage or D&C your bleeding will taper off to spotting within 7-10 days, and maybe random spotting will continue for another week. Your hCG will drop steadily, usually hitting zero during the end of the spotting, or about 10 days after the miscarriage or D&C. Some women find they have mild pregnancy symptoms, or little ovulation cramps. Many many women think they could be pregnant, because strange things are happening and their period is "late" (although almost every post-miscarriage period is late.) These symptoms are due to the body's attempts to regulate its hormones again. It may kick into gear right away, and you will get a new period in 4-5 weeks, or it may struggle a bit, and the period will not come for up to 8 weeks.

More than likely the bit of spotting is just due to some hormone fluctuations as your body tries to get itself regulated again. As I said, many times the first period after a miscarriage is late and it is rarely "normal". It can be heavier than normal or lighter, have alot of cramping or hardly any, or be shorter or longer than it usually is. But it is important to know that you must not bleed for about 20 days for it to be a real period, otherwise you have not gone through the hormone chain properly. (this tiny bit of spotting doesn't count as bleeding)

I'm glad you did the insisting! Don't you often wonder what all lay people go through?? Makes me crazy sometimes.

I hope this has helped you and answered your question. I wish you well.

Brenda