What to expect from an ERPC on the NHS

Categories Gennet (Prague), Misc, My IVF, Pregnancy one - MMC
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First of all, I’m so sorry that you are having to go through this. I had my ERPC procedure following a missed miscarriage over a week ago, so my account is fresh, but not raw.

Yours may be a bit different to mine, but here’s what having an ERPC was like on the NHS for me in April 2019.

Early spoiler – the procedure itself is a bit like having an IVF egg collection, if you’ve ever had the pleasure. By that I mean, it’s not that bad. Don’t worry. You will be fine. If a wimp like me can manage, you can too.

Here it goes…

1. You wait for your procedure

We arrived at hospital full of the hopes of a couple having their first baby, eager to see him or her at the 12-week scan. We left broken people, never to be the same again. From finding out our pregnancy had ended to having the ERPC, we had to wait two and a half days.

During that time, we sat in bed and cried, went to the hospital to do paperwork and blood work (which was a grim process but almost helps prepare you for the procedure itself) and had a day trip in Oxford as a distraction.

Yes, we had a trip out! But it helped. We went to the (rubbish) botanical gardens and had an overly expensive cup of tea, ate a reasonable roast dinner and mooched around the old colleges. Not the most fun trip I’ve ever had, but it was honestly better than both of us sitting in bed and crying all weekend. (Don’t worry, that came later.)

2. You arrive at hospital early

We had to get to hospital for 7am, leaving at 6:15am. We already knew four other couples were having the same procedure that day. It was weirdly comforting to know we were not alone, and it was pretty obvious who the unlucky few were in our waiting room that morning. Basically, all the people under 40!

Out of the other couples, we were called in second. I thought this was a good sign, that we’d have the procedure early. This wasn’t the case. The doctor will prioritise people in order of risk and stage of pregnancy. As I had my ERPC second to last in the end, I suppose the others were ‘worse’ than me. I tried to remind myself of this when I got increasingly frustrated with the waiting around.

3. You get shown your room 

We were soon taken to the ward of six, where we were shown our room. The little cubical was spotlessly clean and modern – I was really impressed. I know some people have a poor experiences with the NHS, but I have nothing but praise. I went in there thinking: I’m never coming to this hospital again if I get pregnant, and came out saying: I would.

Next, I changed into my gown and put on some surgical stockings – but these were thick, green and definitely not sexy. Around me I was aware of the other couples, behind their curtains. I thought that I’d hate the close proximity to them, that I’d be angry to hear their tears. But it was private enough. And, at the same time, I felt a certain connection with the other poor souls going through it, too. I wasn’t alone.

4. You see the nurse, doctor, anaesthetist 

We weren’t waiting long until we had a whole host of medical visitors. We had more paperwork to sign with the nurse, a short chat with the doctor – this impossibly young, smiley woman – and even the anaesthetist popped his head round. All the staff were kind, friendly and sympathetic. We even had a few laughs with them, which I wouldn’t have believed possible. 

I remember at one point the nurse wanted to weigh me. I was dreading this. All I’d done for 12 weeks is eat – the hunger I felt throughout my short-lived pregnancy was constant. But I could not believe it when I stepped on the scales and it showed I weighed the same as I did pre-pregnancy. It must be the lack of alcohol.

Don’t get me wrong, there is a definite paunch on me – that’s what ‘eating for two’ and absolutely no exercise gets you over a three-month period. But clearly I’ve not piled on the pounds as I’d feared. (Also I have since tried to exercise – a five-mile run yesterday – which was horrendous. Note to self: I will not ‘let myself go’ like this next pregnancy… .)

5. You might have to wait a bit… or a lot

I think we were supposed to be second in line for the procedure, but we ended up being fourth. It’s pretty dark, waiting around. I just wanted the bloody thing over and done with, so hearing people being wheeled off, one by one, is frustrating and anxiety-inducing.

My advice? Bring some trashy magazines, if that floats your boat. I never waste my money on these any more, especially Cosmopolitan as it’s full of adverts and, quite frankly, aimed at teenagers. But I bought one of those multi-packs, and enjoyed flicked idly through the pages of Cosmo, Red and Women’s Health as I waited. Anything to distract you is worth it.

6. You might have to take some pills

I say ‘might’, because if you’re already bleeding, you probably won’t. Be I was showing no signs of miscarriage, so I had to take these pills about 45-minutes before the procedure. They soften your cervix to make it easier, apparently. . I was scared I’d get terrible pains, like I’d read online, but I didn’t. I felt a bit of discomfort, but nothing else. Like mild period pains.

The nurse also gave me a couple of paracetamol. I thought: oh great, that’s really going to help! But they also give you intravenous painkiller when you’re under the general anaesthetic, so you won’t feel anything. Honestly, I’m a real scardy-cat when it comes to needles and pain, but on a discomfort level of one to 10, the whole thing amounts to probably a two or three.

7. You get wheeled in for your procedure

A nice young man wheeled me in from my little cubical to the theatre down the corridor. It was so surreal – I just couldn’t believe this moment in time was happening to me. I should have been in Cornwall with my husband’s family, walking along the coast with the sun on my face and the wind in my hair. Instead, I was in this stark medical room, blinking back tears.

There were three or four nurses and doctors preparing for the op, barely giving me a second glance. I have to say, I was a bit annoyed with how matter of fact they were. I wanted them to be all sympathetic, but they weren’t. Some of them introduced themselves, but it was all very business-like. Of course it is to them. It’s another day in the office.

The worst bit for me was the anaesthetist asking me to confirm my name, date of birth and what procedure I was having. I gulped “ERPC”, trying to remember the acronym that – three days ago – I’d never even heard of. ‘Why are you asking me this?’ I thought, angrily. ‘You fucking know what procedure I’m here for.’

The anaesthetist, unaware of my internal dialogue, got the needle ready for the catheter. He did this tapping on the top of my hand to make the veins stand up, which really hurt and I called out like a petulant child. But it was in quickly, and actually wasn’t that bad. He then stroked my hand and said I was doing really well, which I made me feel like a little girl.

Another person said for me to take deep breaths into a mask, which I was told smelled of vanilla – a lie! And then a warning that I’d feel something cold run through my veins. Then a sleepy sensation (which is brilliant, because at this point, you know when you wake up, it’ll all be over…). And so…

8. You wake up

It’s a quick procedure, and I woke up in another ward soon after, without any feelings of nausea, wrapped up like a mummy in a blanket. Apparently I was ‘under’ for 17 minutes. I couldn’t believe it was done – over. One day I’m pregnant, stupidly excited about telling my colleagues at work about how I’d be off for a year in October, and the next… no maternity leave for me this ime.

But you know what, I didn’t actually feel too bad considering, and was chatting to the nurse soon after. She told me she’d had the same procedure a couple of years ago. She was from Czech Republic and had gone on to have a successful pregnancy, she said. I could hear the emotion in her voice as she told me, the pain, despite her having her baby. I so appreciated her sharing her story with me. It made me realise miscarriage is not unusual, sadly.

9. You get reacquainted with your partner

After maybe half an hour, you get wheeled back to your original cubical. All the other women had gone by that point. It was about 12 noon. The nurse went out to find my husband, who was in the reception area with all the other poor partners.

It was brilliant to see him; he’d been so worried. It must have been awful for him to wait around like that, with no role or ability to make things better. I remember feeling such anger towards him that it was me and only me that had to physically suffer for this, as well as having to endure a year of IVF. But I know he’d have swapped places with me that day if he could.

10.  You see the nurse, doctor, anaesthetist… again

You get another spate of visitors – even the anaesthetist who tapped my veins in a rather aggressive manner popped his head round, which I thought was nice. I apologised for being stroppy with him, and said “It didn’t even hurt that much.” Even after an operation, I’m people-pleasing!

A short time later, the smiley doctor came in. I was actually feeling OK at that point until she told me she was concerned about my cervix. She said during the procedure she’d noticed that it looked like my cervix was damaged, or like some of it had been removed.

She asked me when I’d last had a smear test and was it normal. Yes, I said, January 2017. “I want you to come back in a month’s time, just to have a check-up,” she said. “But don’t worry, it’s just a precaution.” Famous last words.

So from one bloody problem to another. I’m now worried I have cancer, that I’m going to die or be rendered infertile. On one hand I’m glad that the doctor is being thorough, that I’m in safe hands. On the other, I can’t believe there might be something more sinister going. Maybe the miscarriage is my ‘fault’ after all.

11. You eat, you have tea, you wee

With that little bombshell, the nurse brought me a cup of tea, some biscuits and a cheese sandwich. As I’d been nil by mouth for many hours at that point, I gobbled and slurped everything down gratefully. Gone are the days where I’d lose my appetite when upset. I can’t eat enough, even on one of the worst days of my life.

Once you’ve eaten, had liquid and gone for a wee (which didn’t hurt but was a bit bloody), you can go home. But just one more thing. The nurse has to remove your catheter, which I found the worst bit. But I am a big wuss when I comes to needles. Why do they use plasters that are doused in super glue?!

12. You go home, you lay in bed, you cry. But it’s over

I was relieved when we got in the car and drove home. I couldn’t wait to get into bed – it was over. And I felt OK, I think. I mean, as well as could be expected. I think I was pretty amazed at how fabulously I was coping, actually. No hysterics, no dramas – I had even laughed, miserable me. But it was over. 

It was the day after that it hit me. The utter unfairness of it all. The emotional turmoil of a failed pregnancy after three failed rounds of IVF. The emptiness. The disappointment that you have to start all over again. But I promise you, I hardly felt any physical pain. A little discomfort, but nothing more. Blood, yes. There’s still blood, one week on. But you will cope with that. 

All in all, I wouldn’t wish the above on my worst enemy, but it’s manageable. And I just think: some people aren’t ‘lucky’ enough to have the ERPC. Some go through miscarriage at home, with pain, contractions and utter fear. At least my experience was pretty quick, painless and done with professionalism and kindness. I hope yours is as ‘good’ as mine.

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