ITP and Miscarriage

Itp and pregnancy, pregnancy complications, pregnancy information, pregnancy facts, itp pregnancy complications

Miscarriage and the loss of a child during pregnancy is probably the worst, most personal, private kind of horror a woman can go through.  It is the kind of grieving where no one wants to touch you, where you look like a collapsed version of yourself and suddenly you can’t understand anything around you.  At least that’s what it felt like to me.  

As more than twice as many women than men have ITP, it makes sense to be talking about how ITP can, and does effect the ladies.  Yet there is not much information out there for women looking for help with ITP and Miscarriage.  There is not even much information for woman with ANY bleeding disorders and miscarriage!

In any natural miscarriage with a healthy mother, there is always a bleeding threat.  Yet for women with haemophilia, ITP and other bleeding disorders there is is an even greater threat.

So what are the treatments for miscarriage? I guess treatment is the wrong word.  Perhaps I should write care or care plans.  There are currently three ‘care plans’ available to a woman for a miscarriage, and none of them will save the baby.

1. The Do Nothing Method, where the woman waits for her body to naturally expel the tissue at home.  This method is claimed by many to be the most natural for the human body as it involves the least amount of intervention (None).  How it effects the mind is a whole other matter.  The Do Nothing Method can take anywhere from an hour to 4 or even 5 weeks.  If during this time the woman becomes ill or feverish, then further intervention is taken.  Also if after 5 weeks, she may be ready to talk about other ‘care’ options.  Which leads us to

2. The Drug Method, There are a number of different drugs that can be given to induce and encourage the body to begin expelling the miscarriage tissue.  This method is more commonly given to women how are diagnosed with a missed miscarriage – where they body may not have recognised that the baby has stopped growing yet.  You are given the drug in hospital and then are free to go home or where ever you would like to wait for the bleeding to begin.  Normally takes about 6 hours, but as always, it is different for everyone.

Method 1 and 2 the Do Nothing Method and the Drug Method are never 100 percent successful and many women may find that they still have tissue remaining inside the uterus.  This is called an incomplete miscarriage.  The care plan for an incomplete miscarriage is surgical intervention.

3. The D and C Method, is a surgical intervention to miscarriage.  The cervix is dilated and the miscarriage tissue removed manually by a doctor while the women is sedated.  It can be completed in under an hour and is normally done in a day surgery unless there are any bleeding complications.

So What Happens When You Have ITP?

The reason why I am talking about these three options is that it is very important in regards to a woman with ITP having a miscarriage.  These options become very important and everyone seems to weigh in on the conversation.  If you have ITP and are miscarrying, you will find yourself discussing all of these options five times a day.  You may not have three options to choose from.  You might only have option 3.

With ITP and a low platelet count, the Do Nothing Method starts to get a little dangerous.  While woman are miscarrying it is recommended that they not even drive a car as it can be dangerous.  A miscarrying woman could faint or black out while driving.  She is not just loosing blood, but her blood pressure is changing, her hormones are crashing and so are her emotions.

If your platelets are falling, the idea of being stuck at home while you are bleeding out could cause a huge amount of panic.  Especially if you don’t feel alright to drive.  Taking The Drug Method poses exactly the same risk as it is recommended that any woman with a bleeding disorder present to emergency at the onset of Miscarriage symptoms.

So what are your options?  Surgery, medically-assisted-blood-bank-supported-highly-monitored-haematologist-approved-booked-in-surgery!   When I was offered the ‘options’, I was given one, a medically supervised D & C in the presences of the blood bank while I was on high dose Immune suppressants at one of the best hospitals in New south Wales.  I felt so sad.

You might be very lucky to find yourself with a high platelet count ( by the time you have learnt that you are miscarrying, nothing in your whole world will feel lucky, but trust me, a high platelet count will be a silver lining, allowing you a small ounce of control) In which case you may be able to return home.  If your count is under a 100, chances are you wont.

How do you know if you are Miscarrying?

This is an easy one.  If you have been able to sit at your computer, or get your phone out and search ‘Am I Miscarrying?‘  then you probably aren’t.  You might be just starting to miscarry, but if you are having a miscarriage then you know you’re having a miscarriage.  If you’re asking this question then I would say the answer is either No or Not yet.

A Miscarriage with ITP- What does it Feel like?

Having a miscarriage can awaken a great deal of fear within you.  Not just for your potential ability to have children in the future but because you are about to or are currently bleeding a great deal.  This is terrifying.  I have to tell you right now – Anyone who says that a miscarriage is anything like a heavy period – Is a man! Or a woman who has never had a miscarriage ever before.  A miscarriage is more like a little birth.

Mostly, a miscarriage is an incredibly private experience.  Not for a woman with ITP.  With an ITP Miscarriage, there are a lot of people involved and she is not often alone.  A lot of doctors, a lot of tests, a lot of waiting for blood, and trying to hold onto the blood you have.  There are a lot of appointments, a lot of people to see, and a lot more blood tests.

And there is a lot of explaining yourself, over and over again.  Name, birthday, allergies known.  Do you know why you are here at the hospital?  What procedure are you having today?  This form is for the blood bank, can you confirm your name and date of birth please?  What procedure are you having done today?  What is you name?  Have you had anything to eat and drink this morning?  Birthday?  What is your name and date of birth?  Heading into the operation I was asked my name, my date of birth so may times that I was crying so much I couldn’t answer.

While you may only have one option for miscarriage, I was having the surgery and I was glad.  I have read a lot of information from blogs and chat rooms and from doctors that a D&C was defiantly the worst thing for your body.  For me I was more worried about my mind.

The body and the mind are certainly linked, and while a d and c is probably the most un natural and interruptive procedure you can have – I must say that my heart was breaking waiting.  It was my mind I ultimately had to protect, my mind that I believed was being damaged.  I knew that my body would be able to heal, I believed that, but it was the damage that I was doing to my head that had to stop.  Every time I went to the bath room, every time I moved strangely or felt something unusual.  Every time my back felt sore or my stomach was tense.  Every time I stood or sat or rolled over in bed I was thinking about it, preparing for the bleeding.

ITP and miscarriage, miscarriage blood disorder, ITP complicationsI stopped going to things because I was scared of getting stuck away from the house.  I stopped making plans with friends and I stopped working.  My last miscarriage, happened in a public toilet and I was trapped in there for ages without my phone before I could even move, let alone get home.  This time, I became clingy and possessive of my partner and needed him to remain within a certain proximity to me at all times.  I took my phone with me to the bathroom.

I was also still experiencing a lot of morning sickness and pregnancy symptoms and could not eat my favourite comfort foods, drink alcohol till my platelets were higher, or do any of the activities and exercises that normally helped me when I am sad.

Things about ITP and Miscarriage

What are the differences between an ITP Miscarriage and a regular Miscarriage.  Well I have never had a regular miscarriage, so I had to rely on friends, family and the internet for comparison.  And ITP miscarriage will involve…

  • More appointments than a healthy woman
  • More fear than a healthy woman
  • More people involved.
  • More conversations with doctors and specialist
  • More waiting in waiting rooms.
  • More time off work.
  • More people present in the surgery.
  • More Blood tests.
  • More closely monitored afterwards.
  • More risks to control.
  • More bleeding / for longer than others.
  • A Higher risk of infection while taking immune suppressants.
  • More worry.  More stress.  More anxiety.
  • Longer time to recover.
  • More follow ups afterwards.

A Plan to get through it…

  1. Drink Plenty of Water – This sounds like something you would say when you had no clue – but water is really REALLY important.  Drink more water than you ever have before.  Abdominal and lower back pain is the most common symptom of miscarriage, to the point where you may not be able to contract those muscles at all.  I had to hold both my hands on my stomach to cough it hurt so much.  You might not have the strength in your abs to do a number two on the toilet.  So keep drinking water.
  2. Drink a bit more water – As your hormones start to crash you might find in the weeks afterwards that you look like a teenager again.  I mean you may be covered in pimples.  Your back, your chest, your face, everywhere…  This is because of the huge hormonal changes that are occurring during this time.  Keep drink that water ladies.
  3. Then Drink a Big glass of red wine – I mean one of those glasses you get from Ikea that can hold half a bottle of red without looking offensive.  Don’t just drink the red wine because it is a cliché, drink it because it is a depressant.  The alcohol will slow you down, help you sleep and bring a bit of stillness.  Feel it.
  4. Return to exercise through Yoga – This is for your mind and body.  Tell the teacher you have a heavy period but want to try and participate.  Yoga will wake up your the body again and get it moving.  This will also help with back pain, abdominal soreness and tightness in your hips.  If you have had a D & C it will also help gently reintroduce your pelvic floor muscles to exercise, as they may have been stretched during surgery.
  5. Drink Parsley Tea – This is a controversial one, but worth considering.  Parsley had a reputation during the 19th century as a spontaneous abortion herb.  It is rumoured to help strengthen contractions in the uterus.  Parsley has a reputation for dilating the cervix and softening the inside of the uterus.  Drinking too much parsley tea can cause cramping (But that might be just what you want?)  It actually tasted quite nice with a tea spoon of honey.
  6. Take extra Vitamin C – I personally did not try this – but I have read a lot of people who had good results from taking Vitamin C to naturally encourage and support their miscarriage during the bleeding.
  7. Stop Eating Chocolate and Bad Foods – There is nothing worse than waking up from the miscarriage coma and realising you’ve become fat – for no reason!
  8. Stop Googling ITP and Miscarriage and go to bed.  You could read forever and still be conflicted between the hopeful messages of excited women who were told they were having miscarriages only to head home with a healthy baby girl OR the ladies who have miscarried 18 times without success.  If you search for long enough you will find everything.

by Meg

Meghan Brewster is a writer and blogger. She is an ITP patient and launched ITP&Me in 2011. She is a coffee lover and a try hard dancer. @meghan_brewster

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