-disregard the date on this post; it was used so that it is not part of the chronological flow of this blog, but rather as a stand-alone resource for women who may be looking for information on a common post-miscarriage diagnosis procedure.
-all information here is based on personal experience. do not use it as a substitute for professional medical advice.
an MVA, or a manual vacuum aspiration, is a type of suction D&C (dilation and curretage), which is commonly used to empty the uterus after a miscarriage is diagnosed. a traditional D&C involves actively scraping/scooping out the "products of conception" with a sharp surgical instrument and carries a risk of future complications, as the uterus may become scarred or infected, which may negatively affect fertility and possible later pregnancies. for this reason, many doctors prefer to use a vacuum aspiration method (in which the pump can be electric or manual) instead, when either they or the woman deem that the non-invasive option of using misoprostol/mifepristone isn't appropriate or preferred.
my OB/GYN chose to use the MVA to finish my third miscarriage. since there was no evidence of any fetal tissue left -- my body had mercifully taken her back, and all that was left was the yolk sac and uterine lining -- she felt it would be completely safe. also, i was hesitant to use misoprostol again after the experience i had with my second miscarriage. since i trust this OB's skill and decisions, and as the actual MVA procedure is outpatient and takes about 15 minutes, i felt it would be better to have the physical aftermath be over more quickly. i do not regret this decision at all.
you will not be under anesthetic for the procedure, but will have taken narcotics, so you must have someone with you to drive you home. my husband wasn't easily able to come with me, so my best friend stayed with me through the entire thing, even coming into the procedure room with me. whoever accompanies you should be aware that they may be able to see what is being removed even if you cannot.
when i checked in, i had already (as instructed) taken one dose of anti-anxiety/relaxant medication; the nurse decided i needed to take another. i was on a table in stirrups; i recommend dressing warmly, because as the medications kick in, you may start to feel cold. although the procedure itself was not exactly physically painful, it was definitely not comfortable either. of course your practitioner's personal style and skill will come into play here; my OB/GYN and her nurse were supportive and gentle, and made encouraging comments along the way while giving me an accurate idea of what sensations to expect next or how much longer we had to go. they were mercifully sensitive to the emotional impact of the procedure as well.
i would also recommend bringing an eye cover of some sort, like a sleep mask, so that you can block out the light and concentrate on relaxing your muscles in the pelvic area, and also so that you do not have to risk seeing what is being removed, the instruments being used, or what is being used to clean you. apparently there is a great deal of blood, fluid, and tissue, and if your doctor is sending samples to pathology, there is a chance you will see what has been saved. you can ask for all of this to be removed from the room before you remove your eye covering.
after the procedure, you will need to start taking antibiotics. you may need additional prescription painkiller; that is your choice. i opted to use over-the-counter ibuprofin, mainly because i know my body responds well to it. you will still be groggy from the narcotics, but do not go to sleep yet! you will need food in your stomach for the antibiotics, so either have something easily digestible and nourishing (like your favorite variation on chicken soup) ready at home, or perhaps the person who took you home can make you a meal.
it is helpful to already have a heat pack -- either an electric heating pad or a microwaveable one -- available; you may have residual mild cramping from the procedure, and it is also soothing to have the heat on your pelvic area. make sure you let yourself sleep afterwards; you want to not only give your body a rest, but also sleep the rest of the narcotics off.
you will need to use sanitary napkins -- no tampons -- for the next few days to a week, as there will still be menstrual-like bleeding. you will also have to abstain from sex for awhile; your doctor will tell you how long. if you have a strict work schedule, i would highly recommend taking two days off for this procedure if you can; both the day of and the day after. you may still feel quite weak and in need of bedrest and recovery; you will certainly want the time to fully experience your emotions privately.
for me, this procedure was a great deal easier (physically) than my experience with misoprostol. my recovery time was faster, and i had significantly less days of bleeding afterwards. of course, i was also blessed to have a skilled and sensitive OB/GYN performing the MVA, which i'm sure made a huge difference.
if you are reading this to prepare for an MVA, know that i truly do hope this post -- or anything on this blog -- will help you during this time of sorrow and loss. know that you are strong enough to get through this -- physically now and emotionally over time -- and that you are not alone in your grief and pain. my wish and prayer is that you will find the comfort and healing you need in your continued journey towards family.
please feel free to post in the comments about your experience if you feel it will help other women looking for more information.