We started the D&E procedure today. Our doctor seems very nice and competent, but she’s YOUNG. (She’s been with my OB practice for less than a year.) She’s one of only two OBs at the office that do second trimester abortions, and her limit is 17 weeks (where we are now). At one point, my husband asked how many of these procedures she has done, and she said, “oh, I haven’t counted.” We joked later it was like five. But I’ve read the procedure is not particularly dangerous (famous last words) so we’re going with her. I like that we can have it done in a hospital in case things go really wrong. Our other option would be to go to Planned Parenthood, where they have people who are more experienced. Because my preference is to do it in a hospital—and be knocked out completely—going with the woman in my OB’s office is a better option for us.
After answering all of our questions, she did a physical exam. Once that was done, she placed the laminara in my cervix. They are basically little straw-like sticks made of something synthetic akin to kelp, with little strings at the end. They look a bit like tiny tampons—they are about as thick as straws, although apparently there are “small” and “large” ones. They absorb moisture and expand, gently opening your cervix. My husband and I assumed I’d be getting like 5-10 inserted. When she was done, she said one “large” on and one “small” one. She said she tends to insert 1-4, depending on how receptive the patient is. Because the whole point of the laminaria is to gently open your cervix, there’s no reason to jam them in and hurt you. Whatever happens with the laminaria before the procedure, they will mechanically dilate you the rest of the way the day of the procedure. But she said the more dilated you are in advance, the better. (Ie. The less likely there is for injury to your cervix from the procedure.)
I’d read a lot about the insertion of laminaria process, and it sounded like a lot of women found it to be very, very painful. So I was a little nervous. But for me it was not that bad. It was like a prolonged pelvic exam. The speculum is always unpleasant (plus it was particularly hot when inserted). Then she put something in to hold something (uterus?) in place, which felt a bit like someone was pinching me hard on my internal organs. Then the actual insertion of the laminaria caused some pretty significant cramping. She had me wiggle my toes, which did seem to help. But it did not take that long (5 minutes?) and it was not unbearable. (I was doing heavy yoga breathing, which caused everyone to repeatedly ask me if I was okay.)
I was also nervous about the part after that process. I’d read some women have very severe cramps, or even contractions, and there’s a chance that this will actually trigger labor (water breaks, actually deliver baby). When the doctor was telling me that, there was a little part of me that thought that would be ideal. Of course, labor and delivery is still an option, but because it’s so uncertain as to time and outcome, and there still might be a procedure at the end, it’s not the right option for us. But if it happened quickly and naturally… well, that would not be so bad.
Anyway, she gave us an Rx for Vicodin in case the pain was unbearable. I told her I think I have a pretty high pain threshold, but would definitely take it if I couldn’t sleep because of pain. She said we should have a good idea of the level of pain/discomfort I’d experience a few hours later.
So, after the sticks were in, hubby and I went to lunch, and then I went home and took a nap. I’ve been taking it super easy since my appointment, but ten hours later I am feeling completely fine. (My complete lack of pain is actually making my husband uncomfortable. He’s like, “maybe it’s not working.”) So unless things drastically change, I can say that the insertion of luminaria, while unpleasant, was not unbearable, and the post-insertion time is a piece of cake.
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