Trying to talk friend into going to hospital after incomplete miscarriage

I am a man in the unusual position of trying to convince a female friend, who has had an incomplete miscarriage, to go seek medical attention.

The situation, AIUI, is that she had a miscarriage and then some parts of the fetus have apparently still remained in her uterus after the miscarriage. There was a D&C procedure done but that didn’t fully do the job; IIRC there is still some of that leftover fetal tissue in the uterus. This was around 2 weeks ago.

I have nagged her for days to go to the hospital, since she keeps complaining of abdominal pain (even as of today), but she has repeatedly refused, saying that she doesn’t have the money to afford further medical treatment. I’ve been telling her that it will only get worse if she doesn’t, and her response is the same - nope, can’t afford it.

(She is a Filipino acquaintance in the Philippines, not the USA, so I have even less clue as to how medical expenses and insurance work there.)
So - is it correct indeed that if a woman didn’t have her uterus completely cleaned out after a miscarriage, that the situation will only get worse and lead to eventual infection and sepsis? That is what I’ve told her but then again I am no doctor.

How does she know the D&C didn’t fully do the job? Did the physician who performed that procedure tell her that? What did her doctor tell her to do? Did they send her home with any instructions?

But to answer your question, yes, there is a danger of infection/sepsis if all the tissue is not cleared. Is she running a fever? Is she having any foul smelling discharge?

Sorry for so many questions, but there are a lot of things to consider.

This pagecontains an overview of an incomplete miscarriage.

It sounds like doing nothing is an option, but if she is bleeding (and continues to bleed), or she starts running a fever (or has been running one), or she has a foul-smelling discharge, then she needs medical attention. Bleeding can cause all kinds of complications, including bleeding to death. Fever or foul smelling discharge would be signs of infection or sepsis. The site also mentions pain as a warning indicator.

If it has been a few weeks and she is still having problems (and it sounds like she is), she should at least be evaluated by a doctor or a trained women’s care practitioner.

If money is an issue and Planned Parenthood is an option, that’s where she should go. They’ll look her over, decide if further intervention is needed and if she’s broke they’ll help her regardless, they do sliding scale for just about everyone they treat.

According to her, yes, she was informed that the first procedure didn’t clear it all out and she needed a 2nd appointment. She then didn’t go because…money issues.

No fever, no abnormal discharge, however, abdominal pain (didn’t specify exactly,) and also “uterus feels strange.”

If she was told she needs a 2nd appointment, and she is feeling strange, she needs to seek medical attention, ASAP. It could be very serious. Ultimately, obviously you can’t make her do anything she doesn’t want to, but keep pushing her to go.

If it was me, I would want to feel like I did everything within my power to make her go back to the doctor.

I think that it’s her body and her decision, and you need to respect that. Once you’ve made certain that she is aware of the danger signs, and of the possible results of ignoring them (up to and including death), you’ve done all you can do. Presumably she’s an adult, and she can make up her own mind.

I’d review the warning signs with her one more time, let her know you are very worried, offer to pay for services (if you are willing and able), and then you need to let it go.

I wouldn’t want to go back to a doctor who did an incomplete D&C so that I’d have to go back. There might be a reason for it, I guess, but I’d expect the doctor to explain why it couldn’t have been complete and what the reason for waiting was. I’d have trouble trusting step two if there wasn’t a good explanation why step one wasn’t complete. Don’t know if that might be contributing to her reluctance, but it would be contributing to mine.

I hate to ask, but is she asking you for money to get this done?

Planned Parenthood has a presence in the Philippines lobbying for birth control, but since abortion is illegal there (except to save the life of the mother), my guess is that they would not be authorized to perform a D&C.

Maybe not, but since she’s already had a D&C they’d not be doing anything that hasn’t already been done. Also might be able to use vacuum extraction to remove any problematical bits left over. Once you’ve had a D&C you aren’t pregnant any more, so the abortion restriction is no longer in effect. And PP is stocked with trained professionals who know a whole lot more about uteruses than the ham fisted idiot who originally “treated” this poor woman.

An abortion ends a pregnancy. When one miscarries that ends the pregnancy too, so it’s clearly not an abortion to do a D&C after a miscarriage, so hopefully there’s no reason it wouldn’t be allowed; even experts within the Catholic church says it’s okay post-miscarriage, which is important considering the Philippines is a predominantly Catholic nation.

That’s really tricky. You can ask her to search for non-government organizations that help women primarily. She needs to do it fast since having remains inside her can be really dangerous if left untreated.

Do you really think Planned Parenthood has its own independent clinical infrastructure set up in the Philippines, purely to address instances of miscarriage? Do you really think the Philippines would permit that, without being concerned that they were setting up to perform abortions? I suspect not, and that the OP’s friend is going to have to go to a physician’s office.

A teeny bit of research turned up: International Planned Parenthood Federation in the Philippines

Update: No fever, but still complains about abdominal pain and says she has difficulty breathing (has said that for days now.) She also says the pain is more on her right side. Would sound like appendicitis except that there is no fever and she’s been this way for days now, exceeding what appendicitis might normally be.
And nope, still won’t go to hospital…

Has she asked for money yet?