Just wanted to share my experience so people can see the differences and similarities in misoprostol use.
I was diagnosed with a blighted ovum, opted to take misoprostol at 8.5 weeks. I started at 6pm on a Thursday, inserting 800mcg vaginally every 4 hours x 4 doses. I didnt start bleeding until 1:30AM. It progressively got heavier. I passed a couple pretty sizeable clots which I assumed included the sac. I had an ultrasound scheduled for the next morning at 8:30, and a visit with my OB right after. I felt fine until I got to the appointment when I began to get shooting uterine/rectal pains. My bleeding picked up, and it made the vaginal ultrasound very awkward. When I went to visit with the OB I needed to use the restroom, and when I did I began to feel faint. My BP had been a little lower than normal (98/60) likely from blood loss. I had to stay at the office for a while, but the OB said the U/S indicated I passed the sac and only had a small clot left and he was confident I would pass it at home. It hadn't even been 2 hours since I took the last dose.
I did continue bleeding very thick and stringy blood for the next couple of days. On Sunday I developed a low grade temperature and chills/joint pain. I alerted my OB the next day and he was worried about developing an infection (which I honestly don't believe would have happened that quickly, but I'm not a physician). He sent me to the ER to get another U/S. That U/S indicated I had retained "products of conception", in other words, tissue remained in my uterus from my pregnancy. He pushed for a D&C, but I refused, ultimately believing my body would do its thing when it was ready. I AM NOT interested in surgical intervention unless completely necessary, too many risks. This was Monday. I continued to bleed Monday, no pain though. Went to bed and awoke this morning (now Tuesday) at 4AM with mild cramping. Bleeding had picked up a bit. By 5 AM I was in full blown labor. With my last successful pregnancy I labored for 10 hours unmedicated, and this was on par with that pain except on a smaller scale as my uterus was much smaller this time around without a baby in it. I got in a hot bath, partner helped me with pain relieving techniques. Extreme contractions just as if I was birthing, closer and closer together, no time for meds although I did take a Tylenol #3 which hadn't had time to kick in yet. I pulled out all my tricks from my natural child birth class, it was VERY difficult, but instanteously the pain just stopped. I had no idea why, I hadn't passed anything. Walked around for about 10 minutes to try and induce labor again, but decided to try to sit on the toilet and push even though I didn't have the urge. When I did that I passed a VERY LARGE mass. Probably about 6 inches by 3 inches. It was not clot like, it was muscle tissue like. Very fibrous. I surmise it passed through my cervix and into my vagina and my pain then stopped, but my body didn't push it out so it just sat in my vagina until I decided to try and push.
I currently have bleeding like a period. Still dark red, but thinner now, and less abundant than before I passed the product of conception. Very mild cramping, but ultimately doing pretty well. Will see OB in a couple of days to see if the tissue has all passed.
My advice is, if your goal is to pass naturally and you haven't done it immediately, don't be discouraged. Don't let the physicians make you think you are going to have some horrible experience if you don't get a D&C. Your body is amazing and this is what it was MADE to do. My OB was so insistent that I get a D&C he refused to let me try another dose of misoprostol and made me sign out of the ER against medical advice. Completely ridiculous move if you ask me, but that's his perogative. My body did what it needed to do in it's own time, and most likely yours will too.