"Yes there's definitely a pregnancy there. About 7 weeks but I'm sorry I don't see a heartbeat" Anya's heart raced, a miscarriage again. She'd known it would be - when she'd been pregnant with her daughter she'd been so sick and tired in those first few months. "No, this isn't a viable pregnancy. At this size a heartbeat would be visible. Ok, come and sit down and we'll discuss what happens next". The nurse wiped Anya's stomach and patted her leg gently. Anya felt bad that they were being kind to her. She didn't want this pregnancy and had been silently hoping for another miscarriage ever since her husband came inside her at the wrong time of the month. She went and sat down next to the Drs big desk, Dr Patel was looking at her with a gentle expression on his face "you have to choose whether you want to wait and let the pregnancy come away naturally or whether you want me to do the procedure to remove it for you. I can see from your notes that you've had miscarriages before so you know what a natural miscarriage is like - painful, messy and who knows how long it will take. The surgery is quick and you've had kids before so it should be easy. I'll use a small tube to suction out the contents of your uterus, I'll give you some anaesthetic in your cervix first and you will take some pills before the procedure to open your cervix." Anya considered for a moment, it would be good to get it taken care of today and forget this whole thing. Dr Patel seemed to think that was the best idea as well "Ok, I'd like to do the procedure please Dr" she said.

After signing the consent form and paying Anya was taken upstairs by the nurse. The nurse took her blood pressure again which was unsurprisingly high and gave her some pills to take. "Now make sure your bladder is empty, put a pad on and go take a seat on one of the recliners there, Dr Patel will be up to start the procedures soon". Anya sat down and tried to relax and not think about what was going to happen to her. She hated gynaecological procedures, the feeling of the speculum spreading her apart and then having to lie there exposed and endure whatever the Dr felt necessary. She had no doubt that this procedure would be worse than what she'd faced before. She shivered slightly and looked at the other women around her all waiting calmly for their turn.

After waiting for about 45 minutes a nurse appeared from the door leading to the procedure room "Sophia" "Oh, she's in the restroom - Anya can go instead of her" the nurse at the desk said. Anya leapt up and went over to the nurse before Sophia came back, the quicker it was done the quicker she could leave. And she didn't want to hear anyone screaming before it was her turn.

Inside the treatment room the nurse directed Anya to stand behind a screen and take off her pants and trousers and leave them in a basket. As Anya folded the clothes and stepped from behind the screen she took in the room before her. It was a small room with an old blue examination table in the centre, knee rests spread wide apart. At the bottom of the examination table another nurse was preparing the instrument cart. Anya looked with shock as the nurse drew up an enormous syringe. She knew this needle would soon be going into her cervix and she quickly looked away and tried not to think about it. "On the bed please, and scoot all the way down" Anya sat gingerly on the bed and moved her bottom to the edge of the table "further, further, you won't fall off. Ok now legs up". Anya put her legs into the knee rests and the nurse covered her lower half with a sheet that was too small and kept falling off. Out of the corner of her eye Anya could see the other nurse still preparing syringes. How many injections were there?? She lay back and tried to relax. The room was bright and cold and she looked at the clock and told herself that it would all be over soon and she could forget this whole thing. Looking over at the nurse again she saw her place a large metal speculum on the trolley. Anya had had kids but her vagina was still tight and small, that monstrous instrument would rip her apart.

"Good morning doctor" the nurses murmured. Anya hadn't even heard him come in. Dr Patel looked down at her, he was now wearing a full surgical outfit - cap, mask, gown and gloves. "I'll just do a quick pelvic exam. You're ok, this will be fast". She barely felt his fingers inside her before he withdrew them and moved down to the trolley. "Only cleaning you" he said and she felt the cold wet solution on her vulva and labia, and his finger spreading her apart, a slight sting on her inner lips. Anya heard him pick up the speculum and felt it enter her, when he opened it the pain overwhelmed her and she squirmed around, "please, don't, can you use a smaller one" she gasped in pain, "I can't, it has to be this size to allow the instruments room" Anya moaned and writhed around, the pressure was unbearable "don't lift yourself up" Dr Patel said before calmly nodding to the nurse who tilted the bed backwards slightly and placed her hand gently but firmly on Anya's leg. "I don't think I can do this" she yelped and felt the speculum close and the awful pressure lessen slightly. A sudden quick jerk on the instrument, pulling it down and the pressure returned but at a more bearable level. Anya relaxed slightly. "Now remember I mentioned the injections, we're going to do that now...this will...you'll feel it" Dr Patel didn't give her time to react before she felt the needle biting into her cervix . She felt the pain deeply inside her and twisted her body as much as the knee rests and the nurse at her side would allow. Again and again the sharp pain of the needle until Dr Patel withdrew the injection and placed it back on the trolley, Anya lay still and shaking, knowing that there was more to come. "Ok, now just one more injection, this one will hurt" Dr Patel glanced at the nurse who pressed her hand on Anya's legs as the Dr picked up the syringe. The needle was so long and thick and Anya tried to brace herself but when the needle bit into her she jerked her body and had to stifle a scream. The pain was over quickly "you're doing well, that's the worst bit I promise" Dr Patel said, gently touching her leg. "I'll do the procedure now, you will feel the cannula pass through your cervix but it shouldn't hurt too much" Anya took a deep breath and soon felt the resistance at her cervix building and building until with a flash of pain the cannula entered her womb and the pain ended. She instinctively moved her hands to cover her abdomen and could feel the Dr scraping the instrument up and down her womb. Again and again she felt the instrument passing through her cervix and each time she'd flinch and suppress a scream as the nurse held her legs open. Finally Dr Patel made a satisfied sound and withdrew the instruments and closed the speculum. Anya could have wept with relief that it was over "thank you Dr Patel, sorry I was so difficult, it really didn't hurt too much I was just so scared". Dr Patel looked down at her amused "come back and see me in two weeks to check that everything is healing. You shouldn't have any bleeding after this." Anya sat up slowly, dressed and left the procedure room very glad that the experience was over.

As Dr Patel had said she had no bleeding that night or the next day but the day after that she felt a sudden warm rush in her pants and when she put a finger inside herself it came away dark red with blood. The bleeding did not last too long before it stopped and over the next two weeks leading up to her follow up appointment it happened over and over.

At the two week appointment she walked nervously into Dr Patel's room "you're still bleeding" he said, looking at the notes "yes, it's not too much though, just every now and then a bit of red blood". "Hmm, let's take a look at the scan and then discuss what to do next". Anya crossed over to the exam table and lay down, praying that everything would look normal and this was just her taking a bit longer to heal. Dr Patel swept the probe over her abdomen pressing down on her uncomfortably full bladder "yes, there's something there" the Dr said peering at the screen and moving the probe. "Ok come and sit down". The nurse wiped Anya and she went over and sat down next to the doctor. He was looking at her kindly "so there is something left inside, it's hard to tell what at this stage. It could be blood clots or it could be some pregnancy tissue that wasn't removed with the first procedure. As the bleeding is not too bad and you have no signs of infection you can wait for six weeks and see if your period returns and expels whatever is inside. I will also give you an injection before you go which should stimulate uterine cramps" "what if it doesn't come out in six weeks?" Anya asked nervously, she didn't think she could face lying on that table again - the painful injections, the pressure of the speculum and the awful pain of her cervix dilating. "It's ok, if the tissue doesn't pass then we can repeat the procedure again. I would advise a slightly more aggressive approach though and would refer you to Dr Tan who deals with our more difficult cases. But I don't want you to worry about that now, just keep an eye on the bleeding over the next few weeks and we'll see what happens. Now please go and lie on the bed, on your side, and lower your pants" Anya did as she was told and risked a glance behind her to see the syringe the nurse was preparing. The needle was thick and long. The nurse handed the syringe to Dr Patel and he advanced towards her, she quickly turned her head to the side "I'm sorry, this will sting a bit, just bear with me. If this works then you avoid the pain of a second procedure". Anya held her breath as she felt the cold alcohol wipe on her hip "ok, just a scratch" she relaxed, that wasn't worse than usual "now a sting" Anya gasped and gripped the side of the table as the medicine entered her tight muscle, burning as it went. After what felt like forever the pain stopped "you can get up now. That should work almost immediately. Make a note of any bleeding you have but we will see you back here in six weeks to review."

Anya left the clinic, praying that she would never be in that procedure room again.