The plan

Caricature from Hearts of All Ages Fundraiser for Orthopedics Department at UCH

Because of my uterine anomaly, I go to the doctor more often than a normal pregnancy.  I’m at high-risk for some things, one being an incompetent cervix.

Next week we start weekly ultrasounds to measure my cervix.  Before my last pregnancy, I always associated cervix measurement with how dilated a pregnant woman was.  Not early in pregnancy (hopefully).  Right now, they’re measuring the length.  A great number is 3.5 – 4 cm.  This time around, for me, anything below 2.5 cm is unacceptable.  If it reaches that point I will have to go into surgery to sew my cervix shut.

Messing with ANY part of the uterus, when pregnant, is risky.  Often, women with an incompetent, or weak, cervix won’t know about their problem until it’s too late, and they lose the baby in the second trimester.  Some studies show that women with uterus didelphys are more likely to have an incompetent cervix, so my doctors take the proactive approach and start measuring for weakness early. Since one of my uteri is about half the size of a normal one, it’s logical to think my cervix would be weaker as well.   I’m lucky we’ve known about my condition for so long.

Unfortunately since it was my first pregnancy, I didn’t know how to recognize physical warning signs.  Some of my friends joked that I started waddling really early.  I honestly didn’t think it was a big deal.  But I was waddling because Hannah was sitting uncomfortably low, and that’s not normal.  I always shared with my doctors every ache and pain, including this feeling and was immediately told that whenever I felt that way, I was to tell them as soon as possible.

We had been measuring my cervix starting at 16 weeks, and since it had been fluctuating in length I was also not allowed to exercise.  For the remainder of my pregnancy I had to sit as much as possible… including at work.  That’s a problem when you stand in front of a weather wall most of the morning for your job!  But I was willing to take heat for it if it meant saving my baby.

In a short period of time my cervix length got slightly lower than 1.5 cm with funneling with Hannah.  Looking at the ultrasound, it looked like my cervix was starting to open at the point closest to the baby.  It’s a huge warning sign that you may go into labor REALLY early, and before 24 weeks, deliver a baby that the doctors can’t save.  My doctors quickly took me aside and explained to me my options… the risks/benefits of not having surgery and the risks/benefits of getting the cerclage.

I lived week by week while pregnant with Hannah.  As every week passed, I continued to have hope.   Surgery was a very scary thought with a helpless child involved, and, initially, I didn’t want to have it.

A cerclage is a controversial procedure for women with uterus didelphys.  But that’s because there haven’t been many, if any, studies done on the effects of a cerclage on people like me.  Does it really work? Is it worth the risk of surgery?  Well, I ended up having surgery around the 19 week mark with Hannah.  The same day we found out we were having a girl we made the tough decision to get my cervix sewn shut.

Here’s what I can tell you… the procedure is scary, and you’re awake the whole time, but my doctors were wonderfully professional and fun.  While my husband and I sat down to make our decision they drew us pictures and took as much time out of their day to help us understand what was going on.  The day of my surgery they did everything in their power to make me feel like I was getting the best care out there.

Because of the position of my cervixes, surgery took a bit longer than they expected, and afterwards you do get bleeding… a little is normal… all of which my doctors prepared me for.  Once I could feel the lower half of my body again, I could immediately tell Hannah wasn’t sitting as low.  I didn’t have to waddle anymore.  My cerclage instantly improved my cervix length.  And I know in my gut and in my heart that if it hadn’t been for that surgery Hannah would have come WAY too early.  My stitches came out at 37 weeks.  I instantly dilated to 3 cm, and one week later my water broke.

Now we enter down the same path.  My doctors and I decided to take a wait and see approach again because surgery is scary and risky and every pregnancy is different.  But this is the same uterus, the same side and odds are it will act the same way.  I feel more prepared… I know the warning signs… I know the risks… but I’m still nervous. I still live week by week.

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