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.

My high risk pregnancy

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14 weeks

Being pregnant is such an exciting time.  But for some of us, it’s also scary.  When I was pregnant with my daughter Hannah, it was hard to believe we were actually going to be parents until the moment she was out, laying on my chest. (That was an awesome moment by the way)

We had 2 miscarriages before we were pregnant with her.  I believe the combination of a fertility specialist and acupuncture helped us start the family we always wanted.  I was diagnosed with severe endometriosis, Factor 5 Leiden, MTHFR, a blocked fallopian tube, and polyps (fortunately non-cancerous) covering my uteri – I’ll get to that one in a minute.  My doctor said it was a miracle I was getting pregnant in the first place.  The polyps were likely causing the miscarriages… as there were maybe 2 places for an egg to successfully implant.  Surgery corrected the problems and I was put on medication.

Within 2 months of getting the green light, we were pregnant.  I was lucky.  It’s for these reasons why I choose to remain quiet about my pregnancies through the first trimester, even if I start to show.  Miscarrying is HORRIBLE, and the only people we feel comfortable talking about it with are our friends and family.

That being said I’m at risk for also miscarrying during my second and third trimesters.  Yes, you read correctly earlier… I wrote “uteri”.  I have Uterus Didelphys.  It’s a rare uterine anomaly that you typically will hear about in the news when a woman gives birth to twins… one from each uterus.  I have the most extreme case of Uterus Didelphys that exists… two uteri, two cervixes, two vaginas. 

I was diagnosed when I was 15, felt like a freak and was scared.

Every uterine anomaly is different, so until you go through one pregnancy, it’s really unclear how your body will handle it.  There are problems to watch out for, including giving birth early.  In my case, my right uterus is slightly bigger than my left.  Both are about half the size of a normal one. With Hannah, I had to get a cerclage at 19 weeks, water broke at 38 weeks and she came in weighing 5 lbs. 10.5 oz… So I’m monitored closely. 

It has been a long process learning about this condition over the years.  And finding doctors who are well-versed in it is not easy.  In 2007 I was once again on my own, in a new city (Denver, CO) and needed to find new physicians.  My cousin (now an OBGYN resident in Chicago), asked around to her professors if they knew anyone or place that could knowledgeably treat me.  Their response was unanimous… go to the University of Colorado Hospital in Aurora.  They specialize in uterine anomalies and high risk pregnancies. 

Not only were these doctors able to help me diagnose my early problems, but they really made me feel like they were going to get me and my baby safely through my pregnancy. 

This time is no different.  And this time I’ve decided to share my journey.  It may be scary at times, but that’s reality.  And I think it’s important for people to know that being pregnant isn’t always easy.   It’s scary to share something so personal, but if it helps just one other person… perhaps another 15 year old who is just finding out she has the same thing… then it’s worth it.