Boy Oh Boy! Week 20

It's been confirmed with a second ultrasound, we are definitely having a boy!  My two year old has been telling me for weeks that the baby was a boy. She has been pointing to my growing belly and saying "Hi Guy!"  The ultrasound machine they used this time was not the best for capturing great scrap booking images, but at least it's something. I'm not sharing the one where they point to his parts, only the one of his side face profile.  They promised me we would use the better machine at my week 21 appointment next week. At week 28, I will get a 3D image so I am definitely looking forward to that one!

Week 19 proved, by far, to be one of the most difficult and most emotional. I started to feel much better from everything that happened in week 17, both physically and emotionally but then had a little setback that brought up some apparently unresolved emotions from my last pregnancy. When I went in for my week 19 ultrasound on May 24, I noticed upon leaving the appointment I started to feel some heaviness again in my lower abdomen, increased uterine irritability, and just overall felt sick after the ultrasound. It didn't make sense to me, especially since I was feeling great when I went in for the appointment.  But I think I am convinced why this is happening.

As with week 17, I spent the next two days feeling like I had completed a vigorous ab routine and feeling pressure in my cervix. Some of the cues my body has been giving me surround a reaction that I believe my body is having to the way we do my ultrasounds. I've been worrying that the internal ultrasound method that we have to use to check on my cerclage is to blame for my increased symptoms in week 19. My instinct tells me that the internal wand probe is causing further uterine irritability and I plan to discuss it with my OB at my next appointment. Starting week 21, I will begin going in for weekly appointments with ultrasound.  I questioned my OB about the internal ultrasound and he said for now all of them will be done with the internal wand because it is the only way to get a good look at my cerclage and cervix.

"I would like to reiterate that an incompetent cervix is not a life sentence.  Many, many women have gone on to grow their families after IC... "

However, given symptoms I consistently experience after this ultrasound I don't think we should do them anymore until I at least have the baby to a viable point. It makes sense that anything inserted vaginally when I am already experiencing complications would further aggravate the situation.  I've spoken with some of the ladies in my preemie support group and several confirmed they've had similar complications with the internal ultrasound and for most of them their doctor did only the external ultrasound probe unless there was an immediate concern.  Since I noticed some slight spotting after the last ultrasound, when I had nothing of the sort until after that appointment, I can only surmise it was from the ultrasound.

Which leads me to wish I had a different kind of cerclage. At my most recent appointment, the doctor had a student in his office observing. I allowed her to come in for my appointment with the doctor.  He explained my complicated case history to her and why I was considered high risk. Interestingly enough, we also discussed the other kind of cerclage -- a trans abdominal cerclage or TAC.  The difference between the cervical cerclage, which is what I have, and the TAC option is that a cervical cerclage is put in place by a surgical method vaginally and can not be placed very high due to limitations.  My doctor explained to her that for me he felt that we should try the cervical cerclage method first. (I have to wonder if the decision was insurance based - see paragraph on TAC and insurance companies below.)

 (See Abbyloopers Foundation. "A non-profit organization which exists to raise awareness about the Transabdominal Cerclage as well as to educate and support women diagnosed with Cervical Insufficiency, otherwise known as Incompetent Cervix, and to provide resources for medical professionals." ) 

 The TAC option is generally done pre-pregnancy (and sometimes in the very early stages of pregnancy), by an incision made in the lower abdomen, generally in the same location as c-section.  The TAC cerclage is then placed as high as possible where the uterus and the cervix join eliminating the funneling like I have had so far in my pregnancy.  The TAC option also limits infections that often happen with the cervical cerclages and most women enjoy living a lifestyle with few limitations and rarely go on bed rest. With a TAC of cerclage, many insurance companies require a diagnosis of deep traumatized cervix, a shortened cervix, and previous failed cerclages.  Many insurance companies will also require a history of incompetent cervix to be documented before a TAC may be deemed medically necessary. It seems crazy to me that one incompetent cervix would not suffice, it's not like your cervix is going to repair itself and suddenly become strong enough to carry subsequent pregnancies.

If we opt for more children later, I will definitely want to have TAC type of cerclage in place given the complications I have experienced thus far.  Also, the number of women in my preemie support group claim that after having the TAC they would never go back to a cervical cerclage. Most describe still taking it easy as a precaution but being able to work, take care of older siblings, and enjoy a normal healthy pregnancy where most describe going full term without any complications. Part of me wishes I had the TAC cerclage in place now, but I am going to remain positive that the cervical cerclage will do it's just job and I will continue to listen to the cues my body has given me thus far. I am already armed with discussion points on why I do not want the internal ultrasound probe anywhere near me until I know the baby is viable.  Many women, also in my preemie support group have described that their doctors had the tech not insert the probe but place it near the perineum and it worked to see the cerclage and cervix. I can say for sure it will not be an option at my week 21 appointment next week as I am just starting to feel better again.


I am doing my best to take it easy and follow my doctors orders, however I do have to say it is quite difficult with a two year old who doesn't understand why mommy can't pick her up, and a four year old who tells me constantly she's bored. But having said that my four year old was so wonderful last week, she knows that I have been trying to drink lots of water as instructed by my doctor, so at one point when I wasn't feeling well she got a glass and poured me some ice water to drink.  Both she and my two year old brought it to me on the couch.  Bless their hearts.  I was so touched. I know they don't quite understand why mommy can't do all the things that she normally does right now (like take them to the park, or run around playing with them), but they have been amazing little troopers.  My sister has been great about helping out by either coming over so her kiddos can play with them or allowing them to spend the day at her house.

I know we will get through this and my baby boy will be born full term, healthy, happy and ready to come home with mommy and daddy! I know it is still hard for some friends and family to understand why I would put myself through this to have one more child, but it is worth it and I have no doubt in my mind that it is the right thing for us.  I did receive a comment this week that I don't believe the person had any ill intention in mind, however the comment came across as insensitive considering the news I had just shared.  I received a call asking how I was doing and and when I explained some of the issues the person said "This is exactly what I was worried was going to happen when you said you were pregnant again.  I hope it will be okay."  Unfortunately, I took it to mean "I told you so."  I know, in my heart, this person did not mean it the way it sounded and so I have chosen to overlook it. It's just interesting the conversations we've had since many close to us found out that we were expecting again.  I would like to reiterate that an incompetent cervix is not a life sentence.  Many, many women have gone on to grow their families after IC and have had full term pregnancies.

Despite these conversations, we've had a lot of supportive people reach out to us and my husband and I very much appreciate the outpouring of support we've had so far.  Please keep the comments coming!  We want to hear from you.  Some people have said that they have experienced some troubles leaving comments on the site, but that should be fixed now. You do not have to be signed in to google to leave a message.  Just click on the link below this post that says "Please leave me a comment."