What’s next?

I’m ready to plan for the future. That doesn’t mean trying again right now. It means figuring what I can do so that I give us the greatest chance of this not happening again. I mentioned in a previous post that I had begun doing some research on the Trans-abdominal cerclage (TAC). If you aren’t familiar with the procedure, the easiest way to explain it is that they tie a suture around your cervix right at the top, closest to the uterus. This is different from the vaginal cerclage (TVC) that I had done twice with Lucas. In the TVC a stitch goes through the cervix to help hold it closed. The thing is going vaginally only allows you so much access as the bladder is ‘in the way’. Doing the procedure from the top down allows the suture to be placed closer to the top. The stuff they use to truss you (yes, truss because I keep picturing a turkey with its legs tied together when I think of this procedure) is strong enough to hold the weight of a full grown adult SO it should have no issue holding a baby. My problem has been that the weight of baby once I enter the 2nd trimester is too much for my do nothing lazy weak cervix. I have been doing extensive research and have PORED over the Abbyloopers website/blog for women who have had the procedure and/or are considering it. I refuse to ‘try’ with another TVC and I was worried that my MFM doctor would recommend this instead of being supportive for me moving ahead with the TAC.

I had my MFM consult/follow-up yesterday. Dr. J (who was the 2nd doctor on 2nd TVC surgery) is amazing. She is a straight shooter and that is what I love about her. We talked about my delivery and before I could even suggest it she said, “we need to talk about an abdominal cerclage”. This was confirmation for me; I have been praying about this procedure because it is major surgery and a big commitment both physically and emotionally. The TAC is permanent; once it is placed, it is there… what that means is you are committing to C-sections for all subsequent deliveries. That is scary for me; not in light of having a c-section to bring home my baby but in having my water break again or something else happen and still having to have a c-section and coming home empty handed. She did say that was a valid concern; if there are issues requiring a D&C prior to 10 weeks or, they can do one. If the loss happens after that, then we will be facing a c-section. Even in light of that scary news, I still want to proceed. If I am taking the risk to try to get pregnant again, I need to know that I did all that was in my power and gave my baby the highest chance possible to succeed. One major plus for me is that I can get the TAC prior to being pregnant; I was so worried last time having surgery while pregnant with Lucas…this way I just have to worry about me getting through the procedure, not the both of us. I did also ask, since we need help to conceive, if I would be making that harder by having the procedure. She said no harder than it was previously.

Dr. J did refer me to another physician for the procedure. She said she has done them in the past…but it has been about 2 years since she did one. She feels the same way I do; if we are going to take the chance on the surgery, let’s give ourself the best chances for a positive outcome. I appreciated that. You don’t find a lot of doctors who will say ‘I’m not the best one for this, here is someone who is’. There is a doctor who performs the procedure who is about 10 minutes from where I work. There will be insurance hoops to jump through and that has started already even with making an appointment to see him as he is ‘out of network’ but I will not be deterred. I am nothing if not stubborn and persistent. So I guess this is the start of new chapter in our journey.

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10 thoughts on “What’s next?

  1. When I had my stitch placed with this pregnancy I was hospitalized for 10 days and received rounds and rounds of IV antibiotics. The MFM I was working with believed that infection was the root cause of cervical incompetence. Through blood work, she was able to confirm that an inflamation marker was through the rough and treated me aggressively. I did ask her about placing a TAC and she really felt that in my case, the inflamation/infection marker was the roots cause of my problems. Also, I had surgery on my uterus to remove a septum. I haven’t snooped around too much but has your uterus been looked at via MRI?

    Best of luck with your TAC!

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      1. The MRI is to look at the structure of your uterus. There’s a link between mullerian defects and IC. I had a uterine septum that was basically dividing my uterus in two parts. Because of this, there was less room and baby would grow on one side only causing the cervix to be under more pressure which forced it to shorten prematurely and ultimate open.

        Liked by 1 person

  2. I’m glad that you’re starting to look ahead to the future. And I’m VERY glad that you’re considering the TAC. In the midst of my pregnancy difficulties, I met someone who’d delivered one baby at 21 weeks, then another at 18 weeks only hours before a planned cerclage. She became pregnant again and had a TAC at 13 weeks and a routine pregnancy, delivering at 39 weeks. Her cervix held steady around 4cm throughout the whole pregnancy. I really have faith that you’ll be similarly successful with a TAC.

    Liked by 1 person

  3. This sounds super promising! I am feeling very hopeful for you. It does sound like there are risks, but I am with you in that I’d want to know I did everything I could to give a baby the best chance to thrive.

    Liked by 1 person

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