It's a girl!!!
Starting off with the phenomenal news, Grace is going to be a big sister to a little sister!! -- and will have to learn to share very soon! "Grant's Girls" are growing! We have a beautiful baby girl on the way with a due date of 2/1/2016. Checking in at the 72nd percentile, all of her anatomy looks great at this point. We are currently 16 weeks and on Monday went in for an ultrasound and a cervical length check (due to my short cervix with Grace).
My husband isn't going to like this...
But I am going to put our situation out there. They say pregnancy/delivery makes a woman lose her modesty. Perhaps, but really we need your prayers right now. I also feel so strongly about sharing after reading Wednesday Martin's book, "Primates of Park Avenue" where at the very end, she mentions her struggle with Incompetent Cervix. That was the first time I have ever seen it in any popculture/media. It is a are condition (1.5% of women), and while I haven't had a chance to meet someone in person, the greatest support I have found is online in Facebook groups through people sharing their journey and through the book and Wednesday's testimony. So this is ours.
At the check, the MFM delivered the unfortunate news that our cervical length was coming in at 1.8cms at this 16 week appointment. Normally you want to be above 4cms, anything less you get the redflag of the offensively named "Incompetent Cervix". While I had clocked in at 2.1cms at 20 weeks with Grace (and put on progesterone and bedrest through week 34), being just 1.8 at 16 weeks is in the more severe category. This basically means I have 1.8cm barrier holding our baby girl in. The MFM admitted she was torn as we did deliver at 39 weeks with Grace (and coming in at a very healthy/hefty 9.5lbs and 23.5 inches) so perhaps my clinically short anatomy could handle it with the assistance of "couch potato" bedrest and progesterone, but a cervix can typically change up to 1.6cms overnight so we were already in the danger zone and at least 8 weeks from viability. We knew it was serious when she scheduled us to come back in in just 4 days. For perspective, 50% of patients who have less than 1.5cm cervix at 20 weeks lose their baby by 24 weeks (pre-viability). We also have funneling. Greater than 50% funneling before 25 weeks is associated with 80% likelihood for loss. It is a hard figure to swallow, and comes with a downpour of tears.
Immediately on Monday we started "couch potato bed rest" which is tough when I have a very active 1 year old (tomorrow!!) to chase around the house and progesterone. Farewell Fitbit, Hello Netflix! The little free time we have had between getting the house ready for visitors and planning Grace's birthday party while getting on with every day life, we have been balancing our options. The weight of responsibility- literally choosing between likelihood of life or death for the little girl who has been growing inside me for 4 months, has been excruciating.
The real kicker? I don't feel sick, I feel great. How can my body/womanhood be failing me so?
- Do nothing and trust in the Lord that we can make it at least to viability but better yet, full term (While an option, probably not ideal as we are both "Type A" and doing nothing for 6 months may drive us crazy coupled with the regret of not trying something if we do lose this baby.)
- Take progesterone injections like last time, coupled with modified bedrest (It worked with Grace, but we are in a much riskier situation this time earlier on and bedrest is tough when chasing after a 1 year old)
- Do the overnight procedure for the TVC Cerclage on Monday and subscribe to modified bedrest for the rest of the pregnancy (TVC comes with a 20% (1:5) chance of breaking the bag of waters/ infection and ending the pregnancy. Once the cerclage is placed and mother released from the hospital, it does have an 80% chance of making it to viability (24 weeks) which is reassuring, but comes with that 20% risk of miscarriage upfront and even a baby at 24 weeks will come with a long NICU stay)
- While not FDA approved, our doctor did provide us with the option of trying a cervical pessary. Widely used and studied in Europe, the cervical pessary has had good results with prolonging gestation for cervical incompetence. (I like having "out there options". Our hesitation is a) cervical pessaries are not FDA approved b) studies are still somewhat limited c) we do not know how it compares to the TVC BUT the risk is very very low in comparison with the cerclage which makes it an excellent option and we can also pair it with the progesterone injections which gives me a bit more confidence. d) it feels weird ordering something like this online)
Friday morning we are meeting with our doctor for another measurement (praying the progesterone we started Monday has curbed some funneling and at least prevented further shortening) and to decide how we will proceed. The weight of the matter - worrying if we go through one door and we lose the baby, what if we had chosen another- is heavy.
In my opinion, as a society, we need to acknowledge and talk about miscarriage and pre-term loss more. So many women whom have shared their stories with me keep saying how alone they felt, when in reality the March of Dimes states that up to 40% of pregnancies end in miscarriage. It is a terrifying reality- especially when you are faced with making a decision like this. Some say knowledge is power, but in circumstances like this, I have to wonder if ignorance is bliss.
Fortunately, our families are all in town for Gracen's birthday tomorrow and party on Sunday, so we are well supported as we make this decision and have help if we go the surgical route on Monday.
Thanks for letting me share, we all have some burden, we appreciate your prayers and will be praying for each of you as crazy things come your way on your own journey.