First, huge thank you to each and every one of you who sent your support earlier this week in response to my post regarding our situation with baby girl #2. It has been one of the most challenging decisions to make, coupled with feeling a bit alone being so far from all of my friends back in D.C. The virtual support made a world of difference in acknowledging that while at times this journey feels lonely, Grant, Grace and I are blessed to never be alone with the love of so many friends, family members, and even strangers. Thank you.
As for an update: after a ridiculous amount of research (Grant was traveling in Boston so I stayed awake all night Tuesday and Wednesday hanging with Dr. Google) we discussed our options and decided on Wednesday morning to go ahead and order the cervical pessary from Denmark.
I came to the conclusion that if by Friday (yesterday) I was still above 1.4cms, we would do the pessary and progesterone combo. If we start creeping below 1.4cms, it becomes too difficult to do the stitch, as we are more likely to end the pregnancy by rupturing the bag of water. As I had been 1.8cms on Monday, I had high hopes since we also started my old Crinone 1% injections (left over from my pregnancy with Grace) until the other progesterone could be compounded and mailed to me (received and began Thursday).
After weighing pros and cons of all options, this felt the most "right" in a situation that didn't seem to have any "right" answer.
On Friday morning I went in for a length check (silver lining of all of this: I get to see my baby girl on the ultrasound twice a week!) and while we received good news that my cervix was still closed from the outside (means we can still do cerclage or pessary as options!!) I had continued to shorten from the inside with a funnel to 1.5cms.
Dr. D and I discussed my options exhtensively. On Monday evening, she and her colleagues had held a special meeting and all concluded that they hoped that we would be game for trying the pessary. Fortunately, all parties were on the same page. Decision made.
No, the cervical pessary is not FDA approved or available in the U.S.A and has limited studies - but from my perspective the 1 in 5 risk of immediate miscarriage/infection causing stillbirth with the cerclage was just too high. As my cervix had shrunk in just 4 days, I knew I wanted to exhaust options (and quickly) beyond bedrest and progesterone. So this is where we landed. Clicked a few buttons after translating a website to order, and waited.
Even though I had ordered it on Wednesday morning, the pessary still had not arrived from Dr. Arabin in Denmark before my Friday appointment- so today I am just constantly pressing the "refresh" button on my tracking link. We had asked to pay whatever it cost to get it overnighted, apparently lost in translation (though shockingly shipping cost more than the actual device). The waiting game is a tough one. Praying it arrives here today/Monday morning so we can move forward. I'll go back in Monday and Wednesday next week for cervical checks, praying for some better results.
Right now were at about 30-40% odds for viability (24 weeks). The Doctors are allowing me travel to upcoming weddings, drive to places in the car, and interact with Grace around the living room - just not walk around much on this "couch potato bed rest". Essentially I need to be lazy, but not bedridden. The frightening reality is that if this baby decides to be born now, there is nothing we can do at this point to get her to term so it is what it is. All said, I remain extremely optimistic.
One major challenge I acknowledge: having baby #2 in California after Grace was born in D.C., I am having to constantly advocate with my new doctors how successful we were with Gracen after odds were against us. If there is anything I have learned from working in health care it is we each must be our own best patient advocate.
Bottom line: one of the most difficult decisions I have ever been faced with has now been made, and thoughtfully so. While it is my nature to doubt the decision every other second, I am confident that we are proceeding the best we can at this point. I have faith, and that faith has been nurtured and strengthened by the prayers and support each of you has bestowed upon our family this past week. Thank you.