Pregnancy With IC

Just in case you thought your eyes were playing tricks on you.... yes. I did choose a new template for my blog. The pink was just a little too... pink for my taste.

My appointment was on Tuesday this week because I was meeting with the social worker from my perinatologist's office. I guess they like to make sure you are, like, mentally sane or something. Sure. That's ok by me, and it wasn't as bad as I thoght it would be. So now I see and/or talk to on a weekly basis: perinatoligist, ultrasound tech, nurse, social worker, and preterm birth prevention team. Is this overkill? I knew it took a village to raise a child, but never dreamed it would take a village to assure that a child is born... and born healthy. Not to mention all the people that come to feed me and clean my house and visit. Oy!

Some factoids for you:
~my cervix was still holding its own at 3.3/2.5 with slight funneling
~evidently I am a BIT sensitive to the progesterone shots because I got a welt that itched and swelled, which I thought was a bug bite all week... I won't mention where they give the shot:)
~we got a decent enough 3D shot of babyb today(who will be referred to as Dorothy from here on out), so as soon as we scan it onto the computer I will be sure to post it for you.
~I have been on bedrest for 10 weeks, 1 day, for a grand total of 72 days
~4 more days until our first milestone of 24 weeks
~32 more days until our second milestone of 28 weeks
~116 days until 40 weeks

Recently on Life After Miscarriage, the support website that I frequent, I wrote a long explanation out for people on what IC (Incompetent Cervix) was all about and what it was like to be in a high-risk pregnancy. Many people don't know very much about either of these things, so I thought I would enlighten my blog readers who are wondering about some of the specifics of what I am going through including facts as well as emotions, fears, and challenges.

I don't really know where to start with this, but here goes...

Maybe some of you don't know a lot about IC. I know I didn't until it happened to me, so I thought I would post about what it is all about. What are the REAL possiblilities of what could happen? What is this pregnancy (and any future ones) like for me? My main reason for telling you these things is so I can feel like I am not alone; like people can understand (at least to some extent) what it is like to be in my shoes. It's true that none of us can say we really know exactly what another person is feeling, but I find it easier to sympathize with someone when I know the situation; what they are facing, what they have been through, and what their fears are. It might be long, but it's there if you want to know why on earth I am a wreck right now at times...

First off, Incompetent Cervix is (unfortunately) a condition that they cannot diagnose until it shows up usually in the mid second trimester but sometimes in the early third. There are normally no warning signs until it is too late to do anything about it. Basically it means that, structurally, the cervix is flawed so that it does not have the strength to stay closed like it should. Therefore, when the baby gets to a certain weight, the cervix opens and your body gives birth to a perfectly healthy child that is most likely too small to survive. This structural weakness of the cervix is not temporary. It is a permanent condition in most cases, and without medical intervention, a person with IC will keep giving birth to babies and watching them die in their arms. Some people have to go through 2-3 late losses before they are diagnosed. Thankfully there are some proactive doctors out there that discover it sooner, mine being one of them.

The cervix is normally long, closed, and hard during pregnancy. With IC the cervix begins to funnel (also known as effacing). Funneling is where the internal portion of the cervix, internal os or opening (portion of the cervix closer to the baby) has begun to efface. The external os or opening will be unaffected if diagnosed in time and a cerclage is put in place. There are 4 stages of funneling, T, Y, V, and U. These stages describe how the cervix appears from the inside. When the cerclage surgery is done, a strong band is used and woven in and out of the cervix as high as they can safely put it (being careful not to puncture the bag of waters) and then pulled tight like a pursestring. This (in many cases) is enough to keep the cervix closed until the baby is ready to come out. There can still be funneling with a cerclage, meaning that the inner portion of the cervix opens to the stitch. The only thing between my child and the outside world is a stitch in soft muscle tissue. That is downright terrifying at times.

For the majority of people with IC the cerclage works; but for some it does not. My specialist said he does not trust my cervix and won't until I get past 28 weeks. My dr. is very cautious (for this I am thankful because it means he is careful to do everything he can for me) and has not told me what he thinks my odds are of carrying to term. The day he did my surgery, my cervix was already as soft as it should be at the end of the pregnancy, already dilated to one, and a little over 2 cm long. A normal, healthy cervix (during pregnancy) should be between 3 cm and 5 cm, commonly around 4 cm or more. As my specialist put it to me, the stitch will hold, so that is not the issue. What the issue would be is that my cervix is so soft that he does not know if it will hold the stitch in there. If something were to happen before it is time for the stitch to be removed, my cervix would rupture and my baby would most likely be born. Depending on what point this happens (obviously these are hypothetical), we could be looking at a number of scenarios. One being a devastating stillbirth, or having a baby that is too small to try to save. The second possibility is having a baby that is small and will have to fight for its life. The long-term emotional effects of having a preemie are many, even if the baby survives and depending on the level of prematurity the child may or may not have long-term disabilities. Having to go down this road is a real possibility for us, though we hope we carry full term there are no guarantees.

As far as being on bedrest, there are many people who think that it is easier than it is. IT. IS. NOT. EASY. The whole reason for being on bedrest in the first place is to try to save your baby, so every minute of every day you wonder if everything you are doing is going to work. My dr. has straight up told me that we are doing everything we can at this point (besides hospitalization) and there is really nothing else that could be done. I have to face the reality that IF this does not work, I will not be a mother to a living child. That is scary for me because I have always dreamed of having a large family and that is not going to be the reality for us. Some people with IC are lucky. They get the stitch; they never have to do bedrest; the stitch works; and they can have lots of kids. I am not one of those lucky ones. The road for me is long and hard. Yes, my baby is with me and alive right now. Yes, I am thankful that she is still with us. Every day that I have her inside me is a blessing. Don't think I am ungrateful because I am not. But every day is also joy mixed with the fear that each day that is added is another day that I have to say goodbye to if she leaves us for Heaven. Every new experience and movement is one more joy, yet one more fear if that makes sense. A good portion of the joy and excitement of pregnancy has been taken from me. It will always be coupled with those thoughts in the back of my mind.

This is hands-down the hardest thing I have ever done; saying goodbye to my first baby and being pregnant with this one (the one that just may be my only biological child). I want to bring her home (God-willing I will), but I will be a different person after this. Things like this change us. How can they not? I am beginning to be a bit more optimistic as the weeks creep by. 28 weeks cannot get here soon enough, then 32, then 36. Odds are that we will bring her home, and I am holding on to the hope that in a few short months we will have a baby in our home. But in the back (and a lot of times the front) of my mind is still the fear, which probably stems from what we went through last year. I will never forget.

So please, baby.... stay safe inside until you are healthy and strong so we can bring you home and love you forever.