WEEK 36 : Week by Week Incompetent Cervix Pregnancy Guide - What to Expect During and After Removal of Cerclage

NOTE : For the regular advice on Week 36, I suppose there are hundreds of other websites to tell you how it goes. This blog serves to supplement those sites, my personal favourites being What To Expect, Baby Centre UK and Parents. Do take note, however that I am not a professional physician, I practise law for a living and the only thing I know about incompetent cervix is through my own experience as a mother of 2 and a 31 week old baking in the oven! :)  The purpose of this blog then is just to simply share the joys and heartaches, the blessings and curses, the sadness and happiness and the disappointments and the pleasant surprises of our journey as a mom with an incompetent cervix.
     Who would have thought you would come this far? Well, if your baby decides to make an appearance now, he/she will be just as good as a fullterm baby.  But for some of us, bear in mind the little stitch is still in there, and we don't want to tear through it until it is removed next week, so just be very aware of whether you are in labour.

Ok, what in the world in being in labour means? Again I'm not going to go into details as hundreds of other websites would tell you how it feels.  But the difference between us and those ladies going through a normal pregnancy is, our cerclage is probably still in there and therefore we do not have the luxury of waiting at home till we have regular contractions.  WE DO NOT WANT TO TEAR THROUGH OUR STITCH! Do read Week 35 on preparations (read : Hospital bag) and what to expect after the removal of the stitch.

Let's talk about what to expect DURING the removal of the stitch today.  First and foremost, treat this as your labour day : in other words, bring along your hospital bag, your birth plan, your carseats installed, video cams, smartphones fully charged equipped with fully charged powerbanks - you get the picture.  You may have breakfast, of course, just in case you DO go into labour and you will need the energy.  Wear something you would wear to go for your regular check up, as when you do go into labour, they will get you to change into the hospital gown anyway.  

Ok, so you say good morning to the receptionist and your doctor's assistant.  After all the paperwork (if any), you will be led into the labour room (most doctors do this, but some will just do it in their clinic).  If your cerclage is a Mcdonald cerclage (this is probably the most common TVC), it will be removed without any anaesthetic, unless you really don't think you can take the pain or if there are other complications (e.g. the doctor can't find the stitch as it has embedded into your cervix over the last few months!).  Some doctors will place your legs on stirrups as when you had your cerclage stitched or during labour, but some will do without it, with just your legs wide opened (similar to when you have your pap smear test), and the procedure will be very much the reverse of when it was put it.  You will probably feel a lot of pressure (ok, PAIN) but there are some women who didn't feel anything at all (ENVY!!!)  From my 2 previous experiences, I remember the cerclage removal procedure to be even more painful than labour itself.  Ok, maybe I exaggerate, but I guess it's all very psychological - this is unncessary pain, unlike the contractions during labour which you know is necessary and have been experienced by women since the beginning of time. 

After the removal, you may or may not go into labour.  They will hook you up to some machines to determine whether the removal of the cerclage has triggered the onset of labour.  They will probably not keep you beyond a few hours, so be prepared to go home before lunch.  Thing is, if you are like me, you will probably have hubby close to you while the stitch is removed and to drive you home if you do not go into labour.  Otherwise I suppose you can drive yourself home.  You will probably bleed a bit so come with a sanitary pad or at least some pantiliners.

This is how the little stitch which has been keeping your little one baking looks like :

 

For the few hours after or perhaps few days after, you will probably feel a bit sore, so eventhough if you haven't gone into labour and now you are officially free to do whatever you want (finally!!!), you will probably be too sore to want to do anything.  But then again, every women is different and every pregnancy is different.  For me, the pain was for a few hours, then... it's INDEPENDENCE!!! Time to go singing, shopping and NESTING!!! Yea, your nesting instincts probably kicked in much earlier (especially if you have been on bedrest and the house is starting to grow mold) but now you can actually do it!

However, do bear in mind that if you overdo it (like me, both times), your waterbag may burst before you start having regular contractions (but it is from the mere fact that you DO have an incompetent cervix and you are dilating without contractions) so very likely... you will have to be induced if this happens.  But you are dilating, why the need for induction? Well... you are dilating but not dilating fast enough, and you have ruptured your membranes! Ok, sounds complicated. But bottomline is, don't go bungee jumping just yet.  Bear in mind also the risk of infection as for some of us, our cervix may have already dilated and/or fully effaced before our cerclage was placed, or maybe during the last few months even with the stitch in place.  And of course there are other late pregnancies concerns which you may want to consider as well, after all - incompetent cervix is just one of the complications of a pregnancy. We always forget that, don't we?

Don't let me scare you any longer. Just go get the stitch removed and enjoy the rest of your pregnancy!