The New Breed : WFHM (Work From Home Mom)

It's been crazy. Completely C R A Z Y.

So, No.3 was born since my last post.  Cerclage was removed at Week 38, and there was quite a bit of drama as OBGYN went on holiday so even after removal of cerclage I had to just stay put and make sure he is back before I dilate further. But then again, I went straight to 4cms dilated upon removal of the darned stitch.  Thank goodness lil one decided to make an appearance only 10 days later, exactly 1 week before her due date. 

There wasn't much drama, except that I really wanted to remember the pain, as I knew this was going to be my last baby. I want to remember every contraction, every twitch, every grasping churning twisting pain.  And there... finally the contractions were getting closer and more intense... and little Lana was finally born on 27 March 2015 - a whopping 3.94kg - bigger than her 2 elder brothers! I love every moment of watching her grow, her beautiful smile, her first laugh, the first time she flipped over, the first time she burped, sneezed, held herself up....

Fast forward to today - she is 8 months and 2 weeks old. My beuautiful little princess. Daddy's little pride and joy. He will pick her up before he even takes off his socks upon returning from work daily - she beams at him and it's wonderful to see the interaction between father and daughter.

Me? Well, all my plans for my career was at a standstill after my cerclage placement - and when little princess was 2 weeks old, I tried to get back to work - my business associate was even kind enough to strike a deal with me where I only need to draft and research - from home. No meeting of clients, no handling of office staff, no court work. Just draft. And research. From home. Now, baby sleeps and sleeps and sleeps - how difficult can it be? The eldest just entered primary (elementary) school, and no. 2 1st year in preschool.  I just need to pick them up after school, feed them, nap in the afternoon - of course I can be a WFHM (Work from Home Mom)!!! It beats being a fulltime working mom, I don't even need make up and high heels and I can fully breastfeed my little princess!!! Surely it beats the SAHM (stay at home moms) too! I mean... I am still earning a decent income and I can still have an identity - I can still call myself a practising lawyer! BEST OF BOTH WORLDS!!! WHAT ARE YOU COMPLAINING ABOUT?!!!

Ok... in the beginning, your newborn does nothing but sleep. She cried only when she was hungry or she was dirty.  Then she started crying when she was tired.  Then she started crying just because she wanted attention. In the beginning, she slept 3 hours in the morning and 3 hours in the afternoon. 6 solid hours of drafting and research - and a decent income. Wow... I could even bake and cook and do laundry and kept my house spick and span!

Then she started to sit, and crawl, and cruise... and before I could say SOLIDS, she was sleeping 1 hour and awake 3 hours instead of the other way round! So here was the crazy schedule (actually I would use the present tense, but it's the school holidays so... but once the holiday season is over it would be this schedule again! )....

Wake up.
Bathe and feed the boys
Prepare the boys for school
Keep fingers crossed that baby sleeps through all the morning chaos
Put laundry to wash
Say bye bye to boys and hubby
On a good day, now baby is up. Feed baby.
Defrost the meat, maybe even cut up some vegetables if she is quiet.
My turn for the toilet and bathroom if she is quiet.
Give baby her bath.
Play with her for a little while, or if she is quiet, keep yesterday's laundry.
Put out laundry
Fold laundry
Sweep and mop the floor a little
Clear the mess a little , if she is quiet.
(note "if she is quiet" becomes the main theme here)
Hopefully by now she needs her nap. If not, then continue to give her attention while trying to do some house chores.
It would be about 11am by now. 1 hour before I need to rush to pick up No.2 from preschool. Yikes, I hadn't cooked yet.
Maybe forget the chicken. Just boil some macaroni and sausages. Perhaps its mac and cheese for lunch today. Again.
Is baby napping yet? Remember the "if she is quiet" earlier when I had my bath and toilet time? If not, now is the time to put her in the crib and if she is still not quiet I will just have to brush my teeth, take my shower and everything else in the toilet WHILE SHE SCREAMS (oh, our neighbours have made comments about her screams several times by now)
Hey, what about that assignment that was due 2 weeks ago? The research about what happens if the Defendant wants to file an application to strike out my client's motion? Oh,maybe will try to do squeeze in some work after my bath, if she is quiet.

Is it 12.15 already? YIKES! Time to rush to pick up no.2. Wait... baby just fell asleep? No choice,have to risk waking her up while transferring her to the car. Rushed to pick no.2 up. He is sulking again as I was late.
No time to pacify him. Have to rush to pick up No.1 now. Oh dear... I forgot to bring his tuition bag... he had tuition after school. Oh no baby is crying in her carseat. Its too warm. Or is it too cold? Looked at all the other coiffed moms enviously... they are even wearing heels. I'm in my slippers (gosh they match today) and my old pair of spectacles (with 1 side tied up with string - no time to even get that repaired). Since when would I go anywhere without my contact lenses? oh well..

Ok, managed to get through lunch time (barely, shoving mac and cheese down my boys' throat with lots of threats "If you don't finish your food now NO PLANTS AND ZOMBIES FOR 3 WEEKS!!!!" and my own isn't really having lunch. It's shoving down lunch... sorry I diverted... ok, finally its 3pm and no2 and baby and myself are home. Perhaps they would nap now and I could finally work. Oh, the laundry still in the washing machine? The earlier "if she is quiet" obviously didn't work. Finally it was 4.30pm and they looked happy enough in their little dreamland. Time to finally settle down and get some work done. WHAT WORK?!!! I"M SO TOTALLY EXHAUSTED!!!! But well, no choice eh. Unless I wanted to work after all 3 sleep at night (about 10pm?). And we are talking about fullblown court trials- the drafting and research takes time. I have to read 200 cases before I get down to 1 relevant one. I'm not doing data entry or crocheting from home. I'm actually going through legal judgments (judges somehow took it upon themselves to write 100 page judgments to say something which can be summed up in 2 sentences. And if it's an appellate court, there would be 5 judges - each will write 100 pages of judgment eventhough all agreed with each other that the Defendant is liable to pay the Plaintiff the sum claimed)

Well, in the evening when the baby had her final feed and smiled to me while No.1 and No.2 give me the BIG FAT HUG (as they call it) and BIG FAT KISS saying "I love you very  much mommy"... everything seems like ... it's all worth it.  I haven't missed any of my daughter's firsts, as much as I have missed most of my 2 sons' firsts.

It's tough. I don't want to make sweeping statements that it's tougher than a full time working mom, or a SAHM. Who am I to say that?  It's not a competition and I am not comparing. But there are days when relatives and friends (ill informed ones) would make statements like "You are so free what, nowadays a lady of leisure" - until I corrected them that I'm actually still earning a living working from home while trying to see to my 3 kids with very very different needs (I have a kid in primary school, everything is new and challenging and I have actually skipped the part about his homework and piano lessons - I have a Preschooler whom, thankfully, is quite independent but he is a sensitive, extremely intelligent child and I do not want to neglect his gift, and of course, an infant child).  There are also days when my eldest would make comments like "daddy is working so hard. mommy is just staying at home"  Of course he doesn't know better. But it still hurts.

And somehow friends are hard to come by. Because I'm always busy. It's difficult to hang out with working friends, as they actually earn real money and carrying real handbags and buying shoes and clothes from real retail shops. It's difficult to hang out with real SAHM as all they talk about are their kids and I want to talk about work too. I'm constantly judged by unmarried friends, married friends with no kids, and many (thankfully not all) fellow lawyers have totally cancelled me out of their address books. I'm stuck in between. I am constantly tired. Physically and mentally. I cry, laugh, scream, shout, all at the same time.

It's crazy. It's inhuman trying to do what I'm trying to do. I love my kids. I love being with my baby 24/7. But I also miss adult talk. I miss wearing make up and get a decent haircut. Now a good day is if I can shower without a baby screaming throughout the 5 minute shower. I hadn't had a haircut in months. Nobody invites me out for coffee and cake anymore because I have turned them down too often. I earn, but I don't earn enough to get help. I don't earn enough to hire a reliable maid or babysitter or to send my kids to daycare. I made the decision to stay at home, so obviously I couldn't earn as much. I turned away enough clients to finally have very few, if not, NONE at all, prospective client calling me.  And even if they do call, I can't shortchange them because my hands are literally full.  If I go back to work... well...

Life is tough.

Very tough.  My 2 cent worth if you are at the stage where you are trying to decide whether to go back to work or be a SAHM?  Well, either way, you are ok. Just not a WFHM. It does NOT work.

WEEK 38 : Week by Week Incompetent Cervix Pregnancy Guide - The Little Rainbow Behind The Storm

NOTE : For the regular advice on Week 38, 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 36 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.
      
Well what do you know? It's week 38! Let's recap based solely on my own experience :

Baby No.1 : I almost lost him at 23w4d, with no measurable cervix left and dilation of 2cm.  It was an emergency transvaginal cerclage, and I came across the term "incompetent cervix" for the 1st time.  Was on strict bedrest till 37 weeks when TVC was removed (scheduled for 38 weeks but uterus was very irritable by then).  Baby came by at 3.2kgs 10 days later after waterbag burst without any regular contractions but induced by pitocin.

Baby No.2 : A preventive TVC was placed at Week 15, strict bedrest for a month after which I went on with normal activities (except gym, heavy lifting, sexual intercourse and any other pelvic activities) including carolling during Christmas! TVC removed at Week 38, baby was getting too big by 40th week. Due to be induced a day after 40 weeks, but baby decided to make an appearance on due date.

Baby No. 3 : Totally unplanned for baby (I have PCOS and conceiving was always with few rounds of Clomid - so this one is a blessing from God). Preventive TVC was placed at Week 14, at which OBGYN observed a lot of scar tissues around my cervix due to multiple TVCs.  Went on strict bedrest but effaced 100% with no measurable cervix left by Week 17.  Lots of prayers and continued bedrest, and twice daily progesterone suppositories - by Week 20 cervix condition reversed. All went well ever since - as at the time this is written, am waiting for TVC to be removed on the 16th of March, 11 days from today.

 I have been blessed thus far, and I am sure we can all beat the odds and do this.  Be it PCOS, an incompetent cervix (well, we are not all that incompetent are we? We have gone through so much yet we braved through the proverbial storm) or anything else thrown at us throughout our journey to motherhood, we are finally here. A mom. Yes, a MOM.

We IC mommies take it by milestones... first, to the point where our pregnancy is viable enough for a cerclage to be placed.  Then the 24 week mark.  Then we take it day by day thereafter... till we have our little rainbow in our arms.  Some of us do not make it through all the way, but we pick ourselves up and go through it all over again.  We don't have to do it alone, as we have others to be there for us.  The main purpose I started this blog was because I was sick and tired reading through those regular "week by week pregnancy guide" websites which tell us "your 2nd trimester is your honeymoon month, it's time to go have that babymoon".  Well, guess what? The only time I had that babymoon it was with my 1st baby.  And I almost lost him. Thank God for my very capable, very professional and very caring doctor, Dr Narinder Singh Shadan from Island Hospital, Penang, Malaysia.  Today I am a mother of 2 (well, almost 3).

I will end this series of blog here today. The rest of the weeks - Week 39 through to the day baby is finally born - well, it's just waiting. And there are hundreds of regular websites which will tell you what to do and what to expect.  I have mentioned before in one of the previous weeks - the only difference is perhaps we will not, IRONICALLY, dilate when the time comes.  It makes sense - the cervix is no longer in its natural condition after the stitch.  So more often than not, we may need to be induced.  

I will miss being pregnant (I'm very sure, and so does hubby) but all I can say is... it's been an exciting journey.  I thank God everyday for the babies, the friends I made all over the world (Do check out the Facebook Incompetent Cervix Awareness Group- the ladies are non judgmental, always caring, always listening), the true friends and family who stuck by me through the journeys (the blessing of the incompetent cervix found me true friends, and of course, made me realise there are many fair weathered friends hanging around too).  What a great filter indeed!  

So I would end this by saying... The incompetent cervix journeys have been more a blessing than it is a curse.  Sure, I may sound insensitive towards some of you IC mommies who may have lost a baby (or several) before, and I apologise in advance.  But whatever it is, we are all sisters, connected in the most intimate way - our desire to be a mother no matter what.

Take care, and don't forget to share my blog with whoever you think may need a friend to listen to.  I welcome comments and questions, but like I said, I am not a professional medical person. Or have any expertise or paper qualifications medically.  I practise law by profession, and I'm ... JUST A MOM.

WEEK 37 : Week by Week Incompetent Cervix Pregnancy Guide - Coping With The Waiting Game

NOTE : For the regular advice on Week 37, 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 36 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.
    
Some doctors will wait till 38 weeks to remove the stitch, but some will do it earlier, depending on the condition of your cervix and your stitch.  Some will keep the KIV approach - and monitor you closely on a weekly basis to see the development of your baby (whether she is getting too big, whether level of amniotic fluid is still stable, whether placenta is starting to calsify) as well as whether the contractions you have been experiencing the past few weeks have affected the stitch.  What is of utmost importance at this point is that you do not tear through your stitch.

You will probably want to ditch the stitch earliest possible, as you are done being pregnant.   And you are done worrying about tearing through the stitch.  You can discuss with your doctor of course, but from experience, my doctor agreed only to remove the stitch earlier than 38 weeks when the CTG scan actually picked up real contractions.  Together with all the aches and pains of late pregnancy, and a whole new bundle of late pregnancy worries, we truly just want a healthy baby in our arms.  And baby is, after all, already full term.

So by now you have probably ditched the stitch, or you are about to do it tomorrow, or next week. Do read Week 36 for what to expect during  after your cerclage removal.  People around you are already in their irritating mode of asking you the cliche questions "So when are you gonna pop?"  or "Have you got a name for her yet?" stuff like that, you know.  And they may think it's funny that you are now WADDLING (boink boink!!!) instead of walking.  Being an IC mom 3rd time around, and observing all the pictures IC mommies posted on FB and forums, I can tell you that almost all of us gain more weight than others during our pregnancy.  Yes, we have a very valid reason - it's the bedrest.  It has caused a lot of weight gain (especially if you are like me, a fitness buff at normal times) and muscle loss.  Just turning from left to right (and vice versa) in bed will probably leave you breathless, and that toilet trip 10 steps from your settee is probably gonna get you panting for breath. 

So if you do feel like you truly want to get this over and done with as soon as possible, don't fret.  You are not alone.  You are not a bad mother.  And well, eventhough I enjoyed my first 2 IC pregnancies, this 3rd one is taking its toll on my body.  Perhaps it's just age.  Perhaps the bedrest I had to endure this time around is for a longer period than the previous two, so the physical and emotional effects are taking its toll on me.  If your stitch is already removed and you had been so looking forward to holding that baby in your arms but he/she is not yet making an appearance, just take this last few weeks as your opportunity to go walk the shopping complexes which you have not seen the daylight of the last 6 or so months.  Go scrub that toilet with a toothbrush, and arrange and rearrange the little pink wardrobe full of little pink dresses and booties.  But remember, though, if you do plan to go out, your waters may break (remember, there is no more stitch down there?) so be  prepared to for that too.  Bottomline is, truly enjoy these last few weeks as a pregnant lady.  If you have been stuck with bedrest all these time, you probably didn't get to wear that chic maternity dress you bought when the 2 pink lines turned up on your pee stick.  Well, now is the time to do that and enjoy the privileges and attention you may find yourself receiving from strangers around you at the mall and public places.

I have had strangers offering me to cut the queue at the public washroom, and seats at wherever I happen to be standing.  I get chatted up by friendly shoppers.  People in general would just give me a knowing smile and they don't seem to be able to help themselves from striking a conversation with me about my pregnant belly.  It is a wonderful change from having been couped up at home in front of the computer/tab/smartphone/television.

Other sites will tell you to talk to your baby and all that... well, as IC mommies... and I think we owe it to our husbands and older children to pay them due attention now. Carry your 3 year old who has been missing it the last 6 months, or more.  Take him to the park, go on that swing with your little girl, do all those things which you haven't been doing the last 6 months with your children, as you know within weeks (or even days) from now, you will be back to being unable to do all those things with them.  As for the dear supportive husband, time for some tender loving care.  If you are up to it, and if your doctor gives you the green light, perhaps it's time to resume some intimacy. :)  

At the same time, always remember that late pregnancies come with its own worries and complications so even though we are totally out of our 'danger zone' (sometimes we IC mommies forget that there is more to a pregnancy than the worry of a preterm baby), it is prudent to still watch our health.  Again, if our doctor gives us the green light, maybe time to resume some physical activities like walking, swimming and some stretching.  Continue to eat healthily and wait for the arrival of the little bundle of joy.

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!

WEEK 35 : Week by Week Incompetent Cervix Pregnancy Guide - THE HOSPITAL BAG AND THE BIRTH PLAN

NOTE : For the regular advice on Week 35, 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 29 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.
    
If you have not packed your hospital bag, now is REALLY the time to do so.  After all, you are scheduled to have your cerclage removed only in 2 weeks' time and really, 2 weeks isn't a lot of time!  Do bring it along with you when you have your cerclage removed, as you'd never know. But then again, if your home is nearby the hospital, then of course it's not a worry.

Ok, so what do you need in your hospital bag? If you are planning for a C-section, you will probably need to stay in the hospital up to 4 days after your baby is born, if not, perhaps give and take a day or 2. In any case, the essentials are :

For yourself :

1) Maternity pads (the bleeding is usually heavier than normal periods, so an overnight pad with wings and at least 28-34cm in length would be great)

2) About 2-3 pairs of warm socks (perhaps a pair which you wouldn't mind throwing away after labour - yup, use that pair for the messy delivery).  

3) Disposable panties (really, you won't want to end up washing panties throughout your hospital stay, or a load of dirty panties to wash once you get home - you have a baby to look after after this, remember?)

4)  2-3 maternity bras (no underwires please, it will be rather painful once the milk comes in within 2-3 days after birth)

5) Toiletries and make up - lotsa vaginal wash, but then again, some hospitals provide 'cleaning services' the first few days.  You will have a lot of visitors, and with Facebook pictures flying all over, and if you are a vainpot like me, you will want to look really nice in those pictures. I even brought my contact lenses along :)  

6) Snacks - or you can just ask hubby to get them from the hospital

7) Cameras, video cameras (or the very handy smartphone which has everything - complete with a monopod for a selfie with baby) charger - ok you get it, the electronic gadgets

8) If you are like me, you would bring the journal too - I keep a journal each for my 2 boys, and intend to keep one for No.3 too, handwritten, to document the pains and aches and of course JOYS of the entire childbirth process... till they are about 2 to 3 years old.  The waiting period during labour is a good time to start writing.

9) Going home clothes (ok you will not magically be back to your pre-pregnancy weight, so bring something sensible... like those clothes you were wearing when you were about 5 months pregnant)

10) Bath towels, slippers,  breast pads, (no need for breastpump yet as the hospitals usually provide and you wouldn't be pumping so soon yet anyway) and anything else you think you may need to kill boredom - books? Well, your smartphone has everything!

11) Of course, documents - but get hubby to worry about this.

12) Oh ya, bring a long lots of energy, excitement and patience! 

For the baby (ok, not all in the hospital bag, but some in your car):

1) 4 pairs of mittens/booties, rompers, diapers, hats, nappy rash cream - ok you get it.

2) Pacifier, baby bottles (frankly, if you a
re a staunch breast feeding believer like me, you won't need these stuff until a month or 2 after baby is born. Your breast is enough for now, both for pacifying and feeding purposes)

3) Car seat!!! (Some countries, like mine, do not make it compulsory. But please... there ARE reasons why some countries make it compulsory.  So please, go get an approved one. This will be your best investment, yes, even a better investment than the expensive crib you installed in your extensively renovated nursery!)

4) Receiving blankets, blankets, anything else you can think of to keep the little one warm.  Again, if you live in a hot tropical country like I do, there is really no need to go overboard (we are not facing winter are we? The cold is from your room aircond and car aircond! So before baby breaks into heat rash, please have mercy on the little one)

Ok, that's just the hospital bag.  Have you actually prepared your birth plan yet?  After the cerclage is removed (usually a transvaginal cerclage - please read Week 34 here) you will usually be allowed to go home after a few hours if you do not go into labour.  You may intend to have a natural birth, and usually this is possible if your cervix dilates normally upon removal of stitch.  However, it is quite common for women with a TVC to have a condition called cervical dystocia which is usually a side effect of the cerclage, where the cervix is unable to dilate and/or efface.  With both my boys, I had to be induced with Pitocin, and even slightly longer labours, I was fully dilated and was able to deliver both babies naturally.  With No.3 right now, my doctor did warn me that there are a lot of scar tissues and I may not be able to dilate this time around even with induction, but well... we'll see! A healthy baby is a healthy baby, natural or C-section!

So what other interventions may there be other than a possible induction?  They always tell you that God will not give you more pain than you can handle, but then again Pitocin isn't exactly what God gave you right? From experience, I can tell you that no matter how high your pain threshold is, with induction, the pain may be  more than you can handle.  If that is the case, please do not hesitate to call for an epidural.  If you are in too much distress from the pain, it is not good for the baby, and may cause fetal distress, or your blood pressure may shoot up, so yes be prepared to do that.  Also, the possibility of forceps or vacuum - keep all that in mind.  Both my babies were vacuumed.  And of course don't forget the possible episiotomy too.

Whatever it is, take it as it comes - after all, we have been through so much up till now!

WEEK 34 : Week by Week Incompetent Cervix Pregnancy Guide - PREPARING TOWARDS DITCH THE STITCH DAY

NOTE : For the regular advice on Week 34, 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 27 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.
  
Oh no... are the hourly toilet trips back?  And you thought your boobies couldn't get any larger? YOU ARE WRONG!!! And oh... the perpetual hangover feeling is back.  You are tired, eventhough the only activity you did whole day was to lie down on your back (or left side, as lying on the back causes breathlessness these days) and surf the internet.  Welcome to the final lap of your pregnancy!  

By this time, most of us would have been itching to get out of the house, and we probably already did.  After all we are way past viability, and if you are having twins, you might even have your cerclage already removed!  It feels like Independence Day!  But for some of us, our doctors may still want us to be on full bedrest till baby is fullterm, and that is only 3 weeks away!  Perhaps your doctor has already scheduled an appointment for stitch removal as well, and if that is so, you know that it's time to get all things ready because many of us IC mommies go into labour right after the stitch is removed.  Besides, some of us may have gone into premature labour anyway, so an earlier removal is required as the last thing we need is to tear through the stitch.  Well, it's all about striking a balance (Read Week 33Week 33 here)

If you had a TAC (transabdominal cerclage), the cerclage will probably be removed through abdominal incision as well.  And commonly, your baby will be born via a C-section anyway, so perhaps your scheduled C-section won't be until 39 weeks.  Or if you plan to have more kids, you may even want to leave your stitch in there.  But if you have a TVC (transvaginal cerclage), then you will have to have it removed before you are able to deliver vaginally.

So what are the preparations like towards the DITCH THE STITCH DAY (DTSD)?

1) A few days before your scheduled DTSD, your doctor will probably need to check through ultrasound and perhaps physical examination the position of your baby, the growth of your baby and other factors before deciding whether or not to go ahead with stitch removal on the scheduled date.  Sometimes, if the lungs of the baby are found not to be fully mature yet, the removal may be postponed for a few days or even few more weeks.

2) Once your doctor confirms that the DTSD will be as scheduled, then it's time to pack the hospital bag!

3) Always be mentally prepared that baby may come soon after (few hours maybe?) the stitch is removed.  Some babies take more time, perhaps even past due date! With my 1st baby I had an emergency cerclage placed at 23w4d when I was already 2 cm dilated, and he came about 9 days after the cerclage was removed.  With No. 2, it was a preventive cerclage at Week 14, and he didn't come by till due date itself!

4) Also continue to look out for signs of premature labour (before the DTSD, that is) as you may still tear through your stitch (it's still there, ladies!) and if you do go into premature labour, your cerclage will have to be immediately removed.

5) Have you prepared your birth plan? It's about time!

6) Have you actually made preparations for the arrival of a baby? Look, removing the stitch is almost as good as your scheduled C-section day! Except that baby may not come yet... you know, until... due date, or even after due date. But hey, please be totally prepared as this may be your last trip to the hospital before you come home with a little bundle of joy in your arms!  After all, doctors usually remove the cerclage in the labour room!

7) Speaking of the labour room, usually the removal would be without any form of anaesthetic. So....

8) Ok, it's not that bad (but really, speaking from pure personal experience alone, both times, I could remember the cerclage removal pain more than labour itself! In any case, also be prepared that there may be plan B, if the doctor couldn't find the stitch due to scar tissues or other factors.  It is rare, and usually the stitch removal is a simple outpatient procedure, where you just get ready to go home and wait for labour to start!

Yes, we are REALLY ALMOST THERE!