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!
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!
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!
