NOTE : For the regular advice on Week 32, 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 25 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.
Your baby is filling out. There is not enough room anymore for those early somersaulting and kickboxing sessions he/she was having, so don't freak if baby does not seem to be as active as he/she used to be. He/she probably still is, but not the sort of movements you have been accustomed to few weeks ago. Cheer up! Less room means more of baby! Now is truly the time to enjoy your pregnancy now that the danger zone is over and done with! (Read Week 31 here)
For most of us, our doctor has probably eased up on the strict bedrest we have endured the last few months, probably since our transvaginal cerclage was placed at Week 14. For some of us, this may just be the beginning, especially for those of us who have just been diagnosed with an incompetent cervix without any cerclage - now you are in danger of a preterm labour, and at 32 weeks, eventhough baby has a good chance of survival, he/she is still pretty premature.
If you have just been diagnosed, first of all, take a deep sigh of relief as you are past viability (before 24 weeks, your baby had minimal chance of making it to smell the roses) but of course, it is scary as you are technically speaking only 8 months pregnant and suddenly you are faced with preterm labour. You may be prescribed with bedrest now, but again, take comfort in the fact that it is probably a couple more weeks, unlike most of us who have been doing bedrest the last 5 months or so. In the meantime, put your feet up and know that in a few weeks' time you will not have this luxury anymore for many many more years to come. Take it as a blessing, especially if you are the type who are perpetually on the go, multitasking throughout the day. Someone is trying to tell you to just take a break before little one comes along.
However, you may also be threathened with preterm labour at this point if you are having multiples. The fact that you are having multiples itself is considered high risk towards early labour. Coupled with an incompetent cervix, there is a chance that you may go into spontaneous rupture of membranes (your waterbag burst) at this point of your pregnancy.
Do look out for signs of premature labour, as your cerclage is probably still in, and you do not want to add to the complications but rupturing through your stitch. I have never had a multiple pregnancy so I will not know what are the other risks involved. But I'm sure it comes with other risks, but here let's discuss incompetent cervix.
In the first place, you would probably been advised against a transvaginal cerclage because there are studies that it may harm your multiples pregnancy. However, you may have had a TAC, but there is indeed an irony here : a TAC is usually done BEFORE you got pregnant, so you won't even know whether you are having multiples in the first place. Perhaps the only indication was if you had fertility treatment which often resulted in multiples. In any case, you are here now at 32 weeks, so let's just get on with it!
The normal progression of labour usually starts with contractions, which will in turn dilate our cervix, and as the contractions become more and more regular and closer in time, at some point, our waterbag will burst. However, with an incompetent cervix, especially withou a cerclage, we dilate even without regular contractions. In other words, we are probably not in labour yet, but dilation already happens, and more often than not, our waterbag burst way before we are in true labour. When this happens, if we have already carried to fullterm or like now... when we are 32 weeks... we will probably be induced to trigger true labour. Or in some cases, the doctor may still want to keep the babies in for a few more days, even weeks.
For multiple pregnancies, your babies are probably much smaller than singletons, so your doctor may want to keep them in for a few more weeks. So you may even be hospitalised for the rest of the weeks till you are fullterm. Usually, that would mean :
- Twins: 37 weeks
- Triplets: 34 weeks
- Quadruplets: 32 weeks
At this point of your pregnancy, whether or not you are pregnant with singletons or multiples, you ought to be keeping a close tab of every signs and symptoms. Your body will always tell you if something is not right. And of course, keep the doctor's number handy. Also, you ought to be prepared by now about what to do and who to call if you need to rush to the ER. Perhaps time to pack the hospital bag if you haven't already! Happy waiting!
NOTE : For the regular advice on Week 24, 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 22 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.
REALLY??? We are in Week 24 already? Well, we made it to viability!
Ok, so what is this viability all about? What does it mean? Does it mean my baby will definitely survive if he/she is born now? Does that mean I don't have to restrict my activities anymore and there are no more worries?
Well, the good news is... Yes, your baby will have a chance for survival if she/he is born now, and if you do go into preterm labour, your doctor will probably take all the necessary steps (do whatever they can) to save the baby. Before this... well... before this, they may just tell you 'that there is nothing that they can do', which translates to : If your baby is not yet 24 weeks, they will just consider it an unfortunate miscarriage which they can't do anything about. But now if you do go into preterm labour, they will do everything that they can to save the baby!
(Source : http://www.mamasaidknockyouup.com/2013/02/fetal-survival-rates-week-to-week.html)
The bad news is... the baby is still terribly premature. 24 weeks is about 6 months... we are still 3 months short, and there is a good reason why nature requires a 9-month period of gestation, not 6. In fact, in normal pregnancies, these women are told to watch out for signs of preterm labour as from now till Week 37, our babies are still considered premature and will have to be confined to NICU for a while.
So, NO, viability just means that the doctors may try to save our babies, and our babies have a better chance at surviving and then go on to live happy healthy lives, but that doesn't mean you are off the hooks. Why take unncessary risk when you can help it? Stay off your feet still - bedrest isn't all that bad (Read Week 23 here). Ask any mom who have had a premature baby, and you will know the tears and heartache which you will have to go through before your little one can finally go home. I mean, wouldn't it be a truly happy occassion if your baby can actually latch on and feed off your breasts right after he/she is born and to be able to breathe on his/her own without painful tubes all over them? Both my boys were jaundiced when they were born, and seeing them naked under the phototherapy is painful enough to watch, what more if they have to breathe and feed through tubes. So ladies.... hang in there. After all we have made it so far so why take risks?
But on the psychological side, yes, you can mentally relax. Stop fretting over every single tingle and twitch, and start to enjoy the pregnancy from now onwards. Enjoy your healthy meals (and those no-so-healthy tub of ice cream and 3 pieces of crunchy deep fried chicken) and enjoy bonding with your little baby who by now is creating a little gymnasium of his/her own in your tummy. Take comfort in the fact that if the worst happens and the little one is born now, there is at least a 50% chance for survival, unless the previous weeks. Anxiety is NOT a healthy part of pregnancy, and many believe that it will affect your baby's mental wellbeing as well. Try to smile more to dear hubby who has been so supportive all these weeks (eventhough some days they may not SEEM to be so TO YOU, but truly, they HAVE BEEN). Believe me... I know.
This is a good week. And congratulations that you have made it to this date. Before you knew it, the 3 months would have sailed by and you will have your little bundle of joy in your arms.
