The Cerclage

A cerclage is a procedure to place a stitch or stitches in the cervix of a pregnant woman to keep the cervix closed as long as possible. This can be done as an emergency procedure if a woman's cervix is found to be opening (or shortening) too early, as long as her water hasn't broken. This can also be done as a preventative measure when there is reason to believe that there may be a problem later in the pregnancy.

Although we don't have an answer as to what went wrong in our last pregnancy, we know that the cervix opened too early. That early opening may have perpetuated everything else that happened, or some other culprit may have caused the cervix to open early. Either way, my doctor recommended we have the procedure done. He said if we agreed, it would be done around 13 weeks, once the risk of spontaneous miscarriage was significantly decreased.

The benefits of the procedure include: strengthening the cervix, keeping the cervix closed beyond when it may have opened on its own, and providing piece of mind to couples who have experienced a previous loss. The risks include: all the normal risks that come with any surgery with anesthesia (infection, permanent injury, death, etc.), and also the risk of disrupting the pregnancy, causing miscarriage.

My husband was on board with the procedure from the beginning, but I was less sure. For one, I hated to admit that there might be something wrong with me that had caused our loss. Second, it made me nervous to interfere with nature, especially considering the risks. In the end, I decided that we could either worry about the procedure and, as long as it went well, be somewhat more relaxed for the rest of the pregnancy, or we could worry for the whole pregnancy. I decided the former would be a little easier.

After our trip to the ER the Sunday before the surgery, when I was convinced my cervix might be opening already (and everyone in the ER looked at us like we were crazy), it became clear that this was a very good idea. (The outcome of the ER visit was that everything was fine, and when we explained our history to the ER doctors and nurses, they were much more understanding of why we were so crazy).

We went in for the surgery on Wednesday, January 11th. We were very nervous. The nerves were made worse when, before the surgery, the nurse could not find the baby's heartbeat, nor could my doctor. After many nerve racking minutes, the nurse brought an ultrasound machine. The baby quickly appeared on the ultrasound screen, with a strong heartbeat (150bpm). Apparently the labor floor (which is where they performed the surgery) is not well equipped to hear tiny babies' hearts. The nurse assured us that their Doppler equipment was not as sophisticated as the equipment at my doctor's office. After the surgery, they again could not find the heartbeat with the Doppler, so they again used the ultrasound machine to confirm that the baby was fine.

Before the surgery, they gave me a spinal (like an epidural, but the medicine goes into the spinal space instead of the epidural space - that's how the nurse described it). I was already in the OR and couldn't hold my husband's hand as I had hoped, so my nurse held my hand. The nurse anesthetist had warned me that my blood pressure could drop which could cause me to vomit or faint. Plus I had heard that the needle for an epidural was painful. I was most concerned about the consequences of the anesthesia, rather than the surgery itself. The needle was painful, but not unbearable and I had no problems after the medicine went in. The hardest part after that was throwing modesty to the wind while wide awake in a room with about 10 people in it!

Once the surgery was over, I went to a recovery room for an hour and then back to a regular room until I could be released. The only hiccup in the recovery was that I couldn't pee until several hours after the surgery because the numbness had not subsided enough. While I was recovering, one of our wonderful nurses from our stay in April stopped in to say hello. She said she had tried to change her schedule when she heard that we would be there, but she wasn't able to make it work. However, she had to come in for a meeting, so she stopped in to say hello to us.

When I was finally able to leave, I went home to rest with my feet up for a few days. The doctor said everything went very well, and I got the thumbs up to return to normal activities at my follow up appointment the next week. Hopefully this procedure will give us the peace of mind we hoped for in this rollercoaster ride.