Adventures of a Dynamic Cervix

My cervix has been called many names. I find the adjectives to describe my cervix quite amusing. It’s been called incompetent, beautiful, insufficient, high, tight, and my personal favorite dynamic.

I am on my fourth pregnancy. To give you a little history if you don’t already know my first pregnancy was with twins who I delivered at 20 weeks and was diagnosed with an incompetent cervix. I was told by many doctors if I ever wanted to carry a baby to viability or term I would need a cerclage placed and extra monitoring. So the next time I got pregnant with my daughter I did just that I got the cerclage placed because who wants to go through losing another child? Now you are asking what is a cerclage. Well its a really fun procedure you go to the hospital for, get a spinal block, put in surgical stirrups and you cervix is literally sewn shut. My perinatologist at the time kept describing it it like a coin purse he was synching closed. That was a fun day, I already have major hospital/surgery anxiety and was in the freezing operating room  with the surgical team for whom this is just another day in the office. I’ll skip the not-so-fun part with the anesthesiologist and skip to the end. My perinatologist took a small step back form me and admired his work telling me and the surgical team that was the most beautiful cervix he had ever seen. He even went as far to leave the room go around the surgical floor pull in all the interns and residents and had them each take a look and applaud his handy work. I lay there spread eagle shivering and exposed and without my consent have a dozen plus doctors and students look into the most personal and private part of my body. I tried to laugh it off and tell them I felt like I was in an episode of Greys Anatomy and they laughed too. Following that procedure the remainder of the pregnancy was having ultrasounds to monitor the baby and my cervix and around 35 weeks I was worried about the contractions and/or Braxton Hicks I was having I asked if we could remove the cerclage. They agreed and told me the removal would be less invasive than it was to place. They would just need a speculum to snip and pull out the strings. It was uncomfortable but they found and cut the stings. Unfortunately the speculum got stuck and they could not loosen it. I was in lots of pain at that point and sent my poor husband to the other end of the curtain to loosen the screws so I could finally be free. I went home to finish off bed rest until I was closer to full term but kept leaking fluids and had my daughter 5 days later. She did not require any NICU time and I was so happy to bring my first rainbow baby home.

For my third pregnancy I knew I did not want to have a cerclage again. I consulted an OB and they recommend that I have weekly or biweekly ultrasounds to measure the length of my cervix and go from there. Anything to avoid the cerclage again. Around 27 weeks my cervix started to show some funneling which is a slight opening around the baby’s head. I was not dilated but my cervix was starting to act up so we started more strict bed rest, treating any preterm labor symptoms and got steroid shots for baby’s lung development in case I were to have a preemie. It was also stressful but I celebrated every week he stayed inside of me and also had him at 35 weeks and 5 days like his older sister, he also did not require any NICU time. Now my fourth pregnancy which leads me to writing this post. I chose the same path as the third pregnancy and started showing some funneling at 28 weeks. Today I’m 30 weeks and 5 days  and had another weekly cervical ultrasound. I’ve had enough of these I know what I’m looking at and whats good and bad. When the ultrasound wand was inserted I could tell there was a change from the previous week. Before the gestational sac was nice and around baby’s head and now it was starting to bulge into the little bit of funneling and when there was the slight amount of pressure put on the cervix that opening widened. You can tell from my scan images below from left to right you can see the opening widen and by the last image my heart sunk.

I thought I would be escorted to the hospital across the street and have the remainder of my pregnancy and bed rest monitored at the hospital. I hate hospital bed rest, I’m more stressed there than at home but I understand its need, I really do want this baby to stay in for as long as we can possibly make it. Thankfully I was not having any contractions and my new perinatologist (who I LOVE by the way) explained something new. It’s called a pessary. Apparently there are different types of these and more commonly it’s for women who have prolapsed uterus. In Europe some doctor redesigned one to work for women like me who have dynamic cervixes. I do not believe any studies in the US have been completed on it yet but there are very minimal risks to it that I had no problem telling my perinatologist to place it today. I’ve posted a picture of what it looks like below but the best way I can describe it is like a silicone donut is placed behind your pubic bone below your cervix. It supports my already dynamic cervix and can hopefully buy us some more time to get closer to term. If you have used a reusable menstrual cup before it’s like that but bigger and with the cup part cut off. Placing it did not hurt and was just like any other manual exam. Thankfully I’m still closed and not dialating or contracting so for the next few weeks I will remain on bedrest, take progesterone suppositories and any other monitoring or medications my doctor might think will help me from going into labor. The great thing about the pessary is if my water breaks or I start leaking fluids like what happened in my last two pregnancies I will be able to tell because of the opening in the pessary. With the cerclage it was harder to tell because it was stitched so tightly.

I really wish my pregnancies were not like this. I’ve cried so many times doubting myself and hating my body for not being like other women who can carry to term with little to no complications. Every pregnancy gets a little better because I am more informed and practice my faith and optimism to keep the anxiety at bay. Today during my scan I wanted to cry and felt a panic attack coming but I said a little prayer for peace and comfort and began counting my blessings. I have so many things to be thankful for.

• My husband who juggles two jobs and takes care of the kids and household chores.
• My beautiful children, two on Earth who give me love and snuggles, two in Heaven who watch over our whole family and one special boy in my womb who I know will be worth all this stress.
• My extended family and friends who help with watching the kids, bringing by meals, lending me an ear or shoulder when I need.
• My medical team including midwife, midwife assistants, ultrasound techs, OBGYN and perinatologist. All who treat me with kindness and respect.
• My readers and online friends who leave messages of encouragement.
• Not having high blood pressure or an anxiety attack yet.
• Netflix and Hulu to keep my mind otherwise occupied and not stressing about every little thing.
• Donuts because they are yummy, good looking and remind me of my dynamic cervix!

*I don’t claim to be a cervix expert but I hope my story and experiences might help someone else out there going through similar issues. Know it’s OK to ask questions about a course of treatment your doctor might recommend. Thoroughly go over the benefits and risks with them and if they feel rushed or try and make you feel less than, go get a second opinion.