Welcome CarePage Readers!

It’s official, Little Miss is going to be a big sister to a very lucky little brother! We discovered on Saturday, June 21 that we are expecting our second child. I am 16 weeks today and I suppose you could say the cat is finally out of the bag.

We initially thought it was going to be a long, long road: a road filled with much nervousness and anxiety, but it is really amazing how quickly time has flown by. I can't believe I'm 16 weeks already. I realize I still have many weeks to go and I have not entered what I consider to be my "danger zone" yet. Thankfully, I have my darling daughter to keep me grounded and focused. Without her, I don’t know how I would make it through this high-risk pregnancy.

It was extremely important for us that Missy Girl not be an only child. We so desperately want her to share her life with a sibling. For those surprised that we might attempt another pregnancy, here is how we got to where we are today:

We (more I) did a tremendous amount of research into why our little girl arrived at 24 weeks. I met with many specialists, talked with numerous physicians, connected with other preemie parents and joined online support groups for women like me: women who suffer from cervical insufficiency. It turns out that I have an anatomically short cervix. Basically, I don’t have much of one.

There were a couple of opinions on how to handle a second pregnancy. Most physicians, even the group that followed my first pregnancy, suggested a transvaginal cerclage (TVC) be placed around 14 weeks. This is cervical stitch in which they “sew” your cervix closed through a vaginal approach. It is amazing to me the number of “experts” who recommended this course of treatment without even knowing if I had enough cervix to stitch. There is much risk of cervical tearing, funneling and other complications that would require bed rest. Prior to even knowing my cervical status, I knew in my heart this was NOT the prophylactic option for me. Not to mention the risk to our unborn baby as the doctors are “fooling around in there” possibly nicking the fetal membranes. By the way, I don't have enough cervix to stitch so had I gone with this option who knows what would have happened.

There IS another option out there that most physicians felt was too radical a step: the placement of a Transabdominal Cerclage (TAC). In fact, none of the physicians who suggested a TVC even mentioned the TAC. And when I did, the feedback we received was to try the TVC first and if that fails, then move on to something more aggressive.

We wanted to do all that we possibly could do to ensure a successful and healthy pregnancy from the start and were not prepared to lose a child just to prove to the doctors something more ambitious should have been done. There is a such thing as instinct and my heart was really pushing me on this one.

All the research and discussion ultimately led to my pre-pregnancy placement of a Transabdominal Cerclage (TAC) on March 10, 2008. I found a fabulous MFM (Maternal Fetal Medicine) in South Jersey who is the board doctor of an online group called “Abbyloopers”. This board advocates for TACs, and after reading how many women have lost babies due to failed TVCs, our decision was confirmed. By the way, of the three physicians that I spoke to about performing the TAC surgery, they all agreed that I was a candidate.

Essentially, Dr. Davis (MFM) went through my c-section and placed a mersilene band (polyester fiber) internally around my cervix just below the uterine artery. While mine was done pre-pregnancy, it can also be done in the first trimester. Hubby and I were not willing to add additional risks to our future baby and knew pre-pregnancy placement was the option for us.

I was in the hospital for two days and had to take it easy for a couple weeks after surgery. The success rate, when done properly, is extremely high, much higher than that of TVC. We absolutely lucked out. Not only did we come across a physician who is expert in the field of TACs (he performs at least three per week and women travel all the way from the west coast and internationally), but he is only 2 hours away and has agreed to monitor this pregnancy as much or as little as I would like.

I am also being followed locally by the same group that handled my first pregnancy. They are treating me with kid gloves this time around and I must say that I am much more educated in obstetrical care than I ever imagined I would be. It is fair to say that I am confident in my ability to not only direct my care but also demand or deny specific care and challenge anyone who disagrees with me. We are sticking with this group because they are the only suburban high-risk group and, in the event our baby needs NICU care, we want only the same fabulous physicians and nurses who took care of our baby girl to take care of our baby boy.

I started this blog back in January documenting our decision to grow our family, followed by my search for the best surgeon. From there I chronicle my journey through surgery, recovery and finally learning that we are expecting. (Previous posts are archived on the right side of the blog.)

This blog is public and my intention is to spread the word about pregnancy after prematurity and Transabdominal Cerclage. I have been brutally honest in my posts and hope to encourage other women suffering from cervical insufficiency to investigate Transabdominal Cerclage. As you can see, due to the public nature of this forum, I have elected to keep the names of my darling husband and daughter private.

I update this blog often as I chronicle the daily ups, downs and milestones of this pregnancy. I am not currently aware of a feature that notifies readers of updates (please, someone correct me if I'm wrong!) so I advise bookmarking this site or adding it to your favorites if you are interested in following our story. Also, please, please, please feel free to direct anyone to this blog who may benefit from reading our story.