What happened when they removed my cervical stitch...

So it has now been about 30 hours since the stitch was removed. I had spent yesterday morning reading forums of other ladies experiences of cerclage removal which to be honest did not put me at ease at all. The worst case scenario for me would have been if they couldn't remove the stitch in the labour ward and then having to go into theatre, have an epidural and then spend hours recovering from the effects.

On the day I was asked to arrive at 8am with no food or drink from midnight. Being pregnant has made me even more thirsty than before, so I did question every health professional who came into the room about whether I could drink- it was a unanimous no by the way. My amazing partner brought a huge bag of food which included water, cinnamon swirls (my favourites), cereal bars and juice. Naturally he ate a cinnamon swirl whilst we waited for the doctor to become available and he also had a smoothie whilst my mum sipped her coffee... you could probably imagine my face.

So we were in this gorgeous beach themed room and I was hooked up onto the monitor for over an hour to see how our little nugget was doing. As per usual he kept his heart rate around 150bpm but preferred to relax instead of move around when the midwife was actually watching the readings. The midwife stayed with us for the majority of the time monitoring him and checking everyone was happy which was really nice and kept everyone calm.

When the doctor did come in it was around 11am and the leg stirrups went up! In went the speculum and I heard the dreaded 'I can't see the stitch'... to which I panicked as I really didn't want to go to theatre. Thankfully with a little moving around the doctor found it and it took all of two minutes to cut it out.

Site: Click here

As soon as the stitch was cut I did jump as I felt a thump in my tummy, my partner could visibly see my bump flatten possibly by an inch. The doctor checked again to make sure all parts of the stitch had been removed and saw that I was a little dilated- I'm not sure how much a little is, I'm guessing 1-2cm but my cervix went straight from 1.6ish cm to a little dilated in seconds. See the picture for dramatic effect!

I had cramping pain for possibly 10mins after before I decided to have a nap listening to his heartbeat as they put us back on the monitor and then I got to walk around. I did enjoy my partners face as he was expecting my waters to break as soon as I stood up and for the baby to come pretty quickly afterwards. I have no idea if I have continued to dilate but not much seems to be happening.

The amazing news is that the pain in my cervix has gone and I don't have this tight, painful pinching feeling at the bottom of my abdomen anymore. I am actually able to walk around more through the pain in my hips which is definitely more bearable than the pain I was experiencing in my cervix. That means generally I am a lot happier... but completely mystified by when this little nugget is going to make his grand entrance!

This man continues to make me laugh through everything!

So to sum up...

1. Did it hurt having the cerclage removed?
Yes, it was uncomfortable and the pain was quite cramp-like in the actual cervix. It also hurt close to the cervix having the actual speculum in as well. Considering the stitch had been in for 17 weeks I was expecting it to hurt due to any build up of scar tissue as well.

2. How long did it hurt for?
The initial cramp-like pain lasted for a good 10mins. The doctor and midwife hung around just to check that contractions hadn't actually started as stimulation of the cervix in this way could bring about labour. After those 10mins, a good rest for about 30mins the pain pretty much went straight away as did the other pain I had been experiencing.

3. Did I dilate straight away?
Yes. The doctors were pretty adamant that the cervix could remain closed after the stitch was removed. I was really doubtful of this as I initially only had 0.5cm of cervix there anyway before the stitch brought it to >1.5cm. My cervix pretty much instantly opened but still no sign of baby 30 hours later.

Two more days until the stitch is out!

Surprisingly the past few weeks have gone past so quickly! Tomorrow I have one last scan before they take the stitch out on Thursday. I have to say I am REALLY looking forward to having the stitch out. The first three months (20 to 32 weeks) of bed rest was full of paranoia and OCD on hygiene. Once we were sure that our little nugget was going to be okay and I started to move around more- that was when more frustrating mobility problems started.

So my last post detailed one of our visits to triage and how the doctor believed the baby was pressing on the stitch causing the pain I was experiencing. I was also sent to physio as I was struggling to roll over in bed and my lower back/hips kept frequently clicking. If you're stuck lying down and then not being able to roll over... I'm quite surprised I haven't slowly gone crazy. Turns out my hips aren't aligned possibly due to extensive bed rest and the baby preferring to hang out on one side of my bump. Topped off with my EDS it makes everything that bit more difficult.

Venturing outside I did feel like I had actually turned into a vampire and might combust in the sun. It felt amazing getting out of the house but as I've gotten bigger and my pelvic pain has increased walking is getting to be pretty much a very difficult struggle similar to Frodo climbing Mount Doom. Not that I'm comparing the one ring to rule them all to a cervical stitch haha! I feel more like I may be turning into a very grouchy elephant with the occasional contraction I'm surprised my partner is still being so nice to me. The constant supply of ice cream keeps him in my good books.

So what's it like being 36 weeks pregnant with EDS and a cervical stitch? I pretty much sleep all the time- after eating/ sitting on the sofa/ mid-conversation... moderate to severe pelvic pain which means I may walk as slow as very fat turtle with no land-legs... cervical pain where the doctors are reluctant to let you have anything more than 4 paracetamol- believe me I tried to get something stronger and none of that pregnancy glow malarkey with this face. BUT my little man is a strong little fighter and I have to hold back tears as I watch him move his long legs to his daddy's voice.

There are a number of bets at the moment with how much they think nugget is going to weigh considering my bump has very random growth spurts which keeps me and the doctors on edge. I am also wondering how long after the stitch is out that this little man is going to make his grand appearance! It is always fun asking the doctors what they think, we have estimates from 2 days to possibly going overdue. So you can imagine my face when they say overdue...

28 weeks!

The most amazing man I know x

So I didn't think we would get anywhere near 28 weeks just two months ago but we did it! It has actually been pretty smooth sailing after the first couple of weeks... not counting the emotional roller coaster. I have been so lucky to be in this position mainly because my workplace is amazing letting me do some work at home whilst being on bed rest and my amazing family around me.

So on Wednesday I had another antenatal appointment to check on my progress and that everything was okay. The doctor was amazing! I did go in with a list of questions as it had been a few weeks between appointments now and he answered all of them... in detail! It's pretty nice to have a doctor who is so helpful.

One of my main worries was whether I was meant to be having cyclogest twice a day as I have been since my cervical stitch (and where it has been written on all of my prescription boxes) or if I am meant to take it only once a day (which it now said on my latest prescription box and on other online resources!). I am at the point now where the doctor says that there isn't much evidence that it can prevent preterm labour, after the 28 week mark.

Cyclogest... what has been helping keep the nugget in! Bump at 24 weeks.

Progesterone has been shown to prevent uterine contractions and the softening/ shortening of the cervix (Dovepress). I definitely wasn't comfortable dropping down from two tablets to one a day especially as I know a dip in hormones can have a cascading effect. Even with little evidence that it has much effect, I am yet to find an journal with these details, but the doctor is happier with me continuing with two tablets a day.

I have had some new symptoms though which includes Braxton Hicks! At first I had no idea what was going on. I always imagined them more as very clear contractions and not my tummy going rock hard... and I mean rock hard- I feel like I could crush walnuts on my stomach. I seem to be getting them every few days now but the doctor isn't too worried about that as long as I don't have any bleeding, lose of water or find them painful.

We have pretty good chances now, babies born between 28-31 weeks have a 90-95% survival rate (Premature birth statistics). There are still no guarantees but I feel like I can breath a bit more easily now and actually get ready for my little man. He should hopefully weigh over 2.5lbs now, he has his quiet days where I feel like he's putting all of his energy into growing before having a break and a stretch, kick and punch on alternating days.

Weight gained every week in grams

Babies that are born smaller than 3lbs 4oz still have a higher risk of serious medical complications and disabilities (The Baby Centre). So I guess the focus now is to make sure he's growing, I did find a website where I decided to put the information into graph form of how much weight a baby does put on per gestational week. So our next aim is 30 weeks which will hopefully take us over the 3lb mark if everything goes well.

My cervical length will be checked on Monday but I am feeling pretty good in myself. I don't feel like my cervix has shortened, it's almost like little nugget is moving up my tummy and not down. He has the odd day where he likes punching my cervix but I am feeling pretty good at the moment! So good my partner has persuaded me to go see the new Alien today!

Third Premature Clinic Appointment & Glucose Tolerance Test

Usually I get pretty excited about knowing I'll be seeing the little nugget but today I had the dreaded glucose tolerance test too. Thinking about it, you wouldn't find it too difficult; have a fasting blood test, drink a glucose drink and have another blood test two hours later. Unfortunately for me that involves two things I severely dislike- being hungry and needles. So that meant my 3am snacks were a big no-no, but a good thing for the rest of my household who apparently can hear a cookie packet opening a mile away.

Plitvice Lakes National Park, Croatia with my other half

I did spend most of yesterday wondering how I could get out of the blood test and if it was really necessary. My mum constantly reminds me that all four of her children (including myself) were 10lbs or bigger, considering I'm 5'6 and my siblings are all 6ft and over, I still find it hard to believe I was that big. So the midwife was pretty insistent on me having the test even though my other half is a questionable height which apparently is the optimum; gestational diabetes can result in big babies making for difficult births, heart/lung problems and premature birth (Made For Mums).

I have to say that the blood test wasn't anywhere near as bad as I thought it was going to be considering I was on the verge of a panic attack about it yesterday. They managed to find a vein a few minutes after looking and the needle was in and out before I knew what was happening. I'm so used to them struggling to find a vein and having two or three attempts, I really can't praise the nurses today enough. They did give me lucozade afterwards as the glucose drink, I was pretty happy with myself. I'm a big fan of lucozade and I haven't had a fizzy drink in months. My other half constantly tells me off about my small addiction to fizzy drinks so I was very chuffed when I was given one by a medical professional.

Nuggets presents today

I had my premature clinic appointment in between the two blood tests. The clinic was very busy today because of the bank holidays (the clinic only runs on a Monday). There was good news today, there's been no change in the length of my cervix so we're all quite happy so my next appointment will be in three weeks. I got to see a quick peak at nugget, considering I felt like I was getting punched and kicked all over I was quiet curious to see what position he was in. The little trouble maker has his head down, hands above his head punching my cervix whilst trying to kick my stomach. As the doctor put it the 'superman' position, the doctor could even see his little hand when he was trying to measure my cervix which seems to be staying at about 1.7-1.9cm. So to celebrate a good result we bought nugget a little Elmer teddy and bear hat.

So being 25 and a half weeks today, my best friend has broached the topic of the baby shower! I have to say I'm pretty excited and I have a feeling she has secretly been plotting what she wants to do for a while now. So we're aiming to do it at the end of next month, I'm feeling pretty confident that the little one will hopefully stay in until after then. I should be about 30 weeks by that point. I did find an interesting website about premature births and cervical length. During my 20 week scan I had a cervix of 0.4cm so according to the chart below it would estimate giving birth at less than 32 weeks. The doctors did believe I was about to give birth at any moment at that stage but it's more reassuring to see higher gestational ages. Now that my cervix is about 1.7-1.9 I would be very happy with a gestational birth age of 34 weeks! Only a few more days until we are 26 weeks!

25 weeks + 4 days transvaginal scan of cervix length

Cervical length at 20-24wks (cm)	Mean birth gestational age
1.0	32
1.5	33
2.0	34
2.5	36.5
Source: American Journal of Obstetrics & Gynaecology, June 2000 cited in: http://www.keepemcookin.com

Second Premature Clinic Appointment

Yesterday was my second appointment at the Premature Clinic. The clinic is only run on Mondays so it is pretty busy but it's reassuring seeing other woman who have had a stitch placed and have had similar problems. The clinic also has a board of photos and thank you cards, it's really nice to see how many ladies have kept in contact years later and how many babies have made it through.

I am lucky enough to have my mum who came to the appointment with me, my partner was literally messaging every few minutes from work to check on his little boy. Thankfully my mum is a lady who tries to lift the mood in all circumstances. The atmosphere isn't great in the department however much effort the staff put in to make it welcoming and calm, a bunch of pregnant ladies worrying about their babies doesn't really do much for morale. Especially when not many of us can sit down comfortably for more than 10mins due to the stitch.

I did find myself comparing bump sizes with every lady that walked in. You do find yourself empathising with bumps that don't look much over 20 weeks. Thinking about how I felt 4 weeks ago, this is definitely the hardest and most emotional thing I have ever done. One of the consultants had also put out a new little booklet about success stories of babies born at 24 to 26 weeks. It did make me feel more confident especially as I'm 23 weeks + 5 days today! I'm pretty sure I need to buy a big present once I reach 24 weeks.

So the news... Previously I had 15mm of cervix below the stitch and 21mm above the stitch. I now have 17mm of cervix below the stitch and above the stitch has opened with funnelling. Now the doctor wasn't concerned about this as the stitch was holding and I still had length below it. I felt like it was a step backwards especially when I heard the dreaded term- funnelling.

Little nugget is happy though, kicking away as usual, completely oblivious to how stressed he makes his mummy. He decided to move head down for the scan which is unusual for him as he really takes great enjoyment in kicking my cervix as hard as possible. I am actually starting to think he uses it as target practice, the similarity between him and his father is funny.

Even though I wasn't particularly happy with the length of my cervix, the doctor did an estimate of how big our little nugget is. Considering all my family were big babies- my mum is constantly reminding us of how we were all over 10lbs. I was quite curious to know how nugget was doing knowing how the bigger he is the better his chances are. His measurements gave an accurate 23-24 week gestational age but he weighs approximately 1.5lbs (660g) which puts him at the weight of a baby at 24-25 week gestation.

So the little one still has some way to go. I'll be back in the Premature Clinic in a fortnight again to check if there's any difference. If things get worse there is talk of starting to get ready for baby making an early appearance, in that case we'll be admitted into hospital and will start on the steroids to get his lungs ready. Until then the focus is going to be on what to name the little trouble maker.

Get Well Card

One of the best things about being a teacher is how sweet my students can be- look at my 'Get Well' card! I haven't quite built up my muscles or confidence yet to really start venturing outside. Compared to the daily excitement that my students used to provide, the lack of fresh air and mental stimulation is really affecting my morale and gives me a lot of time for my mind to wonder. It is all quite challenging. At the moment it seems to be visits to the hospital that really get me out of the house. Alongside the progesterone tablets and typical pregnancy hormones my moods are on a roller coaster so when I got a card from one of my classes today I was very emotional.

The doctors and my SO (significant other) have been stressing the importance of moving around. Pulmonary embolisms are more common in pregnant woman which my SO keeps reminding me. He used to do scans on pregnant ladies as he is a radiographer and has no problems giving me a mini-lecture to make sure I'm at least making an effort to be more active. I do worry that there's only a little piece of nylon string helping to keep the baby inside for hopefully more than 2 weeks.

I think I was a lot more positive yesterday, today I made the mistake of doing another internet search. My attempt this time to see how long a typical cervical stitch lasts... I ended up reading a lot of experiences on forums about ladies whose stitches/cervix's didn't last past the 22-24th week. My heart really goes out to these ladies, considering I never thought I could have a family it feels so close, it is literally days that seem to make a difference.

Different doctors have said a range of different expectations of my cervical stitch. Whilst in hospital one doctor (who placed the stitch) said the stitch typically can last about 5 weeks, whereas during my premature clinic appointment there were talks about having the stitch removed at 36 weeks and quite a lot of optimism. Whilst the doctor actually saw my cervix and placed the stitch, the premature clinic are the ones who usually monitor the stitches. Then again this is all trying to predict the unpredictable using the worried mind of a stressed pregnant lady.

First Premature Clinic Appointment

Today I am 21 weeks and 4 days! It has been 9 days since the emergency cervical stitch was placed and I just had my first appointment with the premature clinic. I am really happy to say that the funnelling has decreased and the stitch placement is looking good! It has definitely started the week off on a high.

I was extremely lucky to have my sister, mum and partner all there for support this morning. It is really amazing how reassuring and comforting it is to have family around at these worrying times. I didn't quite know what to expect today but everything does feel a lot tighter and plugged up down there since the stitch and the progesterone (cyclogest) tablets. They really have worked wonders and I now have 15mm of cervix below the stitch and 21mm above the stitch.

Trans-vaginal scan 21 weeks + 4 days

I was quite confused though as the doctor had previously told me when scanning the morning after the operation that there was 24mm below the stitch. This had been done with an abdominal scan, which I know aren't as accurate, and it could have been the whole length of the cervix. I was still quite shell shocked by everything at that point and I can't find his measurements within my notes.

Nevertheless, I am now very proud to say I have a cervix of 36mm overall, which is the ideal length! I just hope it now stays that way. There were lots of thoughts that had gone through my mind with having the stitch and short cervix- the main being infection. Infection can cause premature labour but with a longer cervix it should be more difficult for bacteria to enter.

During the appointment the doctor did the usual check and update on how I have been doing. It was quite crowded with the doctor, midwife, student and my entourage in the room! They also didn't have curtains for you to get changed behind, considering the past couple of weeks I feel there's not much left to hide. My lovely partner kindly came to the rescue and helped cover me with a towel before the trans-vaginal scan began.

Now baby has been doing cartwheels in there since yesterday and he also decided to move feet first. He often takes joy trying to kick his way out through my cervix. So his placement did make it harder to see the degree of funnelling but I felt better that his head wasn't getting ready to pop out. He also thought it would be fun to kick as they tried to do the measurements which did make me laugh. Every sonographer has always remarked on how active he is... hyperactive just like his daddy.

What made me laugh even harder was the doctor broaching the topic of no sex when there's a stitch in there. We had discussed how to prevent infection; don't use soap when cleaning down there, don't try to clean within the vagina and only have showers. When the doctor looked at my caring partner who was just helping me put my shoes back on and muttered the 'no sex' statement. I did have to bite my lip to stop myself from laughing. My partner seems convinced my mum has trained my chihuahua to go for his man area so I don't think that will be an issue.

Face of a little angel!

I still don't think I will be completely content until we do get to the 24 week mark and I have my next premature clinic appointment in two weeks time. I know that my EDS (Ehlers Danlos Syndrome) plays a factor which is often not really considered by doctors but I am feeling a lot more confident in my little nugget.

What is it like to have a cervical stitch?

I still feel I am very much coming to terms with having a cervical stitch. Having it for just over a week, it has still been a rollercoaster and something that is constantly on my mind. The doctors managed to extend my cervix from 4mm to 24mm (with the typical cervix during mid-pregnancy being 35mm). I never thought I would be jealous of another womans cervical length! Scouring forums often leaves me thinking the worst and regularly leaves me in tears, reading about ladies with lengths of 15mm pre-stitch we just have to remember we have all been in this terrifying position.

20 weeks + 1 day cervical scan

So I thought I would put together a list of questions I would have liked to have known the answers to...

1. What was the epidural like?

Talking to my mum about it afterwards we both had completely different experiences with the epidural. It felt like someone had dribbled some warm fluid down one side of my back whereas my mum found it very painful. The epidural was more effective on my left compared to right which was a very interesting experience because when it eventually wore off my left side took much longer to regain sensation. The doctors test to see if it's working by putting a cold spray on you to see where you can feel it, I think I lost all sensation below my belly button. The doctors then cover you up so you can't see whats happening.

2. Is the stitch painful?

I didn't feel the doctors put in the stitch but I could feel it afterwards. I had very sharp pains on my left and right side near my cervix following the operation. This could have been due to the little one lying on my cervix (just for fun!). The pain is quite dull, bearing in mind it is an operation I wouldn't be surprised if there was quite a bit of swelling. The more I move around the more painful it gets, but sometimes the pain only subsides if i get up! It also hurts if I need to visit the toilet for a more lengthy visit.

3. Can you feel the stitch?

I can feel the stitch, at first I really did panic as to whether this was normal. It feels a lot tighter in my lower pelvis compared to before. It almost feels like there is a tampon left in there, so very different to when there wasn't much left of my cervix.

4. What do you need to be careful of?

Keep everything clean! The risk of infection is big in terms of stitches, making sure everything remains clean is all I think about for hours on end. Bacteria from the vagina can enter the cervix and cause the membranes to rupture and just can't be prevented sometimes. I feel better knowing I am doing everything I can... disinfecting the toilet before every use, only having showers, using alcohol hand sanitiser and not using scented shower gels.

5. How often should you have checkups?

This was the first question on my mind. The doctor scanned me the next morning to check on the baby and stitch but after that it is up to the premature clinic to see you. Do not leave the hospital without that appointment! They don't like repetitive scanning so we'll only find out what is happening on monday during our first premature clinic appointment where I am hoping they will scan.

Cervical Stitch - 21 weeks and 2 days pregnant

It has now been a week since my emergency cerclage, also known as a cervical stitch, and I am still resting in bed. With another 19 days to go until our viability aim it looks like bedrest is the main thing on my agenda. I currently have three different countdown timers on my mobile including tickers, days until due date and the 24 week mark, it is quite reassuring seeing each day pass but I do feel incredibly lucky just to have these days with my little one.

The little one at 3 months

Like most of the ladies I have read about on countless forums I had gone in for my routine 20 week anomaly scan. Thinking that everything would be quite straight forward I brought my younger sister as well as my partner. Even though the sonographer seemed to be muttering the measurements of the baby to herself, everything was perfect with our little one kicking away. That was until something didn't look quite right on the screen.

My cervix was measuring 4mm with funneling, at the time we thought she had said 4cm and didn't quite see what the fuss was about. Now for those who do their research you'll find-

At 24 weeks gestation, the average cervical length is 3.5 cm. When cervical length is less than 2.2 cm, women face a 20 percent probability of preterm delivery. (Source: The Length of the Cervix and the Risk of Spontaneous Premature Delivery. New England Journal of Medicine; February 29, 1996; Vol. 334, Number 9: 567-572.)

So we were rushed up to the labour ward where my mum soon joined us. I did not expect to see the inside of those rooms for a good few months yet. By the constant rush of doctors and midwives coming in and out of the room it started to dawn on me how serious the situation was. It was then that they gave us three options: 

1. Leave everything as it is. I could have been walking around with a short cervix for a while without noticing- I had been feeling increasing pressure on my cervix the past few weeks.
2. Progesterone. This was offered to help reduce the funneling and encourage the cervix to close.
3. Cervical cerclage. This involved putting a stitch in the cervix to regain as much of the cervix as possible. The issue here was that there was a 30% chance of miscarriage due to the membranes rupturing or manipulation of the cervix causing contractions.

So naturally we wanted to go for the safer low risk option, the progesterone. It was only when we saw the doctors face that we realised we didn't really have an option. When my partner heard the words 'hormones would be too little too late', our decision was made. Before I knew it I had signed some forms and was in a hospital gown.

In all honesty the worst part was actually having the cannula put in. Anyone who knows me well can explain my severe aversion to needles. Now this is with good reason, it was only on the third attempt that they managed to find a vein. I just wanted to get into the theatre at this point. There were so many people in the theatre I could not remember all of their names, I can hardly remember what I spoke about in there- I think I was talking about my college and students.

One week later and still feeling very bruised

The whole procedure lasted about 50mins, that included putting in the epidural and waiting for it to start to work. I think I should mention at this point my partner had ordered pizza (someone has been comfort eating and it's not the pregnant lady) so my entourage was missing when I came out of surgery. On the plus side when they were found I had a whole tuna pizza and found out my partner had somehow managed to eat 14 chicken wings.

I stayed in hospital overnight with my partner watching over me, no one tells you how hard it is to actually urinate after an epidural and stitch by the way. The amazing news was that the doctor managed to regain another 2cm of cervix so it now measures 2.4cm but still with funneling. After another night of monitoring I was discharged.

I was probably only home for two hours before I was back in maternity triage with active bleeding from my cervix. Did you know that emptying your bowels could irritate your cervix? Another night of observation with the love of my life sleeping in a very uncomfortable chair next to me I was then ready to go home.

... and here I am now. I have heard a number of different doctors state a number of different weeks the stitch could make it to but it seems 24/25 weeks seems most realistic due to my ehlers danlos syndrome (collagen deficiency so everything is more stretchy). Every day really is a gift and I'm hoping to see him on monday during our premature clinic appointment. Each hour my little baby keeps getting stronger and I feel so lucky to even get this far.

Mummy, daddy and bump at the Baby Show 4th March 2017