DAY V // The Unspoken

Havey is ..  

1 in 100 babies born with a congenital heart defect (CHD).  

Her mama is ..  

1 in 4 mothers that experience Infant Loss shortly after birth due to some type of birth defect (in our case, CHD).  

and is 1 in 100 women that are diagnosed with Incompetent Cervix.  

My daughter and I are that number -- that 1. 

Coming from the healthcare field firsthand, our recent situation was extremely difficult and different for me and to be on the opposite end of the spectrum. For me to be the one receiving care, taking medications, being rounded on, having an IV placed in, and being "helpless" on that hospital bed on bedrest. It was hard for my husband, Paul as well, as we both come from this same field of work. 

Looking back on my time in nursing school, I remember learning about a vast number of diseases, conditions, and diagnoses. I recall before diving in deep into the lecture of every if not all disease processes, our instructors + professors did a good job on going over the statistics and numbers. Not once did it ever cross my mind to be a number some day, more so my very own child/ children. I think there's something about being so "young" and being on the other side of healthcare that makes you not think of certain aspects of it so literally. We, for a fact didn't see this one coming. 

After we learned of Haven's heart defect at her 20 week anatomy scan, Paul and I began studying and researching CHDs a bit more closely and intentionally than we both did while we were school. We went so far as to re-memorize and re-draw the heart, its' chambers and functions. Though we were fearful, anxious, and scared to death that this would soon be our reality, we wanted to both have attitudes of readiness for what was coming our way in just a few short months. I came across other "heart mamas" and their "heart warriors" on social media, Instagram to be more specific and got an immediate spark. Reading many inspiring posts, stories, and testimonies gave my family and I, a more promising sense of relief and hope that our Gavini Babe and us were going to be okay.

We then started to believe that we were able to handle this "one unexpected" obstacle during our pregnancy.

We thought wrong.

At my 6 month checkup, I asked my high risk MFM (maternal fetal medicine) MD to check my cervix before leaving her office. Her next words were ones we didn't think possible. "Myra, I have some bad news ... again ... your cervix is 2-3cm dilated and the bag of waters supporting your little one is bulging out... " My initial thoughts were, "There is no way this was happening - There is no way this was me - Not again - Not something else gone wrong - What did I do - Did I do something wrong - It's my fault - I'm going to lose our first born, our first ever pregnancy - How did this happen" -- all this, and more. I immediately knew my newly diagnosed condition's name without my doctor having to tell me. We touched on this process briefly in Obstetrics theory class and once again very "quickly" when studying for the NCLEX (National Council Licensure Examination for RNs - Registered Nurses).

Incompetent Cervix (IC). 

I decided to focus and re-learn/ study my condition for today's topic of "The Unspoken" and do so here on the blog. If you're reading this, thank you for stopping by. If you're reading this and also happen to be diagnosed with the same condition or know someone that is, I'd love for you to please say hello and shoot me a DM on my Instagram or an email. I'd very much like to get to know you and your testimony on a condition that is easily overlooked in pregnancy. You, my sweet friend are not alone and if you'd let me, I'd very much like to walk down this road with you. 

Incompetent Cervix is also known as Weakening of the Cervix and/ or Cervical Insufficiency. The cervix is the bottom part of the uterus. An incompetent cervix causes the cervix to begin dilating (widening, opening) at the 4-6 months of pregnancy. In normal cases and most of the time, the cervix remains closed for the full 9 months of pregnancy. Having this condition causes the cervix to dilate without any pain or contractions -- an aspect that makes it so scary to have -- commonly resulting in either miscarriage or pre-term labor and delivery of a baby.

Causes for having an Incompetent Cervix are: certain medicine (i.e. diethylstilbestrol (DES), previous cervical trauma from other births or surgery, the change in hormones during pregnancy, or an abnormal cervix or uterus. Certain that I am free from all causes except the normal change of hormones in pregnancy -- I simply am just that 1 in 100 cases. 

Signs and symptoms of this condition include: backache, a gush of fluid, discomfort or pressure in the lower abdominal section, mucousy vaginal discharge, a lump in the vagina and pain during urination. Also, none of which I experienced. I did though notice, 2-3 instances of light spotting around my 20 week mark. Frightened, I immediately let my doctor know. She asked me to observe the quality and quantity closely and to let her know if there were any significant changes. I did and there weren't. It remained steady and consistent the next and last 2 times around. So we both believed it was just part of the "normal" pregnancy spotting occurring. 

IC is diagnosed by ultrasound or pelvic exam. All ultrasounds leading up to our 6 month checkup and scan were normal. I did not get a pelvic exam until our 6 month check up. And it was then that it was too late to receive any medical intervention. Three options were then given to us by our doctor --  1. The "wait and see" game - going back home, resuming day to day life and to wait + see what Baby G was going to do. 2. Induction of Labor - using medicinal intervention (i.e. IV Pitocin) to stimulate labor prematurely, resulting in premature birth of our baby. 3. Emergency Cerclage - an invasive procedure used to place/ sew a stitch in my cervix to keep it shut for the remainder of the pregnancy up until weeks 36-38 to remove it and prepare for a more normal labor and delivery timeline. At this point, Paul and I refused to believe that these were the "only" possisble options available to us. In the few hours, we were admitted to the hospital to meet the vast members of a larger healthcare team (nurses, NICU team, anesthesiologists, pediatric cardiologists, social workers, hospital chaplains and L&D doctors) and to learn more about the options available to us.  

Thankfully, there was another high risk MFM MD that we instantly knew was God-sent and gave us the option of hospital bedrest. And after 11 days of this, Haven made her grand entrance. 

At my first checkup post the delivery and birth of Haven almost a one month and a few weeks ago, my MFM educated Paul and I about the future we need to be aware of when thinking + trying to become pregnant again. Since the birth & delivery of Haven, one of the most important lessons we've learned of is the acknowledgement of my condition and what we can do now that we are more aware. I anxiously anticipate a future of receiving a cerclage preventitively during every pregnancy around 12-14 weeks to help keep my cervix closed -- something we didn't have a chance to choose as a cerclage is no longer normally used after 24 weeks (which I was) and also because my bag was already bulging; going in would only increase the chances of Preterm Premature Rupture of the Membranes (PPROM), increase chances of infection and delivery of the baby early. Along with cerclages, I'll be receiving weekly Progesterone injections. Progesterone, a hormone known to supplement a pregnant woman by reducing the risk of premature birth if one has experienced premature birth in the past. It is known to help decrease the inflammation around the cervix and somewhat "calm/ relax" the tissues to prevent early cervical softening and dilation. 

My "Unspoken" of today's topic is the unspokenness of this condition, IC and how its' forever changed my future + outlook of my life. I still don't know too much about it but the pregnancy and birth of my angel and the becoming more aware of it, is what makes me hope to bring and shed more light on this overlooked, "Unspoken" topic in pregnancy. 

 

If this is you. If you are a 1 in the 100 of Incompetent Cervix. Or 1 in 4 experiencing Pregnancy and Infant Loss. Or parents to the 1 in 100 of babies born with CHD. Let's talk about it. Let's talk together. Let's get going. Help me turn the Unspoken to the Spoken of.