A Stitch in Time

November 1, 2011
Jenn Smith
Jenn Smith

My story to share is a long one of loss, hope and success. I will never forget when my husband and I finally made the decision to start our family. We had so many dreams and mapped out a plan for our lives.

My story to share is a long one of loss, hope and success. I will never forget when my husband and I finally made the decision to start our family. We had so many dreams and mapped out a plan for our lives. We thought we would have 2 children, maybe 3 and all very close in age back to back. Funny looking back how a plan can go so astray and the realization that you can plan all you want but life has a plan of its own.

My husband and I met in 1986. I was 19 and he was 22. All my life I knew I wanted children but my husband had always said he was not interested in having children. During our dating years my husband slowly changed his mind on the family issue and thought maybe he did want children after all.

We were engaged in 1988 and married in 1990. We discussed our hopes and dreams for a family quite frequently. One thing we definitely agreed on was we preferred to wait for 3 years before trying to conceive. We wanted to buy our first house and be well established in our careers. I was special education teacher and my husband a computer programmer. We purchased our first home in 1992 and one year later we started to try for our first baby. Waiting the 3 years before trying to conceive would be the only part of our plan that worked out as you will come to see as you read on.


First pregnancy ( Sept.1993) Our first loss

In September of 1993 I found out I was pregnant after 5 cycles of trying. We were head over heels ecstatic! We ran out and bought our mothers Grandma brag books, wrapped them up and invited them over to announce the surprise. What happened next was not in our life plan, it changed our perspective on life and definitely changed how we viewed pregnancy.

I started out having a normal pregnancy with no prior history of gynecological problems , loss, or miscarriage in the family. The doctor I was seeing was brand new. I had a doctor who was wonderful but wanted to go to someone else closer to home and work. During my pregnancy I was working full time and was feeling great. One day at 23 weeks of pregnancy I experienced a continuous leaking and urination sensation. I had a prenatal appointment that day so planned to ask about the problem at that time. At the appointment, I told the Doctor that I felt soaked from a day of wetness and he explained wetness in pregnancy is normal for the week I was at. I really wanted him to check this out but he didn't feel an internal necessary since I would have other symptoms if I was leaking amniotic fluid. I was really naive since it was my first pregnancy and didn't know better. The next day the wetness continued nonstop and later that evening after dinner I had a mild stomach ache and discovered some red spotting. I immediately called the Doctor who said it is common to bleed if we had intercourse or if I was constipated. We did not have intercourse and I was not constipated so my husband and I went to the hospital for reassurance. During an internal the nurse discovered the cervix to be 3-4 centimeters dilated and membranes bulging. My Doctor was called in and a McDonald rescue cerclage was placed. Overnight they gave me terbutaline and magnesium sulfate IV in an effort to stop contractions. Late afternoon the next day I was transferred to a high risk hospital and it was there I was told by the perinatologist that the cerclage needed to be removed due to a fever that was detected. I had no fever prior to cerclage placement. Eight hours later I delivered Michael Scott who died in my arms after 45 minutes.

We were devastated and scared not knowing where to turn for answers. I could not even return to the wonderful doctor I had prior to pregnancy. He tragically passed away 1 week after my loss due to a sudden heart attack. His death only added to our sadness. I went back to the doctor at 6 weeks postpartum hoping for some input or opinions as to what had happened. He gave us no comfort or answers and all he could say was "Yes, it's sad but these things happen". The rest of my exam was done in silence . I told the doctor that we would be switching to someone high risk. On the way out, the doctor's final comment was that we would be lost in the system and be viewed as a chart number in a large group of perinatologists and he added a good luck statement. My husband and I grabbed his good luck comment, stuffed it into our grief and walked out the door.

I began to look into the group of high risk doctors that were at the hospital I had been transferred to for the delivery. I made a consultation appointment with one of the perinatologists and during the meeting it was the first time we heard the term "incompetent cervix". We left the appointment feeling more hopeful that at least someday we might carry to term with the help of a cerclage. We waited 8 months and started the pregnancy journey again.

Second pregnancy ( Spring 1995) We switched to a perinatologist.

Based on the history of my last pregnancy and results from an HSG test a preventative McDonald cerclage was placed at 12 weeks, before cervical change. Our perinatologist was optimistic and reassuring. His more frequent prenatal care was what we needed mentally to get through the pregnancy. I was still working full time and the pregnancy started out much like my first one, very easy. I ended up having an uneventful pregnancy with no preterm labor, bedrest or restrictions. I had not been a chart number and the doctors were caring and helpful. My cerclage was removed at 37 weeks and I delivered our son Paul Michael 10 days early via c-section due to 12 hrs of labor and he did not clear my pelvis. Paul weighed in at 8 pounds 8.6 ounces and is now a healthy 3 1/2 yr. old.

Third pregnancy (Fall 1996) Our second loss

We decided to wait until Paul was at least a year and a half old before trying for another baby. As luck would have it I found out I was pregnant when he was 18 months old.

The cerclage worked so well for my son that I had a preventative Shirodkar cerclage placed before cervical change at 12 weeks. One week later, I went in to have the cerclage checked for healing. All seemed perfect during my internal but afterward the doctor had a difficult time locating a heartbeat with the doppler. I was sent to ultrasound and my worst fears confirmed, the heartbeat had stopped what looked like days before. Two days later I had the cerclage removed and a D&C was done. The fetal chromosomes were studied and through the study we found out it had been a girl.

This loss brought more disappointment and shock. We felt like life was never going to cut us a break, after all we felt we paid our dues with our first loss. We watched as our friends all around us sailed through their pregnancies and this was difficult to watch.

Again we picked up the pieces and moved on. It was determined that the miscarriage was one of those things that may not reoccur. Several months later I was happily pregnant again.

Fourth pregnancy (Spring 1997) Our third loss

This pregnancy started off a bit differently. I had red/ brown spotting and bleeding on and off from weeks 6-13. We also had CVS testing to check for chromosome defects before placing a cerclage. When spotting stopped I had a preventative Shirodkar cerclage placed at 14 weeks. I was expecting the pregnancy to progress as easily as it had with my 3 1/2 year old son, but this was not to be the case. On and off I felt intense cervical pinching during week 20. An internal exam indicated that the cervix was closed and cerclage still positioned correctly. Pinching continued into week 21 and late afternoon one day I saw a pin dot of pink spotting. I called the hospital (it was a Sunday) and was told by a different doctor to hold off coming in since the spotting was not that alarming. My husband and I went on our instincts and went in regardless of the advice. At labor and delivery during an internal it was discovered that my cerclage had broke loose and my membranes were bulging with dilation of 3-4 centimeters. They placed me on a monitor and discovered contractions occurring every 3-4 minutes and I was not feeling any of them and had no pain except the cervical pinching. We immediately tried IV magnesium sulfate in an effort to stop the contractions. The plan was to leave the cerclage in until morning and if no fever developed we would have a rescue repair in the morning. Eight hours later my water broke and the broken suture was removed. After 10 more hours of labor I delivered Mary Kathryn stillborn.

Now my husband and I were not only sad but very angry. We had mistakenly assumed that once a cerclage was placed it would be an automatic carry to term. We did not realize a cerclage place preventatively could fail. We felt like we were looking at a bad dream from the outside looking in. The loss was similar to our first loss and at the same point of pregnancy that we just couldn't believe it. My husband at this point said he wanted this pregnancy nightmare to stop. He did not want to try for any more babies and thought we should take our precious Paul and call it quits. I on the other hand was not going to give up on my family dream and over time my husband went along with my plan even though we had absolutely no faith in cerclages at this point.

Fifth pregnancy (Spring 1998) The miracle baby

We had been trying for 4 months to get pregnant. All of those cycles I had mid cycle spotting at 8 days post ovulation that was making it impossible to track ovulation. On cycle try number 4 (and after 3 broken mercury thermometers and wasted OPK kits)I decided to go for an exam in an effort to figure out why I was having such short cycles. We decided to have an endometrial biopsy done at 8 days post ovulation. The doctors office did a pregnancy test on the day of biopsy which showed negative. When I never got my period I called and was told the urine test they did was pretty reliable but they would give me the results of my biopsy after I got my period so just relax and wait until I get my period. I had never been late and not pregnant so I tested again at 16 days post ovulation and it was positive. The doctor placed me on progesterone suppositories that day even though my biopsy showed a normal level but mid-cycle spotting was unexplained. This pregnancy was the first one I did not have to worry about bleeding and spotting early on with the use of progesterone. My husband and I commented that this was by far our easiest beginning to a pregnancy yet. A preventative Shirodkar cerclage was placed at 11 weeks. I decided early on in the pregnancy that there would be no AFP testing or CVS testing. We also did not want anyone to disclose the sex of our baby during an ultrasound. We absolutely could not face the idea that if I was carrying a girl, we might lose another again. At 12 weeks I went back to check the cerclage for healing and all was found to be well. The weekend after my internal I saw red spotting with some small clots. I called the doctor's office and was told it was most likely from the internal exam.. I had never experienced red bleeding clots a week after my previous cerclages and felt this was not normal spotting. My husband and I again went on our instincts and asked for an ultrasound that day. The ultrasound revealed that just slightly less than 50% of my placenta had detached and abrupted. Baby was still intact with a heartbeat.. I was hospitalized on the spot for 6 days and given daily progesterone shots (ouch!). After 6 days I was discharged and baby was hanging in there. One week later (14 weeks) I had another ultrasound and my placenta still remaining continued to grow well, the rest torn away formed to clot. I never had further heavy bleeding after the week I was hospitalized, just some light spotting for awhile. At 18 weeks on an ultrasound my cervix appeared to have shortened and by week 20 ultrasound I was funneled down to my cerclage. I had been on 24 hr bedrest since mid July( week 12). I only got up for meals, bathroom and weekly appointments. The finding that my cerclage was all that was holding the pregnancy scared me to death. I had visions of the cerclage pulling out once again. I had an ultrasound every 3 weeks and baby's measurements were on target for gestational dates and the outside of the cervix was staying closed. The part of the placenta that remained attached continued to function and grow well, the abrupted section formed into clot. I continued to go along in the pregnancy with weekly internals and much uterine irritability. By week 18 contractions were making me crazy with fear. I was started on Brethine as needed for contractions. I also had home monitoring as extra reassurance to keep an eye on contractions. My past history was the contractions I had that I didn't feel are the ones that cause the cervix to change. Nothing was to be trusted at this point. I also started steroid shots from week 24-34. At 30 weeks we were getting optimistic that perhaps we could beat the incompetent cervix deal and the potential problems the abruption could have on the baby. I was really feeling fine as far as contractions at this point and just prayed to make it to week 37. At 34 weeks my internal revealed more cervical change, but I felt so good and didn't notice contractions so I figured I would go all the way.

As I mentioned before I did not want to know the baby's sex but I secretly felt it was a boy. In my mind I thought no way was God going to give us a third chance at a girl. Having one girl and one boy would be asking for too much we felt. I figured it was a boy for 8 months because my doctor called it a gangster at every ultrasound and I figured that term was gender specific (LOL)!

On January 12,1999 at 35 weeks and 1 day I awoke with my water leaking. When I stood up it broke! I didn't even feel contractions leading up to this. I was actually very calm but my husband was nervous. My only concern was the cerclage was still in place and I was upset because I had hoped to have a VBAC delivery without the epidural. I had to have the epidural placed in order to remove the cerclage so again our plans went out the window. I was dilated to 5 centimeters when the cerclage was removed and 3 1/2 hrs I delivered but not without further excitement in the delivery room. The baby's heart rate decided to decelerate and 3 vacuum attempts were made and finally with the help of forceps the baby was delivered. I will never forget the 3 little words my husband blurted out as the baby made its entry "ITS A GIRL"! (Oh no and all I brought to the hospital was a blue snow suit!) All our dreams came true! Katherine Anne (named after our previous loss) weighed in at a whopping 6 pounds 5 ounces! There was no mistaking gestational dates with all the scans I had, we were just lucky. She was absolutely perfect and breathing fine with no assistance. We ran into a jaundice problem on day 2 of life that required a one week stay in the NICU.

The NICU was a scary experience. All the babies that shared the pod where Katherine was were very premature and struggling. My husband and I experienced the realization of what could have been for us in the NICU.

Katherine is of course a spoiled treasure and big brother is absolutely head over heels in love with her. She is smothered in kisses by Paul who by the way used to say "Girls are yucky"! Friends, neighbors and family have showered us with gifts for Katherine.(She has at least 35 outfits in her closet at this point).

My husband and I are in loving awe of her existence. We thank our excellent doctors for giving us hope when all we felt was desperation and as the lyrics written in a song "Blessed" by Elton John suggests "We are Blessed".

 

Scott and Jenn

Paul and Katherine Anne

 

Brotherly Love

Katherine's Christening Day