Why do you want a transabdominal cerclage?

After experiencing the loss of my son, there is nothing more in the world that I would want for my family other than to be happy again. Happiness, in my mind, equates to having the opportunity to have more healthy, happy, beautiful children living here on this earth. Children who will live full, long lives. Children who my husband and I can see off to college, walk down the aisle on their wedding days, and who will have multiple grandchildren. Nothing will ever replace the loss of Ezekiel. He will forever be in our hearts and in our minds. But until the day we can be reunited in Heaven, I know that I must carry on as a mother and a wife. In order to do this, I am dependent on my faith and am hopeful for a joyful future. This is the only way I can continue on day to day.

Ever since my hospital stay in April, I recalled reading about a transabdominal cerclage (TAC). I searched for various sources of information and became intrigued about this procedure. While a TAC is viewed as a more invasive procedure reserved for women who have encountered multiple losses, I felt compelled to read more about it. I wanted to know everything I possibly could get my hands on about the TAC. The who/what/when/where/why/how that the internet could provide, I read it! I have stayed up till dawn reading all of the information. I read all about the success rates of a transvaginal cerclage vs the transabdominal cerclage. I worried. I prayed. And then I found abbyloopers and some excellent blogs of women like Beyond This Desert who have been on a similar journey and wanted to do what they could to prevent another loss.

I should also preface that while I was supposed to have my 2 week follow-up appointment after the loss of Ezekiel, the doctors in my OB/GYN group kept postponing my appointment. My real OB/GYN was on medical leave prior to everything happening. Her partner that delivered me was out on vacation and the other partner, my angel physician at the hospital, had just gone out on maternity leave. My preference would have been to discuss my cerclage options with them prior to my research but I had to keep researching until my appointment with one of them.

I pray desperately to the Lord telling Him how I badly want to have more children with my husband. How I want my daughter to have the opportunity to be a loving, big sister to her siblings. While I actively still pray this prayer throughout the day, I knew I had to do something to help give me peace of mind to attempt at preventing my cervical insufficiency from ever happening again.

My son was born with no genetic abnormalities. He was absolutely perfect. During my stay at the hospital, I showed absolutely no signs of infection. I have never had any surgeries completed on my cervix. I have never had an abnormal pap smear. While I boggled the minds of the physicians at the hospital on why this happened to me, I knew there had to be something that could be done so that I would hopefully never have to endure this again. The answer to this is to get a cerclage and there are two options: a transvaginal cerclage and a transabdominal cerclage. When it comes to medical options, in my mind, the higher the rates of success towards a healthy, full-term baby, the better. The transvaginal cerclage only guarantees the pregnancy to viability ~80% of the time. This requires women to be on bed rest. Bed rest for more than half of one’s pregnancy is not attractive to me at all. Of course, a mother will do anything to ensure the health of her baby. But the costs of being immobile while not being able to live a normal life while pregnant with increased chances of blood clots did not sound appealing to me.

I live in New York City. I don’t have a car – I walk everywhere. My husband is a Marine Corps recruiter who is rarely home. I have a six year old daughter and a dog that I need to take care of. We have minimal family or friends here in the city and our whole support system is located in San Diego, California. I work full-time and I travel occasionally for work. If God allows me the opportunity to get pregnant again, being on bed rest is not an option for me. Again, if it can ensure a healthy, happy baby and pregnancy, I would immediately gravitate to the transvaginal cerclage. But I knew there had to be another option. And, indeed, after much searching…there is!

A pre-pregnancy transabdominal cerclage can be performed laparoscopically or through an open surgery. In some cases, the procedure can be completed in the outpatient setting. And when it comes to pregnancy, the higher the percentages the better. A transabdominal cerclage can guarantee a full-term baby ~95%. At a higher percentage rate to full-term birth, the avoidance of bed rest and the avoidance of a potentially long NICU stay for baby – the transabdominal cerclage was a better choice for me.

After reading all about the procedure, my next step was searching for physicians who completed the procedure here in New York. I searched for maternal fetal medicine specialists who specialized in cervical insufficiency. I searched for clinical trials in hopes of identifying a renowned key opinion leader on cervical insufficiency located here in New York. To my dismay, there were only a few. When I saw various reviews of physicians who were referred to as “baby killers” or “she became upset with me that I didn’t take her advice and handed me off to a resident”, I began to get very worried.

After going on Abbyloopers, I saw multiple references to “the Big 3”, the three physicians in the world who were known for completing successful transabdominal cerclages. One of them was previously in New Jersey and had relocated down south but was now retired. The other closest one to NYC was Dr. Haney in Chicago. While I would have ideally wanted a physician close by, the reviews on Dr. Haney were a stark comparison to the physicians I had read about in NYC. Various patients over a several year period discussed how Dr. Haney wiped their tears away, how he was compassionate and funny, and how he was a miracle worker. I prayed and discussed this option with my husband. He supported my decision 100%. And thus begun my TAC journey.