You are your best TAC advocate

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If you decide to get a TAC, brace yourself for the opposition you will be receiving. Stick to your gut and pray about it. Be your own advocate because, sadly, there won’t be many out there.

My OB/GYN’s office is literally downstairs from my apartment building. When I exit my building to the right, there it is. I walk by her office every day. Last summer, when I saw her new office being put in place, this was the light bulb moment in my head that triggered me to think, “I think this is a sign we should try for Baby #2 again!” Shortly after her new office was established, I scheduled my routine appointment to remove my IUD. One month later, we were pregnant.

Fast forward six months to May 2017. I had my follow-up appointment with my OB/GYN 6 weeks after I delivered my son. It should have been sooner but due to her being on medical leave and all of the activities with Zeke’s funeral, this was the earliest I was able to see her.

I had already made up my mind to get the TAC before I stepped foot into her office. Still, her medical expertise was something I welcomed and was open to hearing.

I walked into my appointment and cried explaining my story when she asked about what happened. But then I bucked up, took a deep breath, and told her a detailed explanation of what happened. After I had delivered Zeke, I declined an autopsy for him but said they could test the placenta and me as much as they liked. She reviewed my pathology report with me. The results of the pathology report noted chorioaminiotitis. My doctor admitted that there was no way for anyone to know if the infection occurred before or after my cervix opened. The duration of my hospital stay, I presented with no signs of infection.

My doctor was extremely empathetic and shared her own story of miscarriage which I appreciated. True to my nature, I started to ask questions about my plan.

Me: When can my husband and I try to conceive again?

MD: 6 weeks after your loss, so you can try now.

 

Me: I’ve been researching a lot about the transabdominal cerclage. Are you familiar with the procedure?

MD: I have not personally managed anyone with a transabdominal cerclage. I do think it’s too invasive. This is only recommended for women with multiple losses. You will have a hard time getting pregnant because sperm cannot get through. You will need to do IVF to get pregnant. If you do choose to get a TAC, I would refer you to Columbia. They have the best high risk specialists and one of the best NICUs in NYU.

 

At this point, I controlled my face because I was not pleased with her response. Having a TAC does not automatically mean that a woman will have a hard time getting pregnant.

 

Me: If you refer me to Columbia, will you still be my doctor?

MD: Yes, but then you would also begin to see a Maternal Fetal Medicine specialist at Columbia and they would deliver you there.

 

Me: So when would I see you?

MD: For follow-up appointments.

 

Me: If I get pregnant again, how would you manage my pregnancy?

MD: I would complete a McDonald stitch, a transvaginal cerclage, after the first trimester. I would start to complete ultrasounds every two weeks starting at 16 weeks to monitor cervical length since this is the only definitive way to measure the cervix.

 

She reminded me again that her job was to provide me the information in the literature and that my job is to make an informed decision on the information I receive and review. She concluded the appointment with a urine pregnancy test and an exam. She noted my cervix was fully closed. I thanked her for the information. I told her that I was very much leaning towards the TAC option and I left her office.

Immediately after my appointment, I told my husband everything. I also informed my mother, mother-in-law, sister, and sister-in-law, all of which are nurses. I called and text them a full summary of my appointment results. I’d been keeping them fully apprised of my appointments and research. Their expertise and support has been paramount in my journey.  My mom, ever the hardcore SICU RN, there at my side when I delivered Zeke, listened to me on the phone when I repeated the appointment summary. She concluded the conversation with, “Well I think it’s time to find another OB/GYN, anak.”

Mom is always right! I started my search immediately.

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