Pre-TAC story

In 2 weeks, I’ll be going to Chicago to have a TAC (transabdominal cerclage), by Dr. Arthur Haney. A lot of people have asked why we’ve chosen to go this route over the basic cerclage that is done at 12-16 weeks of pregnancy. So I’ll give a summary of my story and how I came to this decision.

(To preface, I am not currently pregnant) 

After 3 years of infertility, we got pregnant with our son Adam. At 19 weeks I was admitted into the hospital after finding out that I was dilated and my sac was hourglassing (basically trying to fall out). After a week of being on bedrest in the hospital (in the Trendelberg position) and taking meds to try and stop contractions, my body decided it was time to deliver. The labor went from mild contractions to full labor in about a 30 minutes period. I delivered my baby boy on December 8^th, 2013 at 6:40 pm. My water never broke and he was born in the amniotic sac, which they took him out of. He was lifeless, but we found out that he did have a heartbeat. He lived for about 45 minutes. 

Because of how I dilated and the circumstances of when Adam was born, I was diagnosed with an incompetent cervix by my OB. For those that don’t know what that is, it’s basically that my cervix isn’t strong enough to hold that much pressure and so I will start to dilate without contractions.

After I delivered, my doctor told me that next time I had a baby we’d have to do a cerclage. As I waited for my follow-up doctor’s appointment I read up on a cerclage. Basically they go in and sew up the bottom of your cervix when you are between 12-16 weeks pregnant. I thought that was cool, and friends and family started telling me about people they knew that had that and had successful pregnancies with a cerclage. There was hope! 

Then I went in to see my doctor for my post-delivery follow-up. We talked about the cerclage some more and he told me that I’d have to be on bedrest after the cerclage for the remainder of the pregnancy. I left his office and got to my car and sobbed. I was so discouraged and thought about how because of that, I’d only be able to have one more biological child because I couldn’t be on bedrest with a little one at home, I’d have to quit my job, and Scott would have to do everything including work, cook, clean, yardwork, wash the dog, etc. For over a year we’ve been preparing emotionally and financially so that we could get pregnant again and go forward with this. But everytime I thought about the cerclage, I got so depressed and so stressed out. I knew that the odds of having a live birth with a cerclage were about 70%. And that 70% includes preemies. I started thinking about where I would bury another child if I lost another one. Should I buy multiple plots? Would I move Adam to be with any of the others that I could potentially lose? These are the things that haunted me as I thought about this. I would be laying down for 23/24 hours each day while on bedrest, thinking that there was a possibility that it may not end in a happy circumstance. I was having anxiety over how I was going to have to make 6 months’ worth of freezer meals. How could I ever prepare for that? Especially with no immediate family close by. 

I attend a bereavement group at the Banner Desert hospital where I delivered. Scott and I go each month and talk with other grieving parents about triggers, healing techniques and it’s a chance to say our baby’s name without that awkward moment. We look forward to it each month and feel so much better after we go. I’ve met some incredible friends there, one of which is Natalie. Natalie just lost her daughter a couple months ago, and lost a son almost a year ago, so two babies in one year. She is the one that told me about the TAC. She had been researching to see what she could to do prevent another loss and the doctor’s believe she has an incompetent cervix as well. She told me about Dr. Haney in Chicago that performs the TAC. There are only 3 in the nation that do it regularly. I researched and had a phone consultation with Dr. Haney and both Scott and I felt really good about this procedure. There are other doctor’s in the nation that will do a TAC laparoscopic, but the reason that Dr. Haney and the two other doctors prefers not to do it that way is because they likes to be able to feel with their hands to make sure that the TAC is the right tightness. To me, it’s totally worth traveling so I know that I’m getting it done right. 

So what’s the difference between the 2? Here’s the rundown:

Regular cerclage:

• ·         Done at 12-16 weeks of pregnancy.

• ·         Stitch is placed on the bottom of the cervix vaginally.

• ·         Have to be on bedrest the remainder of the pregnancy, can be up for one hour a day.

• ·         It’s either snipped at 37 weeks without pain meds, or at 39 weeks after an epidural.

• ·         Gives you a 70% chance of having a live child, but some of those are preemies.

• ·         Can still dilate and even tear the stitch and cervix.

• ·         Have to be on pelvic rest the entire pregnancy.

• ·         A cerclage has to be done with each pregnancy.

• ·         If on fertility, you have to be heavily monitored to make sure you don’t produce more than 1 egg, because the weight of two babies causes a higher risk of delivering sooner.

• ·         Considered a high-risk pregnancy.

• ·         Have a risk of infection, or pre-term labor after procedure.

TAC

• ·         Is done mostly pre-pregnancy through an incision made where a c-section would be.

• ·         A band is tied around the highest part of the outside of the cervix.

• ·         Can be done up to 10 weeks in pregnancy.

• ·         No bedrest is required.

• ·         A woman’s cervix will never thin, shorten or dilate.

• ·         It is permanent, so all babies are delivered c-section, and the procedure only needs to be done once.

• ·         D&C’s can still be done if necessary as well as a hysteroscopy.

• ·         Does not affect any method of fertility, including IVF.

• ·         Chance of infection is very slim and can be treated before getting pregnant.  

• ·         The band can hold over 100 lbs. of weight from the uterus. Many woman have had the procedure had have had twins with no complications.

• ·         98% chance of a full-term birth.

A TAC is still considered an “experimental” procedure, but I believe it will be a common procedure in the years to come. Dr. Haney works for the University of Chicago, was an OBGYN for years, a fertility specialist, and now does over 200 TACs a year and has an amazing success rate. Luckily our insurance will cover the procedure, when some won’t. Some insurances will require a regular cerclage first, and if that fails then they will pay for the TAC. So basically they will only pay if you've had two losses, which is so sad to me.

We honestly feel really good about this decision and are very excited. Scott and I met with my OB before scheduling the surgery and talked about it for about 45 minutes, and even though he knew little about it, he was excited for us. A lot of people have been wondering why we are going to “extreme measures”, when we haven’t tried a regular cerclage, and for me the answer is simple, I’ll do whatever it takes to prevent losing another baby. It also seems like a no-brainer to me when you look at the odds and benefits of getting a TAC.

Most asked question: Will this help us get pregnant?

Answer: No, so we could still use a lot of prayers please.  

One of the coolest parts of this? Natalie and her husband are going with us, and we are having our surgeries on the same day, back to back. We are so excited to go with them!  

I’m just hoping that if my story can help at least one mother from having to endure another loss, then it’s totally worth sharing with the world. 

I’ll post again after the surgery and give you an update.