Our Little Virginia is a Big Sister

4 weeks ago today we joyfully welcomed Virginia's little brother into the world!  He arrived via a scheduled c-section at nearly full term.  Henry George was born on July 29th at 36 weeks 4 days weighing 6 pounds and 8 ounces and 19.25" long.

I am so thankful for a long, healthy and relatively boring pregnancy thanks to the TAC, lots of precautions, exceptional medical care, and lots of prayers.  I did not spend a single day on bedrest and did not make a single trip to labor and delivery until delivery day.  Still, it was not easy but it was so very much worth it.

Henry did spend his first day in the NICU for respiratory monitoring.  He really was only there long enough for us to see some of our favorite nurses and doctors.  It was disappointing to not hold him in the OR or bring him right up to our room, but we did our best to keep things in perspective and make the best of it.  There was a certain beautiful irony to introduce Virginia to her brother in the same place where she fought so tremendously hard for her life.  It was where we first became a family and where we became a family of 4.

We are adjusting well to life with Henry.  We have learned that there are still some extra challenges with late term preemies but really those things just mean we are more tired (yawn) and are so so minor in relation to the tumultuous first month with Virginia.  Breastfeeding troubles, sleepyness, weight gain, and wonky newborn screenings are the norm for babies born even a few weeks early. We are working through each of these things while getting to know our little guy and adjusting to life at home with 2 kids.  Thankfully my Mom has living with us and helping with toddler entertainment, cooking, cleaning, baby rocking, and diaper changing.  

Virginia absolutely adores her little brother and wants to help with everything!  She is such a proud big sister and takes her role very seriously :)  

We constantly are catching new Virginia-isms - "look at our cuddly little guy"  "he's so cuuuuuuuute" "shh shh shh its ok buddy"

Henry has made our hearts so full and really is just the sweetest little guy.

Homestretch - Pregnancy after my Micro-Preemie

I thought I would write a lot more here about pregnancy after preemie.  My intentions were mostly selfish- I figured that writing here would again be my therapy, my way to think through things, and my way to deal with the challenges and emotions.  Selfishly I haven't needed it, so I haven't found the time to regularly talk about this pregnancy or update the few people who still follow along here.  Selfishly I have enjoyed keeping it all to myself, relishing in each day, enjoying all the things that we missed out on last time, and settling myself into the uncharacteristic zen that fills my subconscious during times of uncertainty.  

This pregnancy has really just gone so well.  I think there are a fair amount of people that are surprised we have (nearly) made it to a scheduled c-section, but honestly Heath and I are not surprised.  We went into this with the expectation that we had done/ were doing everything we could to have a big healthy baby.  It meant surgeries, treatments, hard decisions, sacrifices, and lots of appointments but it also meant that we went into this with equal parts bravery and hope.  

There have been a few bumps in the road, a few moments of fear or panic, but generally we have just been counting down the weeks.  Passing each milestone quietly with just prayers of thanks.  We have a c-section scheduled for this Monday at 36 weeks and 4 days - exactly 12 weeks longer than I was pregnant with Virginia.  We are hoping this little guy is ready for prime time, but know we are in the best place possible if he needs any assistance.  I am feeling really great and wishing that I could go a few weeks longer, but have come to terms with the timing - knowing that it is the safest time for both baby boy and myself.  

For now I am just enjoying these last few days of having him all to myself.  I already know that he is pretty laid back, directionally challenged (breech), likes to give high fives and is a cuddler for sure.  

Thank you all for cheering us on.

24 weeks

A few days ago we officially reached our first milestone of sorts.

At 24 weeks pregnant I am:
not in the hospital
not on bedrest
working
acting mostly like a typical pregnant woman
craving a margarita

At 24 weeks this little boy:
has surpassed his sisters birth weight
is very active in the evenings
is very very loved by Virginia


After a pretty wild and scary first trimester, things have been surprisingly calm.  I am hesitant to even write those words.  However, I am trying my hardest to conquer my own fears, avoid the self protection and actually try to enjoy this pregnancy.  Because hospital bedrest started at 21 weeks with Virginia, we are already getting to experience things that never happened last time.  Maternity clothes, strangers acknowledging me as pregnant, glucose tests, and heartburn are all new experiences.  I am still waiting for that exhale moment, but I don't think that will truly ever happen.  In the meantime we are all just trying to enjoy this time as a family of 3 while we wait for this little boy to grow big for the next 12-13 weeks.


Virginia is doing great and is so excited for her little brother.   She is blossoming at preschool and testing our patience all the time.  She has perfected the art of negotiation and tantrums, but is also wonderfully helpful and sweet.  She is still receiving OT and PT weekly, where she has been working on stairs, jumping, and improving her core strength and also attends a weekly gymnastics class.  We always seem major strides in her gross motor skills in the spring and summer as we spend so much time outside, at the beach and on playgrounds.  Here in Connecticut we are still experiencing the winter that wont quit and are anxiously awaiting some nice outdoor weather.

one big update

So... Its been a few months.  This gap was not for a lack of things to write about or a lack of life changes.  I could blame it on lack of time or simply being overwhelmed, but thats sorta lame.

We bought a new house in October and spent 3 months renovating it, finding renters for our 1st home and moving.  We are getting all settled into our new digs and couldn't be happier.  It was a fun and exhausting process but a labor of love. Our new house truly feels like a home and we can't wait to make many memories here.

Right around the time that we started the renovations we also found out that we were expecting another baby!  It was a long and frustrating but hopeful road to get to this point and we feel so very fortunate.  The journey started with getting a TAC in March of 2012 and had many twists in turns since then, all in an effort to prepare for as healthy of a pregnancy as possible.

There are no guarantees in life, especially in pregnancy and child rearing.  We knew that, but we also knowingly went into this with open hearts.  The idea of pregnancy after a micro preemie can certainly be a scary one, but something we never accepted as scary.  I wish I could say that I truly trust my body (I don't) but I do trust that we have done everything we can to make this pregnancy a long and healthy one.  There have been many doctors and many opinions that we have carefully sorted through, but now we simply wait and let the weeks pass by.

prayers, good thoughts, juju, karma ...  whatever you throw around, we will take.  We are so thankful for our tribe of family and friends who have been nothing but supportive.  We are hopeful that this wild ride plays out as long and boring for the next 20+ weeks.

Transabdominal Cerclage

I'm not usually one to publicly talk about my reproductive organs.  If words like uterus, cervix, transvaginal ultrasound, and dilation make you twitch, you may just want to skip this post ;)  My hope is that this information helps other women navigate their choices for family planning after their preemie or loss.  

On Friday I will be taking the first step in doing everything possible to a full term or nearly full term healthy baby.

No, I am not pregnant.

No, We aren't planning a second baby in the immediate future.

Yes, we would like to eventually have another child.

Tomorrow I am traveling to New Jersey and on Friday I will be getting an Transabdominal Cerclage (TAC) by one of the best and most experienced doctors in the TAC world.  The transabdominal cerclage is a procedure where they open the abdomen in a similar fashion to a c-section and place a strong fabric band around the top of the cervix, just under the uterus.  It essentially keeps the cervix from effacing and dilating and is especially effective because it is placed at the very top of the cervix, eliminating any dilating force or funneling.  The decision to have this surgery has not been an easy one.  There have been many consultations with many doctors with many different opinions to get to this point.

Almost all of the doctors agreed that I had a congenitally weak cervix.  In addition to having a previously diagnosed uterine septum and surgery to remove it, I also showed all of the classic signs of cervical incompetence: I was fully effaced at 22 weeks and had painless dilation thereafter.  There was no sign of infection, my membranes did not rupture, and Virginia was completely perfect- all things that could have made the diagnosis of cervical incompetence a little more hazy.  I did not have a single uncomfortable contraction until I was over 7 cm dilated.  Even then I could have convinced myself that the aches were something other than impending birth.

Some doctors suggested a "wait and see" approach to a future pregnancy.  Umm ... no thanks, we were all shocked at how quickly my cervix changed then stabilized and then changed again. I am not willing to risk that approach.

Some doctors suggested a Transvaginal Cerclage (TVC) at 12 weeks into a future pregnancy.  I very seriously considered this option.  The problem in my case is that I had severe funneling (opening at the top of the cervix) weeks before I had any cervical dilation (opening at the bottom of the cervix). I honestly think a TVC could be successful for me, but not without a whole lot of angst, bedrest and hospitalization.  I have no doubt that if I were to get a TVC that I would be funneled to the stitch by 20-22 weeks.  Cue... lots of panic.  I simply cant do that to myself, my husband, my family, and most importantly Virginia.

I don't think anyone would have even mentioned a TAC none the less suggested the procedure if I had not asked about it.  There are only a handful of doctors in the US that do these procedures regularly.  Unfortunately this leads to a lack of statistics and awareness among the obstetrics and patient community.

I was completely shocked when I read the statistics - A TAC has a success rate of over 95%** for bringing pregnancies to term (37 weeks gestation).  A preventative (as opposed to a rescue) TVC has less than a 75%** success rate.  Most obstetricians and Maternal Fetal Medicine (MFM) specialists view the TAC as an extreme measure saved for people that have had 3 or more 2nd trimester losses.  The all too common complacency to intervene earlier in the wake of of 2nd trimester loss or extreme prematurity when the cause is clearly cervical incompetence is completely baffling and appalling to me.  No one should have to lose 3 or more babies to be at least be presented with all of the options for intervention.  

The TAC is certainly  more invasive than the other options.   It is an open abdominal surgery (open in my case but it can also be done laproscopically).  The TAC eliminates the possibility for delivering a baby vaginally.  For me, a vaginal delivery is not an option because I had a classic c-section with a vertical incision to my uterus.  There is a higher risk of uterine rupture with a classic incision, so laboring and vaginal deliveries are definitely not recommended.  This made my decision for a TAC much easier.

The decision was not made lightly but we feel this is the best one for our family.  We believe it gives me the best chance for carrying to term.  We believe it gives me the best chance to avoid bedrest and more importantly hospital bedrest.  Do we think a future pregnancy will be "normal"?  no way.  Will we be scared sh*tless still? Absolutely.

If you have some good thoughts to spare, I'll take them.  I'm hoping that this the dawn of a new day for us and someday helps bring us a big, chubby and healthy baby.

In the meantime things might be a little quiet around here.  Heath is holding down the fort with Virginia at home and Moma will be with me in NJ for a few days.  I'm hoping to be home in time to spend Easter with Virginia.



** These statistics were quoted to me by my physician.  I will add some of the published research that I came across some time in the future.