Pregnancy Diary: Week 30 – Third trimester, cerclages & enforced bed rest
When they say that no two pregnancies are the same they’re not kidding! My first pregnancy was pretty much a breeze. As a personal trainer and regular exerciser I continued to stay active and work right up until the week before having the baby. At the beginning of this second pregnancy I had ridiculous nausea, was far more fatigued, and the joint aches started straight away; when I finally came out of the first trimester fog I was so excited to get my butt back to the gym and go out walking again but at my 20 week scan we were given an emotional rollercoaster in a short space of an hour; ‘Congratulations, you’re having a girl!’ followed by ‘But we’re calling your midwife right now you have to go to hospital today’. Eek.
I’ve been sharing a little of this journey on social media but I didn’t really feel ready to write a blog post about it until now; call it superstition, fear of acknowledging my situation… I don’t know. But I didn’t want to put it into words properly until we’d made it to the home stretch in case something went wrong. So out the window went my plan to do regular blog posts on pregnancy exercise, my pregnancy diaries and creating my health and fitness pregnancy YouTube vlogs – it’s no coincidence the last time I did one of these diaries was in week 20 just before I went into hospital to have surgery for a cerclage/cervical stitch.
At any rate, here’s my thoughts on my cervical stitch experience, surviving modified bed rest with an active toddler running around the house (around 10 weeks to date!), and finally reaching the third trimester. Woohooo!
My cervix is what? Incompetent?!
I already knew what this was as I’d done my prenatal yoga teacher’s training but I didn’t know exactly what it entailed… Basically we found out almost by accident at our routine 20-week scan that I was already beginning to dilate to 1cm and my cervix had thinned to around 9mm – aka cervical incompetence. To put this in context, it should have been around 4-5cm. This is what typically happens right at the end of your pregnancy; great when baby needs to come out, not so great if it’s early in the pregnancy and they’re not ready yet.
For the first 24 hours or so in hospital I was left in the Trendelenburg position to help take the weight of the baby and my insides off my cervix. This is when they adjust the angle of your bed so your feet are elevated higher than your head. The husband had great fun with that… The next day they placed a suture under general anaesthetic to basically hold the cervix together and support the weight of the growing baby, then after another day in hospital I was allowed to go home. All the forms you have to sign listing the potential problems that could go wrong were horrible. I know they need to run you through it, but I just kept reminding myself that baby coming at 20 weeks would have been a far worse risk at that point.
There are three types of cerclages; an emergency cerclage where your membranes may already be close to ruptured, you’re really dilated and baby is pretty much on his/her way out, a preventative cerclage where they do the procedure around 12 weeks into the pregnancy usually based on previous cases of cervical incompetence, and the third is often called a rescue cerclage – what I had done – which is kind of in between the two. If the pregnancy is any further along than the 20-ish week mark and the cervix has shortened too much, doctors will often take a wait-and-see approach as there is too much risk that the operation will break your waters or trigger contractions.
I’d been given instructions to not bend, crunch, twist, exercise or do heavy lifting. I could generally potter around the house (‘modified’ bed rest as opposed to straight bed rest) but had to wind up my personal training business and my yoga teacher’s training to go on super early maternity leave.
Many people have asked me how I’ve coped with the jump from being so active to almost nothing at all ‘holed up’ on the couch. I decided I had two options:
- Wallow in misery, eat, sleep and watch Netflix for potentially the next 20 weeks straight.
- Make the most of the enforced rest before baby comes.
Modified bed rest, a toddler and a frustrated pregnant lady
So of course I chose the first option. But only for about a week. That’s how long I tolerated my Netflix binge before I force-fed myself the rest of Mad Men then decided to go pretty much cold turkey on television.
By skipping out on TV I’ve gained around 2-3 hours of ‘me’ time every night, and in this time over the past 10 weeks I’ve: Almost completed a nutrition coaching course that typically takes 4 months to a year, made a stackload of lavender eye pillows to sell online, started making soy candles and natural lip balms that I’ll be selling as well, opened an online shop attached to this blog (more inventory is on its way soon!), started writing a book, and am close to finishing a series of eBooks that will be available on the shop hopefully early next year. All things I can do from the couch! It’s amazing what you can get done when the TV gets turned off. These activities have gone a long way to preserving my mental health.
The mental aspect of dealing with the stress of trying to keep baby ‘in’ has been one of the worst parts. From my trusty Googling research of forums, women around the world are given varying advice after the cerclage operation; this ranges from some being able to go about their activities as usual, to being on strict bed rest – or even remaining in the Trendelenburg position – right until giving birth. For the first month or so I took an extremely conservative approach and barely went anywhere further than the house square: bedroom, bathroom, kitchen, couch. My only trips out were to the high risk obstetrician where I also had to initially have fortnightly scans to monitor baby growth and cervix length, and my midwife (as I was now under joint care).
Being so inactive hasn’t actually been the worst thing in the world. I have my bed yoga and meditation which keeps the circulation going and body less stiff. I distinctly remember after giving birth to my first daughter wishing I’d taken more time off before baby arrived. Be careful what you wish for!
Trying to keep my 2-year-old entertained from the couch has been the other difficult thing to deal with. Online shopping has been my savior. We have plans to put her in daycare when we get her free hours after she turns 3, and I didn’t see any reason to bump this forward – especially being on one income for longer than we’d anticipated. I bought playdough, second-hand playdough tools, plenty of coloured pencils, paper, crayons, put up a ball pit tent, and daycare-d out our lounge. She has learned to safely climb (with our help!) in and out of the bath, up and down from her change table, high chair and car seat. And probably has to be a lot more responsible than your average toddler tidying things up off the floor all the time, picking things up I’ve dropped, helping me take my shoes off and such things. But she’s loved helping out and it’s all working well for us now that we have all adjusted. The worst part of it was probably having to take the side of the cot off because I couldn’t lift her in and out, but even that’s come right.
Third trimester celebrations
When you have complications so early on in a pregnancy, you start to think in short-term goals of safety zones. Trying to get your head around making it to your delivery date is too much to handle (the couple of times I’ve entertained those thoughts left me in an ugly-crying mess). The end of your hospital stay. The end of the week. 22 weeks, 24 weeks, 26 weeks, 28 weeks, 32 weeks and then you’re pretty much on the home stretch as baby is more or less developed but just getting some extra ‘padding’.
As of today I’m now at 31 weeks with no more obstetrician appointments until the appointment for the cerclage to be removed in early December, the 36th week of pregnancy, and allowing myself a little more freedom with short trips up the road and a little more activity around the house. We definitely don’t want baby coming before the cerclage is removed which would result in an emergency trip by ambulance to the hospital, but we’re certainly feeling a lot safer.
Not to wish away my time or anything but… roll on 36 weeks!
Image / NZ Real Health