A change of doctors

At 13 weeks, we were in two minds about getting a cerclage. It hadn't helped the first time. It had led to infection and tears. This was a natural conception. If this could happen on its own, maybe it was best not to interfere. On the other hand, history of cervical incompetence has a very high probability of recurring. In fact it is the standard reasons to do cerclages! And the first time, it had been a twin pregnancy, the cervix had already started opening, and the cerclage was put in as an emergency procedure. This time we had time on our side and it was a single baby.

The other thing making us uncomfortable was my gynae herself. Though very experienced, we had only had failures with her in 4 years. Her cerclage had been unsuccessful. She lived and operated far away from our home, and during the miscarriage emergency, we had realized the need of having medical help close by. But I was uncomfortable changing her. She was vastly experience, knew my entire history and literally knew me inside out. It wasn't her fault I was turning out to be such a stubborn patient. On the other hand, in her own words...sometimes the relationship just doesn't click. And this wasn't clicking. Things like her extreme conservative approach and focus on negatives was becoming grating with each successive failure.

We went to her for my 13 week check up, actually meeting her for the first time in my pregnancy. She examined me but was iffy about the efficacy of a cerclage. It must be put of course according to her, but there was no guarantee it would hold. NOT the thing you want to hear after a failed cerclage and loss of 2 babies. She indicated extensive tearing on one side, and was not confident of having enough place to take a stitch on that side. But when we asked her if she would recommend we shouldn't go for it, she said it was chancy. The cervix may not open, but if it did, it would be emergency cerclage again. And 13 weeks is best time for a cerclage. Post that it takes time to settle, and it might be the same story all over again. She told us to think over it, and also the decision of to stay at her hospital or go to one closer to home (where we had had to go during my miscarriage emergency).

We came away feeling troubled. I felt like she had literally left me dangling off a cliff in a damned if I do, damned if I don't position. The thing that hurt me most (and pissed both of us off) was her attitude of not taking any responsibility for the cerclage. It was like I'll do it, but its your luck. I don't guarantee anything. Now I know any surgical intervention has failure rates. But to so totally distance oneself from the result really got to both of us.

We decided to take the advice of my IVF specialist, who consulted at the hospital where I had gone during my miscarriage and had taken an interest in monitoring me then, even though she doesn't practice obstetrics anymore. She actually was my gynae's reference for fertility treatments, and would manage conception to first trimester, post which you would go back to your regular gynae. I was so demoralised by my current gynae's frankly morose predictions that I needed a balancing view. I had found this specialist very technically skilled and hoped for at least a more objective if not positive view.

I made an appointment with her. She was happy to see me pregnant, attributing it to my weight loss (which she had suggested in her very consultation with me). She was confident a cerclage could be placed and was adamant in her advice that I must get one done. She did operate at my preferred hospital and was willing to do the procedure. However, neither of us wanted to slight my regular gynae and she could not help me with obstetrics and pregnancy management for the rest of my term as she no longer practiced it. At this point, I remembered another doctor, who consulted at this hospital, who had in fact done my D&C after my miscarriage. She was younger than my current gynae, but I had found her extremely nice and positive during my stay at the hospital. I decided to consult with her for taking me on as a patient post cerclage and fixed up a meeting on the next day.