The Journey of my Cervix - Around the World and Back Again
Aug 22
7 min read
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I’d only started my expat adventures in Singapore when my previous UK smear test came back with abnormal changes to the cells in my cervix. A colposcopy later picked up that I had pre-cancerous cells, specifically CIN1, CIN2 and adenocarcinoma in-situ. The latter of the three being the one I was told I had to worry about. I was quickly booked in for a cone biopsy which would be done under general anaesthetic. Cue me crying to my brand new boss because I now needed time off work, had never had an op and was about to go under a general anaesthetics with no family around to support me. Oh, and the biggie being an op that would have normally cost me nothing on the NHS was going to cost $8000.
“You’re now at high risk for miscarriage and premature babies” said the gynaecologist, shortly followed by “I suggest you start trying for a family sooner rather than later.” The tears started rolling, as I shared to the tactless professional that I was A: single and B: had only just moved to the country of this random office I now found myself in! It isn’t until you hear such words that you know 110% you want to be a mama and as you can tell it was a roller coaster of emotions!
In a short time the pre-cancerous cells were removed, I then had regular monthly colposcopy check ups for the next four years.
“Remember to start sooner, rather than later” the gynaecologist shouted over to me in the waiting room, as I was paying off my bill. I gave her a look of disapproval and shouted back “Yes, you’ve told me before” She continued with “I’m not saying the next man you walk by in the street. But sooner, rather than later.” And I left the room feeling rather annoyed by this woman who could not have been more blunt if she tried.
Fast forward five years…
I found myself not the next man to walk by on the street but my own, as they say, ‘tall dark and handsome’ fella. We returned home to the UK together and after a year of setting up home, we decided we wanted to start a family.
Luckily, it didn’t take long for us to fall pregnant. But sadly our first pregnancy ended in a very early miscarriage but thankfully only a few months later I was pregnant again.
When registering with our local midwife I informed them of my previous cone biopsy. “That should be fine. If you didn’t have any treatment afterwards you’ll be fine but we’ll book you in for a scan on your cervix. As well as an appointment with the Dr because of your three kidneys” she said. Yes, you read that right, three kidneys or in medical terms ‘duplex kidney’. I know I’m special and greedy!
I headed off to the appointment, alone as we were in the middle of the pandemic,with all of the medical paperwork regarding my kidneys and cervix, even a Polaroid of the removed biopsy and it really is shaped like a cone! The Dr seemed to look concerned as she read over my notes and said she would be doing the scan on my cervix that day, not next week. Thank heavens she did as my cervix was measuring short, only 20-22mm and because of the extra kidney it was putting pressure on my uterus making it the shape of a heart. Sounds cute but with the extra pressure of an already weakened cervix, the Dr didn’t think I would make it to 24wks.
Hearing the chances of losing another baby again but this time at 16wks was too much to take in. What she went onto say was just going in one ear and out of the other. The Dr suggested calling my partner so there we were on speaker phone to my partner explaining I needed a cervical cerclage, also known as a cervical stitch. For a cervix measuring below 25mm having a cerclage is the recommended treatment. The Dr gave us the weekend to think it over, in person together. But said it was something that needed to be done in no later than two weeks. It was a no-brainer we knew we had to go through with the cerclage, we just wanted that time in-person and not on speaker phone to agree.
I had been very positive up until this stage in the pregnancy; following all the positive birth stories I could find, still exercising and trying to stay in the best place both physically and mentally in preparation for the big event of labour. I found myself then trying to search The internet for any success story of a cervical stitch. I spoke to a midwife friend and rested as much as I could. That is one thing I am thankful for during lockdown, I had nowhere to go but the sofa!
I was admitted into hospital a week later. I had to be at the labour ward for 7am. Again alone! We were still in the early days of lockdown, so my partner wasn’t allowed in. A midwife asked if I was there for a c-section … great start! The nerves started to creep in and I was shown to a bed, calming music on and headphones in, to drown out the sound of all the newborn babies as I waited for my Dr. Once the Dr arrived they explained that they needed to do a higher stitch than they first thought. A Shirodkar Stitch, less common and more technically difficult. She drew me a picture and basically explained that my cervix would be stitched up like a drawstring sports bag, you know the ones with the string that you pull closer.
The procedure was successful, albeit a little awkward. As when I agreed to medical trainees being present, I didn’t realise I’d be legs akimbo to a room full of enough people to form a mini football team. The surgeon was very happy and I got to see our baby in the afternoon to reassure me that everything was ok. I just needed to pee and then I could go home. Cue me breaking out of the labour ward at midnight like Cinderella, so I could have my own bed and no newborn baby cries for the rest of the night.
I was then monitored every two weeks, until they could get me to a ‘safe zone’ which was 30wks. Although I was a high risk pregnancy, the fact I got to see my baby during those fortnightly scans made the process a lot easier. Especially, in the crazy world we were living in with Covid, many first time mums still hadn’t met a midwife face to face. I’m extremely grateful for the care I received during this time.
We made it to the 30wks and then I was discharged from the Dr’s fortnightly check ups and booked in to have the stitch removed. Because it was higher up in my cervix, it had to come out the same way it went in. Surgery was planned at 36wks and then it would be time to let nature take its course.
34 weeks and 6 days pregnant…
I woke up at 4am with a back ache. I’d been to triage numerous times with all kinds of false alarms and as I’d only been in that week, so I really thought it was nothing to worry about. I rested in bed whilst my partner worked from home. We also had a flat full of carpenters and painters. Not the best day to go into labour when your kitchen is being fitted! It wasn’t until my legs went from under me, whilst on the loo and a sudden urge to push came across me that I knew we had to get to the hospital.
I headed in alone to be checked out but very quickly my partner joined me. It was like someone was watching over us as triage was empty that day. The midwives established I was “contracting like a trouper and would be meeting your baby soon.” My Dr who had looked after us from the beginning was walking by when she saw me. She asked to examine me “I can see the stitch has slightly come away and I can see the head. We need to take you to a delivery suite to remove the stitch” I burst into tears “but I thought I had to go to surgery for that? “ I asked. “No time for that” and next thing I know I’m being helped into a wheelchair and off we went. I have to admit I did fake a little contraction, just to allow myself a moment to compose my thoughts.
It was explained to me that the baby could come out with the stitch, and I had visions of this baby flying on out of there.They got me in the stirrups and gave me the gas and air. I was told to breathe down as hard as I could when they said go. Within seconds the stitch was out and the room was then emptied. By this point it was 1.30pm and just me, my partner and the midwife in the room. My waters broke not long after and at exactly 4.00pm my 4lbs 14oz baby girl was born. So, a quick debut but thank goodness not as quick as it could have been.
My Dr came to visit us on the labour ward. She shared with me she never goes into triage and was so happy that something that day led her to being there. Also, she added that we had done extremely well as she didn’t expect us to make 30 weeks, never mind 34 weeks and 6 days.
We will no doubt have to experience this a second time around, if we’re lucky to fall pregnant again. Who knows if we’ll make it that far, what with a cervix weakened even more and there won’t be a lockdown next time. But I do know we will have nothing to worry about! The success rate for a cervical stitch is 80-90%, the care and attention from the midwives, Drs and surgeons was all amazing (we really are lucky to have the NHS) and there’s good stuff in little bundles. Our little preemie has shown us that.
By Nicola McQuillan
Mamma of two