Of all the posts i’ve written, this is one of the most vital ones.   It is very lenghthy and chockful of detail on purpose.  There are increasingly a lot of people finding me due to goo.gle searches for information on on the TAC, and I want to offer all the information I can.  This does not take the place of medical advice, but it is my experience and I want it to help you.  If you have lost your baby(s) due to cervical incompetence I am so deeply sorry.  I hope you continue to pursue your dream and to gain knowledge.  Additionaly,  I am more than happy to answer any questions you may have,  just leave me a comment!
The Background

Following the loss of Daniella, I left the hospital empty-handed, but also with the knowledge that I would need a Transabdominal Cerclage or TAC to bring a future baby home.   Dr. Goo.gle dissapointed me; the internet offered very little info on the TAC.  Thankfully, I found a group called AbbyLoopers on yah.oo and through this group several doctors that were well recommended by members including Dr. George Davis.  Beefcake and I met Dr. Davis and came up with a plan that I would have a post-pregnancy cerclage placed at 14 weeks (pre-pregnancy is another option).  I continued to read the experiences of AbbyLoopers members and after a self-imposed break from TTC we were ready to try last fall.  We conceived shortly after and when my first trimester screen revealed a healthy pregnancy I got in contact with Dr.  Davis.  He and his staff had great follow up in scheduling and getting paperwork in order.  I knew I was dealing with a special doctor when he called me one night just after 10pm.  He apologized profusely for calling so late but he wanted me to know that he finally had my operating room booked and that surgery was all set for December 28th, 2009.

Surgery Prep

As planned my husband and I arrived at the hospital where I was registered and prepped for surgery.  Beefcake and I chatted and watched t.v. while we waited for Dr. Davis.  He came by rolling over the sonogram machine, which caused his diet co.ke to fall on the floor andd spill, and then he could not find towels and then he couldn’t get the machine to work.  He wasn’t smiling and it was all Beefcake and I could do not to laugh out loud.  Finally, he did a quick sonogram to check on baby and all was well.

Dr. Davis:  How old are you, again?

Jaded: 27

Dr. Davis: A teenager…Do you have any questions before surgery?

Due to nerves, I completely missed the question.

Beefcake:  Babe, do you have any questions?

Jaded:  Huh?  Oh!  Sorry Dr. Davis, I’m just so suddenly nervous.

Dr. Davis: I’m not.

Jaded: If anyone should be nervous, I’d rather it be me.

Dr. Davis left to prep while the anestesiologist and his assistant came by to talk to us.  The plan was to give me a spinal, so that I would be conscious and just slightly whoozy.  I asked if I could bring my ip.od into surgery and they were fine with that.  I set up a playlist of Mich.ael Jack.son’s greatest hits, kissed and hugged my husband goodbye and was wheeled into surgery.

The Surgery

Upon entering the operating room the flood gates gave way.  I mean I was BAWLING – the bright lights and the cold sterility of the room with the surgical tools out brought back memories of my daughters.  Tears just kept coming without ceasing.  I reasoned with myself: I was now in a position of knowledge, power and preparation.   This was not a reactive attempt to save this baby, but a proactive one – BIG difference.  Compassionate hands cradled mine as compassionate words soothed my spirit.   I was then given more paperwork stipulating that I understood that I was about to undergo abdominal cerclage sugery and that I was agreeing to in-surgery ultrasounds to monitor the baby’s heartbeat.   I signed the paperwork and thought to myself: Wow, after all the research, blood, sweat and tears I am here and this is really about to happen.  The spinal was administered, and we waited for its effect as more lights were switcched on,  doctors strolled in including Dr. Davis and nurses and the anestisiologist monitored my vitals.  So i’m there, spread-eagle, legs strapped, arms strapped and naked from the waist down.  At this point I hear the familiar sound of an electrical razor as Dr. Davis shaves off about an inch of my pubic hair just below my abdomen,  I cringe as he places this sticky material over the shaved area and prepares to pull it off (i’m thinking a salon wax here) –  luckily I did not feel a thing.  Whew. Vulnerable does not capture how i’m feeling.  By now, the spinal should have taken effect, so they decided to put me to sleep.  A mask is placed over my mouth and nose as i’m instructed to breathe in deeply.  I remember my first breath…my second…and my third when I suddenly get this funny taste in my mouth.

Hospital Recovery

The next thing I remember was waking up in the operating room and being told the surgery was over and that I was headed to a recovery area.  I’m very whoozy and so I’m ‘in’ and ‘out’ and don’t remember being wheeled over.  Once in recovery, I ask how my surgery went and the nurse smiles and says very well.  Dr.  Davis strolls over and I ask if surgery went well.  (I think I asked anything that blinked how it went).  He patted my leg and said very well.   My husband is soon by my side and he gave me this loving gaze and told me he almost cried when he saw the doctor heading his way immediately after surgery.   “Dr. Davis said you and the baby did very well and that he’s happy with surgery – there were no complications and everything went as planned, the surgery was over  in under an hour.  Thank God for that, because I could hardly stand waiting to know if my baby and wife were ok.”   Some time later I was wheeled to a private ‘mother-baby’ room.  My vitals continued to be monitored the rest of that day and through the next day.  On day 2 the strong meds were discontinued and I was told that I needed to start walking later that day.  Say what?  The meds had already started to wear off and the pain was creeping in.  The nurse laughed when she saw my face and said it helps with gas.  Huh?  What’s wrong with some gas?, I thought.  Ha!  Who knew gas could be so evil and so painful?  So I took my first step with her assistance and let me tell you  warn you – the pain WILL take your breath away.  I’ll fast-forward through the rest of my time there: I was there 3 nights in total, my husband helped give me a sponge bath and I progressed to taking showers on my own with him standing by.  The nurses were wonderful and I walked every day, despite the pain to encourage healing and help with gas as recommended.  On my last day there, the doctor performed one last sonogram to look over the baby, the TAC and to take my now-improved cervical length measurement.  The doctor was happy with how my incision healed and so he removed the bandage and staples and placed steri-st.rips over the incision.  As he filled out paperwork, I realized he was wearing a Cowbo.ys football team tie.  My husband and I are all about the NY Gi.ants, but I smiled and said that it seemed we were all Cowbo.ys fans that day.  Before leaving, I gave Dr. Davis another of many hugs during my stay and a very teary-eyed, heartfelt thank you.

At-home Recovery

We left the hospital on strict orders to drink water as if it were ‘going out of style’, move a little every day, take it easy, and to have s.ex when ready but on the condition of using condoms until after delivery.  Beefcake tried to drive home slowly, but every bump in the road was agony for me.  Once home, he took care of all meals, assisted with bathing and drying me when neeeded, he took care of Peaches, ran my errands, faxed paperwork to my job, helped with my grandmother who is still with us and at the time was still healing a broken ankle and much more.  We ran him ragged.  I returned to work 3 weeks post surgery.  I was still slightly sore for about a week after.  Now at 20+ weeks I feel fine, although the baby is now kicking me and occasionally making me feel soar above the incision.  However, every kick is like a breath of fresh air.

What is the TAC?

Again, it is always best to talk with a doctor, preferably a perinatologist but… There are 2 approaches to dealing with cervical incompetence.  A vaginal cerclage entails a stitching of the cervix at the site of the external os (the lower part of the cervix that a gynecologist views/’handles’ during a pelvic exam).  It is removed shortly before delivery and is therefore not permanent.  It has a good success rate, but does not compare with that of the TAC.  The vagina naturally has more bacteria than the abdomen, therefore the risk of infection is much higher when done vaginally.  For most women a vaginal cerclage will do the trick – but it can fail and some women are just not good candidates due to factors such as cervical trauma due to a previous birth, cervical surgeries, a congenitaly short cervix and i’m sure a host of other issues.   Ideally you want to get the stitch as high up on the cervix as possible to prevent funneling and the progress of pre-term labor.  This is where the transabdominal cerclage comes in.  To get it higher you have to go through the abdomen and the ideal placement is where the lower uterine segment and the internal os meet.  In other words, you want to get the cerclage at the exact juncture of where the uterus ends and the cervix begins.  Additionally, to my knowledge, abdominal cerclages are not stitched into the cervix, but rather very strong thread is wrapped around said juncture.   Make no mistake about it – this is major surgery and is a painful recovery especially when done post pregnancy, as I did.  In addition, due to the nature and placement you are FULLY committed to cesarean sections for all future deliveries.

However, the physical pain pales in comparison to the agony of losing a very beloved and desired child.

Unfortunately, some O/B’s are ignorant of this procedure or not even aware of it, and they do discourage many patients from pursuing TAC’s when they are clearly indicated.  This is why I always suggest that you also consult with a perinatologist as difficult and complicated pregnancies are an everyday occurence for them and they are usualy up to date on new procedures and technologies.  I was lucky, in the sense that the peri that placed my ill-fated vaginal cerclage was the first one to tell me about the abdominal approach and give me hope.

Sometimes the situation is not black and white and you might be a good candidate for either approach.  What do you do?  In your shoes, I would take the more agressive approach – but that’s easy for me to conclude.  I don’t know your circumstances and i’m certain that there are many variables that you will thoughtfully consider.

Good luck to you if you are considering the TAC or another approach, I hope more than anything that you get your baby.  Remember knowledge is power, please make a well-informed decision.

A smile before surgery.

Dr. Davis and I before surgery.

Whoozy after surgery…

Dr. Davis and I after surgery.

Ready to go home.

Peaches aids my recovery at home.

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24 responses »

  1. THANK YOU SO VERY MUCH FOR THIS BLOG, from the bottom of my heart. I had just called Dr. Davis office this morning to have a phone consult with him, as I am from Georgia and all we have here are ignorant Doctors that do NOT know what they are talking about.

    I had issues trying to concieve, it took me over 10 years and I am finally 11 weeks pregnant through IUI. I had several cervix procedures over the last 8 years due to cancerous cells, and therefore my cervix vaginally is non existent and internal is only 1.9 cm. I consulted a Peri before getting pregnant and he told me I would need a TAC once pregnant, but he does not perform that procedure. Now that I am pregnant he referred me to this only doctor that does them in Ga but he is not that experience on them, therefore discouraging me to get it done, he also tells me he does not recomend them on someone that has not had any loses, no sense of LIFE! I am fed up and ready to move on and get this done by the expert, so praying it does not take long for doctor Davis to return my call.

    I have a question, can you tell me wish hospital you had your procedure done? I am trying to plan this as I have family in NY and need to see if I can use them as help or if I will need to get a hotel. Also, did you meet the doctor days before or just on surgery day?

    Thank you so much for all this info it was very helpful to me and because of it I am now 100% sure this is what I want to do.
    Please reply to my email.

    Thanks, Adi

  2. can you tell me how much cervix you had i am asking for my daughter who has had a cone biospy and had 2cms of cervix removed and now just has 2cms left was never told it could lead to losing a baby and she lost her baby in january at 20 weeks. doctors here said they will put a cerclage stitch in when she gets pregnant again but shes worried 2cms isnt enough and no one here seems to know much about it.

    • When I had my first loss my cervix shot down from 3 to 2 centimeters in less than a week. They attempted a vaginal cerclage at 22 weeks and it failed. I was told that at this gestation the chances of success are like 50%. I was obviously unlucky. I had a leep procedure done several years ago and they removed part of my cervix – doctors also think that I may have been born with a congenital defect to my cervix. In anycase one did not help the other. I was told that any surgery to the cervix compromises it. Because they want to place a stich for your daughterearlier in a future pregnancy she has odds on her side – i think like 70%. A TAC will give better odds – if there are no other issues – like 90% or greater.
      I would suggest that she speak to a perinatologist or maternal fetal medicine specialist that is open to both procedures. You want someone open minded enough to consider both.
      I wish your daughter the best of luck in her next pregnancy and am deeply sorry for the loss your family has endured.

  3. I have read all of the info you posted and I also see that you will be having your baby soon. I want you to know this blog has helped me with wether not I will have the surgery done. I lost Londyn on 4/23/2010 I was unaware I could have the abdominal cerclage done while pregnant. However I have had to failed cerclages while pregnant so I’m going to try doing it before.. god bless you and enjoy Ziggy!

  4. Thank you for sharing your story. I am facing this surgery in a couple weeks. In the past 4 years I have had to have numerous surgeries on my cervix and now there is very little of it left. My husband and I have been trying to get pregnanty for 2 years and have miscarried twice. We are now 8 weeks pregnant.
    during the last 2 pregnancies we discussed a vaginal circlage with her and were prepared for it. however, last week when she examined me she said that she doesnt feel a vaginal circlage would be strong enough anymore and that we should plan on an abdominal one in our 13th week. I had never heard of this and was quite nervous.
    however, your story, and others like it, have made me feel hoepful and have also provided me with a list of new questions for my next appointment (tomorrow.)

    Thank youfor sharing. I am sure it was a hard thing to do, however, I konw it has helped me further understand this surgery and am sure it has helped countless others. I am hoping in a few months to be able to post another comment here about our new baby.

    I hope all continues to do well with your health & your child’s!
    Jennifer Anne

  5. Thank you, thank you, THANK YOU for posting this!!!! Dr. Davis actually was the peri on duty when I went into premature labor with my son and daughter in December 2008 – they were stillborn at 22w5d. Shortly after our loss, we were advised that I would never carry to term without TAC surgery. Luckily Dr. Davis will be performing my TAC in 2 weeks, and it does my nervous self a lot of good to read your success story. If we have to go through this, at least we are in the hands of a doctor who modified and teaches this procedure that saves so many tiny lives.

    Much love and many many blessings to you, your beloved, your angel girls and your precious baby.

  6. Thank you so much for all this information. I to have had a loss due to IC. my husband and I had to bury our sweet Joseph(19wks) this August 2010 . I had no clue that this condition could effect me.I now have had 2 D&C’s due to miscarriage. So i’ve found Dr.Haney in chicago that performs TAC. as soon as I can heal from my last D&C and give my body a break I will look into scheduling a consulatation with him.

    • I am so glad I could help you in anyway. I have heard marvelous things from others about Dr. Haney. I am so sorry for what you have been through and wish you much success in your journey.

  7. Thank you for sharing this bog. I am having surgery in 4 weeks and couldn’t find info about TAC. I’ve experienced 2 losses based on an IC. 1 at 19 weeks (twins) with no cerclege and the second at 21 weeks with a cerclege. Since, one cerclage failed I qualified for TAC. This experience has been so painful, I’m praying this procedure is successful. Please pray for me, and I will pray for you. Your story gives me alot of hope… Thanks again.

  8. Thank you for sharing your story. I had two miscarriages within the last two years in the second trimester. I did not have success with the vaginal cerclage. I was referred to Dr. Haney in Chicago for the TAC. He performed the TAC surgery on Sept. 16th. I am doing well. I can say I never experienced pain just discomfort. He is a wonderful doctor. Dr. Haney will make you feel excited about the reality of becoming a parent.

    • I’m so glad you are progressing well after surgery. Thanks for stopping by and commenting. I am sorry for your losses – losing our babies is so difficult but there is hope for your future and you’ve taken the first step.

  9. Thank you very much for the info. My concern is that since I am overweight (not obesely overweight but about 5’2″ and 205-210lbs) the Dr. may run into some problems when doing it. Also the peri I am seeing has recommended me to a Dr. here in San Antonio who does them laperscopically from what I understand the healing time is cut in half. We have had fertility issues and problems maintaining pregnancies. We had 5 failed IUIs 1 etopic, 1 chemical pregnancy, 1 miscarriage @16 weeks (baby girl) and 1 IVF loss (twin boys) last year @ 22 weeks with a cerclage. This is my last hope. I am hoping that the TAC works for us. I see the Dr. this week so let’s see how this goes. Thanks for providing the words of encouragement.

    • Hi Yvonne,

      I am sorry that I am just getting to this comment now. I am overweight (but not obese) as well. My husband mentioned that during our initial consult Dr. Davis mentioned something about weight, but I don’t remember and neither does he unfortunately. Either way my healing went very well. There are different schools of thought when it comes to laperscopic surgery (although I have always heard that the healing is much faster). If it is done prior to a pregnancy there is not much disagreement on it’s effectiveness (it seems to be more of an issue of preference for the surgeon). Once you become pregnant – it seems to be a whole other issue. Dr. Davis told me that he personally prefers the traditional method, b/c you can actually adjust and feel for the tension of the abdominal cerclage. Please do not let me discourage you in any way from either procedure – but find out what the pros and cons are from the peri if you have not done so already. By now, you should have met with the doctor – I hope it went well. Please let me know here or via email (jaded_me0223@yahoo.com) how it went. I am so sorry for what you have endured but beleive me there REALLY is hope.

      HUGS!!!

  10. Thank you so much for this blog! I just had my TAC Surgery last Thursday(I’m 13 weeks along). This is my 7th pregnancy in four years with the previous six resulted all in losses(5 2ndtrimester losses and 1 miscarriage and 2 failed vaginal cerclages)I had a great doctor here in Houston perform the surgery and besides feeling a little sore, I’m walking around just fine!!! Thank you for all your insight and God bless you and your beautiful baby!

    • Lucy, this is such a hopeful time for you. Take it slow and bake that little baby of yours! I am so sorry for the pain and the losses of your sweet babies, but beleive me, there is so much joy in your future. Thanks for stopping by, my spirit soars everytime someone lets me know that they have found hope in the TAC.

      Hugs!

  11. Thank you for your story. I have had 5 pregnancy losses, 3 in the 2nd trimester. I lost Sara, March 5, 2005 at 22.5 weeks, Angela, January 1, 2010 at 17 weeks and Justin, October 4, 2010 just 3 days before my birthday. I wish so much I had my children and now I’m 42. In my last pregnancy I asked for the TAC. I told them I didn’t think the vaginal cerclage was enough for me. The Dr. I was seeing (at a high risk hospital) refused and said they would need to try a vaginal cerclage first. I wish I had demanded they help me find someone who would do the TAC then. Maybe I would be holding my son in my arms right now. Unfortunately, my husband is run down. He doesn’t want to try again given our risk factors. He is afraid that if we are lucky enough to become pregnant again, lucky enough that the baby has no genetic issues, it is still a risk that the TAC could fail. I haven’t seen any TAC failure stories on the internet and that gives me hope. We will see the specialist in our area that performs TAC surgery but not until sometime in the new year. He is not accepting patients until January so I hope to hear from him then to just book an appointment. I’m not sure if our visit with him will convince my husband that all the effort is worth the risk.
    I am on a premie website and I also see all the devastating stories of the babies born too early but not as early as mine. It worries me so much seeing the struggles and pain these babys and their families endure. What if we make it past 25 weeks but not any further? We could then be dealing with some very different difficult times. I’m scared but I wish so much we could try again with a TAC. It gives me hope reading stories like yours and others that are trying again after many losses. Thanks again

    • Your husband is trying to protect you. He needs to understand that you are going into this with eyes wide open. There is REAL hope with the TAC. Just the fact that your husband is willing to meet with a specialist speaks volumes. My husband and I prepared a list of questions and scenarios and presented them to Dr. Davis and he was very assuring and honest. We talked success rates and failures; we left his office feeling educated and prepared. I may be going out on a limb here but men are ‘logistical’ in their thinking. Go about it from his point of view…cover all the bases…ask all the questions. Regardless of your final decision, you have to be united and on the same page. Also – work with an OB/GYN that is willing to see you very often until you get to 28 weeks. My TAC worked like a charm. It increased my cervical length immediately after surgery and preserved it the whole pregnancy. I am so sorry for the pain you have endured but I have high hopes for your future.

  12. Jaded – I’m so glad you posted all of this information. I’m 9 weeks pregnant and met with Dr. Davis last week. I’ll be having my TAC placed the first week of January. It was great to read the experience from a patient’s perspective and having more information about the recovery time was really help. Best of luck to you in the future and thank you again for a wonderful post!!

    • I had my TAC placed at the end of the year and thought ‘what a wonderful way to end a year’. The first week in a new year is a wonderful way to start one! I’m glad you stopped by and my perspective could serve you in some way. You are in such good hands! Please give me an update in the future.

  13. You’re amazing for sharing your experiences to inspire so many women going through hard times! I’ve had 2 loses, early 2nd trimesters where the last one I had a cervical cerclage in place…not sure it gave out but the sac ruptured and by the time i was tested and rushed to another hospital to be put in a special upside down bed to give the sac a chance to close back up…I went into labor, lost alot of blood so they had to take me into surgery and remove the cerclage and lil baby that tried fighting to be here. Like I say earlier…I dont think the cerclage failed, I think the sac just ruptured somehow even with me being on bedrest since wk 13 and all this happening at wk 21. I want to try 1 more time because I know I once had 2 lil healthy boys that wanted to come into this world and I want to give my husband a son or daughter in our lifetime. My doc says the medical bored she presented all my cases to say a TAC is recommended with our next pregnancy so I have so much to consider but these post help so much! Will I still have to be on bedrest the while pregnancy? Will I need progesterone suppositories, I had to use them my whole last preg before the cerclage then my doc was just about to stop the suppositories then start the shots instead.

    Either way, I want you all to know you are amazing for sharing your stories for others to grow from. Angels among us!

    Please email me if you’d like to me a new friend, I’m in Houston, TX and on yahoo at rlpenuel@yahoo.com.

    Rebecca Lynn

  14. Thank you! so much for this information I’m 6 weeks pregnant and i would like to have the TAC done. I lose 3 babys 23weeks,22weeks and 18weeks going thought this really misses with your mind. I gave up on trying but birth control always don’t work. I had the cerclage perform twice and no success I’ve been trying to find a doctor who perform the TAC in California but can’t seem to find one. Jade reading your story really gave faith so could you please give me the information that i need to get started. Thank U and god bless.

  15. Thank you so much for sharing, it has helped me so much. We have lost 3 beautiful babies 24 weeks, 17 weeks and 23 weeks. We are trying to remain hopeful but is having a difficult time finding a doctor in Los Angeles area. We are willing to travel anywhere in California. We have 2 more IVF’s left. TAC will increase our chances. Please send me any information you may have.

  16. Jade- Thank you for sharing your story. You don’t know how much you have helped me. I had a m/c with my son at 13wk6d and then another one at 14wks5d (within 6 months) in which I was diagnosed with IC. So when I got pregnant recently My Dr. said I needed a cerclage. I got it done when I was 13wks3d for 2 weeks I was happy and relevied cause I beleived that my baby was safe and that I was finally going to see my baby grow up. Then on April 25th I felt a bulge when i went to the bathroom I called my Dr. and he said to go to the ER and he was going to meet me there. The following day I gave birth to my baby boy. I’ve had so many m/c that I’m so scared to try again and specially if the cerclage didn’t work this time but your story has given me so much hope. I’m going to research more about this time of Cerclage and hope to God that it works when I’m ready to try again.
    Thank you so much 🙂

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