When we discovered we were pregnant with Amelia, we discussed if we were going to want to stop at two or try for a third child. We already had a little boy and now we were going to have a little girl – we were all set. My husband expressed that he didn’t think he was going to want a third child, two was going to be tough enough. I agreed that I probably was going to be ok just having Ethan and Amelia, but I wanted to wait a couple of years before he scheduled his vasectomy, just in case. In my heart, I wanted three babies. I knew I would have Amelia and then a few months later I’d start to miss my big pregnant belly and those tiny baby kicks – just like with Ethan. I was 100% convinced we’d end up with baby fever and have another one down the road. Realistically, I knew three would be a lot to handle as a stay-at-home mom, especially with Ethan and Amelia so close in age, but I grew up as the youngest of three and I absolutely loved it.
After Amelia’s Symbrachydactly diagnosis at 20 weeks, my thoughts shifted. Two under two is a lot, two under two with one of them having a limb difference…that was going to be tough. I decided to be thankful for the babies I had and push those thoughts of baby #3 out of my mind. My husband was right, our hands were going to be full enough as it was.
Fast forward to my 36 week wellness check. I was informed when I arrived that I was going to have my cervix checked. Ok, no problem. I had never had my cervix checked with Ethan, as he was breech the entire pregnancy, so I had no idea what to expect. Let me just say this: ouch. My OB informed me she hadn’t been able to reach my cervix, so my body had not yet begun the process of dilation. I wasn’t concerned because I had been told a few weeks prior that Amelia was head down, so I figured my body just needed a little more time. My OB however, wasn’t so sure. She did an ultrasound and sure enough…baby was breech. She had reviewed my previous ultrasounds, which were done at another hospital, and didn’t see any evidence Amelia had ever been head down. She informed me that at this point, the chances of her flipping were slim so I should prepare to have another c-section. I didn’t realize how badly I had wanted a VBAC until that moment. Why had my body failed me AGAIN? Why couldn’t I give birth the way that women had been designed to?
The following week she did one last ultrasound and…breech. We scheduled my c-section for 39 weeks and then she asked me, “and should we go ahead and do a tubal ligation as well?”. Excuse me? This woman wanted to tie my tubes? I never told her I was done having children, why on Earth would she ask me that?
That’s when she explained to me that she suspected that I had a bicornuate uterus, commonly referred to as a “heart shaped” uterus. A bicornuate uterus is when the top portion of the uterus, the fundus, dips in towards the midline of the uterus – creating a heart shape. Uterine anomalies occur during fetal development, so this was something I was born with (in addition to my tilted uterus – thanks genetics!). With bicornuate uteri, the fetus doesn’t have as much room in the uterus as there is a wall of tissue partially down the center of the cavity. Because of this lack of space, the baby cannot move around as freely as they grow and they are often breech.
Thankfully, having a bicornuate uterus does not typically affect your chance of having a successful pregnancy, unless the dip is extreme. In my case, she informed me that she couldn’t tell how severe the dip was via ultrasound so we would have to wait until delivery and examine it then. She didn’t think this meant I couldn’t conceive or carry another baby in the future, but she did warn me that it would almost certainly result in yet another difficult pregnancy and of course, another c-section. I told her I did not want my tubes tied, let’s just see what my uterus looks like when we get in there.
Fast forward again to the date of my c-section, at 39 weeks. Did I in fact have a bicornuate uterus? No! It turns out I have a septate uterus – a much more concerning anomaly. In septate uteri, a membrane called the septum divides the uterus down the middle, into 2 separate cavities. Women with this deformity are at an increased risk of miscarriage and stillbirth, and by increased I’m talking almost double. For those women that do get pregnant and go on to carry the child to term, there is an increased risk of: premature labor, breech presentation and complications due to bleeding following delivery.
So, can it be fixed? In some cases, yes! Women with this condition may opt for a hysteroscopic metroplasty – which is a procedure in which the septum is cut out and removed. After surgery, between 50-80% of women who had a prior history of recurrent miscarriage were able to go on to have a healthy, full term pregnancy and around 20% of women that previously could not become pregnant, were able to conceive.
I was curious how on Earth the OB that delivered Ethan would have missed that I had this anomaly and I was informed that the outside of my uterus is not at all misshapen, which is surprising, and because I had an anterior placenta – there was no need for my uterus to be “explored”. He didn’t do anything wrong, he just didn’t know there was anything to look for.
The fact that I was able to conceive and carry a healthy baby to full term, twice, is nothing short of a miracle. Sure they were breech and that caused a few hiccups in our plans but aside from that – I have 2 healthy children and may have gone my entire life having no idea I was ever at an increased risk.
So why is baby #3 no longer a possibility?
To me, it’s a no brainer. I got lucky. Very, very lucky. I see absolutely no reason to tempt fate and try for another child, knowing I have this issue. I could try – get the surgery, be a high-risk patient, get the extra ultrasounds…but why? There is a reason why I was able to carry my beautiful babies to term whilst being blissfully unaware of the danger they were in & I’m going to trust that God gave me this diagnosis when he did because I was meant to be done. If I had known after Ethan, would I have tried for Amelia? Maybe not. Everything happens for a reason.
The other reason…the immense guilt I feel about Amelia’s hand. Having a septate uterus means a decrease in the blood flow to the fetus and Amelia’s symbrachydactly was directly caused by a lack of blood flow to her developing hand. My OB assures me that her hand was a fluke, a coincidence, but deep down I have my doubts.
I’m content with our decision not to have another child, it’s the right choice for us. I would never forgive myself if I got pregnant, knowing the risk, and something happened to that child. That being said, I still mourn that that part of my life is over. It’s impossible not to.
What has made me feel better about the situation is knowing that as I close out this chapter of my life, I start another. I can focus on me again. I’m done carrying babies that stretch my skin and leave me heavy with extra weight. No more c-sections to tear me open and leave me with numb, squishy scars. No more breastfeeding to wear me down and impact my mental health. It’s time to get in shape, take back my body and be the best version of me I can be for my sweet little miracles.
