Wednesday, January 14, 2009

The Situation

Dear Everyone,

I am creating this blog so that you all can check it and receive daily updates about Rachael and her baby. The outpouring of care, prayers and support has been astounding and we are so blessed by you all. However, logistically the amount of text messages and phone calls we have been receiving are impossible to keep up with and respond to. We ask that you spread the word about this blog as a form of communication. You can leave "comments" with words of prayer and support. Hopefully Rachael and Justin will be able to check this blog and receive your words!

After what happened with Rachael and Justin's daughter Gracie Anne, we were so relieved and thrilled after her ultrasound last Tuesday, Jan 6th. Everything looked perfect and healthy with Rachael and her baby boy.

Unfortunately and shockingly that sense of well being was short-lived. Monday morning (Jan. 12th) she started experiencing spotting and cramping. Later that afternoon it was discovered that she was dilated to approximately 1.5 cm. After being sent home with a follow up appointment in the morning Rachael decided she needed to go to the hospital. While at the hospital Monday evening it was discovered the situation was extremely dire. She was dilated to 1.7 and the membrane (the sack of water that holds the baby) was bulging out of the opening of her cervix. She was stabilized through the night by lying on her back in a bed that tilted her so that her head was below her hips. she was put on drugs and antibiotics and our family stayed and did TKM (hands on energy work) and prayed literally all night long.

In the morning she was transferred by ambulance to Overland Park Regional Hospital and her care was taken over by the Perinatologists there. After an evaluation Rachel and Justin had a hard decision to make.

1. Wait and just let nature take it's course so to speak. Stay in the hospital on bed rest and antibiotics and hope that no more dilation occurs.

2. A surgical procedure called a "cerclage" where the cervix is stitched shut.

The dangers with the first option were presented as:

1. The longer the membrane is exposed to the vaginal canal there is a greater risk for infection which could cause the membrane to rupture (her water to break) and infection would threaten the babies life as well as Rachael’s.

2. Generally when this condition presents the way it has for Rachael at the gestation of 20 weeks if left alone it doesn't usually stabilize. What they are calling "Incompetent Cervix" progresses quickly and does not end favorably.

The dangers with the second option were presented as:

1. There was an immediate risk of rupturing the membrane (bag of water) during the surgery. That would be catastrophic at this point. The chances of this happening were stated at 50/50.

2. There would be a risk of infection that could rupture the bag 3 to 4 days after the surgery.

3. Rachael would have to go under local anesthesia. This is not recommended while pregnant and the baby would be at risk exposed to the anesthesia.

The doctor said there was not a right decision and that he has seen good and bad outcomes almost equally in both scenarios. And that it was completely Rachael and Justin's decision. He said there may be a very slight lean in favorable outcomes towards the "emergency cerclage" procedure, but definitely not enough for him to recommend it over the other.

After much prayer Rachel and Justin elected to allow the doctor to perform an emergency cerclage.The doctor's report afterwards was this:

1. Good news- the bag of waters did not break.
2. Bad news- the situation was worse than he had originally thought. The cervix *was* stitched shut, but the doctor was unable to recreate the cervix in the way that he had hoped. His words were, "This was not optimal!"

So instead of the scenario that after 4 days with no ruptured membranes/infection. She could go home on bed rest and have a lot of hope of going close to term-- now according to the doctor it is touch and go. He can only hope that the stitch holds and supports her growing baby. She will not be leaving the hospital.

The next few days will be crucial. If the membrane is going to rupture from infection, the doctor feels it would be within the next few days. So come Sunday we can be thankful that no infection took hold.

Our goal at the moment is to make it to the 24 week mark, where the baby is then considered viable. He has a fighting chance after 24 weeks. Anytime before that would almost certainly be tragic.

At 24 weeks they will start giving Rachael steroid shots to help the babies lungs develop at a faster rate. The doctor has not given us odds. We don't want to hear them. He has made it clear that this whole scenario is very grim, but not without hope.

We want everyone to stand strong with us in prayer BELIEVING in a miracle in this situation. We know the power of prayer and we need your prayers desperately. Contact anyone you know who will pray and direct them to this blog for updates.

I hope that this will detail a beautiful journey and that Rachael will be in the hospital growing that baby against the odds for many many more weeks. She will be 21 weeks tomorrow, Thursday, Jan. 15th.

Rachael and Justin have named him James Douglas (a family name on both sides)and are calling him Jimmie. He continues to look great. He is active and healthy.

We have asked--of course--"why is this happening?" The doctors don't ever usually really know for sure, but it could be that an infection caused this to happen or that her cervix was damaged during her induction when she had Gracie Anne. The latter is what I feel is the case. She had a drug called cytotec inserted in her cervix during that induction and while most women that have that done do ok-- there are definitely risks and side effects. To me that makes the most sense in this situation.

It has been stated that in future pregnancies one with this history would have a cerclage put in easily and with relatively little risk at 14 weeks and have great odds at going to term.

We cannot thank you enough for your prayers for Rachael, Justin and little Jimmie!

Thank you!


P.S. For anyone new reading this to start from the beginning, just scroll down and click "newer post" to read the next one and that will take you through all of the posts in the order they were published.


  1. Thank you for the updates. We want you to know we are there, but we don't want to bother you with everything that is going on.

    You certainly have our prayers. Make sure you let us know when we can help. And please relay to Rachael and Justin our love. Let us know if they ever feel like vistors.

  2. Rach,
    I just want you know that I love you very much. I don't even know what to say, my heart is aching for you....Just know that I am praying for you, Justin, and little Jimmy constantly. Bed rest can be boring, and your mind can wander alot, so anytime you want to talk, please call me. But, if not, I understand completely. I love you!!!

  3. Justin and Rachael,
    We are sending prayers to the throne of God for all three of you, and our church lifted up many living words of prayer Tuesday night for you. There's action in the heavenlies for Jimmy's life and health! Take courage, you are bathed in prayers and love!

  4. Thank you so much for the updates. We're praying for you constantly! "The effectual fervent prayer of a righteous man availeth much." (James 5:16)

    We love you all!!

    Adrian and Janelle

  5. Rachael and Justin,
    Our hearts go out to you both...
    We continue to pray for little Jimmy and your strenght in getting him to 24 weeks. I know you can do it Rachael, you really can. Amy has been keeping us up to date as well. Our prayers continue regularly as well as thoughts of you and what lays before you, the miracle of life.
    Keep smiling and praying and loving each other,
    Lots of love
    Clare and Rick (Amys sis-in-law)