Did the op I begged doctors for kill my unborn baby?

As it’s revealed cervical stitches increase the risk of miscarriage, one mother’s haunting question...

THERE is a quiet glade in my garden. In the middle stands a lone magnolia sapling, encased in a mesh frame to keep it safe from the herds of deer who roam this unspoilt area on the north Devon coast.

Planted beneath is a tiny white box which says: ‘The remains of baby Marianne Grace Evans, who died on January 25, 2013.’ Inside are some of my firstborn baby’s ashes; the rest are scattered in the bluebell woods of Kew Gardens.

I planted the tree earlier this year after moving from London to Devon and I visit each day to say hello to my little girl, born at just 22 weeks when I was 31 years old. She was too early to live: doctors won’t attempt to save a premature baby until 24 weeks.

I take Rosalyn, my little girl born last August, when I make this pilgrimage. But as comforting as I find it, each visit is tinged with profound sadness. Guilt that I was unable to save Marianne nudges to the surface. I have to remind myself it’s irrational. It’s a daily struggle, but reason has always won.

Until now. My certainty was shaken, if not destroyed, by a new study which suggests that a cervical stitch, made to secure the entrance of the womb for women with a history of late miscarriage or premature labour, could have been the reason Marianne died.

The terrible truth is that I pleaded with my NHS consultant — and ultimately paid privately — to have this stitch, so concerned was I to avoid losing her.

DocToRSwon’t normally perform the procedure unless a woman has had at least one late miscarriage, and Marianne was my first baby. The research, by Imperial college London, says certain types of cerclage, as they are known, can trigger premature labour. In fact, they may be responsible for a threefold increase in stillbirths.hs. When my husband Adrian and I tried for a baby, I was luckyy enough to get pregnant straight t away, but from the start my preggnancy was fraught. I bled heavily, y, each time fearing I’d miscarried d — only to be sent home as Mariianne’s heartbeat was picked up.

I knew something was not right, t, and in the end I saw a privatee consultant who diagnosed ann ‘incompetent cervix’ — a ghastly y term — and said I needed a cervical stitch urgently. I was 18 weeks pregnant and he could not t hide his horror that the problem m had not been picked up sooner.

I had the stitch immediately, at t a cost of £6,000, two-thirds of itt paid by my health insurance.

For 30 days, the stitch, which I should have had before 14 weeks s to be most effective, held before my waters broke in the early hours of a freezing January morning.

I went into labour three days later and Marianne died during those long, dark hours I spent in futile agony — a heartbreakingly beautiful little girl. The years since have Trauma: Jahanara and Susan were both failed by the procedure been marred by depression. only With Rosalyn, I paid £20,000 for Rosalyn’s birth helped restore ante-natal care. I started to dilate some of the light to my life. at 12 weeks, but thanks to a daily

Now, after reading this new dose of progesterone (something I study, I am left reeling. By having was given too late with Marianne), a stitch fitted, did I unwittingly I didn’t need a cervical stitch and cause the death of my baby? she was born at 36 weeks. By coin- cidence, the new research, published in Science Translational Medicine, is by Professor Phillip Bennet, who delivered Rosalyn. His findings raise a serious question over the thread used in m most cerclage procedures.

one in every 200 pregnant women — around 3,250 mothers every 12 months — are estimated to have a cervical stitch fitted.

of these, 80 per cent are fitted with a thick, woven 5mm tape — as I was — in the belief it is stronger than the 1mm singlestrand nylon thread used in the remaining 20 per cent.

The study suggests this thicker t thread creates a dangerous breeding ground as bacteria can latch onto its woven structure more easily, and could be the reason 260 babies die every year and a further 280 are born early.

In fact, babies are three times as likely to be stillborn or miscarried and almost twice as likely to be born prematurely when the thicker thread is used. By using the thinner thread, the report says more than 170,000 deaths could be prevented worldwide.

Was my Marianne one of this startling number? I can hardly bear to think about it.

Professor Bennett, the lead author, has ‘strongly advised’ that thicker threads are not used until the risks are investigated further.

As well as analysing 671 women who had been fitted with both types of stitch, the study saw another 50 women fitted with a cerclage and then monitored. The results were startling.

‘At the beginning of the trial, all women had similar types of harmless bacteria, called lactobacillus, around their cervix,’ Dr David MacIntyre, another of the study’s authors, said.

Four weeks later, 45 per cent of those with the thicker thread had the lactobacillus replaced with potentially dangerous bacteria.

‘Women with the thinner thread maintained normal levels of harmless lactobacillus.’

Leading obstetrician Professor Andrew Shennan, who runs a preterm labour clinic at Guy’s and St Thomas’ Hospital in London, urges women not to panic.

He says one possible reason for the higher miscarriage rate with the thick thread is that it requires more skill to use the thinner one, so the thick thread can be fitted by less experienced doctors.

However, he has found the abdominal stitch, so- called because you cut open the abdomen to fit it, to have a success rate of ‘almost 100 per cent’.

The procedure, available on the NHS but not widely used, involves major surgery to block the cervix. Unlike a cerclage, it means all future pregnancies will have to be delivered by caesarean.

JAHANARAFarley is placing her hopes in an abdominal stitch after three devastating miscarriages. The 35-year-old finance administrator from South London had a thick thread stitch fitted for her most recent pregnancy, but went into labour at 21 weeks. ‘I have suffered from depression, I have felt myself shutting down and it has been very hard,’ she says.

‘I am very scared about getting pregnant again but I will give it one more try and see if the abdominal stitch holds.’

Another of Prof Shennan’s patients is physiotherapist Susan Harper- clarke. She, too, has a weak cervix and suffered two late miscarriages in 2010 and 2011.

Susan, 38, who lives with her husband in Middlesex, was fitted with an abdominal stitch soon after falling pregnant in 2011.They now have two healthy boys, Tom born in July 2012 and Will in 2015.

She believes she would not be a mother today had she relied on a cervical stitch. ‘ What I went through with Emilia and Grace is a deeply traumatic, mind-numbing ordeal. After Emilia I kept thinking, why has this happened? I still beat myself up thinking I could have held on for longer, just a few more weeks and they could have been saved. But thanks to the abdominal stitch, my little boy Tom is about to start school.’

A new trial of 900 patients is underway, organised by University of Birmingham, comparing the threads. Hopefully its findings will allow women to make an informed choice — and to consider progesterone or the abdominal stitch.

For my Marianne and all the others who may have died needlessly, any research comes too late. I will forever be haunted by whether I made things worse in trying to save her. I try to console myself that I did my best. Sadly, it wasn’t enough.