I Heart My Uterus

Piper - 6 Days old.

Piper's birth was amazing in and of itself, but shortly afterward we received information that makes her existence even more stunning. The doctor that performed the c-section mentioned to us, rather off handedly, that I have a bicornuate uterus. We were in in recovery, I think, when he told us, or rather, asked us if we knew that I had this condition.

At the time, I had only a vague understanding of what that meant. A normal uterus is like an up-side-down pear - the top having the most space. A bicornuate uterus is malformed on top with a wall coming down in the middle. Basically, I have a heart shaped womb. There are a lot of variations of a bicornuate uterus - from just having a small septum that creates two little humps at the top of the uterus to ones where the septum runs all the way down essentially creating two separate wombs as well as two separate cervices. Mine, apparently, has enough of a septum to distort my fundus into two large humps instead of the smooth, round shape the top of the uterus is supposed to have - thus, the heart shaped uterus.


When the OB came by our hospital room a couple of days after Piper was born, he gave us a fuller explanation and literally drew us a picture of it. He said that this is something that is formed when you are still a fetus and there is nothing that can be done to prevent the formation and gave us some rough statistics about it. Apparently, this is also the reason that Piper wouldn't turn from the breech position; she couldn't turn. She was stuck in one of the humps of my heart shaped womb. "If only he had known this", the doc said to us, "I never would have even tried the version". He acted like it was a waste of his special skill. He also asked why I had never been screened for this deformity since I did have 4 miscarriages. We didn't know, but some questions of my own were starting to form.

Here is what I have learned and what makes Piper all the more precious to us:

A bicornuate uterus is a birth defect, there is usually nothing that can be done to repair it and it often goes unnoticed until there is a problem with a pregnancy. It occurs in about 0.1% of women. If the baby starts growing in one of the humps on top of the uterus the pregnancy will usually end in miscarriage, because that area cannot expand enough to accommodate a baby. This could explain all of the miscarriages I had.

If the embryo implants in the larger, lower part of the uterus it has a better chance of survival, about 55%. As the baby grows and starts to run out of room they often end up in a breech or transverse position and get stuck that way. There is a 25% chance of preterm delivery with these babies. Piper was born at 39 weeks, which is considered full term, so she was very lucky in that regard as well. Preterm babies can have so many problems, it's scary to think about. Some babies are born with birth defects from being cramped, or have low birth weight or an abnormal size, or general growth retardation - Piper has none of these, another bullet dodged. So, of course, pregnant women with bicornuate uteruses are considered high risk - my old doctors got that right, just not for the right reason.

Knowing all of this answers a lot of questions about what was going wrong for us, but it leaves me with a sense of frustration that none of our doctors ever thought to check for it. The diagnosis can be made with an ultrasound, how could this have been missed for the last three years? The only tests I was ever sent for were blood tests, which all came back normal. Did the doctors just not think that this was a possibility? I may never know.

I knew that Piper had a miraculous entrance into this world, I just didn't know that the miracle started the day she was conceived. It is such a wonder how all of the stars aligned and everything worked out so beautifully. And the whole issue of getting Piper to spin and not being able to do so also makes perfect sense now, too. She wasn't being stubborn, she was stuck in my 'heart'. Griffin, Piper and I are indeed very lucky to all be together now.