Suffering your first loss is very traumatic.  In my own experience I was sick with panic and sheer fear that I would never have the baby I dreamed of.  No one advised me where to turn or what to do next.  I was sent home with printed material about grieving and it made the situation that much worse. I was told to schedule a 6 week appointment and that was the extent of the advice.  My husband and I knew we needed to start over with a new doctor because we felt a fresh start was needed and another opinion would be advisable.  A month after my loss I contacted the hospital I delivered our loss at and sought out the best high risk doctors I could find.  Once I found the office where the perinatologists practiced the front desk made the consult appointment for me and that's how it all began.  I did not have a referral from my current doctor I just called the perinatologist's office myself and set up the consultation appointment.  I also went in person and obtained all my medical records from my current doctor regarding events and appointments leading up to the loss and took them with me to the consultation.  The records probably were not needed but I wanted them so I could make some sense of what happened.

If you are in the beginning stage of pregnancy or not yet pregnant, I would ask the following questions of your doctor.

1. Can you do any diagnostic tests like HSG or dilation test to confirm IC?
2. Can you measure my cervix with ultrasound and tell me my length (2.5centimeters long or less can be concerning)?
3. Do you advise a cerclage for next time?

Once you and your doctor decide on having a cerclage placed I would ask the following questions.

1. What week of pregnancy will cerclage be placed? (earlier the better e.g. 12 weeks).
2. What type of cerclage will you place (MacDonald , Shirodkar, or other)?  If its a MacDonald will it be a double stitch?
3. How often will an internal be done to feel that the stitch continues to be tight?  How often are appointments?
4. How often or will you measure my cervix via ultrasound to check for cervical shortening & funneling?
5. How many cerclages approx. have you done? (If you go to a hospital that is a teaching type hospital ask if he/she performs the cerclage themselves).
6. What restrictions will be placed on you after cerclage is placed?
7. Will an ultrasound be done either day of or days prior to cerclage placement to check for any obvious red flags that could be wrong with baby before that stitch gets placed? (Personal experience I always liked to know my current cervical length before my cerclages so later I knew how much it changed).
8. Who will be the one who monitors the cerclage or will it be checked by a different doctor each time? (Its preferable to have the doctor who places the stitch be the one to check it at every appointment).
9. If you are in with a large group of doctors ask if he/she has a collegue who specializes in the cerclage surgeries or who has the most experience placing these?