Advice for a momma in potential pre-term labor, anyone?
posted 19th Jan
I'm not sure if it's appropriate to post here, my baby is still hanging out in my uterus, but I have had zero luck in the pregnancy complications forum and honestly I would immensely value advice from moms who have just been where I am now.
So, brief history, I'm 29 weeks with baby number two. Baby number 1 made it to 39 weeks 3 days, no complications at all. I'm healthy, I'm a young mom, never had a miscarriage or any kind of reproductive issue whatsoever. Everything with this pregnancy was perfectly normal, aside from my hyperemesis and his dilated kidney which thank god healed without intervention, until now. At 27 weeks I went to use the washroom and found what my midwife believes was a portion of my mucus plug. The next day while out shopping I started contracting. No pain at all, just far more intense than I'd expect BH contractions to feel now, far more frequent too. Contractions are still going, but slow or stop when I sit still. At 28 weeks 5 days I was sent for an ultrasound. Big beautiful 2 lb 11 oz head-down little guy, but my cervix had whittled down to 2.4 cm. So yesterday, 28 weeks 6 days, I went in for every test under the sun. Negative fetal fibronectin, negative amniotic ferning, literally every possible check on both me and baby were perfect. Which is great, but on the other hand they can't treat the cause of my pre-term labor if there is no cause. So, I had my first steroid shot last night and went back for my second shot tonight. I've been put on bed rest. Mostly modified, I can't have sex or pick up my daughter, but I can still walk upstairs to use the washroom and such from time to time. I'm on three hours per day of strict bed rest, divided into one hour sessions after I wake up, after lunch and before bed. Feet up, side lying, no moving around.
So! Question time. The steroids...oh the steroids. The high risk OB consulted my midwives and two other OBs to make the decision and they couldn't, so they basically said sometimes medicine is more of an art than a science and I needed to make the call as a mother. The issue was my fetal fibronectin indicated I am extremely unlikely to give birth in the next two weeks. Steroids can only be given once, and only last two weeks. So by the time my effacement and contractions rev up and he arrives the steroids may have worn off BUT by then we'd be close to the 32 week milestone anyways. She basically said a 29 weeker with steroids would carry a roughly equal risk as a 32 weeker without the shot, but I'm far more likely to deliver a 32 weeker than a 29 weeker, BUT if I do end up delivering closer to 29 weeks he would struggle quite a bit without the steroids. Basically no right or wrong answer, right? I eventually decided to just do it (hurt like hell!). I figured, as a mother, I would spend every moment of the next two weeks terrified that I had made the wrong choice choosing to wait. But now that both shots are in I'm having a lot of anxiety about whether or not my decision will end up leaving him stranded without this treatment available later on. Have any of you had a similar situation with the steroids? Do you think I made the right decision? Even if you think it was a huge mistake, I can take it, I'm just so bogged down in all of this I really need to hear other viewpoints.
So, aside from the big steroid question, I guess I just wanted any and all advice. This is all very new and I don't know what to expect. Does my treatment so far seem sufficient? How am I going to survive bed rest with a three year old daughter to care for? What's going to happen if my next ultrasound shows further cervical change? How scared should I be right now? I'm sorry for basically writing my life story here, but hey, you all know what this feels like and I literally don't know a single person who has dealt with these issues. I need some mamas to calm these shaky old nerves of mine! Thanks to anyone who read this far, and to anyone who can offer any words of advice for one freaked out mama.
posted 19th Jan
With my first, I had contractions starting around 28 weeks. They acted like normal contractions and never actually went away like BH should. My LO was born at 40 weeks 3 days after being induced.
Honestly, it sounds like you are having BH contractions because they go away when you are sitting.
Also, I've never heard that steroids can only be given twice. A girl I know had steroid shots every week starting at 30 weeks until she delivered at 38 weeks. The purpose of the steroids is to help the lungs mature so I don't really see how the steroids would only be good for 2 weeks. I would assume that once the lungs are mature, they would stay that way?
posted 19th Jan
I am no where near your situation. However I believe I would have taken the same path and gotten the shots just in case.
As for your daughter is there any family members who would be willing to help out? Or could you afford to hire someone to help throughout the rest of your pregnancy?
I wish you the best of luck with your LO and pray he is born healthy.
posted 19th Jan
Thank you so much to both of you for your quick replies.
Browneyedgirl, I initially thought all the same things, but then I've been told that any tightening at all that happens more than four times an hour is worrisome. They are showing up on contraction monitors and take my breath away, but Im still thinking of them as just Braxton hicks that happen to be jerks. The reason why I'm paying attention to them is because everything else is so normal! Something is softening and effacing my cervix but after two ultrasounds and four hours worth of every test under the sun they found absolutely zero reasoning behind these symptoms. The contractions definitely aren't my primary concern, but it's still one of those things that makes me go 'hmm', you know? I also hadn't heard steroids only lasted two weeks and didn't think it made any sense either. I started googling similar stories and found a zillion forums where women are asking the same question about steroids and getting the same replies "why would it only last 2 weeks?". My understanding is that the protocol used to be that it could be given more than just the twice, and that it would pretty much cover you for the duration. But then apparently some studies showed that after two weeks the initial "hey, how about we make some surfactant!" reaction starts to dwindle, and repeat shots don't make a huge difference. Babies still fare better than those that never had it, it's just not as dramatic a difference as those first two weeks. I'm obviously not a doctor, this is just what I've managed to piece together. Confusing, right? I feel like I'm studying for an exam here.
Maria+Cory, you're a sweetheart, thank you. I do have my mother close by who has offered to spend my partners work hours with me to help with the little one. Unfortunately she's disabled and can't always be the most reliable due to health concerns, and my husband works 2 and a half hours away which complicates things further. I'm just in "I'm making this work if it kills me" mode, and childcare fits into that category. If I have to bang on neighbors doors begging them to make my daughter lunch and take her to the park, so be it (kidding! Kidding! Sort of...). Feeling pretty guilty about everything, it feels like choosing between my children. Poor kid spend her third birthday at the emergency ultrasound with me and I swore to her I'd take her to the museum and restaurant afterwards, which crashed to a halt when the on-call told me to run home, jump in bed and call the midwife. And thank you for your input on the shots. I'm hoping the dilemma was more of a win/win choice than a lose/lose one, but when someone gives you such short notice to make a decision about your baby's health it's really easy to start second guessing yourself.