Would you go for a third w/2 preemies? *Update*

[Lousli]

My two girls were both late term preemies, one w/no NICU stay who was born at 36 weeks after PPROM and one at 33 weeks with a 3 week NICU stay. She was also born after PPROM but it was following a long chain of events including a stomach virus, 4 day hospital stay with almost no sleep for me, and pulmonary edema followed by a diuretic and then my water broke.

My kids are now 8 and 5 and so I'm a bit older as well, just turned 37. A recent visit with my new OBGYN confirmed that they'd see me as high risk but likely to be able to make it to about another 4 or 5 pound baby. And they'd offer me progesterone shots as well, which were still a fairly new option when I was last pregnant.

Other factors aside, would you go for it? Would you assume a delivery within the 33-36 week range or do you think there's any chance of me making it to term with the shots? I'd like to do my best to time the due date right if I do this since I'm a teacher and a late spring birth would be best.

*Update* We went for it! Pregnant with #3, due 3/15

[moaningminny]

I'm sure you know this is a decision that's very, very personal and is only something you can decide.

Having said that, I personally could not go for a third. DD #1 was born at 31 weeks after PPROM, and we had a scare with DD#2 where I ended up with steroids again, but she made it to 39 weeks. I couldn't go through the stress again as well as a possibility of having a baby in the NICU with two other children to care for.

I wouldn't "assume" anything as far as delivery times go. Considering you've already had two preterm births, you know you have an increased risk of having another one, and although you and your OB can do as much as possible to extend another pregnancy, there really are no guarantees.

Also, for me I wouldn't be happy with another 4 or 5 pound baby, because the challenges that my child went through as well as the consequences of her early birth are not something I would want to repeat. I kind of feel like we pushed our luck with our second, so we're now very firm in our decision to not have a third.

Again, it's a very personal decision. My response is purely from what I would do in my own situation, not what I would expect someone else to do.

Good luck with your decision!

[EmilyG]

I think the risk of a late preterm baby would be worth it for me if I was really wanting a third. I don't know much about the progesterone shots, but if they help, thats even better!

[liberal_chick]

My ds1 was born at 30 weeks due to PPROM. We decided to have another baby but if there was another early birth, even if the baby didn't survive (which was a real possibility with ds1 b/c my PPROM occured at 20 weeks), we would be done.

We were lucky enough that ds2 went full term. Had he been early, I couldn't have risked it again. Statistically, they just keep coming earlier (I know there are exceptions...) and I just couldn't do it; for me OR for the baby. I know prematurity isn't easy on them either. I know someone who has a 30 weeker, a 28 weeker, a 27 weeker and is pregnant again. I think she's crazy, but obviously it is worth it to her.

[sunnygir1]

I agree with a pp that it is a very personal decision, but dh and I have decided not to. For us there are two major factors:

1. Both of our babies were born at 35 weeks (premature rupture of membranes as well) and both were okay. However, it is a major stress and worry wondering how early the baby will come and if the baby will be okay, and having to birth at a hospital with a level two nursery (more than an hour from our home). And it is so much work, stress, and sleep deprivation dealing with slow nursers, underweight babes, jaundice, etc. As I get older, it will only be harder on my body and more likely that I will have twins...

2. I had horrible gallbladder pain with both of my pregnancies. I spent the entire last month of my second pregnancy on the couch or in bed almost all the time because of the pain. I am not interested in surgically removing my organs if I can help it. It is a major stress on our family for me to be so miserable and unable to work or function for much of my pregnancy. It isn't fair to my dh or our two children, and I don't want to go through it again.

[susienjay]

I did the P17 injections with my youngest son. He was born 8 days before his due date. Before I had him I had 32 week twins and a 29 week dd. My 29 weeker was due to a placental abruption which I was told I had a 10% change of having again. I wound up with no trouble at all with ds though. His pregnancy was probably one of my easiest of my 5 pregnancies. The P17 injections made me kind of uncomfortable but not too bad. It wasn't until we got close to week 30 and I'd had over a dozen shots that I started to really feel sore. Had ds been early I think we would have been done because I don't think I could do another NICU stay. Now ds is 2 and I'd love to have another one.

They even came out to my house to do the injections. That was really nice not having to drag the kids some place every week to get my shot. The nurse that came out to do them was an OB nurse that was working pretty limited hours because she had young kids. She usually came on the weekend to do the shots when her dh was home. I also got my blood pressure checked and she'd check the baby's heart rate. It actually kind of helped me relax a little bit since I was being checked so frequently. I'll probably try to do the shots again if we have another. One of my OBs felt that they were snake oil and thought they were a waste of time. My Peri strongly recommended them though.

[sbrinton]

I've had preterm labor with all my pregnancies and have delivered earlier with each, 37 weeks then 35 weeks then 31. My doctors haven't said absolutely no, but they have pretty strongly encouraged us to avoid pregnancy. We're planning to adopt.

For us, I think it came down to knowing how difficult a high-risk pregnancy would be not only for me but for our family. If it was just me and my husband - or if I had the most amazing nanny in the world who could be on-call around the clock for nine months - I would be up for it. But for me in reality, pregnancy would involve bed rest pretty much until I gave birth. This would be too hard for our three boys, who are all under the age of six. Furthermore, we still have ongoing health issues with these guys.

Plus if we adopt, we can pick a girl. :-)

We were offered the p17 shots in my third pregnancy and declined. Our main perinatologist does not like them, feels like the research is inadequate. Some of the other perinatologists do like them.

Do you have any idea why your water broke? Are there things you could do to prevent the same outcome? What kind of support do you have around your family if you do have a high-risk pregnancy, end up on bedrest, in the hospital, or with a preterm baby?

[Lousli]

With my first, absolutely no idea why my water broke. With my second, I'm pretty sure it was due to the complications and the stress my body was under. I had 4 days of contractions, vomiting, tons of medications (for vomiting, for contractions, steroid shots, even morphine to try to help me sleep, the diuretic), very little to eat or drink that I was able to keep down, then because of the fluid in my lungs I had to be on oxygen.

But all that time I never really dilated or effaced and my fetal fibronectin was negative. It was only after my water broke on the 4th day that I went into active labor. So I really think that my chances would have been much, much better if I hadn't gotten so ill.

As far as support, my parents both live here in town and I have several close friends, including one who has had a preemie in the past. My kids are older, one is 8 and the other 5, they would be about 9.5 and 6.5 when I would plan to have the baby. Both are in school since I work at a Montessori school and they attend for free. Bedrest would be hard, certainly, but my plan would be to get pregnant to be due around May or June, with the hope that I could work throughout most of the school year and then be able to be home all summer. If I were due at that time, even if I had to be on bedrest I'd be able to get the kids in my class through bulk of the school year I think.

[mrsfru]

Originally Posted by Lousli

My two girls were both late term preemies, one w/no NICU stay who was born at 36 weeks after PPROM and one at 33 weeks with a 3 week NICU stay. She was also born after PPROM but it was following a long chain of events including a stomach virus, 4 day hospital stay with almost no sleep for me, and pulmonary edema followed by a diuretic and then my water broke.

My kids are now 8 and 5 and so I'm a bit older as well, just turned 37. A recent visit with my new OBGYN confirmed that they'd see me as high risk but likely to be able to make it to about another 4 or 5 pound baby. And they'd offer me progesterone shots as well, which were still a fairly new option when I was last pregnant.

Other factors aside, would you go for it? Would you assume a delivery within the 33-36 week range or do you think there's any chance of me making it to term with the shots? I'd like to do my best to time the due date right if I do this since I'm a teacher and a late spring birth would be best.

I always intended to have a third--later--like when my first two were the age yours are. Instead, I found out that I am pregnant now-34 yrs old, ds1 is 4.5 yrs, and ds2 is 19 mos! DS1 was born at 29 wks after a placental abruption, and ds2 was born at 35 wks after 5 weeks of bedrest (2 in the hospital) for low amniotic fluid. In both cases, I knew my blood pressure was a bit wonky, but no one else caught it or treated it.

At any rate, some things have changed--we know that I have a clotting disorder and are treating that--plus we know how severely affected by stress I am. It definitely causes my bp to vary a lot. This time around I'll be requesting some additional measures to treat my bp. I'm walking every day. I've quit caffeine and fried food. I'm watching my salt intake. I'm eating oatmeal to help get my cholesterol down (borderline high--probably related to stress, genetics, and poor eating habits). I've also been reading up on pregnancy nutrition and the new vitamin recommendations. I hope it all makes a difference. I would assume that this baby is our last, b/c hubby will fight me tooth and nail to get a vasectomy after this one!

And fwiw, I wouldn't assume anything about delivery--every pregnancy is different. Mine was totally different w/ds2 until I hit 30 wks. We did manage to get another 5 wks! If you don't see a Maternal Fetal Med specialist (high risk ob/gyn), definitely consult w/one before you ttc if possible. That could really help. And have one take care of you during pregnancy--they did extra things w/me to help us recognize early trouble signs and it did help a lot!

GL!

mrsfru

[Lousli]

Thanks! I did recently ask my OB for a referral to a perinatologist. I asked to see the one who came in to check on me during my hospital stay before my second was born. He really seemed to know his stuff. So I will see what his advice is when I meet with him.

[pauletoy]

I have 3 premature little ones, with our first we made it to 37 weeks 1 day. 2 of them had an extended stay in the NICU. Our youngest was 33 weeks. He was on CPAP for a while after birth, had RSV twice (now has been diagnosed with asthma), has a speech delay, and other developmental delays as well but we fully expect him to eventually catch up.

I would love to have more children but each one of mine have been earlier than the previous one due to IC. The preterm labor started earlier with each one which meant hospitalization and bedrest started earlier. And the complications of prematurity have increased with each child. We are to a point now where it is just too dangerous to actively plan another child, both for me and the baby. Sadly, I have major baby fever.

OP, given your circumstances, I would definately try again but you need to do what is right for your family.

[SativaStarr]

My first 2 were near-term preemies born healthy.. I decided to go for #3 and declined progesterone shots and had a nightmare pregnancy.. I'll elaborate in a bit here..

DS was born at 35 weeks 3 days after preterm labor began at 35 weeks exactly. Finally after 3 days they determined I had a partial placental abruption and ruptured my membranes. He was born 4 hours later at 7 lbs, 20 inches and was healthy. He roomed in and we both went home 3 days later.

DD was born at 34 weeks 1 day after preterm labor started at 33 weeks. I was admitted a week prior to her birth and by that evening was at 6 cm. Miraculously with round the clock nifedipine and bedrest they were able to delay her birth until 34 weeks. I was given steroids at 33 weeks, but she was also born completely healthy at 5 lbs 9 ozs, 18.5 inches. She was transferred to NICU for observation but sent home after 3 days becasue they had no reason to keep her.

I decided to plan for a 3rd since my first 2 were healthy despite being early.. I figured I'd have another 34-35 weeker.. yep, not so lucky!

I ended up going into preterm labor at 24 weeks, was admitted and put on magnesium sulfate and terbutaline.. they never were able to fully stop the contractions, only stop me from progressing so I ended up in the hospital on the drugs and strict bedrest for 8 weeks! DS2 was born at 32 weeks 1 day after I suffered another partial placental abruption. Again, they ruptured my membranes and he was born an hour and 20 minutes later at a tiny 4 lbs 2 ozs and 16.75 inches. He went to NICU and spent a long 5 weeks. Despite the steroids his lungs were very immature and he required a vent and then CPAP for 2.5 weeks. He is now 17 months and has chronic lung disease, cerebral palsy, developmental delays, and feeding issues.

After what we went through with our last pregnancy we planned on being done, but lo and behold we ended up pregnant while using birth control.. I'm currently 12 weeks along with a very unexpected #4 and seriously hoping things go better this time. I am doing the progesterone shots this time beginning at 16 weeks, and while my OB is not expecting me to go fullterm she is hoping I can at least avoid a lengthy hospital stay and make to hopefully 34 weeks. We shall see..

[henriksmom]

I am in the same situation as you are but am considering a second, not a third. My membranes ruptured at 28w 2d and I went into labour at 29w 6d. It was the best and worst year of my life, as you know.

The cause of my pPROM was never detected. But I did have a hysterosalpingogram to rule out any structural abnormalities. Nothing was found. But I was a preemie due to pPROM.

So it is a very difficult decision. I am in my mid thirties so I need to make it soon. I think that I would be crazy to go through all of that again. Maybe it will be a worse outcome, who knows. But I may forever regret not having another.

Don't take this question wrong. Do you really want another child or want to possibly have a normal pregnancy and full term baby? I really dream for all that I missed out on. Maybe my midwife water birth. The newborn in my room. Going home with a baby, etc. I missed being successful at breastfeeding.

So in addition to the risks associated with another pregnancy I think that it requires a deep understanding why we want the next baby.

I almost had a 28 week old baby. I think that this decision is causing me depression right now.

Do you have any statistics on pPROM?

[wills_mom]

My first son was born at 37 weeks with a ROM followed by labor. Hehad some slight issues with Jaundice and low Blood Sugar but came home after a few days in a Level 1 NICU. He was a c-section, so I was discharged with him. DS #2 was a PPROM at 32w5d and born at 33w3d. He was also a c-section due to a transverse/breech presentation. His birth was rough and he had a hard time coming out. He had a low initial APGAR of 5 and needed resucitation to get him going. After that it was room air, which I am very thankful for. I did get the BMZ shots in the 4 days from rupture to delivery. He did get an infection and meninigitis from the prolonged ruputre, but recovered well. He also had a PFO (hole in his heart) but it closed on its own and the murmur with it dispersed. He does have asthma, but they do not think it is related to his prematurity, rather gentic (I had asthma as a child).

I am now currently 34 weeks along, with a surprise pregnancy. I have been getting 17p shots from 20 weeks and got my last one yesterday. I am also taken a mega dose of Vit. C every day to help with collagen strenght, which is what the amniotic sac is made of. We did not plan this pregnancy, but I am so happy I got this far. Hopefully I have a few more weeks, at least, ahead of me. Good Luck with your decision.

[OneWithTwo]

I would. Both mine were born at 32 weeks. With my first, we have no clue what happened. The amniotic fluid disappeared and there was no leaking.
With my second, I had placental abruption and no clue as to why or what happened?
I want a third. I have always wanted 3. Although I hope I am in a better situation when I have a third, like being married or with a partner for awhile.
While it was stressful, we managed it and survived and I wouldn't trade my son for anything.

[guerrabug45]

My DS was born 34.2 weeks gestation (pProm). I was much to grateful for his health to try for another child. We were lucky once, why tempt faith? Lo and behold six years later we have a surprise on the way. As of today I am 34.4 weeks and every one of those days has been filled with anxiety and worry. I am an emotional wreck. I know that this little one will complete our family, I am not strong enough to go through this kind of worry again. I think many people have carried full term after preemies I really think your willingness to try is a testament to your inner strength. Good luck with your decision!

[Lousli]

I met with the perinatologist, and she was awesome. She has a really good plan for me that I feel comfortable following, and so my husband and I have decided to go ahead and try. It is a bit scary, but all the things worth having in life are a little bit scary imo.

So, wish me luck and babydust and a full term baby this time!

[wills_mom]

Good news! Just for extra encouragement, I am now 3 days from my EDD with my third. Uncharted territory for sure.

[SativaStarr]

Congrats! I hope you have better luck than I do.. I'm 24 weeks 1 day now and I have been in the hospital now for the past 2 weeks thanks to preterm labor.. back on magnesium sulfate and terbutaline with pretty much no hope of getting out of here until delivery.

I'm opting for tubal this time around.