Great idea Lesley! Here is some information from posts I've made before, just to get it all in one place.
Here is my short story of my experience with preterm labor and delivery.... I had severe preterm labor with my twins, starting at 27 weeks. I was on complete bedrest, a terbutaline infusion pump, and uterine home monitoring. I bounced in and out of the hospital several times for "contracting over my threshold". Then at 29+6 weeks, I was admitted to the hospital and put on a "toxic dose" of magnesium sulfate. It didn't help much. They gave me the steroid shots to mature the babies' lungs. Then at 31+2 weeks, my contractions finally broke through and I delivered my twins, exactly 2 months before my due date. 3-14 and 4-4 were their birthweights. They were in the NICU for exactly 4 weeks -- mainly "feeder growers" thank God -- and then came home from the hospital equivalent to about 35 weeks gestation. Fortunately, they thrived and are doing great today. You'd never know they were preemies once.
Two years later I got pregnant again (a singleton this time) and I was monitored for preterm labor again. I worked with a labor doula, a midwife, and the same perinatologist from my twin pregnancy to ensure I didn't have preterm labor again. A lot of what follows is the advice they all gave me... some natural approaches, some the latest research in medicine. Throughout my pregnancy, my preterm labor was kept in check, and I delivered a healthy full term baby boy.
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"Don't Worry... it's JUST Braxton-Hicks" and other well-meaning but dangerous comments:
I think a lot of well meaning friends or even MDC members have a tendency to blow off concerns or actual experiences with preterm labor as though it's a natural part of pregnancy. Everyone wants to believe that everything happening in pregnancy is natural and the way it should be. I used to hear things like "your body's just preparing for real labor" or "don't worry, it's probably just some intense Braxton Hicks" during my twin pregnancy. And a lot of times this is true. Obviously for me, it wasn't.
So when do you know the difference? First of all, if you are worried, take this feeling very seriously. Second of all, if your midwife or OB diagnoses preterm labor, take this information very seriously. If you are less than 37 completed weeks, it is too early for your baby to come. Such a baby if born would be "preterm". And a baby born less than 35-36 weeks would almost invariably be considered "premature" (i.e., body organs are not mature yet). For example, if you are 34 weeks pregnant and experiencing intense or frequent contractions, please do not assume all is well and the baby is just "done a little early". If you are truly sure of your dates, a 34 weeker should be born in a hospital where she will likely need NICU support not to mention weeks of very careful support to even wake up enough to feed.
I think some of the confusion comes because when some of us use the term "preterm-" or "prodromal labor", what we really mean are just normal contractions or Braxton-Hicks that are part of any healthy pregnancy, or a very prolonged early labor (but for a full term baby). If you are contracting 6 times an hour and your cervix isn't doing much, you're not in labor. Labor = contractions that produce cervical change. But if you're like me or Lousli or any number of other mamas who had real preterm labor (i.e., contractions plus cervical change loooong before the baby/ies should be born), you should take serious action to stop the contractions asap. That's different from someone who has contractions but makes it to full term, and that's just how their body does it. Hope that explanation makes sense.
OMG I think I'm contracting too much. Now what?
For those who are at risk of developing or are currently experiencing true (i.e., bad) preterm labor, here are some things you can do:
* Take a lukewarm water (not hot!) bath loaded with epsom salt. Epsom salt is magnesium sulfate(!) which is what they actually use to stop preterm labor in a hospital. Do it every day if you can to keep strong contractions from coming back.
* Drink AT LEAST 12-14 8-oz. glasses of water a day. More if you can take it. Dehydration (even mild) is a leading cause of contractions. But don't just drink water.... remember your electrolytes too [see below for more information about that]
* Stop drinking all tea, coffee, whether caffeinated or not. Tannins in these beverages can be very irritating to the uterus.
* Stop drinking Red Raspberry Leaf tea or eating anything with raspberries at all. Yes, I know this is controversial, but I've read a lot of research saying while it's safe and beneficial for most women, for some women (i.e., women with "irritable uteruses") it can bring on preterm labor. My midwife AND my doula both told me not to drink any, ever, during my pregnancy due to my history of preterm labor. [see below for more information about RRL tea]
* Avoid all herbs in the mint family, including any mint and also basil. Again, these can be irritating to the uterus in large quantities (e.g., mint tea, large helpings of pesto, and so on).
* Lie on your left side as much as possible. It improves blood flow and calms contractions.
* Start taking at least 500-1000mg Vitamin C per day, immediately and throughout your pregnancy, and, after 28 completed weeks, 2-3g of Alfalfa per day, which will help prevent premature rupture of membranes (PROM).
* Talk to your doctor/midwife to see if you should be on full bedrest.
* Talk to your doctor/midwife to see if you should be taking a tocolytic drug (e.g., terbutaline) to stop or lessen the contractions.
* Have a drink... or two. I know everyone hates this recommendation, but the bottom line is a baby is better of with a little alcohol in her bloodstream every once in a while than being born at 24 weeks.
In fact, Ina May Gaskin wrote in her book Spiritual Midwifery that she recommends women who are contracting too much preterm to sip vodka!
To recap... to stop contractions as quickly as possible and buy yourself some time, do this ASAP:
* Lie down (completely horizontal) on your left side.
* Drink 4 huge glasses of water and some Gatorade.
* Call your OB or midwife.
* Sip some vodka or other non-tannin containing alcohol (no wine). These will settle the contractions. Do NOT drink if delivery is imminent. Disclaimer: This is NOT a license to go on a drinking binge - we are talking about 2 maybe 3 drinks at most over a period of an evening every once in a while to stop contractions that are too frequent/strong/building in a preterm pregnancy.
* When your contractions settle a little, take a bath loaded with Epsom Salt.
* Go the hospital if you detect cervical change (from self-exam), feel crampy, are contracting too much, contractions are regular, or if you just KNOW something is wrong. They will monitor your contractions, stop the contractions with an IV of sugar and saline (aka gatorade
) and medications if necessary.
Supplemental Progesterone:
There is a lot of cutting edge research going on now about the benefits of supplementing with progesterone throughout pregnancy for women with a history of preterm labor. Progesterone has always been known to "quiet" the uterus and prevent the uterus from contracting during early pregnancy and harming the fetus, and it looks like it is needed throughout pregnancy too. Women with low progesterone are now thought to be at higher risk for premature labor and delivery.
http://www.ncbi.nlm.nih.gov/entrez/...t_uids=12592250
An OB or midwife can prescribe progesterone suppositories, or you could look into getting a natural progesterone cream (e.g., "Happy PMS cream") to rub on the belly.
On Drinking Water:
About the drinking gallons of water advice, which is given again and again by mothers and doctors (etc.) alike as a way to prevent/stop preterm labor... my perinatologist, who is a world renowned specialist at Johns Hopkins, told me that new research is showing that drinking TOO MUCH water can throw some women's electrolytes out of balance, and actually can CAUSE preterm labor. Gasp. The very thing many women are trying to avoid. Drinking Gatorade-like beverages to restore elctrolytes helps a lot. In my second pregnancy (not the one where I delivered early) I drank Gatorade Ice - it's the clear (no dye!) one and was yummy... the ratio is 1 oz. per 8 oz. of water. So every 4 glasses of water, I'd have 1/2 cup of Gatorade. No biggie. If you can't get past the concept of drinking Gatorade (it took me a while lol - I'm pretty obsessive about eating organic, etc.) you can make your own but keep in mind that "electrolytes" means more than just sodium chloride (salt)... there's potassium, magnesium, etc. too. And sugar. And there's actually a careful balance of all of these together so make sure you get it right - Google homemade recipes. So yes you want to drink a lot - at least 12 glasses of water a day - but have 1 or 2 Gatorades a day too.
Red Raspberry Leaf Tea -- Conflicting Information:
If you have a history of preterm labor OR if you have an "irritable uterus" you should consider avoiding drinking RRL tea. I was specifically told my both my midwife and my labor doula in my second pregancy NOT to go near it because *some* women like me (i.e., with a history of preterm labor and an irritable uterus) don't handle it well, I guess because the LAST thing a uterus like this needs is a strengthening tonic! I've done a lot of research on line and found there is highly conflicting information out there about it... some studies or opinions show it's safe, others say it's absolutely not safe for women with previous miscarriages or preterm labor or uteruses that are "irritable". I for one was in no mood to be a scientific experiment, thus I steered clear of it.
It sucks I know. Everyone else is contracting like crazy with no cervical change and there I'd be dilating and effacing for the littlest BH.
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