Another preterm labor lecture...

[wwisdomskr]

Okay, Mamas. Brace yourselves. I'm here to lecture you again.

Know the signs of preterm labor:
***
What Is Preterm Labor?
Preterm or premature labor happens when you go into labor before 37 completed weeks of pregnancy. This is too early for your baby to be born. Babies born too soon can have lifelong or life-threatening health problems.

Can Preterm Labor Be Stopped?
Many women are given drugs to try to delay or stop preterm labor. In some cases, birth can be delayed long enough to transport Mom to a hospital with a neonatal intensive care unit (NICU). Women may also be given medications that can improve the baby's health, even if the baby comes early.

Warning Signs
Here are the warning signs:

* Contractions (your abdomen tightens like a fist) every 10 minutes or more often
* Change in vaginal discharge (leaking fluid or bleeding from your vagina)
* Pelvic pressure—the feeling that your baby is pushing down
* Low, dull backache
* Cramps that feel like your period
* Abdominal cramps with or without diarrhea

What Should I Do If I Think I'm Having Preterm Labor?
Call your health care provider (nurse, doctor or midwife) or go to the hospital right away if you think you're having preterm labor, or if you have any of the warning signs. Call even if you have only one sign.

Your health care provider may tell you to:

* Come into the office or go to the hospital for a checkup.
* Stop what you're doing. Rest on your left side for one hour.
* Drink 2-3 glasses of water or juice (not coffee or soda).

If the symptoms get worse or do not go away after one hour, call your provider again or go to the hospital. If the symptoms get better, relax for the rest of the day.
****

40 Weeks is full-term. Most babies will do great at 37 weeks. There is usually always a good reason for baby to choose baby's birthday! It is rare for baby to truly NEED to come out earlier. Those of us in this DDC who have these needs probably already know it!

Just because babies can survive being born earlier does not mean that they SHOULD be, kwim? We don't have to use the NICU just because it's there. Believe me, you do NOT want your baby to be in the NICU. It's painful and scary to be separated for so long. Going home without your baby is not fun.

Now, even if your baby doesn't have to go to the NICU...having a preterm baby is much more difficult that having a full-term baby. Babies born before 37 weeks are more likely to have trouble breathing, breastfeeding, regulating their body temperature, gaining weight, regulating sleep patterns, etc. They tend to be emotionally high-needs babies, as well. Of course, there are always exceptions to the rule...but we're taking about statistical patterns here.

The last weeks of pregnancy are very important developmentally for baby's brain and baby's fat stores. When baby has enough fat, then little things like pressuring moms to supplement before their milk comes in are exposed in their true, ridiculous light. (Most babies are born with enough reserves to be just fine until the milk comes in, btw).

So, I'll step down from the soap box now. Drink your water, listen to your body, talk to your baby and get enough rest. If you're feeling tired of being pregnant, find ways to be pampered a little more...ask your friends and family for it. Pregnancy is really hard, but it's much easier than having an early baby...

[Momma Aimee]

* Contractions (your abdomen tightens like a fist) every 10 minutes or more often
* Change in vaginal discharge (leaking fluid or bleeding from your vagina)
* Pelvic pressure—the feeling that your baby is pushing down
* Low, dull backache
* Cramps that feel like your period
* Abdominal cramps with or without diarrhea

see i am so confused ....

if you think you're having preterm labor, or if you have any of the warning signs. Call even if you have only one sign

I am so confused.....

I often have back aches, like almost every night after dragging around a 22 month old and going up and down stairs a zillion times

contractions every ten minutes? well yes, BH I assume, but all evening they go and go and go ....

..............

i guess i am, and have been, very confused about the difference in normal third tiremester ( i typed in tried - tirmester when i typed this, caught it in the proofing ) things (groin pain, back aches, BH) and PTL....like where the line is, YK?

I read a lot about PTL... but MOST of it (not the bloddy discharge or the crapming) is also listed as common normal things ... and even BH can start to feel crampy when the muscles get too tight too long and start to hurt ....

i didn't really expereince any of this with Theo -- i was bigger a month ago than i was the day i had theo -- and i was so lazy when i was carrying him..... so all the 'normal' stuff is new to me (never had an ichy belly before either) and it is freaky .....

uhhhhhhhh

i guess i just have to trust if somthing is wrong i will know it. ???

Aimee

[pixiesmommy]

I think it's a matter of trusting your instincts. Discharge and blood would scare me, true PAIN would scare me, the feeling like something just wasn't right would scare me....

Labor for me caused cramping in the tops of my thighs, which I had early in the first trimester of this pregnancy- THAT scared me!!!

My MW's "rules" for me to call are:
-low or no fetal movement during times when I normally feel the baby move (especially between dinner and bedtime)

-feeling like something just isn't right

-BH contrax or cramps that won't go away after drinking copious amts of water, taking a warm bath, or laying on my left side

-Bloody show

[Curlita]

Originally Posted by wwisdomskr

Okay, Mamas. Brace yourselves. I'm here to lecture you again.

Yes ma'am! Duly noted!

Thanks for the info and the reminders.

[*Lindsey*]

Thank you, Jessica!

[melissakc]

Yes, thank you! Everything you said about the NICU is true. If--no, WHEN--I am still pregnant on Oct. 28, which is 37 weeks for me, you will all hear me yelling joyfully and doing the world's biggest happy dance!

[Isaac'sMa]

Thanks for posting this, Jessica!

[marisa]

Originally Posted by Momma Aimee

see i am so confused ....



I am so confused.....

I often have back aches, like almost every night after dragging around a 22 month old and going up and down stairs a zillion times

contractions every ten minutes? well yes, BH I assume, but all evening they go and go and go ....

Your backaches are probably 'posterior pelvic pain' and are most likely made worse by picking up/carrying Theo. I'm going to a chiro twice a week for this and I can't get complete relief because I have to pick up my 22 mo old alot.

At this point, BH contractions will start to feel more crampy instead of the regular allover tightening that happens earlier in pregnancy, even might need to breathe through them. And this is completely normal. Especially for it to be happening in the evenings. You will know if labor is impending - there is a shift. They don't let up and they seem to get lower, hurting behind your pelvic bone.

I think you'll be just fine, Aimee!

[scheelimama]

Aimee, I get crampy often as well, like from pushing a heavy cart too long at Walmart. Sometimes even if I've had buckets of water. And I agree that the BH's can definitely hurt or at least be very uncomfortable at this point. My mw said if there is no blood, that things are usually okay. And, I can't exactly remember why, but true labor contractions felt different and I knew from the first one that it was labor, not BH. They weren't painful for me though, not until transition, and even then, not real painful. They were just different, but I can't recall what was different about them. I'm really not worried. If it was my first baby and I was having this kind of crampiness/back aches, I'd be much more worried, but I know most of it is just from overdoing it and picking up/carrying my almost 3 yr old too much.

[*GreenMama*]

Thanks for posting the info.

I'm wondering if you're saying that if you go into labor at 35 or 36 weeks it would be better to take the drugs in the hospital to keep baby in than to let baby be born. My son was born at 35 weeks, and the nicu was NOT fun, but short of begging my midwife to give me medicine to stop labor there is nothing I could have done.

And my only warning sign was pressure for weeks which was just chalked up to being over 30 weeks pg, and what felt like a bad bad backache on the day. They had to convince me I WAS in labor because I didn't "feel" the contractions but only felt the back pain.

[Da WIC Lady]

Originally Posted by scheelimama

Aimee, I get crampy often as well, like from pushing a heavy cart too long at Walmart. Sometimes even if I've had buckets of water. And I agree that the BH's can definitely hurt or at least be very uncomfortable at this point. My mw said if there is no blood, that things are usually okay. And, I can't exactly remember why, but true labor contractions felt different and I knew from the first one that it was labor, not BH. They weren't painful for me though, not until transition, and even then, not real painful. They were just different, but I can't recall what was different about them. I'm really not worried. If it was my first baby and I was having this kind of crampiness/back aches, I'd be much more worried, but I know most of it is just from overdoing it and picking up/carrying my almost 3 yr old too much.

I rarely have painful BH unless it catches me off guard. I've had the pelvic pressure, and some cramping, but nothing that lasts a long time. I never went into labor with DD, so I have no idea what this is supposed to feel like. I'm also scared that I'm going to have to go on bedrest. I'm the only one working at the moment, so that would be very bad, especially since DH won't be here after tomorrow and won't be getting paid until at least the middle of Oct. It is time for a nap though even though I've been sleeping like mad lately.

Anna

[GinaRae]

Originally Posted by *HolisticMama*

My son was born at 35 weeks...
And my only warning sign was pressure for weeks which was just chalked up to being over 30 weeks pg, and what felt like a bad bad backache on the day. They had to convince me I WAS in labor because I didn't "feel" the contractions but only felt the back pain.

I get BHs and contractions now and then, but more often I have pressure, pain and/or a cramped feeling. Almost like a Charlie Horse in my belly. Especially if I have to pee. And sitting on the toilet hurts the belly.

I don't remember if I ever felt like this with the other boys. I've never had PTL issues with any of them, so I assume I won't this time either. Of course, if I get some other symptom with that crampy feeling, like pain or bleeding, I guess I should have it checked out!

[marisa]

The Charlie Horse in my belly is exactly how I was describing my BH contrax to my husband the other night.

[wwisdomskr]

Okay...sometimes, babies come early and there's just nothing that we can do. Sometimes, some babies NEED to come early, for various reasons.

There are different facets to the issue...preventing preterm labor is one and stopping preterm labor is another.

Yes, it would be difficult to convince a hospital-based provider to actively stop labor at 35-36 weeks. In fact, every hospital-based provider that I've ever dealt with has been fine with a 34-week birth. Why? Well, since babies can survive in the NICU much, much earlier, then just a few weeks early is not a big deal, right?

With dd2, my midwives actively prescribed herbs, massage and water therapy to *stop* the PTL that I was having until the day I reached 37 weeks. Then, they tried to cajole me to 38 weeks. Now, one could argue that this was simply because they didn't have the resources of an NICU...or one could argue that it's because it's generally better for babies to gestate as long as they possibly can.

I think it's important to frame things in the light of the best possible outcome, rather than the worst possible outcome. Should babies "survive" and "do fine?" Or should babies get nice and fat, have the ultimate readiness for breastfeeding and life outside the womb and then "thrive?"

About different symptoms... I think this is really important. Our prematurity rates are really, really high here in the US and no one seems to know what to do about it. Now, we're finding that common symptoms of PTL are often downplayed by both providers and mamas...mostly because mamas are overtly or covertly chastised and shamed for complaining... I mean, how could we possibly know our bodies more than someone who went to medical school?

During my pregnancy with dd1, I had constant "BHs" and a few instances of finding one spot of bright red blood after wiping. Alone, these things can mean any number of things, right? But, FOR ME, a pattern was developing. The contractions were really poo-poo'd even though I brought them up all the time. Our providers were focused on asking me about pain-level and not about frequency, duration or other sensations. The contractions weren't comfortable, for sure, but they also weren't what I imagined labor would be like...

So, here's what I've learned since... Yes, many of these symptoms are also symptoms of late pregnancy...even mid-pregnancy for us more experienced mamas. In relation to preterm labor, the biggest issue is constancy. Yes, the back pain and pressure may FEEL constant...but, is it really? Generally, if what you are experiencing is just a symptom of something else, then switching either from rest to activity or from activity to rest will CHANGE the symptom. No, it may not stop it completely, but it will probably not remain the same.

Here's an example. When my sciatica and hips are really hurting badly, sitting on the floor "tailor-style" relieves the pressure and the pain for a bit... If, instead, it continued through this and other position changes, I would call my midwife to check in. This isn't to say that the pain doesn't come back again after awhile , but it doesn't stay constantly the same, kwim?

Sometimes we also describe things and use words differently, as well. What feels like pressure to me, maybe doesn't feel like pressure to you. IMO, a first-time mama should not be feeling any pelvic pressure prior to labor...but, maybe we each mean different things by that...

Anyway, I interpret the March of Dimes advice in this way: if you are having contractions, back pain or feeling pressure, then drink water and change to the opposite of whatever you are doing. If you're already resting, try some light activity. If you're already active, try resting. Things should change. If they don't, call your provider and just check in. Everyone has a different "normal." But, the only way to determine it is to pay close attention.

[Momma Aimee]

Thanks wwisdomskr -- the wisdom of the more expereinced mommas is appercipated

Yes, it would be difficult to convince a hospital-based provider to actively stop labor at 35-36 weeks. In fact, every hospital-based provider that I've ever dealt with has been fine with a 34-week birth. Why? Well, since babies can survive in the NICU much, much earlier, then just a few weeks early is not a big deal, right?

Sis doc stopped her labor at 32 week and again at 33 and tried at 34 but could not do so -- the boy was born with a micoium (sp?) inhalation and THAT resulted in 6 weeks of NICU .. he was otherwise 5 pounds 15 oz and healthy. The feeling was that maybe, no one could say for sure, if she had been allowed to birth at 33 weeks when her body again tried so hard to birth, that maybe DN could have voided the womb experince -- it did not happen durieng deleivery and they are prety sure well before she very short and fast labor, was then he would have been fine, a tad smaller and not in NICU ................so there are plus and minus things to consider when really gighting to stop labor -- sometimes our bodied KNOW to get the baby out, even early.

ETA ---- this is not to be taken to mean i don't think PTL should be PREVENTED, by what we do and by good medical care for any postinal contion in us or the baby -- just stating that once it STARTS you are in a whole nother ball park and things change and the answers change and you can end up in a situation where eventhe "best" answer (allowing the child to be born early) is not great.