Signs of preterm labor - Mothering Forums

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Old 12-21-2005, 01:38 AM - Thread Starter
 
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It is difficult to distinguish between preterm labor and an irritable uterus, but it is important to check with your provider if you are having signs of preterm labor. Some of the signs are frequent contractions (more than 4-6 per hour) that may or may not be as intense as contractions in full-term labor. Early loss of mucous plug. Premature rupture of membranes (water breaking). Lower backache or menstrual-like cramping. Intense cervical or vaginal pressure (although this is normal later in pregnancy). Vaginal bleeding. Sometimes just a feeling or sense that something isn't right with your body.

Often Braxton Hicks contractions will go away with rest and hydration. If they don't, please call. It is *generally* not considered safe to homebirth a baby prior to 36 weeks gestation. I know there are some differences of opinion on this, but before that gestation, babies can definately have problems with lung maturity and require breathing assistance. Even earlier babies will generally require more assistance with breathing, keeping body temperature up, learning to coordinate sucking and swallowing, possible jaundice and other complications.


I'm going to add to this after much thought. I think with the ideals of MDC in mind, many of us view birth as a natural process that should go unhindered. I agree with this. Unfortunately, with a preemie, things change a little. Frequent BH contractions are normal, many women have them, they usually aren't a cause for concern. I think this is something that you have to evaluate yourself, sort of on a case by case basis. Use your intuition. It may be normal for a 3rd time mama in her 34th week of pregnancy to have BH contractions frequently. It may be normal for a first time mama in her 30th week of pregnancy as well. But in the second case, I'd say there is a lot more personal evaluation needed to think about what decisions to make in terms of deciding if this is normal for you and your body or not. The earlier you catch PTL, the better, in terms of possibly halting it or at least delaying it. Waiting to see if contractions get more regular or more painful could mean waiting until it is too late to do anything to help. Trust your gut.


If you have other signs of PTL or want to post about some of the treatments used for PTL, feel free to add on to this thread!
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Old 12-21-2005, 02:56 AM
 
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Thanks for this thread Leslie!
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Old 12-21-2005, 01:17 PM
 
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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.

*********

"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.
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Old 12-21-2005, 03:09 PM
 
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Quote:
Originally Posted by Lousli
Sometimes just a feeling or sense that something isn't right with your body.
This is very true and bears repeating! Even if this happens during your first pregnancy please get it checked out. This was my only "sign" when I went into preterm labor with DS.

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Old 12-23-2005, 10:43 PM
 
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awesome post Periwinkle

With my first I had no noticable signs i was in PTL, luckily i had an ultrasound and i guess the tech noticed something and sent me to the hospital. With my second one, i noticed some very minor and i mean minor pinkish/redish discharge at about 24 weeks. I mean if i didn't even look i never would have saw it. I really didn't think anything of it, sorta blew it off but later decided well i should call just in case, well good thing I did. That was my mucous plug, i was dialated already. Never hurts to call just in case!
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Old 12-23-2005, 11:27 PM - Thread Starter
 
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In addition to Periwinkle's advice about what to do for PTL:

Avoid sexual intercourse or orgasm until you can check with your doctor or midwife about possible restrictions (often this is one of the first restrictions).

This one might be a difficult decision for you, but try to decide whether you will continue to nurse an older child. I personally chose to continue nursing, not noticing any increase in contractions during nursing. However, if you are having PTL contractions, and find that nursing is triggering those, you might want to cut down nursing if your child is old enough to do so comfortably.

Also, many people will say, "Drink a glass of wine" which I'm sure doesn't hurt, but it might not help all that much. If you are having true PTL, wine isn't going to stop it. This is something that I would check with a midwife or doctor about before doing it.
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Old 12-24-2005, 12:16 AM
 
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Re: drinking... Ina May Gaskin says a woman should sip vodka (yes, vodka) if she is having PTL -- 2 to 3 drinks worth. I know everyone FREAKS whenever I write that but ya know what... the baby is better off with a little alcohol than being born at 24 weeks. Period.

ETA - I just added this info to my original post.
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Old 12-24-2005, 12:32 AM
 
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Lots of great information! I am a mommy of 3 preemies! 2 35 weekers and a 31 weeker.
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Old 04-25-2006, 12:54 AM
 
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Just bumping this up! I've been having a lot of PTL signs the last 3 days and suspected the RRL tea I started drinking may have been causing it. I had serious PTL issues with my dd and a history of m/c. I wont be drinking the tea again until D-day!

Seriously?
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Old 04-25-2006, 01:44 AM - Thread Starter
 
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Thanks for the bump. I always see lots of posts in the various due date clubs about signs of PTL.
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Old 04-25-2006, 12:49 PM
 
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Great thread! Thanks so much for all the info, gals! The too much water and not enough electrolytes thing... could it contribute to PPROM as well? My PPROM occurred at 29 weeks (baby was born 4 days later after I got steroids). I had protein in my urine at 20 weeks last time, so my midwife told me to drink 2 gallons of water a day (there were no other signs of pre-e - it really was me just not drinking enough water). I managed to FORCE 1 gallon/day into me, and my urine was fine at 24 and 28 weeks. I continued the 1 gallon/day regimen (again, I had to force myself). I put lemon in it to make it a little more tolerable. I really hate drinking water. Anyway, I was not drinking Gatorade with it. I also wonder about yeast contributing... The docs all said no, but I had recurring yeast infections and they were resistant to some of the typical drugs. I did not have any bacterial infections that they could find, was GBS-, etc. I'll probably never know what caused it, but I definitely want to prevent it this time if I can!

I've also read recently that taking extra Vit. C can help prevent PTL/PPROM. Certainly worth trying!

Mama to Tornado Boy (6/04), The Brute (11/06), and Mischief (05/09)... expecting in February '15
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Old 05-10-2006, 08:02 AM
 
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great thread!
i have an irritable (sp?) uterus, so i had BHs off and on from week 31. no cervical change, of course. it was very frustrating, but i kept remembering it is not preterm labor! and it wasn't!
it is not easy to see the difference...you are right, we have to be careful and listen to our bodies!
i didn't know about alcohol and vit C, both make sense for me!
great advices, keep going!

Liv, SAHM of 3 kiddos 

 

 

 

 

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Old 06-01-2006, 11:53 AM
 
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Thanks for the thread. I've started having more than BH contractions the last day or two - a lot more menstral cramp feeling. I'm 35 weeks tomorrow and I'm not too worried b/c I know it would be okay if the baby came in the next week or so, even though it would nix my homebirth. I'm also feeling a bit "out of sorts"...I wonder if I'm going to go into labour early?

I'm off for a nap.

Beth
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Old 12-13-2006, 09:58 PM - Thread Starter
 
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A new bump for a new group of pregnant women...
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Old 12-21-2006, 12:47 AM
 
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Quote:
Originally Posted by Periwinkle View Post
Re: drinking... Ina May Gaskin says a woman should sip vodka (yes, vodka) if she is having PTL -- 2 to 3 drinks worth. I know everyone FREAKS whenever I write that but ya know what... the baby is better off with a little alcohol than being born at 24 weeks. Period.

ETA - I just added this info to my original post.


My perinatologist with baby #1 and midwife with baby #2 never suggested vodka, but both suggested wine, I have an irritable uterus that likes to contract for no reason and an incompetent cervyx that likes to start dilating from simple BH contractions...not at all fun.

Jillian wife to Ryan and mommy to Janelle Ashlynn (9/09/2002), Kincaid Chance (3/29/2004), Travis Neil (8/13/2007) and River Anderson (5/02/2009).
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Old 12-21-2006, 01:26 AM
 
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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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Old 12-21-2006, 01:32 AM
 
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My perinatologist with baby #1 and midwife with baby #2 never suggested vodka, but both suggested wine, I have an irritable uterus that likes to contract for no reason and an incompetent cervyx that likes to start dilating from simple BH contractions...not at all fun.
Just wanted to also point out you might want to try WHITE wine or brandy or something, that has no tannins. Red wine has tannins, which, like tea and coffee, can be irritating to "irritable uteruses".
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Old 12-21-2006, 06:25 PM
 
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Just wanted to also point out you might want to try WHITE wine or brandy or something, that has no tannins. Red wine has tannins, which, like tea and coffee, can be irritating to "irritable uteruses".


Actually, the perinatologist did say that, I'd forgotten, since it's been over 4 years now!

Jillian wife to Ryan and mommy to Janelle Ashlynn (9/09/2002), Kincaid Chance (3/29/2004), Travis Neil (8/13/2007) and River Anderson (5/02/2009).
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Old 12-27-2006, 06:59 PM
 
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What is the definition of an "irritable uterus"? I feel BH from practically the beginning of pregnancy, earlier with each child, and they become more frequent if I don't drink enough...
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Old 12-27-2006, 07:01 PM - Thread Starter
 
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That pretty much sounds like it velcromom! Unless your BH turn into labor, or make you dilate or efface. If you get tons and tons of them but without going into labor, that is an irritable uterus.
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Old 01-12-2007, 06:48 PM
 
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bump for twin mama
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Old 01-22-2007, 09:24 PM
 
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What about interstitial cystitis? I have that and it seems to be causing a lot of discomfort. How would I know if I have an irritable uterus or it's just the IC causing me issues?
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Old 01-22-2007, 11:37 PM
 
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What about interstitial cystitis? I have that and it seems to be causing a lot of discomfort. How would I know if I have an irritable uterus or it's just the IC causing me issues?
When you say "causing me issues", what issues specifically?
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Old 01-23-2007, 12:51 AM
 
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Oh - sorry - that's from another message I posted today. I'm in my 25th week now and started this at my 19th week and I have BH a lot! Sometimes I feel like I'm in one perpetual contraction all day. My dr is monitoring me closely and my cervix is good at this point. I monitor them to make sure I don't go over 4 per hour (my dr said go in at 5/hour). I also have a lot of pain that I've associated with my bladder (the interstitital cystitis) in the lower abdomen. I'm pretty sure that the lower abdomen pain is the bladder just from the symptoms but I had been blaming the bh on the bladder as well. I hadn't heard of an "irritable uterus" before so now I'm wondering which I'm dealing with in regards to the bh.
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Old 01-23-2007, 05:30 PM
 
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Aw that stinks. I really don't know anything about interstitial cystitis... is it an infection? If so, infection is well known to increase the risk of preterm labor (even gum infections have been linked to early delivery).

Regardless, I think an "irritable uterus" should be fairly easy to distinguish from I.C. if you can feel/count contractions. If for example, this is your first child and you are kind of constantly contracting 4+ times an hour, or if you don't drink enough you contract, or you stand for too long or do any sort of activity and you contract, or eat or drink the wrong thing and you contract... basically, doing "normal" stuff sets off your uterus and makes you contract a lot. BH you can feel at 19 weeks (esp. for a 1st pregnancy) is early -- not unheard of, just something that should raise an eyebrow and make you take a closer look (which is sounds like you're doing).

I guess, at the risk of being overly simplistic, it doesn't matter WHAT is causing you to contract this much, the issue is minimizing those triggers (read the whole thread if you haven't already for tips on how to do this). And fundamentally, you can contract 700 times a day but if your cervix is a steel trap lol and not budging -- meaning NO shortening, NO funneling, NO effacement -- then it's a pain in the butt / uncomfortable but your baby's not going to be born without cervical change.

The only time you have to worry about having an irritable uterus is a) if it's causing cervical change (i.e., preterm labor), and b) if you have a history of preterm labor and/or preterm delivery.

If it's your first pregnancy, you don't have a "history" to go on, so the assumption should be that everything is NORMAL, and you should only get alarmed if your cervix is changing this early. If you're really concerned about it, get a transvaginal sono and watch what happens to your cervix when you contract. My cervix would be long and closed on a normal exam or sono, but then boom I'd contract and it would funnel so badly there was barely any length left to it. Horrifying.
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Old 01-23-2007, 10:47 PM
 
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Wow! This is my 3rd - but it's been 10 years since the last one. Just for fyi, IC is a bladder condition that is not the direct result of infection but frequent infections can lead to it. It is actually where the lining of the bladder has leisons and hemorrages on it causing flares of pain, leaking and frequent urination. Feels like an infection but treated very differently. I've had a lot of pain with this pregnancy because of it and wondered if it was the cause of the bh. I don't have a history of bh this early - started with my daughter at 7th month and she was born at 37 weeks.

Today I decided to get all dizzy and nauseaed to the point that I almost passed out. We went to urgent care and no medical reason other than possibly blood sugar fluctuations or b complex is low. This has been a rough pregnancy on me but baby is really good - if I can just make it to week 37!!!
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Old 01-27-2007, 01:22 PM
 
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One symptom I had both times (the first I lost at 21w, the second I managed to get to the hospital in time - curreently 30w) was diahrea.
If my bowels start behaving weirdly and I have this feeling that something is not right I just go to the ER.
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Old 01-30-2007, 08:05 PM
 
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Hello,

I am new here and just got out of the hospital for bleeding and contractions. I am 31 wks and 3rd pregnancy. I am also 43. I was coming up the stairs the other day and it felt like my water broke, however, it was all blood and I continued to bleed for about 5 mins where I could feel it running out, then it slowed and lasted for a few hours. It was bright red and started up again the next morning for about an hour, then stopped again. When mild contractions started (during the night) in my lower back, I knew I would have to go in. So ended up getting the four steroid shots and contracted off and on. No more bleeding and now at home on bedrest.

Has anyone had anything like the bleeding that I described or have any idea? I have no placental abruption, Previa or placent adhering to scar tissue (I had 2 previous C/S). Cervix is long and closed tight.

Thanks for any insight and all the great tips that I have already read!

Jane
Mama to Erik 9 (Autism), Julie 6 and Christopher to be, hopefully not until 4/2/07!
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Old 02-19-2007, 12:24 AM
 
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This is the first time I have posted in this area. I just got out of the hospital for going into labor at 33 weeks and 2 days. According to the chart at the hospital they sent me too. I was not having very painful contractions but I felt nausea and so I went in and I was dialating so they stopped it with the Magneseum Sulfate and gave me the 2 steroid shots. Now I am on Nifedipine and I am not happy with the drug, I am now 34 weeks and a few days and I really am not concerned that the baby is going to have any significant trouble if at all, but the hospital I planned on delivering at won't take me until I am at least 35 weeks and I don't think my little one is going to wait that long. So I found a different hospital that will take me. Does anyone have any advice at this point. This is my second baby and my first one carried until 42 weeks, so this is new to me. I am already dialated to a 3 or maybe even a 4. Any info would be greatly helpful. Thanks

,,,,
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Old 02-19-2007, 12:27 AM - Thread Starter
 
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What sort of advice are you specifically looking for? Do you want to stop taking medication? Wondering which hospital to go to? If your hospital is not equipped to take a baby at less than 35 weeks gestation, they will most likely want to transport you (if early enough in your labor) or your baby after she is born to the hospital with the better NICU.
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