Popping in for JIC advice... - Mothering Forums

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Old 01-03-2008, 05:16 PM - Thread Starter
 
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Seems my water has been leaking since last night. I am 31w2d. No signs of labor or other issues. I'm doing everything I'm "supposed to" about pPROM, but in the mean time, I want to arm myself for a preemie. Be proactive about this, instead of falling into the clutches and whims of the medical world, kwim?
I'm a homebirther, but I won't homebirth if I go into labor before 36 weeks. I am quite afraid that the hospital would/will try to make me go ahead and have the baby with pPROM. I have been told that might not necessarily be the case... that I might "luck out" with bed rest.
I guess my biggest q's for you mama's are things along the lines of:

What can I expect as a VERY AP mama in case this baby comes soon?
Advice on how to handle NICU?
Suggestions on Kangaroo Care? How supportive are hospitals REALLY when it comes to APing a preemie?
How to fight high intervention with a premature labor & baby?

I hate to think that just because my baby may be here too early that I have to give up ALL my hopes for AP type care?

Any thoughts or advice are appreciated.

Different drummer dancing with 3 kids in 3 decades.
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Old 01-03-2008, 05:24 PM
 
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Good luck to you- I really hope you're able to keep cooking your LO a bit longer!

I don't have specific advice for you, except to read the website of the NICU at your chosen hospital- mine was very AP friendly on some counts (kangaroo care, lots of support for BF) but they had some stupid policies, too (supplemented with formula while they cultured my colostrum). You could always call and tell them (anonymously) that you've been advised your baby might be premature and you have some specific questions. Usually if you talk to the charge nurse, they'll be pretty forthcoming (just don't call around 7-8 AM/PM because it's shift change).

But I also wanted to say that, even if your babe is early and has an interventional birth and a NICU stay, you can be every bit as AP as you want to be. Most mamas here have had *much* longer NICU stays than we did (15 days), and I think it's safe to say that your LO won't hold it against you if you can't do certain things all of the time, or til they come home with you.

Best of luck to you!
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Old 01-03-2008, 05:52 PM
 
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I can totally understand your desire to maintain your AP beliefs in the midst of this time but when dealing with a preemie that's not always 100% possible at first. It sounds like from your post that you have not seen anyone about the leaking water, be it a midwife or anyone. I desperately hope this is not true because despite your desire to stay away from the high interventions of the medical community, when dealing with a preemie, if you want that baby to survive, it's often necessary. I cannot in good conscience sit by and not tell you to get checked out and possibly head to the hospital.

All of us here have unfortunately had to make compromises when it comes to dealing wtih a preemie and our beliefs. I desperately hope you do not deliver now and that you do get the proper medical treatment to delay that delivery and enhance your babies lungs, ie steroid shots.

If the baby comes now there's a chance of needing to be intubated and needing oxygen. I would say at this stage you should be successful at pushing for nuzzling at the breast though they will want you to pump before hand most likely. Kangaroo care is awesome but some hospitals are more hip on it than others. Push for it. You are your babies biggest advocate and while you may have to let go of some things during the NICU stay, you don't have to compromise on everything.

Honestly I would say you absolutely should not fight the high intervention necessary for a premature baby or preterm labor. For the safety of your baby they will have to do things that as an APer you don't feel 100% comfortable wtih.

Every hospital has different policies and different beliefs on parental involvement. Your baby will possibly need to be on abx, have blood transfusions, ventilation as previous mentioned. A lot of high medical intervention to get the baby out the door into the real world.

choose your battles. Fight for the breastmilk, fight for the bonding, fight to get nurses who treat your baby like a person but realize not everything is optional. Our hospital was very supportive of kangaroo care and extremely supportive of pumping/breastmilk. They provided donor milk for babies who's moms didn't pump enough. You can be involved in teh decisions about bottles versus breast. Make your opinions and your standpoint known.

Good luck to you! Take care of yourself and that baby.

Wanted to add that absolutely no good hospital will make you have the baby with pPROM at your stage. In my experience talking to many women from different hospitals, they really do strive to get you as far along in your pregnancy as possible. I can't say ALL hospitals because I don't know that for sure but unless you have an infection or the baby is in distress they won't deliver you. They will give you steroids to mature the babies lungs and stick you on bedrest to monitor you. I spent 2wks on bedrest with my son when my water broke at 27wks and I was allowed to go into labor on my own and labor for 60hrs without drugs or anything. He ended up turning breech and was a c/s. With my last baby I pPROMed at 24wks and was on bedrest for only 4 days because I did develop an infection despite the abx and her cord prolapsed. They waited as long as possible and let me labor but she ended up being a STAT c/s which I do not regret. I feel like my hospital at least did everything possible for me and the babies.
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Old 01-03-2008, 06:34 PM
 
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Honestly? you need to go get checked out by your midwife or doctor. Water leaking at 31 weeks, while it doesn't mean you're going to suddenly have the baby, is serious, because it's a sign that you might.

IME, an OB's goal is to keep you pregnant until the risks of having that baby are less than the risks of keeping you pregnant. In the case of water leaking, I can't see why they would have you deliver unless you are showing signs of an infection, or the cord prolapses - in which case the balance would tip. So I wouldn't be afraid at all of being seen. A 31 weeker is a situation, where, unfortunately, you can't really fight a lot of birth interventions, as those babies just aren't designed to be breathing on their own yet.

When it comes to the NICU, it really is about fighting your battles. We were able to do kangaroo care on a fairly regular basis and we also did breast milk as much as possible. Our hospital was supportive of both. However, I had a 24 weeker so I had to let a lot of things go - for instance, she needed thickened feeds due to aspiration issues so breastfeeding wasn't a possibility until after she came home. With a 31 weeker, you're looking at a baby who won't need nearly as much as my daughter did so you'll have a lot more flexibility.

Good luck!!! I hope this is just a scare and baby stays in for a good, long time.

-sarah-
mom to three, 4 and under.
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Old 01-03-2008, 07:37 PM
 
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My hospital wouldn't stop labor, but they also wouldn't induce unless their was an infection/prolapse or you hit 34 weeks. They considered the scales to tip from prematurity being the bigger risk to compression issues becoming the bigger risk at 34 weeks. However, I had a full rupture and not a a leak.

I hope you keep baby baking a long time, but at the very least I'd go get some steriod shots. They really help, IME.

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Old 01-03-2008, 07:57 PM
 
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My hospital wouldn't stop labor, but they also wouldn't induce unless their was an infection/prolapse or you hit 34 weeks. They considered the scales to tip from prematurity being the bigger risk to compression issues becoming the bigger risk at 34 weeks. However, I had a full rupture and not a a leak.

I hope you keep baby baking a long time, but at the very least I'd go get some steriod shots. They really help, IME.
I have to strongly agree with the steroids as well. Also to give the OP some hope, some hospitals will stop labor. Mine stopped my labor multiple times before I physically could not take it anymore and decided what was to be would have to be and told them to just let me be.
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Old 01-03-2008, 07:58 PM
 
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OP, I hope your MW appointment went well (I read your other thread in the UC forum), but I wanted to point out a couple of things from my own pPROM experience:

First, small gushes, IMO, generally mean a rupture, not a 'leak'. When my rupture occurred, the hospital specifically asked if I soaked through a pad when I changed positions (I did). You're replacing the amniotic fluid constantly.

Second, PTL contractions don't always feel like 'contractions'. I had pain in my bad hip and in a tiny spot on my uterus for 3 days before my pPROM. They didn't turn into full-on contrax til about 3 hours before my son was born (12 hours exactly after my rupture).

ETA: my labor wasn't stopped, even though I was 33 weeks, because I'd been having contrax since 24 weeks (my uterus and cervix are scarred), my baby measured large, and they'd never determined if I was beta strep positive or not. By the time I got to the hospital, I was already 4 cm dilated anyway. Just didn't want you to think I was induced at 33 weeks.
I hope you and baby are doing well!
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Old 01-03-2008, 11:05 PM
 
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I guess I read over the gushing part. I gushed, some were small, some were big, and I had full ROM, not a leak.

Thinking good thoughts for you.

Wife to an amazing man love.gif, mommy to 3 wild dudes: ds1 (5/23/05 @ 30 weeks), ds2 (3/5/09) hbac.gif, and ds3 (9/26/10) hbac.gif. Part time librarianread.gif, full time mommysupermod.gif, occasional chef and maid.

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Old 01-04-2008, 01:56 AM
 
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Good luck to you, I hope things are going well. My dd was in NICU, due to meconium, she was not a preemie. A very good friend had 2 preemies, and her advice to me when dd was in NICU was to get in there and ask to do everything I could do. She explained that the nurses might say not to touch dd (which they did), but that SOMEONE needs to lift the baby up when bedding is changed and that someone should be me, not a nurse. Little things like that add up.

: to you and babe.

mama to two DD's, 7 and 3 (3 rounds of IVF and more FET's than I can remember)
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Old 01-04-2008, 03:40 AM - Thread Starter
 
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Thanks mamas... I'm laying in the hospital bed right now. Looks like I won't be leaving here anytime soon.
Full ROM.
The upside is:
No labor.
No infection.

I've had the abx.
I've had the steroids.
Baby looks good.
I feel fine. (other than being here at all)

They are being very nice to me and are "willing" to just let me sit and cook.
Let's hope I sit and cook for a long time.

Different drummer dancing with 3 kids in 3 decades.
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Old 01-04-2008, 03:52 AM
 
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Thanks mamas... I'm laying in the hospital bed right now. Looks like I won't be leaving here anytime soon.
Full ROM.
The upside is:
No labor.
No infection.

I've had the abx.
I've had the steroids.
Baby looks good.
I feel fine. (other than being here at all)

They are being very nice to me and are "willing" to just let me sit and cook.
Let's hope I sit and cook for a long time.
I'm so relieved to hear there's no labor still. That's a great sign. I was told that 95% of people go into labor within 24hrs. Of the remaining, 5% will go into labor within 4 days of pPROM but if you make it past then, all bets are off and you could go on for weeks just sitting in that hospital bed. I wish you many boring days in the antepartum resting up for the moment your baby is born and needs your constant care.

There's another mom on here in antepartum with pPROM but I believe she's only around 27wks and ruptured at 24wks so earlier in the pregnancy than you.
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Old 01-04-2008, 07:19 PM
 
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Yep - that's me!

I ruptured at 24 weeks and today is 27 weeks! I've been in the hospital for 2 weeks now and I'm finally adjusting and accepting.

Did they tell you how long they will let you go?
My hospital won't let me go past 34 weeks. And I totally hear your concerns about how AP you'll be able to be. I was *supposed* to have this little boy at a birth center in a nice tub and start nursing right away

We're now planning a c section because he's breach and doesn't appear to want to move... and I will be pumping to get my supply up for when we get the chance to start nursing.

We can be bored on bed rest together!

Mariah
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Old 01-04-2008, 07:48 PM
 
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Yep - that's me!

I ruptured at 24 weeks and today is 27 weeks! I've been in the hospital for 2 weeks now and I'm finally adjusting and accepting.

Did they tell you how long they will let you go?
My hospital won't let me go past 34 weeks. And I totally hear your concerns about how AP you'll be able to be. I was *supposed* to have this little boy at a birth center in a nice tub and start nursing right away

We're now planning a c section because he's breach and doesn't appear to want to move... and I will be pumping to get my supply up for when we get the chance to start nursing.

We can be bored on bed rest together!
Don't get too discouraged yet. Your LO is still tiny and even without much fluid can sometimes rotate. My ds was head down throughout my entire ante-partum stay and then after 58hrs of labor I felt him move and a sonogram showed he'd turned breech! After 60hrs of labor I did have to have a c/s but he moved his little 2lb 13oz bootie without any pockets of fluid in my uterus! Could always go the other way around too. It's always best to be prepared for c/s with preemies I think, even if it's just so you don't get dissapointed later.
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Old 01-04-2008, 10:24 PM - Thread Starter
 
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We can be bored on bed rest together!

wow two weeks... i still have hope then!!!
I was told that when you are pre-term, it's easier to NOT go into labor than if you were term... that 4-6% chance of not going into labor goes up a bit... so i feel a little better about that too.

they say 34 weeks, but if i am still cooking at 34 weeks, I will not be inducing... if there is no infection, I will NOT be inducing...
my next best plan is that if i go 35.5 weeks, I'm going back home. one can hope, but I won't get my hopes QUITE that far up.

So we still have a head down baby... and i'm pretty happy with my labor and birth options if I go into labor on my own. i can still labor naturally and how i want to... xing fingers.

The folks here have been really great so far. I met with the NICU and they are on board with the Kanga Care and bfing support. I can be in there 24/7 'cept for shift change (30 mins. 2x a day) I can't complain about that kind of opportunity!

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Old 01-04-2008, 11:02 PM
 
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Thanks mamas... I'm laying in the hospital bed right now. Looks like I won't be leaving here anytime soon.
Full ROM.
The upside is:
No labor.
No infection.

I've had the abx.
I've had the steroids.
Baby looks good.
I feel fine. (other than being here at all)

They are being very nice to me and are "willing" to just let me sit and cook.
Let's hope I sit and cook for a long time.
I'm so glad you got checked out, and gladder that you are still pregnant. Hang in there. Bedrest sure does suck, but it's much better than the alternative.

Betsy, mama to beautiful, strong MZ twins Lillian and Kate, born 11 weeks early on January 10, 2006.
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Old 01-05-2008, 09:46 PM
 
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Keep that baby in!! I will be watching the thread.

"The true joy of life is the trip. The station is only a dream. It constantly out distances us."
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Old 01-08-2008, 08:43 PM
 
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my next best plan is that if i go 35.5 weeks, I'm going back home. one can hope, but I won't get my hopes QUITE that far up.
Good luck, momma!!! DD was born at 35 wks 2 days and she needed a night in the NICU to get her breathing straightened out even though she was big (5-13). So, just wait and see how you feel when you get there... I'm REALLY glad we went to the hospital with a NICU rather than the natural-birth friendly one we were planning.

Be prepared to stand up for bfing and make sure you get a really good LC immediately, too. We had to wait a few days and that really messed things up at the beginning for us.

You're so prepared - you're both going to do great.
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Old 01-08-2008, 10:08 PM - Thread Starter
 
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thanks!

we are still hanging in there!

i ordered some preemie clothes over the weekend and they will be arriving this week. they are SO CUTE!!! although i have tons of things for baby, we have nothing for a baby under 8lbs.

she seems to be doing great so far, all looks good on her end anyway

Is there any particular reading material or websites that you mamas would recommend about preemies? I will tell you this, I KNOW NOTHING!

Different drummer dancing with 3 kids in 3 decades.
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Old 01-09-2008, 01:01 AM
 
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You've gotten great advice so far. I just wanted to stop over and say hi because I'm the mama of a full term babe with no issues and two preemies due to PPROM. My first preemie I had high blood pressure and bedrest at 21 weeks. PPROM at 32 weeks and induction at 34weeks. She weighed 5lbs 3oz at 34weeks and came home 2 weeks later from the nicu. She wore cloth diapers at home, breastfed until 22 months(obviously we had to do bottle feeds int he nicu since I couldn't be at every feed with another child), she rode in the sling until 2 1/2(when she refused and started wanting to walk everywhere), and was just a generally AP parented type of kid. She just turned 3 and she pretends to nurse her baby dolls and wears them in a mei tai and cloth diapers them. And she's STILL in her own cloth diapers! I just had my second preemie girl a few days ago and she is in the nicu now. PPROM and induction at 33weeks. She weighed 4lbs 12oz and has a tentative nicu graduation date for this friday so it will be a week's stay. Not bad! She's doing extremely well. She will be cloth diapered, breastfed, worn in a sling, and AP'ed right along with her big sisters. Yeah she's in sposies now and uses a pacifier and has to bottle feed and yes she had some formula until my milk came in but she is obviously thriving and will be doted on and loved and given all the natural comforts that her sisters were once she's home with us. I try to just remember that we are so lucky to have her here healthy and strong and fighting her nurses each step of the way that a few sposies and bottles won't matter. My first preemie transitioned well from bottle back to breast when she came home and I have all faith that little Gracie will too. The main thing with preemies is patience. It's a rollercoaster ride in the nicu and at home. But with patience, all things are possible.

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Old 01-09-2008, 02:26 PM - Thread Starter
 
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Thanks for sharing your story!

We took a tour of the NICU last night. I've seen such tiny babies before, but to think that those babies could/might/probably will be MY BABY... caused me a great deal of anxiety and I had a hard time sleeping. I know she will be "fine" at any time now if she decides to come, but I have to admit, it was hard to see. It's crazy to think that these babies, as tiny as they are, can't just be picked up, loved, nursed and do fine... they seem so PERFECT. It's hard to believe there is anything "wrong" with them, "just" because they are small.
I know my baby will be fine and safe. I am just at such a loss to think that if I didn't have all this medical help, she probably wouldn't make it at all... I am used to being able to mother on my own... all I've ever known is that all babies need are loving mommas... now I know that isn't always true. It's hard for me to accept. I'm sure many of you can relate to that moment you realized this.
It's so odd how much we take for granted in our everyday lives... I can't just "run to the store" for crochet thread of my choice. I must rely on every single errand, duty or job to be done (or not) by those who want to help. It's certainly a lesson in a certain kind of surrender...
What a loop this is throwing us into. We live very far away from this hospital. I will be staying with relatives for the entire time she's in NICU after she's born. I have no idea when I will be going home, with or without our baby. With everything still so up in the air, I just have to remember to take a deep breath and take it day by day.

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Old 01-09-2008, 03:02 PM
 
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I would like to second what the pp said up there, even if the nurses strongly encourage or insist you don't hold/ touch baby, the sheets need to be changed and the diapers changed as well, the baby needs to be touched during these procedures and it should be you doing the touching. During my second son's nicu stay (born 32/33 weeks, in the nicu for 2 weeks) some nurses were insistant I was very hands off with the baby, then there was one wonder nurse who told me here pick him up I think those sheets look dirty, I can't tell you how much of a difference that one little act made to me. this was 8 years ago and I"ll never forget how kind she was.

I hope you stay pg for many more weeks!

I've had a full term baby, one at 32/33 weeks with a two week nicu stay, one at 35 weeks who roomed in and came home with me, and one at 36 weeks who spent 12 hours in the nursery and then was rehospitalized for jaundice from days 5-10, and then my last son was born at 38 weeks and was supposed to be my home birth but had some complications in the end and needed resusitation.

I think 34/35/36 weeks is a great gestational age to strive for
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Old 01-10-2008, 02:13 PM
 
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I'm so happy to hear that you are still pregnant. It really does change your perspective on everything. All you can do is make the best of your situation and do the best you can. But don't be afraid to ask questions and question authority if someone tells you that you cannot hold your baby. IME, every nurse is different and after my son's heart surgery some let me touch him and others wanted his isolette closed at all times.

I hope your baby stays in for a lot longer. Keep up the good work mama. You can still be AP with a preemie, it just looks a little different that AP-ing a full-term baby. It doesn't make you less of a loving mama.

Zen doula-mama to my spirited DS1 (2/03), my CHD (TAPVR) warrior DS2 (6/07) & a gentle baby girl (8/09)
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Old 01-12-2008, 04:19 PM
 
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Just checking in on you! Glad to hear you're still cooking! How are you holding up?
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Old 01-12-2008, 06:13 PM - Thread Starter
 
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I'm holding up!

I'm crocheting a tiny little cap out of bamboo thread. It's soooo soft!

I hope these tiny things become useless QUICK!

The sensitivity of the preemie was something I had no idea about until the tour the other day... I would have never thought they didn't want to be held. Interesting how they change in only a few weeks!

Different drummer dancing with 3 kids in 3 decades.
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