Friday, April 9, 2010

Daniel's Birth Story- part 1- preterm labor

Here I am at 28 weeks pregnant, going out for a date- little did I know it was to be my last time leaving the house for anywhere other than the hospital for 8 long weeks:

I got pregnant in August of 2007 (on our one year anniversary, just as planned) and we moved from Utah to Texas when I was about 20 weeks along. I had a very uneventful first pregnancy- no morning sickness and no complications... until one morning when I was about 28 weeks along, I was feeling particularly crampy and my back ached. Nothing awful, but enough for me to complain to my sister, L, who was also pregnant at the time. L then said "um, you should go to the doctor, that's exactly how B (our oldest sister and mother of 4) felt when she had preterm labor issues."
I thought she was overreacting- I really didn't feel that bad. But as the night dragged on, I didn't get feeling better. My husband and I prayed that we would know if we needed to go to the hospital. At the exact moment the pain got worst. We took the hint and headed to L&D.
When we got there, we discovered those "cramps" were back-to-back contractions, and I was beginning to dilate (at first they said 2 centimeters, then as time went on they changed their analysis to one centimeter and finally to "only barely open"). All of the sudden I found myself the subject of a lot of attention. They wheeled me into a delivery room, shot me in the butt with steroids (to help the baby's lungs develop) and put me on *shudder* magnesium sulfate to calm my uterus. An ultrasound showed the baby was still healthy and measuring slightly ahead of schedule.
The mag sulfate was AWFUL. I was super hot and shaky. I was weak, which sucked, because they were pumping full of liquids and I had to go to the bathroom every few minutes. At one point I told the nurses I was going to lose consciousness (I pass out a lot, I know how to recognize that feeling) but they didn't believe me- said my levels looked perfectly fine. I then passed out. Shocking. I also threw up for the only time in my pregnancy. And I got to experience bed pans for the only time in my life. In short, it was HORRIBLE.
Amidst all of that, we never really panicked. I don't know why, but we felt strongly that it was going to be ok. The biggest things I worried about was that we still hadn't decided on a name, and didn't own an infant carseat yet (though if the baby came at 28 weeks he would not have been needing a ride anywhere for a LONG time).
After 3 days, they sent me home. I was still contracting but it had slowed down a bit. I was put on full bedrest, with "bathroom privileges" only. They prescribed Terbutaline, which my doctor correctly stated "would make me feel like a crack fiend looking for my next hit". I continued to work from home from my bed for 6 weeks, during which time I contracted 6-10 times each hour:

My husband took AWESOME care of me while on bedrest. He was essentially functioning for the three of us. I will never forget his selflessness. The weeks progressed. We had a few scares and more trips to L&D but I didn't progress. I complained to L (who was on her third baby shower) that I never had a chance to meet anyone in my area because of bedrest and that I was sad I didn't get a baby shower. She told B, who told my mom, who mentioned to my sister-in-law C (who lives about 15 minutes away) and she got right on it! In the end, about 25 people, most of them complete strangers from church (who have since become good friends) came to my shower. After weeks of bedrest and isolation, and being unable to do any baby shopping myself, I couldn't have gotten a better gift.
By 35 weeks, after 7 weeks of contractions, I still wasn't dilated to more than a one. I was effacing, but really... nothing was happening. I wasn't in pain- I could really only tell I was contracting by poking my tummy and seeing if it was hard. My husband let me sneak off bedrest to go see a movie in the theater- 21- and I was in heaven. I began to wonder if the "emergency" stay in L&D or the bedrest was necessary. I researched mag sulfate and terbutaline and learned that NEITHER of them are proven and tested for laboring mothers. There was a class-action lawsuit out for perceived negative fetal side effects for Terbutaline.

Considering at one point I was worried I wouldn't make it to 34 weeks, once I hit 35 and then moved on to 36... I was almost disappointed. While I wasn't particularly uncomfortable, I wanted to be done with the whole mess and meet my baby! Every little twinge I felt, we worried we needed to get to the hospital. My sister B showed me pictures of her baby born at 35 weeks- gray and floppy and small- and her baby born at 36 weeks- pink and happy- and convinced me a week could make a lot of difference and to try and be patient.

Finally at my 36 appointment, there was change! I was dilated to a 4 and my bag of waters was bulging (mind you, I still wasn't feeling anything down there). That was April 17th.

April 24th, my sister L had her first child with a midwife at a hospital:

It was a fabulous birth- spontaneous rupture of membranes, 3 hours in the hospital, half an hour of pushing, no tears... She called and told me the pain was bad, but it wasn't non-stop. Between contractions she could rest and regroup. I think part of me was subconsciously waiting for her to have her baby before I would have mine- she was technically 3 weeks further along and had also had (more painful) preterm labor issues (apparently women in my family do) but had made it to nearly 39 weeks. Now it was my turn, and after hearing her great birth story, I was ready!

That day at my appointment I was 6 cm dilated.  My OB (a very nice but perhaps unwise lady who I hate more and more with time) was TERRIFIED that I was that far along and still not in active labor under her care. She wanted to break my water right then and there. I knew that if she did I would be on a timer for when to deliver before they'd start intervening. I still wanted a natural childbirth and didn't want to start my labor with an intervention. My sisters also helped talked some sense into me and firm my conviction. I also knew my baby needed to bake a bit longer. So even though I wanted to meet him and was sick of wondering "am I in labor or not", and despite my doctor literally BEGGING for me to be admitted and induced, I convinced them to let me go home.
That said, I still tried every natural trick I knew to start labor. I told my boss no matter what, I was done working for at least 8 weeks. We went for walks, I ate spicy food, I was as active as I know how to be.

The next morning my doctor called me directly and asked me to please check-in to L&D to be measured. I was now 7.5 cm dilated. I was 75% done with labor and it hadn't even started! We ran laps around the hospital to get things going, but no luck. I made hospital history by walking out those doors 7.5 cm dilated. We went to toys-r-us and bought Legos to work on together to fill in the waiting time:

The next morning (I was 36 weeks and 5 days along), we had sex for the first time in 8 weeks, for the sole purpose of hopefully kickstarting labor. Needless to say, it wasn't the best we'd ever had. But it did the trick. I started bleeding a lot and contractions got much stronger. I sat in the bathtub (didn't want to get blood anywhere) while K made breakfast- it looked like there was clear liquid in the blood, so I thought my sac had ruptured (in retrospect it may have just been semen.) We then got in the car and headed to the hospital for the last time...


  1. I'm curious what the details were of the research on mag sulfate and terbutaline. I did a little research on PubMed on mag sulfate. I was just looking specifically for pre-eclampsia, and it seemed like the research supported that use. I'd be curious to know more.

  2. spells it out pretty well: it's an unlabled use of the medicine and the studies I've seen show that it doesn't do much to stop preterm labor, especially for more than a day or two.
    It is one of the drugs that DOES cross the placenta and effect the baby. So if I was throwing up and passing out, I don't want to even think about what it was doing to Daniel in there. also has some scary info about mag.

  3. So do you know if anything has been proven effective for preterm labor? I have read the Cochrane Review for even bed rest, and bed rest isn't proven effective either. If I remember right, the mag sulfate link was saying that it's found to be more effective than the other drugs, but it still isn't proven effective compared to a placebo. So are all these treatments used because there simply isn't any known effective treatment, and they feel compelled to do something?