Preterm Scare

Monday was in many ways an ordinary appointment for me, with ordinary errands to attend to afterwards, and I did them while feeling crappy, which is a very normal thing for me when pregnant. Over the weekend I felt like or had an intuition that my body was up to something, so perhaps I should have been more vigilant. Then again, intuition is unreliable, and I have an irritable uterus so how was I supposed to know that Monday was any different? Regardless, I ended up in the hospital where I needed to be, and Dr. CalmNGentle was able to stop the preterm labor. I do keep replaying the events of the day to see if I could have seen it coming and or maybe its just a method to calm me down. Either way this is how my week has gone.

Last Friday and Saturday, I was more uncomfortable than usual due to more frequent contractions from my lovely irritable uterus. My cervix has not changed in texture, thickness, or dilation since 26 weeks - still very soft, a little thin, a fingertip dilated but technically still closed - so with confidence from my doctor that if the level of pain does not change or that there is no detectable pattern then the contractions I experience all day, every day are just Braxton Hicks. I have also had 2 FFN tests performed at 26 weeks and at 30 weeks, both with a very encouraging negative result. Using this information, I do as usual and rest as much as possible outside of work and watching my daughter while my husband works. I do, however, notice that I am having frequent, loose stools that women sometimes experience during prelabor, but that can occur weeks before actual labor so I choose to ignore this.

Sunday, my plans were to meet my mother to pick my daughter up from her (she watches her on weekends sometimes for us). Then I was going to take Jaden to her new friend's 2nd birthday party and check out a community yard sale for baby stuff in the same neighborhood. Instead, when I met my mother, I had to run to bathroom because I was sick then the contractions started. We went back to my mom's apartment, where I decided that if the comfort measures that usually work didn't then I would call the doctor. Well, the all fours on the floor position took the pressure off my back and pelvis, the hot bath helped and laying down did a little good. The contractions didn't disappear, but they improved significantly. After several hours, I drive Jaden and I home. I remind myself to mention it at the appointment in the morning.

Monday, I drop Jaden off at my MIL's house while I go to the appointment and run my errands afterwards. From here is where I keep replaying the events, I know I wouldn't change anything about the weekend but what if something, anything had been different on Monday? What would I have done then? Dr. CalmNGentle does not share his practice with another OBGYN but he does have a PA that assists him in the office. Routinely, a patient sees the PA for the first OB consult then every appointment after the patient will alternate seeing Dr. CalmNGentle and PA every other appointment until a patient is at the point when visits are weekly, in which case the patient sees only Dr. CalmNGentle. At this appointment, it was my turn to see the PA. I briefly describe the weekend, a couple of other symptoms, and ask about Nathan's breech status. PA does a cervical exam and does a quick swab to make sure not leaking fluid. Still soft and closed and no amniotic fluid present. PA then explains that I am 34 weeks and 3 days and that she can do another FFN swab if I wanted but they don't do those after 35 weeks, which is just a few days away. PA goes on to say that the other 2 tests came back negative earlier in the pregnancy and high probability that this one would too. "This is probably just going to be a miserable pregnancy." I agreed with everything that she said - after all I don't want to pay for an expensive test that had my appointment happened to be later in the week, they wouldn't have even considered performing anyway. After my irritable uterus and 3 negative FFN tests with Jaden, I still had to be induced with her. Even if PA had done the test, I would not know the results until Tuesday afternoon, which would have been too late anyway. Nothing had changed so why worry unnecessarily. Lay down as much as possible was what I was instructed to do. And I planned on it, after my errands. I went to USPS, then Target, then Walmart, and ate a quick lunch. Sounds like a lot, but they were all short, in-and-out trips. My MIL said she would bring Jaden by the house after I got home. Good, then I can go to a friend's for a little while and give her a belated baby shower gift. While at her house, my friend looks at me funny, "You've been sitting on my couch for awhile now and you face keeps going blank every so often. Are you having contractions? I have contraction timer app if you are." Yes, I was having contractions, but I just came from the office a few hours before so I wasn't worried but did agree to let her time the contractions. Turns out, they were lasting 45-60 seconds with 3 minute intervals. After a call to the office, my friend drives me to L&D. I am immediately admitted and hooked up to monitors, contractions are regular, strong, 3 minutes apart, and building. It did take them 30 minutes to find Nathan's heartbeat (all we could hear was him stubbornly kicking the monitor). Dr. CalmNGentle prescribes 20 mg Procardia and determines that I am 50% effaced and my cervix is funneling (dilated outside to 1 cm and closed on the inside). After 2 hours, the Procardia has had no effect on the contractions and second cervical exam shows I am 50% effaced, Nathan is head down and -2 station, and solid 1 cm dilated. So he switches me to magnesium sulfate and orders corticosteroids shots. After 36 hours on mag sulfate and 2 rounds of steroid injections, Dr. CalmNGentle observes how I do back on the Procardia for another 12 hours before releasing me on strict bed-rest Wednesday evening. He explains that I had a strong labor pattern and to call/go in to L&D if any of a short list of symptoms return. The goal is to stay pregnant for another 8 days when I hit the 36 week mark.

The entire experience was scary and surreal. I feel stupid for having a 'that will never happen to me' mentality, even though I am/was considered high risk. Is it naivete, ignorance, what? But then again, would I have been living in fear, walking on egg shells had I known just how at-risk I was? Would it have been different if I skipped my errands altogether and went home to rest? Am I the only who experienced this, that really didn't see it coming though I probably should have? If I had gone home instead of to my friend's house, would I have tried to relaxation techniques or gone to the hospital? Would I even have made it in time for Dr. CalmNGentle to be able to stop the preterm labor? The truly scary thing is, that had I gone home, I probably would have waited for my husband to get home from work several hours after the labor pattern started then ask him, "What should I do?" It's not his body, how can I put that judgment call on him? I don't want to think what might have happened to Nathan after that. Then, my mind goes on a justification bender to try to ease my guilt with thoughts going through my head like, "I wouldn't have done anything differently if I had been in PA's shoes. How could I have known?" Or my mind minimizes the situation like "It could have happened last month, then you really would have been in trouble" or "34 1/2 weeks really isn't that premature, Nathan would have been fine regardless whether the labor was stopped or not" or "You only got to 1 cm, did the Dr. really need to worry that much about it?". Reality is that, yes, it could have been worse, but that does not mean the situation I was in was good. Nathan still would have had problems just not to the extent of a extremely premature infant. I am thankful for all the measures my doctor took to stop the labor and ensure Nathan's health.

Each day that passes, my anxiety over Nathan's well-being eases. I have new sense of reality-based clarity and health fear that reminds me how important my adherence to the bed-rest, pelvic-rest, and Procardia regimen really is. So here is to hopefully more than 8 days until Nathan's birth. And should he come sooner, I will have done everything in my power to keep him in, pray the steroids did their job, and trust God to care for him in everything else that I have no control over.