Week 31 revised: Early Labor

Warning! This is: long, only sort-of-coherent, but more importantly, DETAILED about what happened last weekend.

I had written the 7-month blog post right before my routine doctor’s visit. Uncanny timing.

At the check-up, I told my doctor about how I was feeling more contractions and some soreness once in awhile. I mentioned a slight coloring in my urine the other day but it was only once and not burning. My last question was whether Ben would be able to go to a climbing trip up in Washington next weekend, about 5 hours away. Given my concerns, she decided to measure my cervix. It turns out it was short, meaning thinner than it should be at this point. It was still closed and not an alarming thinness, but she said to back off on activity for a week and see how that goes. And no climbing trip for Ben.

I went home with a very different feeling from that morning, and well, I started to stress. I referred to the pregnancy books, which suddenly were no longer simply my references for the martian’s equivalent fruit size. I googled “short cervix” to learn about symptoms and causes, and didn’t find any real data, except that it essentially increases the odds of early labor by a factor of 13. I read up on complications and too many scenarios.

I blamed myself. Did I over do it? Could I have prevented or detected it? Every contraction or tightening made me worry. Later Ben told me he was already planning to call our doctor the next morning to have her explain to me that it wasn’t my fault, so I would in fact relax for the next week.

Tennis plans canceled (obviously), I decided to tag along with Ben to the climbing gym to hang out. I hadn’t seen our TGS crew in awhile and wanted to catch up before they went on the annual Oktoberfest trip. Before we left, one rubbed my belly and said “don’t have your baby yet!”

The rest of the evening I continued to feel the usual contractions and discomfort, but now with a little more worry. That night, for the first time, I felt lower abdominal pain, almost like cramps. They eventually went away, but I tossed and turned so much Ben moved to the TV room. At 4am, I woke up again, this time to sharp back pains on my lower left side. They were crippling, the most pain I can ever remember having. We tried to massage my back, using labor positions we had just learned in class, relax me, and control my breathing. Ben gave me a Tylenol; I immediately threw up. The pain felt consistent but after noticing it would peak, we thought to time them. Still, there didn’t seem to be any pattern or downtime (and apparently there should be a painless period). I didn’t even notice the contractions; all I could think about was the sharp pain. At 6am, somehow it eased and we both managed to fall asleep for an hour. But as soon as it started up again, we called our doctor who told us to go straight to the hospital.

This was a different hospital than we’re planning to deliver at, but it has a better neonatal intensive care unit (NICU). They strapped me up right away and started monitoring my contractions and the baby’s activity. The contractions are measured by pressure and because I’m small (that seemed to be the repeated comment all weekend, how small or skinny I was), it would catch any muscle movement. Even though the data was somewhat noisy, it was clear that the contractions were peaking off the chart, 6 min. apart. They also confirmed that my cervix had opened up 1-2cm from being closed only yesterday.

To try to stop the contractions and going into preterm labor, they give you magnesium sulfate. Yes, apparently Epsom salt is a very effective muscle relaxant. They dosed me with 2 grams/hour. The “mag” doesn’t take effect immediately. On top of the back pain and contractions, I was throwing up aggressively. It was a brutal 20 minutes before the drugs finally kicked in.

The baby’s activity and heart rate was fortunately healthy. The ultrasound verified my theory, based on where I could feel the hiccups, that his head was right at my cervix, in other words, at the door, ready to go. He was even facing the right way (backwards). They measured the different parts of his body and amniotic fluid, and estimated he weighed 3 lbs. 10 oz, an average size.

At this point, there was still the possibility I’d go into labor despite the mag. To prepare for it, they also injected steroids to enhance the baby’s lung development. At this stage, the baby’s lungs aren’t ready to breath, but if you can hold off labor for two days, which is how long they planned to keep me on mag, that’s all it takes for the steroids to take effect and speed up the development. It’s amazing really. In the ultrasound, we could see the lungs practicing breathing, and in two days, they would visibly be able to tell the change. They reassured us that the steroids have no after affects on the baby should you still go full term. I was also put on no-food and fluids for the next 12 hours and antibiotics since babies delivered early are prone to infection.

It wasn’t a pretty sight with all the IVs, needles, tests, and well, emotion. Aside from the fact that I wasn’t ready to give birth (mentally or physically), I wanted my martian to have his full chance to develop inside the womb. Lots of good stuff happens in the last trimester and I did not want to deprive him of that. And I wanted that connection with him at birth, the skin-to-skin contact. I was a bit hysterical. I tried to look deep into Ben’s eyes for any sign of worry, but he continued to appear strong and tell me everything was going to be fine.

The mag also makes you feverish, hot, groggy, and nauseous, so the next two days is kind of a blur to me. After a few hours, the contractions had become less strong and spaced further apart. By the afternoon, they let me drink more water which was a good sign. I was still on restricted fluids because the salt from the mag makes you retain liquid which can then clog up your lung area, especially if you’re lying down. There were frequent breathing tests as well as reflex tests to make sure the mag dose wasn’t too strong and causing my muscles to spaz. They also measured my urine (blah). By the evening I was allowed to eat. I wasn’t hungry but that meant they did not think I was going back into labor. What a relief.

The nurses are amazing. All of them are labor nurses but they rotate in the pre and post partum wards. Several said they prefer it here because they get to see their patients over several days. There were three shifts over the 24 hours, each with her own style. Though I felt very weak and incapable, I knew I was always in good hands. I needed help any time I had to sit up or even just to walk a few steps to the bathroom. Whenever I asked how things were looking on the monitors, they knew how to answer reassuringly yet not too promisingly. I did want to know the facts after all. I was also in a lot of discomfort. The room was kept so cold even Ben pulled his hood up whereas I was in a thin gown and constantly needed a wet cloth to cool my face. I rotated constantly to find comfortable positions for my back and stomach. I didn’t have an appetite and felt very parched, and took advantage that fruit, like watermelon, didn’t count as part of the fluid intake.

Even with sleeping pills, I didn’t sleep well through the nights, another affect of the mag. As my body took on more of the dose, I became weaker and unstable. I remember the nurse checking on my stats throughout the night. They also drew blood twice to check the mag level. I was able to doze in and out, which seemed to be the calmest time for my belly. Even the martian, who usually is quite the kicker, felt the effects of the mag and you could tell when he was mellow or resting with me.

By Sunday noon, things were looking good and they took me off the mag. The change was almost instant. Within 5 minutes, I could open my eyes, talk normal, even sit up by myself. It felt like a gift to have as much liquid as I wanted and actually be coherent. As Ben said, it was nice to have Annie back (well, sorta). They monitored me and the baby for another 24 hours to see if the contractions would act up again. I was having about three an hour, which was not alarming, and they weren’t painful. By Monday noon, my doctor said I could go home. She said I have an irritable uterus and I don’t disagree. It’s just that before, I never thought anything of the contractions; now I wonder if they’re really trying to do something. She also assured me that it wasn’t because of my activity level. The causes of preterm labor are unknown and unpredictable; it’s increased since the 1900s and they’re trying to understand why.

It was a surreal feeling leaving the hospital. It felt like I was in a movie, where someone wakes up, so much has changed, and s/he appreciates any detail of life. As I waited in the wheelchair for Ben to pull up, I watched the hustle: nurses coming back from lunch, visitors with their balloons and teddy bears, the construction loud yet invisible to the people multitasking, the rain in daylight comforting. For me, it took only four days and not even a serious incident to feel like this happy observer. Makes me really wonder if sometimes we do too much.

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7 comments

  1. Natalie · · Reply

    Wow, powerful post. I teared up in parts, imagining how stressful and unnerving the whole experience must have been for you. Your last paragraph, however, had a real zen feeling about it – just you, observing the rest of the busy world as it whizzed by. I’m glad you put all these emotions down in writing.

  2. Yes, your post gave me goosebumps and had me tearing up, as well. Those nurses are wonderful. So glad Ben is so reassuring and positive. And Annie, you are so strong! Someday, the Martian will delight in hearing (a less detailed version, of course) of how eager he was to come into this world and meet Mom and Dad.

  3. it’s funny how well we know our bodies, isn’t it? you knew something was off immediately, and that was probably something that helped you get through this ordeal so well. i’m glad you have such great hospitals nearby and that you have great people taking care of you. i definitely think that people tend to always be on the go, rarely slowing down to just relax. perhaps it’s a sign for all of us to take time to smell the roses?

  4. Haritha · · Reply

    Like others have said, this post gave me goosebumps. Please be assured that you didn’t do anything to cause the scare of pre-term labor. Glad you are out of the hospital and resting. Going through traumatic situations does make you stop and think if we do too much some times. A big hug to you! Stay clam, as clam as you can, enjoy some quiet time.

  5. Damn this distance – I wish I could give you a big hug. You are so strong Annie – even strong women can cry or just lose it at times. What an intense experience you and Ben went through – thanks for sharing. I’m thinking of you along with so many others wishing you some better sleep and no contractions for a while.

  6. Your story made me cry as well. The fear, the stress, the worry….what was going through your head…what Ben was going through…I’m so sorry both of you had to go through such an ordeal and am so darn happy that the Martian is still healthy and safely in the womb. You are all fighters and I look forward to meeting the amazing little boy who is so eager to see the world.

  7. […] a nice change, but otherwise, I’m ordered to stay off gravity as much as possible. Sigh. The detailed blog post explains more, but essentially, I’m slightly open (dilated), the membrane is thinner than it […]

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