Saturday, November 2, 2013

PAM FOD #2 - Second trimester preterm labor

Prematurity Awareness Month
Fact of the Day
Day 2

Q: How can I tell the difference between preterm labor and braxton hicks contractions in the second trimester?

A: It's not as easy as you'd hope. If you have any questions about what you're experiencing, call a doctor and talk about your symptoms. Also, check out these sites: American Pregnancy Association, and the March of Dimes for signs of preterm labor.

Disclaimer: I am not a medical professional. Please take this as advice from a girlfriend, not as advice from a doctor. Check with your doctor, not the internet, if you feel like you might be in labor. 

Here are some signs: Is the person pregnant having more than five contractions in an hour? Has she tried resting on her left side for an hour and drinking LOTS of water?  Has that helped?  If it hasn't helped within an hour, call the doctor or go to the hospital.  At triage she will be checked, and while most people will be told it was braxton hicks, for the few of us that found out it was really preterm labor, we will have possibly saved our child's life. If you have any reservations, get it check out!

For me the difference was very small. I was in my 20th week of pregnancy, had had my second trimester ultrasound done over a week before, and all looked really good. I'd had lots of braxton hicks contractions with my other pregnancies, and was sure that was all I was experiencing. Plus, I had NO (zero, none, nope) risk factors for preterm labor. I'd delivered two full term children, and thought myself pretty good at carrying a baby to term.

For me I became a bit concerned when the contractions didn't go away with hydration and rest -- I was having eight to ten an hour -- and they felt more crampy than what I remember from braxton hicks.

 Note: For me second trimester contractions did NOT feel like third trimester contractions. They were mild, like menstrual cramps, sometimes even less painful, and sometimes DID NOT EVEN SHOW UP on a monitor. I told the nurses that I was feeling contractions that were not showing up on the monitor, and they gave me a button to press at the start and stop of every contraction I felt.  Even then it was hard to tell if it was a true contraction or not. I was surprised to find out a week later when being monitored by ultrasound while contracting that even my least painful potential contractions were dilating my cervix.  In other words, it's really really hard to tell.

Since second trimester contractions are not obviously painful and hard to spot on a monitor, in addition to monitoring my contractions and checking my cervix, the nurses had an ultrasound done. The cervix was closed, but the ultrasound showed funneling. Within a few hours of that ultrasound (at 20.8 weeks pregnant) I was dilated 2 cm straight through.

By being extra diligent, the nurses caught that I was truly in labor. Looking back at all the steps taken and the persistence of the medical staff, I am in awe.  This was the labor that almost wasn't caught.

By going in when things didn't quite seem right we were able to keep me pregnant for two more weeks. That, in turn, brought us from a not-viable pregnancy to the cusp of viability.

In hind sight, I shouldn't have pushed that other pregnant lady up to labor and delivery. That said, I will never regret going in. I didn't know it at the time, but going in and risking looking foolish saved my son's life.

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