I'm so confused!

My doctor has contradicted himself like 15 times in the past two weeks regarding our continued plan for "stopping" labor. What is everybody else on bedrest for? Are you having contractions in addition to having cervical issues? Just cervical issues, no contractions? Just contractions, no cervical issues? I have both, but it seems to be that the dilation of the cervix brings on the contractions. At the beginning I was on mag, terbutaline, indocin, and niphedipine. A combination of all those at different times. I was slowly weaned off of all of them except niphedipine. When I have too many contractions they give me a shot of terbutaline, but mainly I've just been on the niphedipine. Now that my contractions are starting to pick up and I've lost my upper cerclage, I'm nervous whenever I contract AT ALL. I really want to make it past 30 weeks. But now they're telling me that they're not sure how much more "aggressive" they're going to be with the medications at this point because it may be "mother nature's" way of telling us it's time. WTH?!? Wasn't mother nature telling us it was "time" at 20 weeks? I just don't understand why they seem to be more relaxed about the babies coming now that we've hit 29 weeks. I know they have a good chance, but they'll have an even better chance later on. Has anybody else received the confusing runaround from your doctors? What is your opinion on all this? :huh:

 

My MFM and OB docs take the stance that meds will not stop labor if it's going to happen. Some of the meds may slow the contractions down, but nothing will stop the labor if it's on the way. Does that make sense?

I take nifedipine twice a day - more as a "precaution"/mental thing - than as a drug that's going to stop labor. I have a cerclage/cervical issues and painless contractions. Some times of the day during some weeks, I may contract every 6 to 7 minutes. . . some days, I'll go for hours with no contrax. I have a history of contracting and dilating like this in previous pregnancies, and I've always gone fullterm. . . twins are different tho as there is more stress on the uterus/cervix earlier.

My docs no longer give mag sulfate or terbutaline due to research that's been done. But there are other docs here at the hospital who still prescribe those treatments.

Survival rates are better at 28 weeks as compared to 20 weeks when survival chances are nil. That's why your docs are more relaxed now. It's true that the longer they stay in, the better, but the docs may feel that either you aren't dilating as much as you think with each contrax (that it's just what your body does) or that at this point, your body may not respond to stopping this kind of labor.

It is aggravating and anxiety-causing to experience this. 29 weeks is a relief. . . just keep going week by week, and try not to be anxious (which can cause you to contract). Unfortunately, there's not really any drug that will effectively stop labor if it's coming. . . and they all have side effects. I have found bedrest to help to keep pressure off my cervix. Also, your bladder may irritate your uterus causing contrax. I experience this too.

Hang in there!

 

I'm on bedrest for cervical issues, contractions and an irritated uterus. I was given nifedipine to stop contractions, but I can't really say it helped. Same as Emily, I think it was more of a mental thing. My OB took me off the meds 1 month ago and I was so worried, but nothing happened. My OB doesn't give mag or terb.

I think what helps me most is bedrest and take it week by week. You've done amazing already, but of course you want to go further!!!!

I got the runaround all the time, I was constantly told that I was going to be sent home until I finally asked what is your plan with me. Then he said, to keep you here until 32 weeks and if you're stable you can go home. Until that point it was frustrating because I never knew what was going on.

Talk to your doctor. Let him know your concerns.

Brooklyne

 

Are you seeing a peri? I was on every drug that you have been on, for cervical issues, contractions and funneling. I was on hospital bedrest, and on 4.25/mg mag an hour on top of all those other drugs for over 3 weeks. In the long run they didn't stop my labor completely, but it bought me 3 crucial weeks that I was able to keep my babies in.

Is there any way you can talk to another dr? And if your not seeing a peri, I would recommend seeing one, they are the ones that specialize in this. GL! I hope your contractions get under control soon.

 

thanks for the responses. My doctors also take the stance that if it is real labor, it can't be stopped. I am seeing a peri and very much trust him. He was the one that performed an emergency cerclage for me when I wasn't a candidate for that because of active labor and bulging membranes. I fully believe that if he hadn't done that, I would have had them by now. I think what is hard is that there is no set solution for preterm labor. There's just so much that they still don't know and what seems to work for one doesn't seem to work for another. So I end up hearing something different every day since they're actively learning. It's just frusterating. I know that some contractions can be normal, but I have weekly cervical checks and last week, my cervix had changed pretty drastically from the week before. I lost one of my cerclages and my length below the lower cerclage went from 1cm to 2mm. Not a huge distance, but big change comparably. I'd been at 1 cm for about a month previously. Right now I'm just trying to get them to try the maximum dose of procardia before they put me back on mag. They're considering putting me back on mag to get me to 30 weeks. This trying to fight preterm labor is just crazy. I truly feel like I've been in a battle these past 8 weeks. I'm tired for sure, but still not ready to let go of these babies...

 

If you don't want to do the mag and instead prefer the procardia (nidedipine), show them some of the research (can be found on internet) that now says mag can be harmful to mom and babies. I had to ask/beg for the procardia myself. . . told them it was worth it even tho it might just have a "mental placebo" effect. You have the right to refuse any medical treatment you don't want.

If it encourages you, I've had a .9cm cervix (with cerclage) since 21 weeks, dilated 1 cm and 70% effaced for many weeks now. I'm thankfully almost 32 weeks. Bedrest is crucial for me too, and I truly believe I am one of those women who dilates/contrax like this over time. . . not that my babies might not come early, but just this can happen. My docs never thought I'd make it to 28 weeks, let alone 32.

 

Also, I found my greatest mental battles seemed to crop up between 28 and 31 weeks for some reason. I felt my lowest and most discouraged then despite the 28 week good news. Hang in there. . . it's hard being in the hospital. (We have TTTS with polyhydramnios, PTL symptoms and a bad cervix.) Keep your "fight" up! You are doing great at something most people have no clue about. They think it's easy, but I know it's not. . . I admire the women who do this as long as they can for their babies' safety.

 

QUOTE(lovelylily @ May 27 2008, 01:59 PM) [snapback]795640[/snapback]
thanks for the responses. My doctors also take the stance that if it is real labor, it can't be stopped. I am seeing a peri and very much trust him. He was the one that performed an emergency cerclage for me when I wasn't a candidate for that because of active labor and bulging membranes. I fully believe that if he hadn't done that, I would have had them by now. I think what is hard is that there is no set solution for preterm labor. There's just so much that they still don't know and what seems to work for one doesn't seem to work for another. So I end up hearing something different every day since they're actively learning. It's just frusterating. I know that some contractions can be normal, but I have weekly cervical checks and last week, my cervix had changed pretty drastically from the week before. I lost one of my cerclages and my length below the lower cerclage went from 1cm to 2mm. Not a huge distance, but big change comparably. I'd been at 1 cm for about a month previously. Right now I'm just trying to get them to try the maximum dose of procardia before they put me back on mag. They're considering putting me back on mag to get me to 30 weeks. This trying to fight preterm labor is just crazy. I truly feel like I've been in a battle these past 8 weeks. I'm tired for sure, but still not ready to let go of these babies...

You are doing a great job!! It is SO frustrating that they dont have concrete answers for PTL. I hope they get everything straightened out and those babies of yours stay put for a while longer!

 

Amanda, I agree with everyone else! You're doing great and proving what a wonderful mother you already are!

I remember in the hospital, whenever someone was admitted I'd always be curious to know what gestation they were at. It made me sad that out of about 20 plus roomies I was ALWAYS at a lower gestational age. It made me feel like I was never getting ahead. I used to look at tickers that would be over 30 weeks and think wow.....they are so lucky!!! Well, now I'm in my 32nd week and I am so thankful to of made it this far. However, I still want to make it further. I know I can't control when these babies arrive other than by taking bedrest seriously.

I hope that your babies stay put for longer! Take it day by day! Keep us posted!

Brooklyne xxx

 

QUOTE(Emily@Home @ May 27 2008, 07:26 PM) [snapback]795430[/snapback]
My MFM and OB docs take the stance that meds will not stop labor if it's going to happen. Some of the meds may slow the contractions down, but nothing will stop the labor if it's on the way. Does that make sense?


My peri was the same way. When real labor starts, these meds typically will not stop it. And the further along you go the higher the chance of true labor beginning.

I was on Nifedepine up until the very end. But my labor never got intense, I just got regular contractions 6-7 minutes apart, some I had to do yoga breathing through, about 2 days before I delivered. Got to L&D and found that my water had broken on baby A. With IV hydration and continuing my Nifedepine, the contractions did stop. But baby A was threatening to push her cord out with her foot so they delivered me 48 hours after my rescue dose of steroids. They totally intended to keep me pregnant longer, barring any infection, if baby A had not been trying to kick her way out.

I was never given a shot of terb or mag.

 

Amanda,

I agree...you're doing a great job!! I've had PTL issues for the last 10 weeks due to contrax, shortened cervix, dilating and funneling. Been on bedrest since 24 weeks, with 3 weeks in the hospital. Just like you, I've been on mag, nifedipine and terb. (Never got to try the indocin!!) Anyway, one thing I learned during this period is that obstetrics, especially pre-term labor, is a very inexact science!!!! There is sooooo much that is just not known or understood. It is definitely frustrating to not have direct answers, and every doctor has a different opinion. When I was told to go on strict bedrest at home, I was also told at the same time that there is no clinical evidence that shows bedrest helps. Same thing with all the meds!!! Quite frustrating! I will say, that for me, bedrest has certainly helped. I've been more relaxed, my body has been less stressed, and pressure has been off of my cervix (which still continues to shorten...) I think my daily doses of nifedipine help. Contractions pick up right the hour or so before my next dose...again no clinical evidence that it helps, but I have managed to keep these babies cooking for the last 10 weeks.

The flip side of the uncertainty in OB, is the advances in neonatal medicine. It is absolutely amazing what they can do for premature babies!!! Have you visited the NICU? When I was in the hospital, I made it a point to tour the NICU. I expected to be completely sad and depressed by what I saw, but rather had the complete opposite reaction. It was incredible to me to see these tiny little babies thriving!

You've done a terrific job so far, passing major milestones! If born now, your babies will be a great shape. Of course, every day they stay in, the better. Just try to relax, keep off your feet and take it day by day. I'm amazed that I've been at this for 10 weeks so far! Keep it up and soon enough you'll have two happy, healthy babies in your arms.... :love0028: