Pregnancy Update: Preterm Labor, Bedrest and Taking Things a Day at a Time
If you follow along with me on social media, you likely saw that I recently spent a little time in the hospital. Ok, four days did not exactly feel like a "little," but when the alternative was an extended stay on hospital bedrest, I'm counting my blessings. It's taken me some time to process everything and get to a place where I felt ready to commit my thoughts to paper, I'm still feeling pretty raw as we are still very much in the midst of things and dealing with a lot of uncertainty, but I wanted to get it out there anyway.
We knew going into this pregnancy that it would be complicated and based on my pregnancy with my daughter it was more likely than not that we would face similar issues. We had been warned in advance that the particular way in which my body behaves was more likely to be worse with every subsequent pregnancy than better. I've lost a lot of sleep being torn between the desire to have a second and the fear of going through it all again, coupled with guilt over the idea that I am likely to deliver very prematurely. Despite that we were hopeful. We have a great team of doctors following us closely and have been proactive with treatment and carefully monitored from the time I got a positive test.
I have hyperemesis which, while not responsible on its own for my preterm labor, complicates things further. If I get dehydrated, it can set off or intensify my contractions as can the fits of vomiting themselves. While I was able to start on medication to help manage my symptoms almost immediately, it's still a daily battle. I have a limited diet of "safe foods" and an even harder time with liquids. I have to get very creative to stay hydrated, relying on things like Italian ice and fruit when nothing else is working. Some days I am nauseous but otherwise fine, other days I don't keep anything down. There doesn't seem to be any rhyme or reason to it. Unfortunately, after getting a bit of relief during my second trimester, it appears to have peaked again just as we are dealing with everything else.
In my first pregnancy, I had similar symptoms to this one but dismissed them and tried to keep up with my daily activities. I went to work in a photo studio, photographed festival-style on the weekends and generally tried to be the ideal active pregnant woman (who happened to have to run off to vomit a lot.) I had been having regular contractions from 16 weeks on but was told they were just early Braxton-Hicks and that my uterus might be a touch "irritable." Everything came to a head when at 29 weeks my contractions started coming at more regular intervals and intensifying. I called my OB and was sent to triage to get checked out but was assured I would likely be given a shot to calm things down then be sent on my way. When I arrived and was hooked up to a monitor, we discovered my contractions were only five minutes apart, and suddenly the room was packed. What happened next was a blur. I was told I was starting to dilate and that because the baby was breech, I might be having a c-section that day. They started me on a Magnesium drip, which makes your body feel as though it’s on fire for anyone who hasn’t experienced one, then started the steroid injections to help mature my baby’s lungs. I was given drugs to help slow the contractions, and things began to calm down gradually. It took the better part of a week until things were managed enough that I was able to go home on maintenance medication and bedrest. From there were a lot of trips to the doctor, a few more hospital stays and seven weeks of bedrest before my daughter made her appearance just shy of 37 weeks, technically a late-term preemie. She struggled a bit with her blood sugar and with jaundice but was ready to go home when we were.
Fast forward to this pregnancy. I’ve been seeing a high-risk doctor since the very beginning, getting regular ultrasounds to monitor things like my cervical length (short and dynamic, but not enough to merit a cerclage) and have been receiving injections of the hormone Progesterone from 16 weeks on, which is meant to lower the risk of a preterm birth. My contractions started even earlier this time, at 11 weeks, and I was placed on activity restriction with limits on things like how far I could walk and told to avoid bending, lifting and stairs when possible. I honestly felt as though this time we knew better and were doing everything right. Despite all of this at 28 weeks and 5 days (just two days shy of last time), I began to have regular intense contractions. I tried all of the usual recommendations, and when they continued to worsen I called my husband to come home, and we headed to Triage. When we arrived, it became clear that I was, in fact, experiencing preterm labor again, and when the did a swab to test for the presence of FFN, an indicator that your body is preparing to deliver, it came back positive. I was admitted to the hospital, and given steroid injections for the baby’s lungs then started on medication to help slow my contractions. It was the first time I had been away from my daughter overnight and was a difficult adjustment for all of us, and we relied heavily on some good friends and babysitters who all did everything they could to make it as seamless as possible.
They discharged me late on Monday after about a four-day stay with medication to keep my contractions under control and orders to stay on bed rest until this baby makes an appearance, and I'll be checking in frequently with visits to the doctor. Around the same time, I was diagnosed with pregnancy tachycardia, and am currently wearing a heart monitor and taking medication to help keep it under control. It’s another aspect that will need to be managed in delivery, and they’re currently running tests to see if there’s an underlying cause.
For now, we’re taking every day we can get. Every additional week that I stay pregnant is a milestone worth celebrating, and while bedrest, frankly, is not the vacation I wish that it was, it’s where I need to be right now.