What to do when you have pre-term labor contractions

Note: I am not a medical professional and this post should not be taken as medical advice.  Consult your hospital or doctor with any questions that pertain to your medical situation.

So you're well into your third trimester and you wake up in the middle of the night to use the bathroom.  When you lay down again, you realize that the pressure you feel is more than just the baby moving--you're having contractions.  You haven't reached the magic 37 weeks that classifies your baby as "full-term" and therefore safe for delivery.  What do you do?

1) Find the phone numbers for your Labor and Delivery department as well as your Advice Nurse (if your hospital offers those; Kaiser Permanente does) and put them in your phone/hospital bag if they're not already there.  Make sure your partner has those numbers, too (go ahead and wake him or her up if it's nighttime--if things get serious, you may not be able to talk on the phone or tell your partner where to find the appropriate number to call!).  If you have a midwife or doulah, you should also have their numbers at the ready.

2) Breathe deeply through the contraction you're feeling.  Notice how much pain you're feeling on a scale of one to ten.  Can you talk through the contraction?  Being able to talk through it is a sign that you probably don't need to call the Labor and Delivery department yet.

3) Time your contraction for two things: the length of the contraction, plus the amount of time from the start of the contraction to the start of the next one.  If your contraction lasts 45-60 seconds, it may be early labor.  If the time between the start of one contraction and the start of the next one is three to five minutes, it may be time to call L&D.

4) Try changing positions.  If you're laying down on one side, try rolling onto the other side.  If you continue to feel the same way, try sitting up or standing up.  Do the contractions intensify or decrease when you change positions?  If the contractions diminish or otherwise significantly change when you change positions, they may be Braxton-Hicks contractions (also known as false labor--a good thing if you're still pre-term!).

5) Try drinking water.  Does increasing your fluids by eight or sixteen ounces diminish the contractions?  Dehydration can stimulate both Braxton-Hicks and early labor; being well-hydrated, on the other hand, is enormously helpful for your baby and can help you reach the full-term mark safely.

6) Notice if anything else unusual is happening with your body.  The most obvious change would be your water breaking--if you notice that your underwear is soaking and there's fluid coming out, now's the time to call L&D.  Notice what color the fluid is--pinkish is a sign that things are probably normal, but bright red needs to be addressed immediately.  Notice what smell the fluid has. Also notice whether your heart-rate has accelerated more than normal, or if you're feeling short of breath, nauseated, or otherwise uncomfortable beyond the contractions.  L&D will want to know as much of your present condition as possible.

7) Armed with the observations above, if the contractions don't stop or diminish, even if you're not sure whether labor is imminent, call L&D.  They'll want the information you've gathered from your observations, and they'll be able to recommend on that basis whether you should come in.

8) If at any point you believe you or your baby might be in imminent danger, call 911 or have someone drive you to the emergency room immediately.  It's always better to err on the side of caution than not!

Late last night I experienced pre-term labor contractions.  I noticed that the contractions were enduring (45-60 seconds long) and frequent (every two to five minutes from the start of one contraction to the start of the next).  I also noticed that the pressure/pain was about a two on a scale of one to ten, my heartrate was up, and my water had not broken.  Having gone into labor once before, I decided that even though the contractions were frequent and lengthy, they weren't intense enough yet to suggest imminent labor.   After 15-20 minutes of breathing deeply, rolling over from one side to the other, and observing my contractions, I fell back to sleep.  Now I'm sitting at my dining room table, typing away and drinking lots of water, grateful that I didn't end up having to go to the hospital.  I would have gone if things had gotten more intense, but I'm glad it turned out not to be time yet.  Barring complications (like a knotted umbilical cord), the longer the baby has to grow and be nourished in the safety of the placental sac, the better!

Week 35 and odd appetites

That's right, Decimal's due five weeks from today, and I can hardly wait!  Two days ago the Hubby and I pulled out all the baby stuff--bottles, clothes, blankets, breast pumps, and so on.  I took AEMA's blue baby bouncer into work and set it on top of my desk, even though I'm sure the person who's temping for me while I'm gone will move it.  I also brought in the squeaky new baby bathtub from the trunk.  Hubby assembled what needed assembling while I filled out the registration card.  The hospital bag is more or less packed, and the only necessary thing that remains before the birth is to install the infant carseat (which currently resides in a box next to our collection of board games).  Soon Decimal, sweet little kick-master that she is, will arrive.  My hope is that she won't arrive in the car because of rush hour traffic (or in an ambulance because the car is somewhere else when my water breaks!).  Chances are good that, even if Decimal is bigger this time, the dilation of my cervix will happen just as rapidly as last time (if not more so), and that'll leave us with a very small window in which to get ourselves to the hospital.  If anything were to go wrong, I'd at least want to be within reach of a blood supply--know what I mean?  (Speaking of which, if you're eligible to give blood and you haven't lately, consider doing so in honor of Decimal.  It could turn out to be a gift of life at the brink of someone's death.)

I've had some odd appetites.  With AEMA I ate a plain double cheeseburger for lunch almost every day for several months.  This time?  Black beans and green salsa with mozzarella melted in is one of my favorites (I happen to be eating it for breakfast as I write this!).  I'm also an enormous fan of reuben sandwiches, warm chocolate chip cookies, warm apple pie, and not-too-hard ice cream with almonds, walnuts, and/or pecans.  My usual breakfast consists of a bowl of Cheerios (assuming we haven't run out, as we did a few days ago), and I find that by the time I get to lunch, despite being hungry, I have little appetite for what's available to me.  I usually want a very specific taste or combination of flavors (for example, last weekend while the kidlet and Hubby were out, I tried to go to Chipotle for a burrito and was thwarted by a town parade).  Fresh food (i.e. I could eat all the carrots in the universe, especially with a healthy portion of hummus thrown in) and baked food (DESSERT OM NOM NOM NOM) are my favorites this time around.  The thought of eating my favorite ham and cheese sandwich from the coffee shop near my workplace makes my stomach turn, but an entire pecan pie would be no match for me!  It's hard to remember what normal appetites are like. 

I've found myself daydreaming about exercising hard, which is something I'd be foolish to do right now.  I have bad knees, but I drool over the thought of going to a physical therapist who will help me strengthen my knees to the point where I can jog.  Jog!  What a marvel it would be to jog to the coffee shop a mile and a half away!  Or even biking--how great would it be to have a bike again and pedal all over town?  I have cardio dance dvd's that I was using before I found out I was preggo, and I would totally dig being able to do those without throwing my knees out.  Mama loves to dance.

Five more weeks, my friends.  Five measly weeks till I have sleepless nights again.  Only four weeks till maternity leave begins!  Two more weeks until Decimal is considered full-term (and therefore able to be delivered safely without being considered premature).  It's so close!   Keep your fingers and toes crossed that she arrives right around her due-date, since that would be the very best thing for her.  We're nearly there!

Week 34

It's funny to look back at the first posts of this blog, back when I was still pregnant with AEMA.  Today marks week 34 with Decimal, and the week 34 post I wrote for AEMA still resonates, although there are differences:

Today marks the 34th week.  There's no mistaking it anymore.  Today someone walked into the office and asked me how far along I was.  My shape is that of one and a half people, not just one.

(This time around I've been obviously pregnant for three months now.)

In three weeks, Corn Dog will be full term.  In six weeks, she'll be due.  She's so very close to being here--I mean, she is here, but locked in her cocoon still.  What will she look like?  Will she have dark eyes or light ones?  Brown, black, red, blond hair?  Curly or straight or wavy locks?  Will she have dimples? 

(These same questions occur to me, but I have a little model in AEMA for guessing what Decimal may look like.  Not that I imagine a duplicate of AEMA, but I suspect there will be more similiarities than not.  And I have a small hope that Decimal will be a red-head like her uncles.  Fan of Merida, much?)

Will I stop calling her Corn Dog when she's born, or will that fall away with the use of her birth name?

(I can't wait to begin calling Decimal by her legal name.  The prenatal nickname is fun, but her birthname is breathtaking, imo.  And I'd love to share it with you, but I'm not gonna!  It's not official till it's official.  Gotta leave room to change our minds.  :) )

Will she be as wiggly in the world as she is in the womb?

(If Decimal is as wiggly in the world as she is in the womb, she'll be a star little leaguer, karate master, and tap dancer before she turns four.)

Will she smile as much at us as we do at her? 

(The question now is, will we smile as much at her as she does at us?  AEMA grins so freely and often that I can only imagine Decimal will be the same.)

Will she take to the breast, or will I have to pump milk into bottles for six months?

(I have a more structured game plan in mind this time around.  Make the doctors wait until she's fed for the first time to do the tests/exams, for one.  It's extremely important to me that Decimal have the very best chance of learning how to latch properly as soon as possible.  Most of the breast milk AEMA received came to her in a bottle.  If I can manage direct breast-feeding, I'll be really grateful.)

Will her skin take to cloth diapers, or will we end up having to spend a fortune on disposable ones?

(We're not bothering with cloth diapers this time--it makes no sense for us to try, since we don't have a washer/dryer of our own.  The hassle would be immense and unmanageable.  I just purchased size one diapers this morning to go with a box of size fours for AEMA.  Reality sets in!)

Will she cry a lot?

(This has been such a tough pregnancy compared to the last one, I can't help but think that Decimal will be more of a cryer, or even be colicky.  This worries me a little, but there's not much use in worrying--what will be will be, and we'll deal with it.  Hubby and I did an outstanding job of calming AEMA when she cried, if I do say so myself, and we haven't forgotten our old tricks.  We'll see.)

So many questions linger!  Nothing to do but wait.  I'm excited to meet my little honey face to face.  

Guest Post: Breastfeeding

Bec is the mother of four, the author of Path: Ethic, and an ecologically oriented philosopher by training.  She's also one of Corn Dog Mama's favorite fellow mamas.  She lives in Australia.

 

Want to polarise a group of mothers, any age?

Just start talking about breastfeeding!

There is so much conflicting advice and so many different recommendations surrounding feeding your baby, and that's before you even get to the judgement and the emotion which often comes along with it.

When I had my first child, I was sure that I'd know exactly what to do. I was going to epitomise the modern, environmentally-conscious, attachment-parenting earth-mother. However, inconsiderate child that he was, he refused to latch straight away, and then developed jaundice which meant we felt even more pressure to get him to feed. We wanted to avoid having him stay in hospital. The midwives were wonderful, teaching me to hand express, and siphoning colostrum directing from my nipples to squirt into the baby's mouth. It wasn't exactly the quiet, nurturing experience I'd been expecting!

Still, we persisted, and he soon got the hang of the latch, and I got the hang of relaxing enough to enjoy it. We did really well with breastfeeding until I had go back to work fulltime when he was about five months old. I didn't want to stop feeding, but since I was a teacher, my breaks weren't regular from day to day, so pumping was just that bit too hard, and I gave up. I felt awful, putting my little baby onto formula during the day, but you know what? It really worked for us. I fed him in the morning before work, and again when I finished school, and a few more feeds in between, and we fell into a routine – sure, it was different to how I'd imagined (again!) but it was successful.

Since then, I've had three more babies, the last of which I'm still breastfeeding. I've had the pleasure of engorgement, mastitis, cracked nipples, and bitey babies! Here are a few things which have helped to keep me sane:

1. Realise that it might hurt, sometimes... but if it hurts all the time, something's wrong.
   While I found the afterpains from Baby Two and Three pretty debilitating, I had assurances they wouldn't last – and they didn't. (Hot water bottle and warm wheat pillows work wonders, by the way!) On the other hand, when I had mastitis, it steadily got worse and worse, and I knew I needed help to get past it. Which leads me to... 
   
   
2. Don't be afraid to ask for help.
   Every baby is different. Your first experience breastfeeding might be great (like mine turned out to be) but a subsequent one might throw up several challenges, including throwing up.  Baby Two had colic and reflux and it floored me, because I was all, 'ha, this is my second baby, and I *totally* know what I'm doing.' Silly me! The flipside is, don't feel discouraged if you have a less than fantastic experience for one baby, because it won't always be that way. 
   
   
3. 'Short-sightedness is natural, too.'
   I need to wear glasses, or I can't see. It's true they're not 'natural', but without them I'd be hard-pressed to recognise faces, read street signs, or watch TV (which isn't 'natural' either, if we're being picky)! I think that we feel like failures if we can't breastfeed as much/at all, because we're told over and over how women have been doing this for millennia and it's such a natural process. But for millennia we had very strong support groups of other mamas who could help if things got tough and wet nurses for those babies whose mothers couldn't feed them. Breastfeeding can be hard: don't beat yourself up if it doesn't 'come naturally'. 
   
   
4. Stay healthy.
   Breastmilk is the best kind of food for you baby, we all know that. But breastfeeding shouldn't take over your life, either. If you're struggling with other issues – supply, depression, healing after surgery – then breastfeeding can feel like a huge overwhelming burden. It does not make you Evil Incarnate if you need to supplement with formula; it is not the worst thing in the world if you need to stop after a few weeks. Staying healthy also means maintaining good mental health, and the most important thing is for you to be able to care for your baby.

My breastfeeding journey is almost over. I've nursed babies now for almost four years in total. I'm loving how much I can engage and have fun with my children as they get older, and I'm very much at peace with this baby being my last. However, in the evening, when I sit down on the floor with him, just us two and my partner after the other children have gone to bed, and the baby snuggles into my neck for a cuddle after his last feed for the day: that's when I think that despite happily farewelling the exhaustion of pregnancy and births, and long days and interrupted nights...

This, right here...

This is what I'll miss.

Week 32, OB's, cravings, milestones, etc.

Just eight weeks (or, to be more precise, fifty-four days as of today) to go!  At this point in my pregnancy with AEMA, I still had all of the Jewish High Holy Days to sit through.  I'm grateful that that's not the case this time.  I don't think I would make it!

I decided yesterday to switch back to my original Bay Area OB after over five months of dealing with an OB who never struck the right chord with me.  Note to self: don't give up a good thing when you've got it.  I originally changed from the OB I liked because her office was so far from where we had moved to, and I wanted a more convenient location.  Over the course of my visits, however, I realized that my new doctor wasn't working for me (figuratively or literally): she seemed habitually inattentive to my medical history/record, she often seemed to rush through appointments without utilizing the extensive and advanced technology at her disposal, and when I brought up concerns, she dismissed them all-too-quickly with a patronizing "I'm-a-doctor-and-you're-fine-if-I-say-so" sort of response.  More than that, she said a couple of things that, according to my experience and research, were either wrong or dangerous.  Given her dismissive approach to responding to questions and concerns, I realized pushing back would be fruitless.  The switch back was as simple as clicking a button.  It will be a longer commute to see my OB from before, but absolutely worth the peace of mind that comes with being able to trust my doctor.

Even though the change has been made, I can't shake the feeling of being let down.  I spent months attempting to put my faith in this person, to give her the benefit of the doubt, even when my intuition warned me to be cautious.  It is the worst feeling to have worked at seeing the best in someone just to discover that all those subtle suggestions of a problem actually pointed to something serious.  I feel as though my time has been wasted and my confidence has been betrayed.

In other news, my latest cravings include black beans covered with green salsa and shredded mozzarella as well as Pastaroni (in any flavor).

I've also reached a couple of important personal milestones recently.  First, this blog has reached ten thousand views--woohoo!  Thank you!  :)  Second, I can now count myself as a paid author: my first paid story will appear in an anthology called Fae Fatales. Third, I think I've found someone to design the cover for my collection of short stories and poetry that will be published soon as Life. Love. Liturgy.  It'll be my first published collection of work.  I'm nearly there!  Finally, I've been doing some paid editing projects for folks here and there in the last few months, and I've just been taken on as a Staff Reader for an indie publisher called Fey Publishing (which is just getting started under its new owner).  My inner English Major rejoices.  Life is good, even though this pregnancy is significantly more difficult than the last one.

Thanks as always for reading along.  It warms my heart to know folks are joining in my journey this way!