Preterm Labor (Part 1)

30 weeks

We spent 17 days in the clear. Dr Jones gave us the all clear on January 9th and after she did so I told her I hoped it wouldn't change - especially after my glucose test the following week. Thank goodness my glucose came back fine. I was anemic and had to start iron supplements but other than that, nothing else was looming over our heads anymore.

That changed pretty drastically on January 26th.

I (unknowingly) started having contractions at 10am that day. They were pretty sporadic and I had no idea what they actually were. I just chalked it up to one of those "unknown to me" first pregnancy things that I shouldn't really worry about. Despite not thinking whatever was happening was too serious I decided to stay home and rest and drink water for the afternoon instead of attending my niece's birthday party. When I woke up from my 2 hour nap I realized that whatever it was that I was feeling was becoming more and more often and more painful. Kevin made dinner and at that point I couldn't even make it through eating without having to get up a few times and lean over a counter to relieve pain. 

I got ahold of a friend and asked about what contractions felt like. She suggested I time whatever was going on and then possibly call in to the on-call nurse. At that point I had thought they were maybe ten minutes apart. I laid down and pulled up a pregnancy app to start to time them. 6 in a row all lasting 30-45 seconds, 3 1/2 minutes apart. It was then that I decided to call in. It took an hour to get to talk to someone who was able to talk to me, but after taking down my symptoms she said she was going to call my doctor and call me back. It wasn't long until she was calling me back telling me to please come down to labor triage and that my midwife (actually the person she works with in the clinic) would be meeting us there as well. 

I still felt kind of silly. I felt like I was overreacting or I'd get there and they'd roll their eyes at me and send me home. They hooked me up to the monitors - one to monitor contractions and one to monitor the baby's heartbeat. When the first contraction after being hooked up hit me the nurse came over quick and said "I want to feel your belly during this contraction."
"How did you know I was having one?" I asked. 

"It came up on my screen," she replied. 

I looked over at the paper printing out in the machine next to me and noticed that during my contraction the fairly straight line had formed a fairly large hill. At that time, they were measuring at a 10 - 10 1/2. The top of the scale seemed to only rise to 13. The nurse started me on an IV shortly after. Dehydration can be a cause of contractions. 

After a little bit of monitoring they decided to give me a shot of Terbutaline - one of 2 drugs that could help to try to stop the contractions. If they were false labor contractions (which she reminded me were still painful - so not to be confused with telling me I was overreacting) they would stop with the drugs. If not, we'd have to proceed accordingly. 

They seemed to slow down and become less intense - but only for a half hour. The midwife came in and did a few tests/swabs. She was checking for signs of infection and testing for fetal fibronectin. (Fetal fibronectin is a test that reveals if a protein is present that your body throws off if it's going to go into labor within 2 weeks).  

The contractions started to come back just as strong and frequent as they had been before. They gave me a second dose of terbutaline and we waited to see what that would do. They'd monitor me over the next hour and if everything calmed down then I'd be able to go home. 

I only expected to get home late that night.
Maybe go into work late on Monday.
That's not what happened. 

The midwife came in before my hour was up. I was still contracting - that much I knew - but now they had more news and none of it was good. They had to admit me to the hospital for the night, the fetal fibronectin came back positive, they also had to start me on an antibiotic because a bacteria had been present and since contractions weren't stopping or slowing anymore they'd have to start me on the other of the 2 drugs to stop them, magnesium sulfate. The magnesium sulfate would make me feel really icky and would cause them to need to insert a catheter because I wouldn't be allowed to get out of bed at all. 

She took another swab for another test and checked my cervix. At that point I wasn't dilated - but my cervix was soft. They still felt confident that they could slow things down and bring them to a stop. 

I was moved across the hall to a regular room (still hooked up to the IV and monitors) and they started the antibiotics through my IV, a steroid shot to help the baby's lung development, hooked up a large dose of magnesium sulfate (I was told that the first dose was strong and given fast because they wanted to get it in my system and working immediately.) The second dose would be a less potent, slower drip. The first dose was in my body probably within 20 minutes. During that time she put in my catheter and Kevin ran home to get me a pillow and blanket for the night.

At 12:15am the nurse finally finished with all of her paperwork and had started my second bag of magnesium sulfate. She told me they'd be back to check on me in an hour at 1:15am. Kevin came back around 12:30 and I barely had enough time to fill him in before the nurse and midwife came into the room rather quickly at 12:45. My contractions weren't subsiding and by the way they were moving so quickly I'm guessing they had started to appear stronger. My midwife checked me once again and this time I was dilated to 1cm. She told the nurse to call the ambulance for transport and gently explained that the hospital I was at wasn't equipped to handle a premature baby before 35 weeks. 

As we waited for Lifestar to arrive I trembled in my bed. I was confident that no matter what happened I would be well taken care of but everything had escalated so quickly that it was overwhelming and I'm never good with situations that aren't planned for. I'm typically the one who wants to always do things the same so I always know what to expect - this was all very far from my realm of comfort and need for predictability. 

The ambulance crew arrived and Kevin started to head out to drive down to meet us there since it would take him a lot longer not having a quick in to the hospital like we did through the ambulance bay. 

At this point I had asked for a bucket because I started to feel sick.
"Can I take my bucket?" I asked to the people huddled around me. They were all prepping my monitors and transferring my IV lines to the portable pump.
"If she's feeling sick you might want to give her something - it's not pretty out, it's a bumpy ride..." the EMS, Becca, said to the nurse.
"Can I have some Zofran?" I asked the nurse.
"Are you a nurse?" Becca asks.
I shake my head no. I unfortunately just know my stuff. 

They moved me over to the ambulance cot and started to strap me down.
I turned towards Becca's partner Jeremy, "Is it snowing?" I ask.
He nods his head.
"I'm really scared to drive in the snow... especially if I'm a passenger." I tell him. He paused his efforts for a moment and looked at me. "You'll be the safest one in the rig, don't worry."
They wheel me out with the assistance of my nurse. I want to take my nurse with us. It's amazing how comforting someone can become in such a unexpected situation. I make sure to thank her before she parts ways with us.
Becca climbs into the back of the rig as they pull my cot in. Jeremy doesn't follow and starts to close the doors.
"Jeremy?" I ask. "Are you driving?"
He nods.
"Be careful, ok?"
He nods again. "Will do," and closes the doors. 

Bumpy was an understatement. I'm thankful I got my Zofran and I'm thankful for Becca's constant reassurance that everything was ok despite the loud sounds and bouncing of such a large vehicle.
A security guard met us at the bay and escorted us through many halls, floors, elevators until we finally made it to labor and delivery. 

(to be continued)
Click here for part 2