First Trip to Labor & Delivery

(Don't worry, everything's fine.)

In the second or third trimester of pregnancy, many people have what are called Braxton-Hicks contractions -- sort of "practice" contractions that aren't actually labor but are part of getting the body ready for labor. They are normally not a concern except for when they start becoming frequent, in which case they might be an indication of preterm labor.

My doctor's office defines "frequent" as 6-8 contractions in an hour. I'd been having contractions on Thursday night, and they continued again on Friday afternoon and evening. It seemed like a lot of them, but when I timed them, it was mostly more like 4 or 5 an hour. I checked with the nurse and she said that if they were coming more frequently or if they seemed to be falling into a pattern instead of being sporadic that I should call back or come in.

We went to dinner with friends on Friday night and had a great time, but toward the end of it, it seemed like the contractions were picking up again. We went home and I drank a bunch of water (since dehydration can cause contractions) and lay down on the couch. After an hour with 6-7 contractions, I called the hospital, but the OB on call was busy and didn't call back for a while. I kept timing and the contractions kept coming, so I called again. The doctor on call, an OB resident, said that usually those types of contractions don't cause changes in the cervix (e.g., don't really start labor) unless they're 3-5 minutes apart or painful (and these weren't painful -- just a squeezing sensation). So she said that if they changed, I could call again or come in.

Right after that, I had about four contractions in a twenty minute period, so I told Mike that we needed to go to the hospital. I was pretty sure it wasn't preterm labor, but I also figured that if things weren't slowing down, I didn't want it to be too late for them to do anything if we had to sit around in the ER for three hours or more. There are drugs that they can give to try to stop labor, and they can also give steroid shots to help the babies' lungs mature more quickly, but these things both work better (as far as I know) the earlier they're done. I figured the worst that would happen is that it would cost us some money and doctors might say we were stupid to come in, but I'd much rather have that than be wrong and have the babies arrive too early when it could have been prevented. Babies born at 24 weeks (or in this case, 24 weeks and 3 days) can survive, but some of them don't and a significant percentage of those that do have disabilities that can be quite serious (blindness, cerebral palsy). And although white men have a lot of advantages in the world, that advantage doesn't extend to prematurity -- statistically, white boys have the worst odds for problems when born early.

So we packed up some reading material and some snacks and headed out. We arrived at the ER and I told the person at the desk why I was there. To my amazement, we didn't have to wait at all -- he buzzed me back into the hall and said that the nurse (orderly? I'm not sure) would take me up to Labor and Delivery.

We went up and got checked in, and they put us in a triage examining room. While we were standing at the desk, we could hear a woman in one of the other rooms moaning with the typical labor-type noises. I must have looked a little shocked, because Mike said, "Don't listen to that!" The receptionist smiled at us and said, "It IS Labor and Delivery!"

They had me change into a hospital gown, took a urine sample and blood pressure, and then the nurse hooked me up to some monitors. They have one monitor that keeps track of the contractions, and then one monitor for each of the babies' heartbeats, to make sure they're not in distress. They had a really hard time getting the babies on the heartbeat monitors, because apparently they were moving around a lot, and they're small enough at this stage that they still have room to swim around in there. (I wasn't at all worried about the babies; they'd been kicking me all evening, so I was pretty sure they were doing fine.) They did a quick ultrasound to figure out where the babies were and see their heartbeats, and that made it a bit easier for them to place the monitor.

(It turns out we were in the room with the "good" ultrasound machine. It actually had a little note on it warning people not to remove it from that room -- and "If you do, Wolfe will hunt you down. Yes, that's how it is." Hee hee! Dr. Wolfe is one of the maternal-fetal medicine docs, and she's the ultrasound expert.)

We were in there just being monitored for a while, I think for them to get a baseline and also because it turns out was a pretty busy night on the floor. The doctor (the same one I had spoken to on the phone) came in, and she checked my cervix and took a sample for a fetal fibronectin test. My cervix was closed, which was great -- had it been starting to dilate, that would have been a bad sign (and at a minimum probably would have put me immediately on bedrest). She said that the monitor showed I was having contractions, but it only shows how many contractions there are, not how strong they are, and the strength can be more of a predictor of problems. (They rely on the patient to say whether the contractions are painful or not.) The nurse said that it looked like from the pattern that I had what was called an irritable uterus, which means that it's showing more activity than usual. It's apparently not uncommon in twin pregnancies, because the uterus is getting stretched more than in a singleton pregnancy. So, we were feeling more relaxed at this point. The doctor and nurse also both said that we were smart to come in (which was very kind of them, especially since the doctor had basically said on the phone that I didn't need to come in). And the nurse said that it probably wouldn't be the last time during the pregnancy that we'd need to come in.

We waited around being monitored for maybe another hour or so waiting for the results of the fetal fibronectin test to come back. If this test is negative, it means that there are very low odds that the babies will be born in the next week or two. If the test is positive, it's inconclusive -- the risk is higher, but it doesn't necessarily mean that labor is about to start. While we were waiting, they had unplugged the monitors so I could to go to the bathroom, and when they went to hook them up again, three different nurses tried to find a place to put them that would get the babies' heartbeats. (Previously, they'd go in and out -- the baby would swim into the right position for a while, then go somewhere else, then come back again.) They never did find a good place for the monitors -- the boys were too busy doing their acrobatics.

Finally the fibronectin test results came back, and they were negative. That was a big relief!! We were able to go home after that (it was around 3 AM by this point), and get a few hours of sleep before heading back to the hospital for our Newborn Care class in the morning.

Since then, I've had a few contractions here and there, but not too many -- and I also haven't been trying to keep track of them, since the doctor said that if I could sleep through them or do other activities without noticing them, that they weren't strong enough to worry about. And I wonder if maybe the stress of focusing on them makes them worse!

All in all, it wasn't the most fun way to spend a Friday night, but all's well that ends well, and I'm glad we went to know for sure that things were okay.