OB nurses: What do you think of this?

  1. Thank you in advance for any responses to this.

    To OB nurses: if a patient with prior preterm labor and premature delivery came into your hospital with painful contractions about 5 minutes apart, would the doctors at your hospital have her cervix checked?

    I am asking because I am 33 weeks along, have already dilated to almost 2 and 50% effaced, and my doctor tells me that my contractions are normal. (every 2-5 minutes) She did not even check my cervix....she only did the NST for about 30 minutes and declared that I could go home.

    This does not sound right to me. In my last pregnancy, I had PTL many times between weeks 23 until birth (36 weeks). I was always treated in the hospital for the contractions. I am now at home and very worried and in a lot of pain.

    Does her behavior and reasoning sound normal to you compared with the doctors you work with?

    Thank you so much!
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  2. 17 Comments

  3. by   SmilingBluEyes
    Unless there is a SPECIFIC reason NOT to check a cervix, (e.g. placenta previa, infection, etc), yes we would check your cervix for changes...also we would be doing fetal fibronectin test to see your chances of delivery within the next several days to week. Do you have a medical condition that makes cervical checks inadvisable? I wish you luck!!! If you are concerned, you MUST vocalize this strongly to your care providers...contracting this often is NOT normal by any standard this early on! Good luck!
  4. by   Sick&Pregnant
    No, I have no reason that she would not want to do an internal exam unless it's because of already being dilated a little. My water has not broken and I don't have an infection or Strep.

    I'm such a pushover that I always just nod and say yes or no or whatever. I just don't feel right calling her and demanding a cervical check....obviously if she thought it was necessary, she would have done one today. I'm so mad though that she is not taking this seriously. I know 33 weeks is much better than earlier when I had PTL, but it's still very premature! I just don't know how to make her take me seriously.

    Thank you for your response.
  5. by   rdhdnrs
    Should have been checked for sure. Call her and express your concerns.
  6. by   AlaskaKat
    We would have checked your cervix for sure and probably given IV fluids and meds to stop the contractions. If they are regular every 2 -5 minutes and painful, they are something to worry about.
  7. by   mother/babyRN
    We would have checked also, if for nothing else than to eliminate the possibility that you may have dialated even further. Unless this doc is psychic or in some way more informed without the benefit of checking to see if the contractions are affecting the cervis, I think I would be a bit leery...If she was concerned for any reason about checking your cervix, she should have indicated why and possibly done an ultra scan to "see" if you were any more dialated. If nothing else, then to get a baseline...Do you have a history of rapidly progressing labor in the past? If so, I would have thought the OB would DEFINITELY have wanted to check and see if things were moving along, especially since you were already dialated. As the nurse in this scenario more than once, I have asked the OB if he/she desires to check the cervix, or have me check, and if the answer is no with the fact that a labor pattern exists on a pretermer with a past medical history of same, if the answer is no, then I will politely repeat the history and mention that the fact that I inquired will be incuded in my notes, along with his/her response to my query. Amazing how that tends to stimulate some docs into appropriate action..Good luck and let us know how you're doing!
  8. by   mother/babyRN
    At the very LEAST she should have ordered a liter of fluid and hydrated you to see if the contractions subsided. This is really starting to bother me.....Now I am worried about you...{{{}}}
  9. by   Sick&Pregnant
    Well tonight I decided to just go to the hospital to have my cervix checked. I had not dilated further, but my contrax were every 2 minutes and very strong (lamaze breathing). About a 6 or sometimes even a 7. She gave me 3 shots of brethine and those did not work. So she SENT ME HOME!!!!!!!!!!!!!!!!!!! Can youi believe this? She gave me a pain pill and said to go to bed. I'm so mad right now I guess I will have to conront her. 33 weeks pregnant, contractions every two minutes........I'm sorry but I think that warrants mag sulfate.
  10. by   hollybear
    I would have checked you ( unless you have a condition not to) we would have given you some fluids and probably some other meds to stop the contractions. we try to get everyone to 36 weeks here.

    are you still contracting? let us know how it goes. can you get a second opinion. remember you have the right to another opinion

    hope all is well!
  11. by   Sick&Pregnant
    Oh, and no IV either. I just don't get it!
  12. by   Laura C
    sick and Pregnant,,,,,,,,,You do have the right to a second opinion,,,and if you are still hurting I would keep going back to the hopsital and not put my baby at risk for being born to early. You know how you feel. Keep going back until she does something to get you relief
  13. by   parker in arkie
    Sick & Pregnant...

    I'm not a nurse...but i want to ask...how afraid are you of having this baby early? your fears could be feeding the tension pain cycle and making what could be normal braxton-hicks contractions more painful. You did say she checked you and you were not dilated anymore.

    This will be YOUR BIRTH when it gets here. ASK QUESTIONS of your medical provider.

    and according to the American Academy of Pediatrics.....there have been NO DRUGS proven safe for the unborn baby.



    Good luck...

    oh! and you might want to try deep abdominal breathing...lie as you do when you are sleeping...NOT ON YOUR BACK....breathe with your mouth slightly open and relax every muscle in your body...put on some music if it helps you to relax...
  14. by   SmilingBluEyes
    Some more thoughts: Did they check to see if there is an infection process? For example, do you have a bladder infection, Also, how well-hydrated are you? Are you drinking a minimum of 2 liters of WATER a day? How is your dental health? I ask because many do NOT know, a mild form of gingivitis CAN be linked to preterm labor. It's epidemic, actually. If you have not seen a dentist lately, I recommend you do this and get taken care of! CRITICAL! Just an aside, I learned flossing the teeth EACH AND EVERY DAY adds roughly 5-10 years to your life versus only flossing OCCASIONALLY. This was eye-opening information given me by my hygienist. I share it with all my patients now.

    Some reassurance: I contracted for several weeks very regularly with my dd for about the last 8 weeks of my pregnancy (to 38 weeks at which point, she was delivered by csection for breech presentation). I never changed my cervix at all, but was always worried about preterm rupture of membranes, esp with breech positioning. I urge you to seek further investigation to see if there is some cause you can address to stop this contraction pattern. Even a vaginal yeast infection can do this to you. Also,I would ask about FETAL FIBRONECTIN testing to see if you are really on a pattern of preterm delivery. It is not perfect, but a fairyly good predictor.

    I wish you luck! Hang in there!

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