MD confused me- need interpretation

  1. You guys tell me your opinion on this one.

    My OB kinda confused me on my appointment this week. I had been having the abdominal pain that I have been having off and on this whole pregnancy. Hesitantly he checked me. I could tell he was suprised when he said I was already 50% effaced but not dilated at 32 weeks.

    So in one breath, he tells me that he doesn't think that I will make it to term. But not to worry because after 34 weeks they can safely deliver in the hospital and not ship me to Mayo.

    I ask him if I can work. He knows that I work 12 hour swing shifts and that if I have a problem it is from working and all the stress that work entails. He says sure, No problem. Ok, now I am confused at this point.

    Long story short, the next night of working I made it 5 hours L&D for an overnight stay and a round of Terbutaline to stop contractions that were coming 2 minutes apart.

    So what do you guys think? I don't know when effacement normally begins. When I called work to tell them that I wasn't coming back for a week, they said they were surprised that the MD okay'd work in the first place.

    So, my question is when does effacement normally begin?
    Should I be worried?
    Should I even attempt going back to work? Or take maternity leave early.

  2. Visit moonshadeau profile page

    About moonshadeau, ADN, BSN, MSN, APN, NP, CNS

    Joined: Jul '00; Posts: 639; Likes: 70
    Specialty: 15 year(s) of experience


  3. by   canoehead
    How many children have you had, and when did you start to dilate with them. Were any early at all?

    Right off the top the doc is contradicting himself, and you certainly don't want to be working if it makes you needs drugs to stop labor. TELL him to reassess the situation and explain himself clearly.

    I should add that I know women who have spent the last month 2-3cm dilated. But those were the woment that tended to go quickly. You don't need the extra ctx at 32 weeks.
  4. by   moonshadeau
    Thanks canoehead.

    Actually this is my first pregnancy so I don't know what is normal and what isn't.

    And as for the doctor, he speaks with a very thick accent and sometimes it is difficult to understand him. I think that at the time I did the patient thing and the instant he started talking about shipping me to Rochester, everything else went over my head. You don't go to Rochester unless things are really bad...
  5. by   angelbear
    I dont know nuthin bout birthin no babies, but from what you have said I surely dont think I would want to take any chances. I vote early maternity leave. Good Luck and your are in my prayers.
  6. by   FROGGYLEGS
    I agree with angelbear on this. If your doc doesn't think you will make it to full term and after 1/2 night of work you started having contractions, you should definitely stay home.

    No kids here either and OB is not my forte, this is just an opinion. Take it easy.
  7. by   mother/babyRN
    I think you should have been told to stay home too, but on the flip side, if it was your first and you were closed, perhaps he was just surprised to find that you had started thinning but were not dialated, especially if he had dismissed your abdominal discomfort as nothing special and had to deal with the fact that they were substantive contractions, after all. If you were closed, I can see why he wouldn't have been excited about letting you continue to work, but he should have been more upfront with you. I was told I could go back to work even though I was crampy , had a complete previa and pih...That from the chief of OB..I had to stop work one horrible night on delivery, but I figured if anything happened, I was already where I needed to be...Now that you are and have had contractions requiring tocolytics, I would definitely curtail my activity and be out of work, whatEVER gestation and gravida you are..Good luck!
  8. by   Anagray
    Moon, I was in the same situation you were, if I were you, I would INSIST they pull you out of work on bedrest (modified or not).
    I think u can go into labour any minute, just because it sounds so similar to what happened in my case. It was also my first child. I went into labor at 32 weeks, they stopped it, I was on bedrest for 4 weeks, they stopped terb and I delivered 2 days later.
    Even at 6.5 he was teeny-weeny.
    With this pg, i started having contrax at 10-12 weeks, my OB wasn't very concerned, so I switched the practice and they ARE paying attention now. They are going to see me every 2 weeks now ( I'm 29 weeks currently).

    34 weeker is going to be OK, but why go through that, when just being on bedrest can stop the labor.

    imo, your OB is not being attentive and is taking this too casually.

    Good luck!!!
  9. by   jnette
    L&D is not my forte either, Moonshadeau, but I do believe I'd go with the advice given above ! Just common sense, right? Go with it.

    And keep us posted ... both of you ! Wheeeeeeee... more babbies !!! Can't wait !!!

    The best to both of you !
  10. by   SmilingBluEyes
    STOP WORKING!!!!!! Yesterday! As a mom and L and D nurse, let me tell you, you don't need preterm labor. Effacement is needed to dilate and once you are thinned, it is easier to open up and quickly. You are already 1/2 there. Having had a baby at 34
    weeks, I can tell you, you do not want this. Both pregnancies, I went into preterm labor at 30-31 weeks. I took it easy the 2nd time and kept the baby "in there" til 38 weeks and she was fine.

    My son who came early is fine too, but only after spending days in the special care nursery on O2 and IV ABX and bili lights. It was not fun, to say the least. He had all kinds of problems with getting sick his first 2 years and he was a tough baby to bring home. Preterm babies are a whole different animal to care for altogether.

    Nursing is back-breaking work; you and I both KNOW! MY advice is you STAY off your feet, Drink 2-3 liters of water a day, void at least every 2 hours to keep your bladder empty (and uterus less irritible), and keep this up til you get to at least 37 weeks. If you are contracting more than 4-6 times an hour despite this, you need to call your doctor.

    Hon, WORK it not worth it; you can go back after baby is here. Your body is warning you NOW to take it easy, so please heed this and have a healthy baby. Your doctor is remiss in NOT putting you on bedrest and giving you these warnings himself. I am not happy with his wishy-washy way of caring for you. YOU know you don't want your baby born this early......and so does HE. I wish you the BEST; hang in there and if you need anything else, please PM me.
    Last edit by SmilingBluEyes on May 23, '03