The 24-28 week "fear factor

[reprise]

How do you ICU nurses cope with this in your own lives. I'm not an RN or a RM - I'm just a humble grandmother to be who is really, REALLY hoping that I never have to be the one to explain the realistic options to my daughter should my grandson decide to be born in the next four weeks. She's currently 24+ weeks and mother and baby are both doing disgustingly well, but we are both fearful of something happening in this extremely grey area of "viability" We know babies who've survived and done spectacularly well at 24+, and we know babies who've simply not had a hope and whose torture has been prolonged. There is no reason whatsoever to believe that my daughter will go into premature labour, but she knows that this is the grey area and it's driving her nuts that she'll *might* have to make such a decision. I keep telling her that the hardest weeks of her pregnancy in terms of making decisions are the next four weeks and that every single day counts, but I also see her fear at the possibility of having to make the decision in a labour ward at short notice.

Right now, my method of helping her to cope is to help her feel the baby often, look at the scans and blood test which exclude any major problems, and encourage her to take joy in the discomforts of pregnancy. She was terrified this morning when she thought that she was having a heart attack. Several hours later, she had learned to feel the position of her baby for herself and realised that the kick under her ribs which she felt was actually a sign that her baby is healthy and active. Am I doing the wrong thing inteaching her how to "feel" for her baby? Because if anything goes wrong in the next four weeks I just know I'm going to regret having taught her "hey, that's a head and that's a bumb".

I'm waffling. I know how incredibly low risk she is. She knows how incredibly low risk she is. But it still continues to haunt us both.

[dawngloves, BSN, RN]

SOunds like she's going to worry herself into PTL!Does she express her fears to her OB? Is this her first? Any miscarrages?

If it is her first, fear of the unknow is great. You wonder about every little ache and pain. You gobble up all the stories from a friend of a friend of a friend that had her baby at 23 weeks in a taxi and you wonder if that'll happen to you.

And with all the reality TV on to feed her fears, that can't be good.

You know she is at low risk. With no risk factors I believe she has a less than 10% chance of delivering before 37 weeks. Probably less than 3% before 28.

Why do you think she has a difficult time accepting that?

[reprise]

SOunds like she's going to worry herself into PTL!Does she express her fears to her OB? Is this her first? Any miscarrages?

If it is her first, fear of the unknow is great. You wonder about every little ache and pain. You gobble up all the stories from a friend of a friend of a friend that had her baby at 23 weeks in a taxi and you wonder if that'll happen to you.

And with all the reality TV on to feed her fears, that can't be good.

You know she is at low risk. With no risk factors I believe she has a less than 10% chance of delivering before 37 weeks. Probably less than 3% before 28.

Why do you think she has a difficult time accepting that?

I think it really is "the unknown". In the last two years, the adolescent antenatal unit which is providing her antenatal care has had only one mother deliver

Yes, it's her first pregnancy, no history of anything which would indicate the likelihood of any problems. She doesn't have an ob/gyn (low risk pregnancies are handled by midwives here, so she won't see an obstetrician again until 34 weeks unless something happens which warrants medical management), but she does have pretty much unlimited phone access to the birth centre midwives and the dedicated midwive who oversees all adolescent pregnancies (her next checkup is in about 2 weeks).

And I think you're right about the plethora of "real medical drama" type TV shows not helping much, especially with her hormones going crazy.