Ugggh!!!

[StrongMom]

Oh, and they started doing non-stress tests immediately and they all came back perfect.

I know there is the possibility that I was in the early stages of development of preeclampsia, however given the costs associated with inductions in general-- and given that all monitoring came back great, and there had been no change in my bp waiting until 38 weeks should have been discussed at the very least.

[StrongMom]

Regarding the March of Dimes study:
"... The reduction in early elective delivery reduced NICU admissions, reduced both the induction rate and the C-section rate, and ... presumably reduced costs. However, these benefits were achieved at a very steep price. The stillbirth rate increased from 2.5 to 9.1 per 10,000 term pregnancies. Instead of 3 stillbirths between 37-39 weeks among 12,000 patients, there were 11 stillbirths between 37-39 weeks among a similar number of patients after reduction in early elective deliveries"

My youngest was born at 33 weeks and I had hoped to get further in the pregnancy. I second guessed the decision even though I knew it was in the best interest for both of us.

I don't know what happened during your son's nicu stay, but I'm sorry it was such a bad time for you.

Those are still pretty remote numbers an increase of possibility from 0.025% to 0.091 yes that is a big increase but still very remote possibility.

I would NEVER click on a link of someone who publicly attacks children (no matter what you think of their parents), who thinks that women should stay with an abuser no matter what the cost to her, who purports that epidurals have no side effects, or harasses and has her followers harass people with different opinions especially while the labor. Additionally, someone who has been kicked off of scientific sites because she was unable to provide anything but her opinion or papers with her opinions does not hold any value in my book.

[StrongMom]

[quote
Every relationship in my life has suffered tremendously from it, including the one with my son. That is part of the reason that rather that the health care professionals need to present everything in the BRAND. Women need to get the choice to decide based upon those risk factors that they find most important to control for with those risks and their related probability presented in a non-emotion driven way.

What is the BRAND? Am I understanding correctly that you feel women should get to make the final decision regarding delivery based upon risk factors and what they are comfortable with? Our OB's or MFM's have one thing we mothers do not, extensive training and lots of experience managing mothers & unborn babies in high risk situations. They are responsible to keep both safe. At a certain point the risks of an early birth outweigh the risks of continuing a high risk pregnancy.

BRAND is evaluating the Benefits, Risks, Alternatives, and Do Nothing. I absolutely feel that women should have the choice of how their pregnancy is 'managed' with the guidance of their physician. I have seen and learned waaaaay too much since having my son to put blind faith in a doctor. I have interviewed different doctors since then, and have been amazed at how many times they have 'managed' a pregnancy not based on what was best but what would leave them with the least liability. This is part of the reason that the US has one of the worst maternal mortality rates in the developed world despite countries which have the same risk factors in their population (i.e. hypertension, obesity, ect). Absolutely, there are times that early birth outweighs the risk on continuing a pregnancy. However, there are also a lot of doctors who act before that time has been reached due to fear of being sued, not what they truly think is the best course of action. I know that there are good OBs/mfm out there who can think selfishly, but they are few and far between. And I know that in situations I know where I risk being sued, I personally act differently so I cannot blame them for that.

I remember my MFM telling me anything after 32 weeks was frosting on the cake when I was admitted at 30 weeks. That didn't mean my baby would encounter no difficulties, but that he preferred an early birth with resolvable issues vs. me having a seizure or stroke and suffering permanent damage. Also, the doctors take into account how you are feeling (swelling, headache, visual disturbances, increased bp), not just the lab results.

"Resolvable issues" in a MFM's book and in my book are very different. Yes, having a child who survives is paramount--- but if the cost is disability when it hadn't needed to be that is still not "resolvable" in my book. MFM very rarely look at long-term affects. They look at short & mid-term affects-- often they do resolve. They often stop following the child when they hit school age, which is when many issues start to become apparent. Whether these raise to the point of having a disability or just are 'different' from their peers in some of the 'soft' neurological signs are part of what the difficulty in defining "resolvable issues".

I don't know any mother who has had an early delivery not wonder if she could have stayed pregnant longer or done something different. I thought I wasn't feeling "that bad", but when looked at my old messages to my friends and my posts on a message board I realized I had forgotten just how bad I really was feeling. It really took me awhile to get past the second guessing and what ifs. Staying home from Oct. to April was hard and having a preemie who was gaining weight slowly the first few months was nerve wracking.[/quote]

I had absolutely no signs or symptoms other than a slightly raised bp, I have asked others and everyone around me says the same. (no swelling, no headache, no pain, no general uneasiness) I felt better than I had my entire life.

[mom29]

I don't know anything about guest's claims about the blog I linked. Since this site is about supporting moms who have had preeclampsia I removed the links because supporting moms is more important than debating about a blog. Please feel free to edit your posts also so the links are not available.

[mom29]

[quote
Every relationship in my life has suffered tremendously from it, including the one with my son. That is part of the reason that rather that the health care professionals need to present everything in the BRAND. Women need to get the choice to decide based upon those risk factors that they find most important to control for with those risks and their related probability presented in a non-emotion driven way.

What is the BRAND? Am I understanding correctly that you feel women should get to make the final decision regarding delivery based upon risk factors and what they are comfortable with? Our OB's or MFM's have one thing we mothers do not, extensive training and lots of experience managing mothers & unborn babies in high risk situations. They are responsible to keep both safe. At a certain point the risks of an early birth outweigh the risks of continuing a high risk pregnancy.

BRAND is evaluating the Benefits, Risks, Alternatives, and Do Nothing. I absolutely feel that women should have the choice of how their pregnancy is 'managed' with the guidance of their physician. I have seen and learned waaaaay too much since having my son to put blind faith in a doctor. I have interviewed different doctors since then, and have been amazed at how many times they have 'managed' a pregnancy not based on what was best but what would leave them with the least liability. This is part of the reason that the US has one of the worst maternal mortality rates in the developed world despite countries which have the same risk factors in their population (i.e. hypertension, obesity, ect). Absolutely, there are times that early birth outweighs the risk on continuing a pregnancy. However, there are also a lot of doctors who act before that time has been reached due to fear of being sued, not what they truly think is the best course of action. I know that there are good OBs/mfm out there who can think selfishly, but they are few and far between. And I know that in situations I know where I risk being sued, I personally act differently so I cannot blame them for that.

I remember my MFM telling me anything after 32 weeks was frosting on the cake when I was admitted at 30 weeks. That didn't mean my baby would encounter no difficulties, but that he preferred an early birth with resolvable issues vs. me having a seizure or stroke and suffering permanent damage. Also, the doctors take into account how you are feeling (swelling, headache, visual disturbances, increased bp), not just the lab results.

"Resolvable issues" in a MFM's book and in my book are very different. Yes, having a child who survives is paramount--- but if the cost is disability when it hadn't needed to be that is still not "resolvable" in my book. MFM very rarely look at long-term affects. They look at short & mid-term affects-- often they do resolve. They often stop following the child when they hit school age, which is when many issues start to become apparent. Whether these raise to the point of having a disability or just are 'different' from their peers in some of the 'soft' neurological signs are part of what the difficulty in defining "resolvable issues".

I don't know any mother who has had an early delivery not wonder if she could have stayed pregnant longer or done something different. I thought I wasn't feeling "that bad", but when looked at my old messages to my friends and my posts on a message board I realized I had forgotten just how bad I really was feeling. It really took me awhile to get past the second guessing and what ifs. Staying home from Oct. to April was hard and having a preemie who was gaining weight slowly the first few months was nerve wracking.

I had absolutely no signs or symptoms other than a slightly raised bp, I have asked others and everyone around me says the same. (no swelling, no headache, no pain, no general uneasiness) I felt better than I had my entire life.[/quote]
************************************************
StrongMom, I am very sorry to hear you had a 37 week delivery. It sounds like you are saying that you did not even have pre-eclampsia? None of the typical symptoms of headache, swelling, spilling protein, sudden weight gain, two or more elevated bp's 140/90?

How is your ds doing now? Has he hit all the developmental milestones so far? What kind of complications did your son encounter during his nicu stay? Did you have to keep him isolated during RSV season (that is hard, especially during the holidays)?

[StrongMom]

I don't think I did.... they told me at the hospital that my blood work came back abnormal and I had bps in the 130/85ish range-- which is high, but not alarming (especially given my pre-pregnancy baseline was 125/80ish). My other doctor just recently looked at all of my blood work from the hospital as part of determining which tests we were going to do to ensure everything was good to go for another pregnancy and I had a question about them asking me to participate in a study about having postpartum anemia. When she looked at the records she said that all of my labs were normal.

Obviously, there is the very real possibility that this could have progressed into preeclampsia. And I will treat my next pregnancy as if it was just to be on the safe side. However, I don't think we were at preeclampsia yet. I am not sure if they were looking at the wrong info at the hospital or what. I trust what my other doctor says, since she is able to see the results and has been very transparent with all of my care. The drs at the hospital were hard to get info from or track down.

My son does have a slight delay in the area of speech. Most other areas seem to be right on or even a bit ahead.

[JB]

It depends on who's defining 'full-term'. There has been a push to label 34-37 weekers as 'late pretermers'.

I was going by ACOG guidelines, which state that labor that begins before 37 weeks is considered "preterm."
http://www.acog.org/~/media/For%20Patie ... 2208028709

I'm very sorry you felt pushed or coerced into inducing your pregnancy earlier than you believe was necessary. At the very least the next time you will know what to expect and can demand to see any test results yourself before making any decisions based on them. However, I do think your experience is the exception on this forum, as most of the women here had very real and very serious medical conditions that justified their early deliveries.

[mom29]

I am so sorry you suffered ptsd and that your son had a complicated nicu stay. Perhaps a group for people who have had ptsd would be helpful to you? It might be encouraging for you to connect with other mothers whose babies have been born at 37 weeks. They would understand your specific concerns. I joined a preemie message board and the moms were so gracious in answering my questions.

I'm sorry your son has speech delays. Have you checked into your state's early intervention program? You might also be able to find an online message board for parents whose children are speech delayed and get some helpful tips.

It might be helpful for you to write a letter to the nicu clinical manager to express your concerns/dissatisfaction with the care your son received. I am so sorry he had a complicated stay. My 33 weeker did not have severe complications, but it was very hard leaving her every night. Some of her nurses were great and some were not. That is amazing your SIL says they had a good nicu experience. Did they have option to stay 24/7? I would have been so thankful to be able to stay with my daughter 24/7. As it was, I was just overjoyed the day we were able to bring her home. Running back & forth to nicu was exhausting. I developed blood clots the day she came home and wound up in the ER. I am so glad that experience is over!

Again, I am very sorry for the trauma you have experienced and the problems your son has. I hope your next pregnancy goes full-term and that you have a care provider that you feel confident with.

[lemons]

I feel it is important to correct a math mistake in one of the previous posts in this thread, especially since, subsequently, it has been quoted.

Guest quoted mom29 regarding a March of Dimes study and then Guest incorrectly translated the numbers into percents, see below (for clarity, I deleted the part of mom29's quote that wasn't directly about the study):

Regarding the March of Dimes study:
"... The reduction in early elective delivery reduced NICU admissions, reduced both the induction rate and the C-section rate, and ... presumably reduced costs. However, these benefits were achieved at a very steep price. The stillbirth rate increased from 2.5 to 9.1 per 10,000 term pregnancies. Instead of 3 stillbirths between 37-39 weeks among 12,000 patients, there were 11 stillbirths between 37-39 weeks among a similar number of patients after reduction in early elective deliveries"

Those are still pretty remote numbers an increase of possibility from 0.00025% to 0.00091 yes that is a big increase but still very remote possibility.

To calculate percent stillbirth:
for the original, pre-intervention group: (3 stillbirths/12,000 patients) X 100%= 0.025%
for the second, post-intervention group: (11 stillbirths/12,000 patients) X 100%= 0.091%

To go a bit further with the math, this is a three-fold increase (0.091%/0.025%) in the number of stillbirths. Now I haven't seen the study. I can't vouch for the methodology or the accuracy of the numbers as quoted above. All I can do is try to make sure that we do not propagate wrong information as we debate the issues and give support to those of us effected by PE.

On a side note, I don't think being in the 0.025% or the 0.091% of patients that ended up with a stillborn baby is anything to discount as just being a "very remote possibility". We often speak about percentiles and probabilities on these forums and I would like to remind everyone that behind these numbers are real families dealing with the very real grief of losing their baby.

StrongMom, I'm sorry that you had such a traumatic experience during the birth of your son and I hope that you are able to find some peace with your situation.

[JB]

My 33 weeker did not have severe complications, but it was very hard leaving her every night. Some of her nurses were great and some were not. That is amazing your SIL says they had a good nicu experience. Did they have option to stay 24/7? I would have been so thankful to be able to stay with my daughter 24/7. As it was, I was just overjoyed the day we were able to bring her home. Running back & forth to nicu was exhausting. I developed blood clots the day she came home and wound up in the ER. I am so glad that experience is over!

24/7 access makes a huge difference, I think. If I weren't able to be with my daughter whenever I wanted to it would have been much more difficult than it already was. Our NICU had private rooms for the babies (although it took a few days for our daughter to be stabilized enough to be transferred from the pod to her room) with sofas that folded into single beds for a parent to sleep on. They also had hospital grade breast pumps right there in the room we could use, and a kitchenette area for sterilizing our equipment and having meals/snacks. We were allowed to come whenever we wanted, and were only asked to step out when they were performing sterile procedures (for example, inserting and removing chest tubes) or when she had chest x-rays taken. The rest of the time we were encouraged to help with her regular care (diaper changes, taking her temperature, etc.).

I'm so sorry you had a rougher time, including the blood clots. That sounds horrible!