04/07/09 OB Appointment

Yesterday was my first OB appointment since being placed on bedrest and Procardia last week.  It has been several hours since we visited with the doctor, but I think I'm still processing everything we talked about.

My weight gain and blood pressure were good as were the babies' heart rates.  My uterus is measuring 34 cm at 29 1/2 weeks--only 1 cm of growth in the past 2 1/2 weeks.  This is of no concern, however, as we know from Thursday's ultrasound that the babies are growing wonderfully (Baby A was weighing 2 lbs. 4 oz. and Baby B was weighing 2 lbs. 8 oz.)!

All that routine stuff aside, Travis and I were able to visit with the doctor concerning the modified bedrest and Procardia which were prescribed during our recent stay at the hospital.  We wanted to get an idea of whether these things would be continued indefinitely or whether my "condition" could be re-evaluated and a little bit of normalcy possibly reintroduced to my life.

As for the modified bedrest, the doctor said it's pretty standard that they would say to continue that until 34 weeks of pregnancy.  He went on to say, though, that I shouldn't feel bad about doing the activities necessary to care for myself and my family and, furthermore, that there is no medical evidence that bedrest delays the onset of labor.

In regards to the Procardia, the doctor said that many doctors won't even prescribe it due to the fact that it is only effective in slowing or stopping contractions that aren't doing anything anyway.  Procardia does nothing, he said, to slow or stop or even to delay the onset of real labor (where contractions are accompanied by dilation of the cervix).  In effect, Procardia is given more for the mother's convenience and peace of mind, as in slowing or stopping "practice" contractions it eliminates some of the worry and uncertainty of whether or not the contractions are indeed real labor.  That being said, he gave me the choice to space out my doses of Procardia or even to stop taking it altogether.

Additionally, we learned that the fetal fibronectin test (fFN) which I had done last Monday--and which came back negative--serves as a good indicator that I will not go into labor within two weeks of the negative result.  So, essentially, if I am looking for a medical source of "peace of mind," I could have this test repeated every two weeks and not have to live with the unfavorable side effects of the Procardia which is apparently prescribed for just that purpose (i.e. "peace of mind").

Needless to say, I left my appointment feeling some weird mix of relief and confusion.  Why wasn't I better informed about exactly what the Procardia would or wouldn't do before paying for the prescription and taking it every six hours for a week?  And if Procardia and bedrest are ineffective in delaying the onset of labor, why were they prescribed in the first place?

I feel without a doubt that I do not need to be medicated in order to have "peace of mind" concerning this pregnancy and that I do not want to unnecessarily medicate myself and my unborn babies.  I have therefore chosen to stop taking the Procardia.  My last dose was almost 24 hours ago, and I already feel better--this morning I was relieved to wake up headache- and congestion-free and without the feeling of lightheadedness and a pounding heart.

As the medication continues to clear from my system, I would like to try adding a little activity back into my routine while still imposing on myself some mandatory periods of rest throughout my day.  I don't know yet what this activity should look like, so I will continue to prayerfully consider what will be best for me and my unborn babies.

To those of you who are praying for us and those of you who have made yourselves available to help me in this time, I am eternally grateful for your support.  I know that God is hearing our prayers, and I am comforted with the peace that only God can give.