Showing posts with label treatments of preterm labour. Show all posts
Showing posts with label treatments of preterm labour. Show all posts

Wednesday, July 11, 2012

Flu shot reduces premature birth risk?

I feel like I know everything there is to know about preterm labour and birth. It's not very helpful after the fact, but I gather the facts as obsessively as a squirrel gathers nuts for the winter in the hope that forewarned will be forearmed next time.

Ominous words, 'next time'. I don't know if there will be another pregnancy, another baby. It feels foolish to hope. And yet, I still do, even though sometimes I feel that Max was my only chance at motherhood and that somehow, I screwed it up. Max's death is not something I can undo even if I did know how or why it happened. But the thought that I might be able to do something differently to 'beat the odds' or something like that, stays with me. Though I now know, more than anyone, how little control I have over anything that happens to me, or over life and death, I still find myself looking for ways that I can be just a little bit more in control next time, as if I've learned no lesson at all. It's infuriating, but I guess we're all wired that way, or at least I am.

During my foraging for information I usually come up with the same kinds of stuff. There's the rare story of a 'miracle' baby who has survived birth at 23 weeks which the media have pounced all over. There are the same risk factors touted on websites over and over again, none of which I have - smoking, obesity, low-socio-economic status. There are the hopeful medical journals that document treatments that seem to prolong pregnancy and prevent premature birth, though usually they're still not quite sure how. These include the use of progesterone supplements from 18 weeks, fortnightly testing of fetal fibronectin, a chemical marker, which if present in the cervix is the earliest sign they have that the body is preparing for labour, regular ultrasounds, bed rest from 20 weeks onwards, the administering of oral antibiotics and steroid shots throughout the pregnancy. Hell, I won't even need an obstetrician at this rate. 


What I'm trying to say is, it's unusual to come across something new that I haven't read before. This news article, published in 2011, is brief, but thought-provoking, as I have never read of the connection between flu vaccination and lesser rates of premature birth before. I'm yet to follow up the original research, but here is the story:




Friday, May 4, 2012

A beginner's guide to losing control

In the moments where Leslie and I feel a bit more positive than usual, and tentatively peek out from under our protective cloaks for a glimpse of the hopeful future, we consider telling the universe of our wish for another baby.

We do it in whispers, presently - part of us willing our wish to be heard, and a part of us terrified that it will be so.

To express our heart's desire boldly and unapologetically seems to us akin to that thing called 'tempting fate', or as school children say, 'jinxing it'. For many say that the more desperately you want something the less likely it is you will get it.

It's funny how superstitious you become after something happens to you that defies reason or understanding. As you can't create any overt meaning from the tragedy that has befallen you, you begin to look for hidden meanings instead.

You begin to ascribe immense power to your thoughts, for example. If you have moments of doubt where you think 'I don't know if I can do this' you become afraid that the universe (whatever that is, I don't know exactly what I mean by that) will hear this and not give you the baby you so desire. After Max died I was quite convinced I'd caused his death because I'd wished for a baby girl, not a boy. A powerful being, or force, or whoever/whatever's in charge had listened and taken my disappointment seriously, I thought. 'But I didn't mean it! I didn't mean it!' I screamed when he died, the regret weighing on me, cutting through my lungs, like I was drowning in an icy cold sea.

Daily you become more critical of yourself. In times of doubt you think you don't deserve to have a living baby, and you've now got evidence to prove that belief, so it's a hard one to shake because to you the beings in charge have already decided any baby of yours would be better off dead than taken home to live its life with you. It's a fatalistic view, but one that is almost as comforting as it is distressing. It's far easier to accept that you didn't deserve something, than that you were just as deserving, if not perhaps more so, than others, but that your baby was taken away from you nonetheless. That seems a far crueller reality to sit with.

Things I have blamed for my preterm labour:

  • I didn't drink enough water (chronic dehydration was at fault)
  • I ate a salad at Leslie's sister's house on the previous weekend (lysteria was to blame)
  • I emptied the cat litter that one time (toxoplasmosis killed my baby)
  • I didn't do enough exercise (my muscles were too weak to hold Max in)
  • I ran too vigorously up and down the stairs at work (too much exercise was to blame)
  • I should not have used perfumed soap in the shower (perhaps I had an undiagnosed vaginal infection caused by irritation by the additives in the soap
  • I wished for my pregnancy to be over when I was desperately sick with hyperemesis and 'someone' listened (my thoughts are to blame)
  • I desperately wanted a girl baby and therefore did not deserve my beautiful boy (my thoughts are to blame)
  • I took anti-depressant medication during my pregnancy (depression is a weakness and a flaw I should not have despite getting pre-conception advice from a specialist psychiatrist that it was necessary to continue treatment)
I could go on and on. There are plenty of other things I've blamed, too, but they are all things I had or hadn't done, should or shouldn't have done. The key message here for me to learn is that I have a very strong internal locus of control. I genuinely believe(d) that I have control over my life and that everything that happens to me is a direct result of my personal efforts or failings. 

Having a strong internal locus of control is usually a good thing. If you've got one it means you usually  work hard and strive to achieve things on your own merits and are committed to self-improvement because ultimately you believe that you have control over your own destiny and can change your life for the better. You don't pass the buck and you don't make excuses when you fail.

When things happen that are genuinely outside of your control, however, you tend to start experiencing the shadow side of this. You feel equally as responsible for things that are entirely out of your control as the ones that were in your control. You feel responsible for things you could not possibly have prevented. Many sleepless nights are spent re-living a series of events looking for the point where you failed; where you should have acted and didn't, or where you did act and really shouldn't have. 

Thinking towards a future pregnancy, this strong internal locus of control means that I have been on a researching frenzy trying to find more information about the risks and management of preterm labour. I find it very hard to accept that this could just happen to me again for no reason. 

On the one hand this is a good thing. I have the research skills to be able to ascertain and interpret the facts so that I will be armed with knowledge that might help me prevent or identify it happening again. I don't have to rely on others to tell me the right information. I don't have to feel helpless. 

On the other hand it is incredibly stressful as I'm a layperson in this area and I feel like I have to collate and manage all of this complex, often statistical information, that I have to commit it to memory in case the worst case scenario does happen, all the while managing the already existing level of anxiety that a new pregnancy will understandably bring.

Today I've been researching hospital guidelines from all around the world on the management of preterm labours and women at risk of them. If you're interested enough, you can read what I found in these research papers and clinical guidelines:

Clinical practice guidelines
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