I've written a little about my 2nd pregnancy here.
I know that this subject is the source of so much pain for parents who want more children. I wish I could say that there is some magic pill that can ensure your next pregnancy will be different, but sadly, this isn't the case. There is no magic pill. I will, however, share my story in hopes that the information will help in whatever research someone else is doing.
With my 1st pregnancy (Paige) my water broke at 23.0 weeks. I was coughing (had bronchitis) and felt a huge gush. At the hospital, the fluid was tested and blood was taken but the reason for PROM (premature rupture of membrane) was never found.
In the first few years after Paige was born hubby and I saw specialists that basically told us that the risk was very high that it would happen again, since the cause was never found. Hubby and I could never bring ourselves to have more children. The fear was too great. We have friends who are preemie parents that told us that we should just "go for it" like they did. Unfortunately, I am not the "just go for it" type of person. I felt that it was selfish to bring another child into this world with the risk that he/she may be born premature.
The decision to not have any more children was not an easy one. There were times when I was feeling courageous and hubby was not, and vice versa. I seriously worried about our marriage at times. Then I decided that I wanted to try again. Hubby did not share my desire. At all. I begged. He shared valid concerns and reasons not to have another. I cried.
When one partner has an intense desire to have another baby and the other one does not... it does a number on your sex life!!
Finally (it took years), I made up my mind to live with the fact that I would not be having any more children. It took some time but I was actually ok with the decision.
Then I got pregnant (huge surprise). After I left the doctors office with the news, I immediately went home and started researching (no surprise there). I read up on all of the research and studies (there aren't many) about subsequent pregnancies after having a preemie. I felt more scared than I had ever felt in my life.
The first thing I did was join a group designed around being pregnant after having a preemie. It was very helpful. Even if you are thinking about having another baby, the information is wonderful.
At my next OB appointment, I brought up my concerns/fears about being pregnant. She told me that there was nothing that could be done to prevent PROM and if I had this child early I shouldn't worry since babies were being saved as early as 21 weeks. I asked her about 17P and she said that I should just stop researching.
Not the doc for me.
My next OB was a high risk doc. She was awesome. She presented the info on 17P at my first visit, before I could even ask her about it. She told me that the shots were showing promise for women who had preterm labor (PTL). Even though I had PROM and not PTL, she felt it was worth a try since I could have had PTL and not even had known it (I did have severe back pain that all docs ignored).
OB also felt that she did not want me to go past 36 weeks due to the risk of uterine rupture. I had a c-section with Paige (at 25.5 weeks) and she felt that my uterus was sewn at a time when it never had a chance to stretch to full term. She was very worried about me rupturing. She told me that she had seen women who ruptured and both the moms and babies died. I was not happy about this. I wanted a full term baby and intended on arguing about this all the way to 38 weeks. Her and I agreed to not talk about it until I got closer.
I had the weekly 17P shots starting around week 16 and continuing through week 34. At the time, the research was showing a 36% reduction in premature births. I was willing to do anything.
I developed gestational diabetes very early. I was able to control it with diet until the end when I needed Glyburide.
Despite keeping my sugar levels under control, I still developed polyhydramnios (too much amniotic fluid). It was discovered around 29 weeks. It was always just barely over the cutoff.
Around the same time I also started PTL and was dilated to 1cm. I was put on bedrest.
Next week PTL continued and I started to dilate more. I was put on Procardia (via pill) to help stop the contractions. The only problem was that it is a blood pressure medicine and I have chronic LOW blood pressure. I was in a constant state of dizziness.
At 32.6 weeks my contractions were still coming at a rate of 6 - 8 of them an hour. My doctor told me that she would be surprised if I made it to 34 weeks. She wanted to schedule my c-section for 34 weeks (due to her fear of uterine rupture). I refused and asked her to do a fetal fibronectin test http://www.fullterm.net/html/fullterm_faqs.htm Basically the test measures the amount of fetal fibronectin in the vagina. If it is not present then the likelihood that you will deliver within 7 - 10 days is less than 1%. She didn't want to do the test because insurance may not pay for it and because there are false positives. Since she was sure I wouldn't make it to 34 weeks, I felt that we had nothing to lose. The test came back negative and she agreed to hold off with scheduling my c-section.
At 34.5 weeks I was dilated to 3 and 25% effaced. My doc was no longer comfortable putting off the c-section. I pleaded my case. My contraction were less and my fluid level was lower. She agreed to wait for a few days.
35.2 weeks I was 4cm. The doctor put her foot down and scheduled my c-section for 2 days later. She ordered an amnio to check his lung function. She said that if his lungs were fine then she would do the c-section. If not then she would put me in the hospital for a few days.
35.4 weeks I went in to the hospital for the amnio. That morning I told her something wasn't right. I was having an odd pain on my right side. It felt like nothing I had ever felt before. It was like a tennis ball was in my uterus, trying to come out my right side. The amnio showed his lungs were not developed. 2 of the 3 markers were not there. OB told me that she wanted to wait for a few days.
I refused. Now remember, I'm the one who was adamant about going to 38 weeks. But, something was not right. At all. I freaked out. My baby needed to come out now and I knew it.
She checked me and I was dilated past 5. Between that and the pain I was feeling, she agreed that it was time.
My precious boy was born at 35.4 weeks weighing 6 lbs 10 oz. He came out screaming, breathing on his own and never needed any oxygen. Hubby and I cried. OB cried. She said, "You did it!" I replied, "We all did it!" It was the most incredible moment of my life. Hearing my son cry, instead of hearing the 30+ medical staff that was trying to save Paige, was so peaceful. I never thought I would have a (almost) full term baby. Never. My son was a surprise pregnancy, one that we never planned. Oh but what a gift!
Oh, and that odd "tennis ball" feeling.... During my tubal (you better believe I had my tubes tied!) my OB leaned over the curtain and said, "That feeling you had that caused you to strongly persuade (she was being nice-I became a bitch and pretty much forced her to do the c-section) me to take him out was your uterus just about to rupture. If we had waited any longer, it wouldn't have been a good outcome."
I cannot tell anyone whether it is a good decision to have another baby after you have a preemie. It's one that is a very personal decision. Other moms have told me that it would be healing. I'm not sure that is the way I would describe it. I'm not sure the way to heal yourself after having a preemie, is by having another baby.
I also am still on the fence about the 17P shots. They are supposed to prevent PTL, which I had for a good portion of my pregnancy.
But, what I can suggest is that you find a doctor that you have a great relationship with. One that will respect your wishes and not dismiss any concerns you may have.
Also, listen to your body. If something does not feel right, get the docs to listen to you. If you are being ignored, change docs!
With my first pregnancy, I was horribly sick, all of the time. I clearly had polyhydramnios with Paige. At 3 months I was measuring the size of 7 months! I clearly had diabetes with that pregnancy too but no one listened. All I ever heard was, "oh, is this your first pregnancy?" or "Welcome to the pains of being pregnant."
And, finally. If your partner does not want more children and it is causing stress in your marriage, get help. The divorce rate in preemie parents is so high and I feel this is one of the causes. Pregnancy after having a preemie is scary for all involved.
If anyone out there has more medical information to share on ways of preventing future preterm births, please share it in the comments section. My story is only about PROM and PTL. There are people out there searching for answers and your story may help.