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Premature Labor?

Posted Oct 02 2008 3:16pm

My friend just had a 72 hour labor.  WOW, 72 hours, now there is a number that could get a mom really discouraged.  It was preterm labor (35 and 1/2 weeks) and her midwife offered morphine to help her rest (which would mean staying at the hospital), I suggested home, rest, hot bath, and wine.  So this birth has gotten me thinking about two things.  One, when is a mom in labor, and two, what is a good way for mom to get rest/slow down contractions.  I don't think I am ambitious enough to tackle both in one blog post so let's start with helping mom rest/slowing down labor.

In Spiritual Midwifery, Ina May writes:

"If there is no bloody show and there is no or very little dilation of the cervix (less than 1 cm), give the mother a full glass of water followed by a glass of wine.  Alcohol is a depressant, and it suppresses the release of oxytocin from the pituitary gland.  It works well for stopping labor in the third trimester.  Alcohol should not be given in the first two trimesters to inhibit labor because of possible damage to the developing baby.  The woman should stay in bed and everything should be as nice and quiet around her as possible."1

Now my friend was 4 centimeters dilated, not one, but the midwife was offering morphine so my thought was, if wine works (and there is no history of alcoholism in the family), why not?  And the wine was indeed a tremendous help.  It slowed down my friend's contractions, helped her manage a long labor, and possibly helped keep the baby in her an extra two plus days, which got the baby a lot closer to 36 weeks.

So a few days after my friend's birth, I was listening to the tape on Prolonged Labor by Diane E. Barnes, CNM and Gertrude L. Welsh, CNM, NP from " Midwifery Today's Clinical Tape Package" and the CNMs were discussing ways to help mom sleep when she is faced with a potentially long labor or just really needs some rest.  Instead of morphine, they recommend 50mg of Vistaril and 1000 mg of Tylenol.  If the mom's contractions are more painful, they suggest giving a Tylenol #3 (with codeine) in addition to two regular Tylenol). Apparently the midwives have had success promoting the Tylenol/Vistaril combination to hospital doctors as an alternative to morphine.   Among other things, lack of rest, nourishment and hydration can also encourage pre-term contractions, so before tackling the problem of how to help mom rest/slow down those contractions, you should ask mom are you hydrated/how much rest have you had/what have you been eating, etc. etc.?

Which brings me to another thought.  One of the midwives on the tape noted that she didn't believe in Braxton-Hicks contractions before 36 weeks.  She felt that contractions before 36 weeks were due to an irritable uterus or a sign of potential preterm labor.  What an interesting way to think about uterine contractions.  If there is no such thing as Braxton-Hicks contractions before 36 weeks, then if you experienced contractions before 36 weeks, you might think to yourself, I need to hydrate/rest/nourish myself.  If Braxton-Hicks contractions can be experienced before 36 weeks, you might think to yourself, oh, there goes my uterus again.

In any case, my friend said no to the morphine, returned home after laboring in the hospital for a while, took a few hot baths, rested, had a glass or two of wine, and these things seemed to slow her labor down, keep baby inside for a few more days, and gave her the energy she needed to birth her baby when the time came.  I should add that my Midwifery Tape on Prolonged Labor did not recommend wine due to fetal alcohol syndrome, but if Ina May recommends it, alcoholism doesn't run in the family, and you are in your third trimester, I can't help but think it seems like a good idea.  A mom I know who is German mentioned that a glass of wine or beer is a common recommendation for moms in early labor.  What do you think?  Oh, and if you have Spiritual Midwifery, there is a great birth story on page 70 of a mom who uses wine to stop pre-term labor.

Post to be continued....

1 Ina May Gaskin, Spiritual Midwifery, Fourth Edition (Summertown, TN:Book Publishing Company, 2002) 425.

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