Thursday, November 17, 2011

Normal Pregnancy or Preterm Labor?

One of the problems with the symptoms of preterm labor is that they are very similar to the symptoms of normal pregnancy.  Two of these symptoms that I have been struggling to decipher are nausea and back pain.

Back pain is something that pretty much all pregnant women experience.  Preterm labor back pain is slightly different in quality and location from most back pain.  It is a low, dull back pain.  However, what if you just happen to have a sore lower back?  I have gotten a sore lower back when not pregnant by slouching in a couch or chair, so might my slouching now be causing me low back pain?  As for the quality of the pain, it is really hard to determine what is causing it.  It can either be musculoskeletal, gastrointestinal or preterm labor if you have dull pain in your lower back.  This one has been a bit tricky, but I think I have been able to determine the difference between a more superficial pain (musculoskeletal) and a deeper pain (preterm labor or GI pain - however, if no GI symptoms show up in the hour after pain I assume it is preterm labor pain).

The other tricky symptom is nausea.  I had morning sickness until I was 26 weeks pregnant.  This caused me to lose about 18 or 20 pounds (depending on how well hydrated I was).  I didn't gain any weight until I was 29 weeks pregnant, at which point I gained 3 pounds before my 32 week appointment (the one where my OB sent me to the hospital).  I was still nauseated about 1-2 days each week, but the other 5-6 days I felt pretty good.  While in the hospital I lost weight (this is a pretty normal occurrence, but I am now back down 18 pounds), and I also developed a new symptom of steady nausea.  I have had nausea every day since last Friday.  If I don't eat it usually isn't that bad.  But once I eat the nausea gets worse.  I thought part of the problem is that at the hospital I was forced to eat on a specific timetable, mostly at times when I was not hungry.  But now that I am at home I am still becoming nauseated whenever I eat, however much less so now that I am able to choose when and what I eat.  So my question is this: is this just par for my pregnancy course, or is this a symptom of preterm labor?  If my morning sickness would have gone away at the end of my first trimester, as it does for many pregnant women, I would attribute this to preterm labor.  However, there has been nothing normal about my pregnancy nausea, so this might just be my normal.

I guess it doesn't really matter if these are normal pregnancy symptoms or if they are pre-term labor symptoms.  I am on bed rest.  I am taking a tocolytic (a medication that calms down your uterus).  And if I were to go into labor today despite these interventions they wouldn't do anything to stop it - they would just let things run their course.  I guess I will mention these symptoms to my doctor at my next appointment, but I'm not going to sweat over them because worrying won't change a thing.

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