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This is your Pea in the Podcast for week 26 of your pregnancy. I’m Bonnie Petrie joined by Dr. Laurie Swaim, an obstetrician with Houston Women’s Care Associates in Houston, Texas.
Okay, momma, you may sometimes now be feeling a tightening and releasing sensation in your uterus, sometimes it might feel like menstrual cramps, well it could be Braxton Hicks contractions, “Braxton Hicks contractions are just regular uterine contractions that are non-painful, that have presumably nothing to do with labor or even preterm labor.” Now they’re called practice contractions because they presumably get you ready for the real thing but they shouldn’t hurt, you may not even feel them, in fact you may be having them now and not even know it. Dr. Swaim says if your contractions become bothersome, you may want to think about calling your doctor. “You take a pregnant woman in the third trimester and you put her on a monitor the later she is in gestation; the greater chance you’re going to see contractions. A lot of women are surprised to know that they’re contracting. At 26 weeks we don’t want to see too many. For a woman to have 1 contraction an hour, okay, but if she has one every 10 minutes that’s not normal. We tell our patients who are at risk of preterm birth, if they feel themselves contracting 6 times an hour or greater they need to call us, period.”
How do you tell the difference between Braxton Hicks and the real thing? Well Braxton Hicks will be occasional, mild, irregular and you can’t predict when they’ll come or how intense they’ll be. They should not increase in regularity or intensity, if they do, pay attention and look for other signs, “significant change in discharge, certainly if you’re having any abdominal pain, but if you feel your uterus tightening up and letting go, and tightening up and letting go, it happens here and there intermittently but if it’s a repetitive thing, like I said 6 times an hour or greater pick up the phone.” You might also feel discomfort that might signify a problem and might not, “Lower back pain maybe but that’s kind of hard because most women have lower back pain when they’re pregnant but if it’s intermittent, kind of crampy feeling, that kind of stuff. I’d much rather hear from my patients than not, but it could mean that you have a bladder infection that will cause contractions, that’s easy to fix.” So if you’re contracting and you’re worried go ahead and call your doctor.
Now as the second trimester, the honeymoon of pregnancy, winds down this week, you may be feeling more discomfort in general. You may be experiencing aches and shooting pains as your pumpkin size uterus continues to expand. Indigestion may plague as may constipation, the problems with your digestion are coming from the higher levels of progesterone you’re producing to support your pregnancy, this relaxes the muscles in your GI tract which slows digestion down. Constipation can be very frustrating. You can try a few things to get things going, try increasing your fiber intake with fruits and vegetables, oatmeals or whole grains. Some people swear by a glass of prune juice. Also increasing your activity level may increase your activity level in the ladies room, if you know what I mean. You can also talk to your doctor about this; they may be able to help.
Now at about 26 weeks your doctor may want to do a little housekeeping. “We remind the patients to pre-register at the hospital, get all the paperwork done. I always have the discussion earlier in the pregnancy that I’m part of a group practice and by now people should absolutely know what the situation is with their obstetrician. There’s a bunch of paperwork and stuff that needs to be done, most of it’s fiscal, with the hospital and stuff so we usually try and remind our patients to get that done. I usually talk to my patients about pain management and labor at this visit, as the pregnancy progresses then we try to take care of some of these little technical discussions: circumcision, how you’re going to feed the baby, child birth education classes, all that kind of stuff.”
You may want to consider signing up for some of several classes available to you right now for you and your partner; many of them are available through the hospital. “Most hospitals in our area have very reasonable classes that talk about pain management in labor from the standpoint of nothing to everything and no one is made to feel bad one way or the other. There are some people who are more interested in no pain medicine that may want to hear in more detail other methods of coping with that that might find classes elsewhere. But it’s not just the childbirth education that I’m interested in them knowing about, there is an infant and child CPR class at our hospital, I’m sure most of them, which I would think is exceedingly important and I try to encourage them not only to take it themselves but to have the baby’s caretakers take it. A lot of people use family members to watch their children. I think most daycare centers that are accredited anyways will have someone who knows how to do it during all shifts or certainly I hope so. But Grandma doesn’t know it and most of them will take it. The other classes that are offered at our hospital are there is a VBAC (vaginal birth after c-section) class, there’s a teen pregnancy class, there’s the childbirth education, which is what everyone calls prenatal class, and then there’s a ‘life with baby’ class. I think they go over feeding issues, care, care for the baby issues, when to call a pediatrician issues, what have you. And then there’s a lactation class too that I always tell my patients that they certainly can be a successful breast feeder without the class but it’s a good class available to them. So if they can only take two then I suggest infant and child CPR and then childbirth education class. And I’ll tell you something, childbirth education isn’t so much for the mom but it’s also for the dad: where to park, where labor and delivery is, simple things like this, what monitors mom is going to hooked up to, what paperwork people are going to make you fill out. All these things that can maybe decrease dad’s anxiety on that day and then what the actual labor and delivery is like. Other classes you may want to sign up for outside the hospital include Bradley birthing classes, or Lamaze or hypno birthing, that kind of thing. There are all kinds of classes out there that may help ease the anxiety of labor and help you deal with the pain. We’ll have more on that at our website, peainthepodcast.com.
So by this week you may have gained around 15 pounds or so. Your baby doesn’t even account for two of them. The bean is about 1 pound, 12 ounces just over 9 inches long. They’re still adding fat but their skin is still hanging lose on those. Your doctor or midwife though may now be able to hear their little heartbeat through a stethoscope. Your baby’s hearing continues to improve and you may notice them jumping when they hear loud sounds in your environment. If your baby was born now by the end of this week their survival rate will jump to between 80% and 90%. You’re 26 weeks pregnant; you have 14 weeks to go until week 40.
That’s your Pea in the Podcast for week 26 of your pregnancy. Dr. Swaim and I look forward to talking to you again next week. Enjoy this week. For a transcript of any of our Pea in the Podcasts go to our website peainthepodcast.com. For Pea in the Podcast, I’m Bonnie Petrie, thanks for listening.