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Writer's pictureMaxi-Ann Campbell

Prodromal Labor

So, it was August 8th, Thursday night. I had been to Shanghai that day for my prenatal appointment. I had already started having contractions intermittently, but they were mild. That night, I organized things in my apartment as I normally do before going to bed. I knew the baby could come any day now, and it was important to me to come home from the hospital to a clean apartment. When I got in bed, I started to feel the pain of contractions. This wasn’t surprising. They said that practice contractions tended to happen more at night, but maybe it’s that people are busy during the day and notice them less than they do when trying to rest at night. In either case, rest would not come. The pain from the contractions made sleep impossible, even so, I still tried. I knew this could be early labor, and it was important to get some rest.

I laid in bed until almost 2am, but sleep would not come. So, instead of laying there, I decided to get up and do some more things around the house. I had wanted, for instance, to do a load of laundry. I puttered around the apartment trying to distract myself from the discomfort; however, the pain was becoming more intense. I put our phones on the charge; I changed the timer on the rice cooker so that it would finish making our congee by 4am. I had a feeling we wouldn’t be home at 7am to eat it. At 3am, I started tracking my contractions, and they seemed to be coming about 5 minutes apart and were about a minute in length. This would continue until 4am. This is called the 5-1-1. This is when you’re supposed to head to the hospital; contractions are 5 minutes a part, 1 minute in length, and they have been like this for 1 hour. So, at 4 am, I finally woke up Ben and told him that I was in labor.

It was startling news to wake up to, and his reaction brought a smile to my face. “Breath honey,” I said. “Relax.”

He got out of bed, and we started the process of getting ready. This included calling the hospital to confirm that we should come in, then contacting the ambulance service that would take us from Kunshan to Shanghai. It would be a while before the ambulance arrived, and we had plenty of time to eat breakfast and gather everything we needed. As contractions came and went, Ben would help me by applying counter pressure, and I bounced around on our birthing ball. 

Unfortunately, the ride to the hospital was less than ideal. When the “ambulance” arrived, we came to realize it was really just a van with a bed in the back. Also, we were traveling to Shanghai in Friday morning rush hour traffic. To make it worse, the driver smoked at least 3 cigarettes on the journey. I think he thought that since his window was open, the smoke wouldn’t filter back to us. He was wrong. That awful trip to the hospital cost us $250; that’s dollars, not RMB. Arriving at the hospital after 10am, we’d have been better off taking the high-speed train. 

But that was the least of it. The worst of it was that my contractions which had been coming at 5 minutes a part at 3 am this morning were a mild irritation by the time I walked into the lobby of the hospital. I turned to Ben and said, “I just want to go home. I was wrong. This still isn’t real labor.” However, Ben said we should see a doctor since we were already there. At that point, a nurse had arrived to guide us with a wheel chair. I said I didn’t need it, but they made me sit, and we went to see the doctor.

The doctor did more fetal monitoring, and she confirmed I was having contractions but only at 15-20 minutes a part. She did a cervical exam, which showed that I was 80% effaced and 0 cm dilated.

I was not dilated at all.

She then took us to do an ultrasound to confirm the baby wasn’t in distress. The ultrasound doctor confirmed that everything looked fine and stated that our baby was skinny. This wasn’t surprising. Have you met my husband?

After the check-up, she suggested we not go back home because a typhoon was heading for Shanghai, and it took us so long to get here this morning. We should find a nearby hotel and stay there for the night. 

The first thing we did after leaving the hospital was get some food. It was already after 12 at that point. I was really upset as we ate. I felt like an idiot. Even after all the information I had about early signs of labor and not going to the hospital too soon, I still went too soon. I wanted to go home, but I also wanted to understand what happened. I chocked this up to counting my contractions incorrectly and prodromal labor. Let’s say that a contraction is an earthquake, and it has aftershocks. I was probably counting my aftershocks as earthquakes. This may be why I thought I had been contracting 5 minutes apart for one minute in length for an hour. It also appears that some women for some reason have what is called prodromal labor. Here’s a definition from the American Pregnancy Association:

Prodromal labor consists of contractions that can be fairly regular (between 5-10 minutes apart) and can be painful like active labor contractions, more so than Braxton Hicks contractions. Typically each contraction will last just shy of one minute. These contractions are preparatory. It is suggested that they may help encourage the baby into a suitable birthing position, that they prepare the muscles, ligaments, and pelvis for active labor, and they may help prepare the mother for what is soon coming:  active labor. It is not always easy to determine at home whether what you are experiencing is the “real thing” or not. Prodromal labor contractions may happen very close together (say, every 5 minutes) and may be more painful than the Braxton Hicks contractions you’ve already been through.

As I learned more about prodromal labor, I began to feel less like an idiot for showing up at the hospital when I did. However, I also felt blind sided. I felt like everything I’d been reading and learning up until that Friday morning had told me that only real labor will be regular and painful like active labor contractions. However, here was this asterisk. Here was this little point that was, in fact, mentioned in the Know Your Options Birth Course but was probably discussed for about 2 minutes amidst hours of content, and I didn’t pay it any mind. I figured I wouldn’t be one of those women. Why did I think that?

Only 1% of women actually faint during pregnancy. I did that. Why wasn’t it possible I’d suffer from prodromal labor too?

As I sat eating my lunch exhausted and upset, I just wanted to go home. It didn’t look like this baby was coming today, and it may not be the next day either. What was the point of wasting more money on a hotel? If we didn’t get back to Kunshan this afternoon, it was possible we’d have to spend two nights in the hotel as we wouldn’t be able to travel on Saturday due to the typhoon. At best, we’d be able to head back home on Sunday. With this thought in mind, Ben and I discussed what train to catch going back home. Once I finished my lunch, however, a deep feeling of exhaustion settled over me. After all, I hadn’t slept the night before, and I realized I desperately needed sleep. I was also  39+ weeks pregnant. I was hardly in the best shape to be traveling back and forth. So, instead of going back to Kunshan, we decided to stay at a hotel. 

When we got to the hotel, I just wanted to sleep, but it wouldn’t come so easily as I was still having painful contractions. I would fall asleep only to be awaked 10, 15, 04 20 minutes later due to the pain. It was not a restful two hours, but I did feel slightly better. Ben and I started thinking about what to do for dinner, finding to our relief, that the hotel had a nice restaurant we could go to. After all, the weather outside wasn’t the type you’d want to walk in.

Throughout dinner, the contractions got slowly closer together. As I was eating, I would have to suddenly stop and focus on my breath, Ben applying counter pressure to my lower back to help me through each contraction. After dinner, we decided to walk around the lobby. Walking is supposed to help the baby get into to position for delivery. I set the goal of 20 circles around the small lobby. However, it was very difficult. I’m not sure I even made it around twice before I suggested we walk around on our floor of the hotel (the 7th) instead. There were many people in the lobby, and I could feel all the eyes on the very pregnant foreigner walking around in circles.

Back on our floor, I set a new goal of 10 times through the hallways, making sure to pass the door of every room on each lap. I again only made it 2 laps before returning to the room. The contractions created pressure on my bowels making me feel like I had to use the bathroom. However, I would just sit on the toilet in pain with nothing happening. 

The contractions would get increasingly closer together throughout the evening. When one would come, I would repeat to myself, “Rellaaaaaaaax,” while Ben applied pressure to my pelvis. I tried to view prodromal labor as practice for the real thing. The problem was that we had left our hospital bag at the hospital. So, all of my natural remedies, like essential oils and heating pads were there, not at the hotel. As the time grew later, I became desperate for a heating pad or anything beyond breathing and counter pressure to help ease the pain. As I started putting on my shoes, Ben asked me where I was going. I told him that I didn’t care if I got soaking wet. I was going out to that convenience store down the street and buying a heating pad. 

Ben, of course, is a very smart man, and he went instead. He was able to borrow an umbrella from the hotel (not that it’s much use in that kind of weather), and he went to the store. It seems like the heavens smiled down on us at that time, however, because Ben hadn’t been gone long before the rain stopped. So, he didn’t end up getting very wet at all, and I got my heating pad. It helped some, but the contractions kept coming. By 1:30 am, they were coming one on top of the other. This means that as one contraction was declining, another would begin building on top of it, delaying relief for another minute. 

I felt this simply could not be normal. After all, prodromal labor wasn’t supposed to get that close together. I now felt confident I knew contractions separate from the aftershocks, so what was going on? Was this real labor this time? I didn’t know, but I knew I needed to get back to the hospital. If nothing else, our hospital bag was there. So, without knowing whether or not we would be admitted, we asked the staff at the front desk to keep our room key when we left for the hospital. If we were admitted, they would help us check out, and we would come back on another day to get our deposit. 

The trip to the hospital was painful, and I felt that the taxi driver who picked us up was a little weary. Was the foreigner going to have a baby in his car? He was probably as relieved as I was that the hospital was close by. Upon arrival at the emergency room, I declined the wheelchair this time. I was still embarrassed by what had happened that morning. However, it wasn’t that easy to walk. I would hold on to the railings that lined the hallways and elevators as I made my way to the Labor and Delivery Ward. As I walked toward the doctor on duty, a contraction hit me so hard my knees buckled, and I was fortunate to catch the receptionist desk with my hands as I rode the wave. It was the same doctor from the morning as she was working a 24-hour shift. She saw the contraction occur and quickly suggested we get into a bed so they could monitor fetal movement and contractions again. She also checked my effacement and dilation status. It was the same as in the morning, 0 cm dilated. This was not what I wanted to hear. 

All of this pain. One contraction on top of another. And I still wasn’t dilated at all?

Normally a hospital will not admit you until you are at least 4 cm dilated. However, they admitted me for two reasons. The first is that they had 10 labor and delivery rooms and only 2 people needing to deliver at that time. It’s a new hospital, and many people don’t know about it yet (Alaya would be the 35th baby delivered at the hospital). The second is that they could see that I was having frequent and long contractions. I wasn’t dilated yet, but my body was doing the work necessary to get dilation underway.

Or was it?

**The featured image is of our hospital bag. We used a full size bag to carry our blowup tub, newborn clothes, and many other items. We figured it was best to have everything we might need and not use it than want something and not have it.

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