Courtesy Megan Zander

Here's What Happens When You're Given Terbutaline & Magnesium Sulfate For Preterm Labor

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I was 27 weeks pregnant and had spent the weekend at home under my doctor's orders to take it easy. My weekly OB appointment on Thursday had revealed that my cervix was shortening, and he wanted to make sure I wasn't going into early labor. I felt great all weekend. I was sure that my checkup on Monday morning would be routine, and that I would be cleared to go back to work. I even texted my co-worker and made plans to meet at our favorite Thai cart for lunch that afternoon.

But my ultrasound showed I was having painless contractions and was already in labor. I was rushed to the emergency room, where a team of people in white coats came in to see what was going on in my beige granny panties. After a while they looked up from their football huddle at the precipice of my vagina and told me they'd be dosing me with magnesium sulfate and Terbutaline in hopes of keeping me pregnant.

If I had known what was going to happen that day, I would have worn cuter underwear.

Courtesy Megan Zander

The doctor, who looked like he could be an extra on Grey's Anatomy, explained to me that they wanted to give me some drugs to prevent me from going into labor. Terbulatine, he explained, is a drug that's injected into the arm to delay labor and stop the uterus from contracting if you're having contractions before 37 weeks. Magnesium sulfate is also given intravenously, and it's used to lower calcium levels in the uterine muscles to get them to relax more.

"We think we have a chance of stopping your labor from progressing and keeping your pregnant longer," the doctor said. "We'd also like to give you steroid shots over the next two days to help the twin boys' lung development, so that if they are born in the next few days, they'll have that on their side. Does that sound like a plan?"

There I was, naked from the waist down and surrounded by a team of doctors, without my partner or any family members to ask for advice.

I thought about it carefully. Generally speaking, I like to think that I'm not a sucker: I can haggle the price of a lamp at a flea market down from $30 to $3 and I'll look up reviews on a shampoo I'm considering before throwing in my cart at Target. But there I was, naked from the waist down and surrounded with a team of doctors, without my partner or any family members to ask for advice. I couldn't ask them to hang on just a second while I check and see what the internet thinks about their plan for saving my babies. Plus, I did trust that they knew what was best, and I was really scared at the thought of going into labor so far ahead of my delivery date.

Before I could say anything, Dr. Hottie leaned forward and asked if I trusted him. Of course I said yes.

"I'm hot!" I declared.
"Yes, you're still sexy, babe," he told me, patting my stomach.
"No, no, I'm HOT!" I said. "Like Melisandre from Game of Thrones. I feel like my insides are on fire!"

"Oh, I should tell you," said my nurse as she pushed the syringe of medication into my IV tube. "The magnesium sulfate might make you feel a bit warm, and that's perfectly normal."

"That's great!" I told her, determined to stay positive. "I'm freezing!"

"You might feel a little dizzy too," she continued. "And you may get a headache. And don't panic if your vision gets fuzzy, that's fine too. The Terbutaline might make your heart go a little faster too, but we're monitoring for all that."

Sure enough, by the time I was settled in my private room about a half hour later, my veins started to feel like there were flames running through them instead of blood. At this point my partner had shown up.

"I'm hot!" I declared.

"Yes, you're still sexy, babe," he told me, patting my stomach.

"No, no, I'm HOT!" I said. "Like Melisandre from Game of Thrones. I feel like my insides are on fire!"

He pulled my covers off, but the side effects only got worse from there. As predicted, I did end up with a nasty headache, extreme dizziness and blurry visions. Thanks to the Terbutaline, my heartbeat was racing, a fact that concerned my nurses each time they checked on me. I felt like I had the flu, but it was just the drugs coming from the IV in my left arm.

Courtesy Megan Zander

The plan was to give me magnesium sulfate and Terbutaline for 48 hours, long enough for the boys to get two steroid injections for their lung development via a giant needle in my hip. I was on board for that part, even through I have a huge phobia of needles, because I was willing to do just about anything for the sake of trying to keep my boys inside me longer.

I was less enthusiastic about my doctor's insistence that I stay on an all liquid diet while on the drugs. Just that morning I had been looking forward to a huge pile of spicy Thai noodles, and now my options were limited to broth, Jello, and more broth. Being so hungry only added to my headache and dizziness.

After a few hours on my drug cocktail, I started to get a little loopy, the way you feel after a few glasses of wine. My vision was too blurry to focus on the television that was mounted across the room and honestly I was too worried about the babies to concentrate on anything anyway. Instead I kept singing, "Girl On Fire" to my partner. I also, apparently, told the nurses to call me Katniss.

giphy

I also started to hallucinate just a tad. The long-term maternity ward at my hospital faces the ocean, and while looking out over the waves is usually calming for me, the combination of being scared, hungry and on drugs made me afraid of the vista before me. I started to panic about the possibility of a tsunami, and worried about how I would get the babies to safety in the event that a giant wave overtook the hospital.

My poor, exhausted partner comforted me the only way he knew how, but my nurse knew exactly what to say to get me to calm down. She pointed to my giant belly. "See that?" she said. "We're keeping them in there, and while they're in there, it's like a flotation device. So you're good, Mama."

By the next morning, I was feeling really crappy. My contractions had stopped, which was amazing news, and the boys were doing well, which was the point of this whole endeavor, but my body felt restless and I was starting to have muscle tremors in my hands. My regular OB was on rotation in the hospital that day, and when he came to see me on his rounds he was surprised to see that the team the day before had made the call to put me on Terbutaline.

It turns out that while the drug is effective at preventing preterm labor, using that way is considered off-label. Terbutaline is actually a drug that's meant to help breathing conditions like asthma and bronchitis. I found out afterwards that the U.S. Food and Drug Administration (FDA) had issued a warning in 2011 saying pregnant women shouldn't be given the drug for more than 48-72 hours because of the high potential for serious maternal heart problems and death.

Courtesy Megan Zander

Obviously, I didn't die, and seeing as how the drugs did manage to stop my contractions and keep me pregnant longer, on the whole I feel like I still made the right call to trust the doctors. I stayed pregnant for another two months before giving birth, having the boys when they were 33 weeks along. That's still early, but the health risks they faced coming at 33 weeks as opposed to the uphill battle that would have lay ahead had they come at 27 weeks are vastly different.

Even though these medications made me feel awful, for me they were worth it because of the outcome. But I do wish I had been a little better informed about the risks before agreeing to have the drugs pumped into my body. I probably still would have chosen to take them, but it would have been nice to know just how much of a risk I was placing myself in before I did.