My daughter in law started having preterm labor at 27 weeks. She received Tributaline 2 times to stop contracts. Since then she has been experiencing contractions on and off.She is now 36 weeks and 1 day. Starting 2 weeks ago today she started having contractions, 3-5 minutes apart and has been to the hospital (which is a 40 minute drive) 3 times. When she reached 34 weeks they stopped giving her the shot to stop the labor. On examination she is 1cm dialated, baby is down and in position but she is still thick. With her first child they had to strip her membranes 3 times. She can not sleep because the contractions are that intense. On the monitor they are showing up averaging in the 70-mid 80 range. She is very run down and exhausted. The hospital that she goes to is very small and they refuse to induce until she is 38-39 weeks. Also another thing I have noticed is when she first started going in the babies heart rate was about 165, the last visit the heart rate was down to 120 the entire visit and dropping slightly during contractions. Is this a cause for alarm? I guess my question is keeping in mind how exhausted she is, the fact that she has a 20 month old toddler and that there is a 40 minute drive to the hospital, is it time that we take her to a different hospital or is this kind of thing normal? Is there something that we are missing (other then it being a small hospital) as to why the doctor seems to be making no moves to help her? Any input you could provide would be greatly appreciated. Thank you!

From the sounds of it they are going along recommended lines. The longer the baby takes at this point the better it can survive outside the womb. I would be more worried about a babies higher heart rate because it's a sign of stress. The main thing is that she is being monitored by a doctor along the way. Its true not all LDR's are created equal it still doesn't sound outside the norm. Is there any way for someone to live with her to help out over the next few weeks? Having a 20 month old can be tiring by itself let alone under these conditions. Can she aford to hire an in house baby sitter even for the daytime or does she have access to daycare facilities?

These are all very normal late pregnancy symptoms.

The fetal heart rate ranges from 110 to 160. There are times when it can go higher or lower without worry. For example, if the baby is very active, the heart rate can increase above 160.

I work at a very rural hospital as well. Even the higher level of care hospitals will not induce until 38-39 weeks. It's an across the board standard of care.

Her doctor, and the nurses, are acting appropriately. She is not considered "in labor" until there are cervical changes. Considering she is just 1cm and thick, this could go on for a while.

What my facility recommends is Tylenol Extra Strength every four hours, warm baths, and if necessary, Benadryl for sleep.