Progesterone Shots to Prevent Preterm Labor (Long)

o_so_in_love · June 2012

My midwife has been talking to me about getting weekly progesterone shots (17P) to prevent preterm labor. I am still undecided on whether to get them. My first son was born at 37 weeks but prior to 37 weeks in considered preterm. He had no complications at all. My second son was born at 35 weeks, 2 days. He also had no complications and weighed 6lbs 3oz.

To be a candidate you have to have had a singleton preterm birth that was not because of premature rupture of membranes and currently be pregnant with a singleton.

So far myself, MH and my pregnant cousin are all on the side of opting against it. My babies are born healthy. Maybe my body goes into labor sooner because I couldn't handle it otherwise. There are other methods of stopping preterm labor. There are no long term studies on the effects of extra progesterone in the children from those pregnancies (the longest I can find is children 4 years old). What if I have a boy? How will all the extra progesterone effect him during puberty? Will it effect a daughter? How much of the use of this drug is being pushed by the pharmaceutical companies?

I will have to drive a one hour round trip to receive these shots. They are supposed to be administered from 16 weeks to 35 weeks. While I understand these shots are beneficial, I just don't know that they are necessary. Stories of women online say they still delivered at 37 weeks, 35 weeks, etc. A lot of these women had previous preterm births earlier than 34 weeks.

When I asked my midwife how late is too late to start taking the shots if I change my mind, she responded with when I am dialating. But since the recommended time to take the shots are 16-35 weeks, there aren't any studies I can find that talks about the effectiveness if started later.

The only reason I am doubting my initial reaction now is solely on "what if". What if I deliver at 34 weeks this time? What if my baby is not healthy?

I'm really arguing with myself a lot over this. Anybody care to share any experience they've had or join my argument?

Here is one of the links I have visited on this matter:

https://www.marchofdimes.com/pregnancy/pretermlabor_progesterone.html

denise_m · June 2012

My water broke with ds when I was 23w5d pregnant. I had no risk factors for a preterm labor or delivery. I spent 10 weeks on hospital bed rest before delivering at 33 weeks. He died from SIDS at 10 weeks old. His main risk factor was prematurity.

After I got pregnant again, my doctor said my risk of rupturing again was 70%, mainly because we didn't know why it happened. After three losses and the Leiden Factor V diagnosis, he upped it to 90%, with it happening sooner than it did in my prior pregnancy.

When I was pregnant with dd2, I asked to be referred to the MFM office. I talked to them about p17. They were largely in favor of them. I started them at 16 and had my last one at 36 weeks. I delivered at 39w3d. She's 19 months now.

I will start them again on July 10. At 16 weeks pregnant.

I asked A LOT of questions about them. It is never recommended to start before 16 weeks because there are some really small research studies that suggest it can effect the sterility of boys. But, there isn't any conclusive research indicating that the shots caused the sterility issues or prematurity did.

As of this point in time, there is not a lot of research indicating there are negative long term effects. There is a lot of research indicating that it can prolong pregnancy and lessen the lifelong struggles seen in premature pregnancies.

In the beginning, it took a long time for the drug companies to be able to even give them to pregnant women for this reason. Doctors were using them off label before it was approved in 2009 (or 2010).

Here is some more information on the shots:

https://www.chiff.com/health/pregnancy/17P.htm

https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm242234.htm?sms_ss=email&at_xt=4d50034cbfa7fa33%2C0

https://www.helpourbabies.org/Documents/17P_Factsheet.pdf

When I had the shots, they really calmed the BH. I could tell when I was getting close to the day I was due to have the shot, the BH would pick up. Since excessive BH were the cause behind why they believe my water could have broken, I do believe they are why I have a full term baby after they said I wouldn't.

I did have to go into my office for the shot. But, I also did a doppler check just to help peace of mind. But, when I went on vacation, I was just given the shot to give myself. I had the option of doing it that way through the pregnancy if I chose.

The FDA recommends for best usage, you do not start after 22 weeks. The effectiveness drops dramatically.

I will warn you. The shots are painful. They are really, really thick. They go in the buttocks. Massaging the area after to help get the meds to start moving helps. So does ice after.

In the end, it is your decision. It's up to you what you are most comfortable with.

JessAnnJ · June 2012

I do not have any experience with the shots, but my sister went into labor at 26 weeks and despite being on bed rest in the hospital gave birth at 26 1/2 weeks. I watched my nephew, my sister and her husband struggle and my nephew passed away a couple of weeks ago after spending his life in the hospital struggling. I was born 7 weeks premature and my brother's children were 4 and then 8 weeks premature. My doctor says that doesn't mean it will happen to me, but if I were offered the shots after having already given birth early I would take them. To me it's not worth risking what could happen.

LyseeH · June 2012

I've already had one and umm i can't remember what its called but the shots for people who are rh- my doc think its a good idea! But you need to do whats right for you and if you aren't sure then maybe talk it over with hubs or whoever else you rely on because later down the line you need to be comfortable driving out that far to get them and we deff want that baby healthy!!!!

denise_m · June 2012

LyseeH:
I've already had one and umm i can't remember what its called but the shots for people who are rh- my doc think its a good idea! But you need to do whats right for you and if you aren't sure then maybe talk it over with hubs or whoever else you rely on because later down the line you need to be comfortable driving out that far to get them and we deff want that baby healthy!!!!

Rhogam. . I get those too

LyseeH · June 2012

denise_m:

Rhogam. . I get those too

YES! thanks you! My word retrieval lately has been absoultly aweful!!!!

Progesterone Shots to Prevent Preterm Labor (Long)

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