A Close Call: Dilation, Preterm labor, and Admissions Decisions

Our first #DilationMatters birth story is generously shared by Karyn, who had quite the surprise with her second baby, Jackson. After noticing stronger-than-normal contractions a full month before her due date, Karyn checked in to the Labor and Delivery Triage. She was almost sent home after one dilation examination was read as 2 cm dilated. But everything changed when another provider re-checked and found she was 5 cm dilated. Read this amazing story of how a difference of 3 cm in dilation measurements completely changed her care plan and ensured that she was in the hospital when her preterm infant was born.

By Karyn Samson**

Four weeks before my son Jackson's due date, I checked in at Labor and Delivery after noticing more-than-usual cramping and contractions. I was placed in an observation room, and my contractions began to become irregular and farther apart. I was only 2 cm dilated, according to one of the nurse's measurements. Dr. Hanson (OBGYN) came by not long after and told me I would likely be sent home since the contractions were becoming more irregular and since I was only 2 cm dilated.

At this point, I called my husband, Ryan, who was on his way to the hospital. I told him I was starving and would like him to pick up some dinner on his way to the hospital. He brought a large turkey burger and fries, and I devoured most of it, thinking I would be heading home soon. Contractions were still happening but not getting stronger. Dr. Hanson came back in and said we could head home after one last cervical dilation exam. Dr. Hanson performed this cervical examination and said I had dilated to 5 cm! Dr. Hanson was surprised and said, "The baby is coming tonight." That one dilation examination completely changed the doctors' plan, and the next month of my life.

The baby is coming tonight.
— Dr. Hanson, after a dilation exam

I was transferred to the last labor and delivery room available (it was a full house that night), and I proceeded to have an emotional meltdown. I had been convinced that I was going to return home that night, and I was terrified that the baby was coming 4 weeks early. An epidural was placed, and Ryan and I tried to get some sleep. When it became time to push, it took less than 15 minutes for me to push Jackson out. He was born at 5:22am on May 12th, and he weighed 6 lb 3 oz. 

I was terrified that the baby was coming four weeks early.
— Karyn

It is unclear whether I truly dilated from 2 cm to 5 cm that quickly or if there was a discrepancy between the nurse's measurement and the doctor's measurement. If I had known I was dilated to 5 cm, I would not have eaten all that food, which later made me feel nauseous during labor. I am so grateful Dr. Hanson performed that last cervical exam instead of just sending me home. Based on the contractions alone, I would have been asked to go home and would have had to return only several hours later when the contractions got stronger. I also may not have been able to receive an epidural in time. In the end, I am very grateful for that "one last dilation check" by my doctor before sending me home. It made all the difference.


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