So if you’re lucky enough to be on bed rest for preterm labor or incompetent cervix, it’s likely that you are one of the lucky ones that get to experience the joys of progesterone injections. I thought I would tell my story and then give you some useful tips I’ve discovered over the past 7 months of being on them.
My doctor believes in the Creighton Model. My husband likes to joke that it’s his answer to everything. It extends to fertility and cycles, but in terms of progesterone and pregnancy support, it basically means they test my progesterone every two weeks and then mark it on a chart. The chart then gives instructions to the amount of progesterone needed to support the pregnancy.
My insurance covers the labs but does not cover the progesterone. We buy it from a compound pharmacy. They compound it in sesame oil and it costs $75 for a months supply of 20 ml.
The majority of my pregnancy has required 200 mg twice a week. It seems like a lot and my butt has paid the price. I started them immediately after finding out I was pregnant as I tested low and have a history of preterm labor. My husband came with me and they taught him how to administer the injections. I will say that’s been absolutely priceless. I couldn’t imagine having to leave work twice a week to drive to the doctors for a two-minute injection. Although it forced us to work through some trust issues (can you believe I was terrified of needles before this pregnancy started??) it has been a life saver to be able to do them on our own time when it’s convenient for us. I have a very irritable uterus so it’s also nice to have the freedom to do them when I need to. I’m normally most irritable the day of the shot so if I’m having a rough morning I can have him run home on his lunch break to do it and it normally calms things down. If I’m still contracting a few hours after the shot it’s a good indication that I need to go get checked out.
When I first started they would leave me in excruciating pain. I would have trouble walking and sitting, my hip and thigh would be incredibly sore into the muscles. I googled and googled and couldn’t find a lot of stories with the same experience. I lived off Tylenol in the beginning and sat on pillows at work to make it through the day, although I found myself leaving early occasionally because I just couldn’t take it along with being exhausted and nauseous I was miserable.
Things I found to help:
- Heating pad and massaging right after
- Doing it right before bed, the days I had to sit on it right after I was much sorer the next day.
- Smaller needle. I’m small and have no fat on my butt, so going to a 22 x 1-inch needle was life changing.
- Finding the sweet spot, injecting too high or too low irritated the muscle.
- Benedryl cream for the times that it welted and itched.
- Warming the oil in my bra for five minutes before the injection. It seems to help it thin out a bit.
- Don’t flinch, the more relaxed I was the better. I’d lay down and play a mindless game on my phone. Husband would give me the signal and I would take two slow deep breaths and on the bottom of the second, he’d do the deed.
- Not too fast but not too slow. The office recommended spreading the injection out a minute for every 100 mg. We eventually found that that wasn’t necessary. I was less sore on the days we sped that up to about 30 seconds per 100 mg. Something about laying there with a needle in my butt for two minutes begging the kid and the dog to stay far away from the bed was just agonizing.
- Tylenol & lots of it.
It gets better. My muscles have gotten used to the constant poking and it’s rare for one to bother me. This took about two months of toughing it out but I’m there. It used to take us a while to get prepared and do the injection. We’re now a well-oiled machine. Husband and I can get the injection done and back to our evenings in under 5 minutes.
It’s effectiveness? Like I mentioned before it is great at calming irritability but I can’t vouch for whether or not it’s prolonged my pregnancy. I’d like to think it has, though. My son, I didn’t have preterm labor until 28 weeks and again at 34 where I eventually delivered at 35 weeks. I did have a very irritable uterus with him. My second pregnancy with my daughter I started contracting and bleeding at 15 weeks and my water broke at 17. I had cord prolapse and delivered at 20 weeks. This pregnancy, contractions and bleeding started at 17 weeks. Despite all of the heavy bleeds I’ve had from a low lying placenta and bouts of preterm labor, my water has stayed in tact and my cervix has stayed closed. I spent most of my pregnancy at 3 cm of cervix and at 29 weeks have 2 cm left. I’d like to think the progesterone has been effective at strengthening my amniotic sack and cervix. I would say they are worth it even if they’ve only bought me an extra week!
ETA: I ended up dilating after a big bleed started contractions at 29 weeks. I dilated to 3 cm and 80% effaced. I made it a week past that to 30+1 when my water broke. I would still say they are worth it if they helped me buy those 6 more weeks past viability!