I am struggling with whether or not to do progesterone injections... I gave birth *very borderline pre-term* with my son at 36+5. (full term is 37 weeks) so technically my OB had to recommend to me to start the Makena progesterone injections weekly starting at 16 weeks. I am already on progesterone vaginally because my progesterone was very low and it helped me get pregnant twice. I tolerate it well.
My hesitation is just that I am wary of meds.... I feel like medication is pushed out without 100% vetting of don't want anything to mess with the wonderful, easy labor I had with DS (ya know, besides being 3 weeks early). Apparently progesterone is safe for baby.
Argg!!! Anyone have advice? Would you do the shots in my situation?
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I took them for DS because DD was born at 36w, but preterm labor started at 32w. DS was born exactly at 40w. My labors were very similar time wise both less than 8 hours start to finish. No ill side effects besides an itchy butt where the injection goes. I will have to do them again if we have a third. I took them from 15 or 16 weeks until 36 weeks. He was 9.7lbs and she was 6.4. I think they did help keep him baking longer. And my experience with him being born at 40w and DD at 36w there were a lot of differences. She was colicky, had reflux and had a hard time eating and gaining weight for most of her first year. He was a very happy big chubby baby with minimal issues. And even Now DD is 4.5 and she has a speech and language delay as well as sensory issues and gross motor delay. You can't know for sure if any of it was cause by the issues I had or the meds I was on but I can only wonder.
And just as a side note if you decide to take the shots and insurance doesn't cover the mekena, because it is VERY expensive, you can call and "apply" for a lower cost. I did but they were a pain to deal with. I would request the compound version from your dr. (I think that is what they called it).
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I think you need to trust your doctor. For DS2, I took progesterone (compounded) vaginally from @18 weeks-36 weeks. I had a placenta previa so I was at risk for pre-term labor.
My placenta moved and my delivery was perfect. Baby came @38.5 weeks. My baby-boy was/is fine, no side effects from the drug. I'm totally into natural pregnancies and in general try to avoid meds, but when it comes to your baby's health, trust the dr.
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@Alba4: I think the problem is I will never 100% trust anyone, even myself haha! Human error happens. It does sort of seem like a no-brainer I guess tho. There is a real possibility of early labor and a tiny possibility of ill effects from the shots (I don't care about me, I can handle them I think) so I should probably do them...
I actually think they are covered by my insurance. I checked the formulary and they said "Tier 3" and not "Not Covered" -
@pinkb: I so appreciate your info. I wonder how my guy will do. He seems to be right on track developmentally, nursed like a champ and was a very healthy baby so I kinda feel like it wasn't that bad but that's silly.
Were you able to do the shots at home? -
@pachamama: yes. DH came to an appointment and the midwife taught him how to do them. Or you can do them yourself if you choose. I know several bees have had a nurse come to their house that was covered by insurance too.
And for DD since I went into Labor at 32 weeks I had several other meds that I question the effects on her way more than the progesterone on DS. I had the steroid shots and procardia to take to keep me from having contractions. I had to take that very 4 hours around the clock. I also had something else in the hospital but I can't reall what it was. I just feel the progesterone is the lesser of the evils. -
I tend to not think of progesterone as a medicine. It's a naturally occurring hormone. That I just happen to not produce enough of.
However, I take the bioidentical version. I think Makena is synthetic. If you want something more natural, maybe ask for a compounded version. But it might not be covered by insurance. I pay $50 a week for two 200mg shots
ETA: and DH gives them to me
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I totally get about wanting to limit medication interventions, but if your levels have been actually low, it seems like a no brainer!!!
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I took them for my second and third pregnancies (first came at 35 weeks). My second was a 36 weeker and my third a 38 weeker, so it seemed they worked for me.
Since you have low progesterone I would definitely do it. -
@MaryM: yes agree. I don't think of progesterone as a medicine, it's something we already do/should create naturally and some jusr don't.
It's not the same as taking, say, diclegis for example. Though I'm totally ok with that too and take it (the B6/unisom version)
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@mrsbubbletea: I know... But I've read about quite a few seemingly benign medications and treatments that "posed no risk" and ended up being not as harmless as the FDA studies purported, but progesterone does seem to be on the safer end of the spectrum. @SweetiePie: that's a good point
@MaryM: I will ask about the compouded version! -
I'm asking this as an ignorant person but could you possibly start it a bit later if it appears that you are progressing too quickly (i.e. If you have early labor signs)? FWIW, I had my first at 38 weeks exactly and had to be induced at 40 weeks with #2.
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@Shantuck: I was wondering if I didn't have to do them from week 16 on but I imagine the progesterone needs to be injected during all those weeks for a reason? It indicates starting between 16-20 and continuing through 37.
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From my NICU nurse perspective this seems like a no brainer. You have a med that has been used for a very long time that is naturally produced by the body that can help carry your baby to term. You are considering declining on the small chance that there are risks they haven't identified, then risking a late preterm baby, which comes with very identifiable risks. And since you have a history of preterm delivery your chances are higher than average of an even earlier birth this time around which compounds the risks further. It just seems like putting a lot of weight on a "maybe" discovery of a currently unknown med risk ...
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@MsMini: Yeah, the more I think about it the more logical seems that I will do it. I am 100% right now, I just have questions for her She said I had to get them in office and I want to do them at home which most people seem to do.
Also, here's something: I had pPROM but it was strange- I had gone in to my OB in the afternoon (appointment at 3pm, water broke 11pm) for an aggressive cervical check (my request, she didn't really want to do it). Part of me thinks somehow maybe the midwife could have nicked my sac and caused labor. My water broke veryyy slowlyyyyy and I never progressed. Absolutely no contractions, no pain, nothing. Just a very slow leak. They induced me with Cervadil at 8am and my cervix and uterus kicked into high gear after that but I still always wonder if my water wasn't broken by her? That would explain the pre-term.
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I got weekly shots with my second because my first came at 30w5d
(She's completely fine and a healthy 4.5 year old now!). I was able to get to my due date (and then some) with my second. Maybe that would have happened without the shots, but maybe not? They could never find a reason why I went into preterm labor with my first.
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@Ginabean3: that's great you went full term! argg I wish I had a reason for what happened. See above, it was very odd.
I imagine being on the shots is going to give me a lot of comfort! -
Bumping this thread- I was going to write a new one about this but so much great info on here already.
I am 10.5 weeks pregnant w/ baby #2. DS came at 35 weeks after 3 days of prodromal labor (no other symptoms or issues in that pregnancy) and I am concerned about this one coming that early or even earlier. My Dr. said we would start P17/Makena at 16 weeks, but I am concerned about the negatives- if there are any, and side effects. Specifically increased anxiety. I do think DS came early because we had a lot of stress/anxiety that week (which I am prone to anyone) and I worry that if these shots increase it, then they could be doing more harm than good.
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@lioneyes my first came on time at 39 weeks but I had a short cervix, preterm labor, and I was on bedrest for a long time. I am now pregnant with #2 and even though I didn't have a preterm birth with #1, my MFM doctor wanted me to take progesterone because of the short cervix/PTL with baby #1.
I am 34 weeks now, I have been using vaginal progesterone suppositories. I haven't had any side effects at all and I am going to be on them till 36 weeks. My cervix did get short, but not nearly as bad as baby #1 and I've avoided bedrest, which is awesome.
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@lioneyes: (I already posted my experience above) I have not heard of Makena having a side effect of anxiety. That said I have anxiety and had no increased anxiety with the shots, and I believe stress at work mostly caused my preterm labor with DD, although I cant prove it. In my research there was no ill effects on baby. And the only side effect I had was itching at the injection site, which the MFM Dr. warned me about as the most common side effect.
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Very late update: I miscarried at 8 weeks but didn't find out til 12.5w. I was taking progesterone suppositories which might have prevented some bleeding. It was an old Missed mc. 8 months later, still not pregnant or close to it
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