THE IRRITABLE UTERUS

The uterus is an extraordinary organ that holds much responsibility in the lives of women and their babies. When the uterus tightens and contracts during pregnancy, it’s our biological way of pushing our babies out and into the world. However, when contractions don’t happen at full term or without a definite pattern, they can, but not always, be attributed to a condition known as uterine irritability.

When we think of preterm contractions, the first thing that comes to our minds are Braxton Hicks contractions. They aren’t a requirement of every pregnancy, but they are fairly common. Braxton Hicks can happen when the uterus is activated during sex or physical activity, when your baby is very active, or even when your body is dehydrated. Uterine irritability isn’t always triggered by these same events, and can feel very different from Braxton Hicks contractions. 18 PINKBLUE | FALL 2020

Amanda Lewis, MSN, CNM, and Clinical Director of Midwifery at the Birth Center of Baton Rouge explains, “Braxton Hicks contractions are more of a long cramp in certain areas of the uterus, and uterine irritability can be felt all over. Braxton Hicks contractions tend to be very sporadic and can cause prodromal labor–not producing cervical change.

Prodromal labor can start and stop. Real labor has a definite start and stop, and you will feel the entire uterus contracting.”

In some cases, uterine irritability can be triggered as a result of a vaginal infection. Lewis has also observed that women may have irritable uteruses when their baby is trying to move but cannot due to muscles being too tight or due to the mother’s hips. She has referred patients in the past to a chiropractor for some relief.

According to the American Journal of Obstetrics and Gynecology, a 1995 study

showed that 18.7 percent of women with an irritable uterus experienced a premature labor. Uterine irritability is especially concerning at times because a woman may think she is having preterm labor, but that may not always be the case. Many women who experience uterine irritability are still able to deliver at full term and may continue to have their condition closely monitored. In some extreme cases, bed rest and pelvic rest may be necessary.

The American Pregnancy Association suggests pregnant women drink 8-12 glasses of water per day. Hydration is critical during any pregnancy, but to those prone to uterine irritability, water is a key component in warding off contractions, and drinking plenty of fluids can even eliminate the need for a hospital visit to receive intravenous fluids. Lewis agrees that staying hydrated can help. She advises to “step in a tub–your body is porous and that will help you too, and if you feel this starting, drink two big glasses of water and it usually helps.” Other important care strategies are to try to reduce stress, get plenty of rest, and reduce your caffeine intake.

As with any concern in pregnancy, contact your doctor or midwife if you think you are experiencing contractions. In some cases, an irritable uterus can cause preterm labor. Your doctor may perform a variety of tests to rule out an active labor. Some common ways your healthcare provider may monitor uterine irritability for preterm labor includes ultrasounds, vaginal fluid samples, and checking the cervix for dilation. ■

“For me, I had an irritable uterus from about 15 weeks on. I had contractions on the monitor basically every time they would check. It mostly felt very crampy all the time, and it usually occurred when I was dehydrated or on my feet a lot. I actually had incompetent cervix as well and my maternalfetal medicine doctors believe the irritable uterus may have played a role in that. I did not deliver full term. I delivered at 34 weeks and 1 day. This was my first pregnancy.” –Janelle Greenstreet

“I have uterine irritability from this pregnancy and I am 34 weeks and 5 days. I’m so sore from the dull pain and it’s so fatiguing.” –Angel Magbutay ■

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