This is kind of what I meant

I was talking to a friend of mine on the phone yesterday. She is pregnant after many IVF’s. She was initially pregnant with twins but lost one very early. She is 19 weeks now and her doctor has put her on bed rest for the last month or so due to some slight spotting.

 

I told that I was glad she was taking it easy and she replied that she just wanted to get to 26 weeks, because that was when the baby would be ok, and that after 26 weeks she would go back to work.

 

For a split second I was stunned into silence. What should I say? Should I say to her “No! 26 weeks is too early, not all babies who are born at 26 weeks are ok, in fact some babies die. The majority do survive, and are ok, but not all. Ask me, I know., Ben was born at 26 weeks and he died”. I could have said that. It didn’t happen to a friend of a friend, it wasn’t a hypothetical situation, it happened to me. It is very personal. And this is a friend of mine; I want her to be careful, very careful. 

 

But what purpose would that have served? It would have completely freaked her out, made her paranoid and make her feel guilty and terrible for saying that or for potentially making me sad.

 

Instead I said to her “yes, 26 weeks is a big milestone, but it is still not a guarantee; not all babies do survive. 28 weeks is better, 30 weeks is even better, in fact it is very important that you go for as long as you can go, and so I strongly suggest you stay on bed rest for as long as you can”.

 

I didn’t mention Ben. I don’t want her to carry that in her conscious at this time. And yes, she knows about Ben, but she obviously has either not thought about him, or doesn’t know exactly when he was born.

 

I understand why some people might want to mention it though. When I hear people say; and they say it often; “I just want to get to 26 weeks”, a stab goes through my heart, every time. Because I thought that too. And yes, most babies do survive. Just not mine. Ben was the unlucky 10%. But I don’t mention it.  

 

I honestly don’t think it adds any value to scare people with my story, or make them feel bad or sad for me. I am able to carry across the message without mentioning my worst case scenario; my tragic story.

 

This is what I meant. Does this make sense?

 

Comments

[Kalin]

I don't know what I would do. I think it would be very hard NOT to remind her of Ben, just because it's probably what can screaming to the forefront of your mind immediately. I hope all goes well for her though. :)

[andrea]

Yes it makes sense and I think you did the best thing by reminding her that the longer a baby can stay put the better rather than making her feel any more scared.

[Jen]

I think you handled things beautifully. You let her know that something bad could happen without upsetting her unduly. It is always hard when faced with that scenario, but I truely believe that the important thing is how the message is delivered and the way you did it shows your sensitivity and compassion. If I was your friend and in that situation,I would want to know that my presumption of a 26 week pregnancy always ending well could be wrong. After all that trying and finally falling pregnant, I would want to have all the info I could get for every possible scenario, so that I could prevent a possible tragedy.

[Scout]

I don't know how you could have not said anything, but I'm also stunned that she thinks that after 26 weeks everything is ok. Maybe she's trying to take her mind off of the circumstance she's in?

[Izabela]

It makes sense and you've said it perfectly.

[Kerry]

Oooooh I don't know Tertia ... I think that a little bit of a jolt could have made her rethink the situation. I'm not sure how anyone could get the idea that a baby born at 26 weeks will be 'fine' ... merely being alive isn't the only concern ... there's cerebral palsy and a whole range of defects possible from such an early birth. I've known of very few born that kind of early who are fortunate enough to be completely problem free.

I think I would have reminded her about your Ben. At least if she knows prior to making her '26 week' decision, then if the worst case scenario happens to her too (and I certainly hope it doesn't), she will not have reason to ask you 'Why didn't you say anything?'

[Kim]

I don't think it would be a good idea to tell her about your experience because like you say the odds of that are fairly low even though still there. Telling her would not give her somethng she could do to stop it happening if it were going to and only make her stress out - which could be stress for nothing if everything turns out O.K. I remember once I asked you for some advice regarding the cervix cos I was pregnant at the time and my cervix went down to 2cm at 28 weeks. I asked about this and bed rest and you informed me that a shortened cervix does put you at risk for PTL and bed rest doesn't prevent PTL if it is going to happen and that had happened to you twice. Thing is - that advice wasn't very reassuring even though based on your experience and the facts I suppose. In the end I went to term and would have been overdue if I didn't have a caesarian. I guess there are plenty of people who don't have problems in the end too and probably more than those who do so. I imagine though if someone brings up a topic of which you have experience it is hard not to share it or their concerns if they are also similar to ones of your own. I am sure that the women who said about 26 weeks being a good point to feel relaxed is that she sees it as being her aim in the present and seems more achieveable than 30 weeks etc. I doubt that at 26 weeks she would get up and do silly things - probably just aim for another goal. I guess her saying 26 weeks is cos she is hoping to feel a little relief and hope in her own mind about the situation and she sees 26 weeks as not too far away and possibly achievable. I think as long as you're not telling someone to do something that could in the end be harmful then why tell them the worst case. Encourage them to do the things that you know are the right things to do in that situation and then withold the rest and let whatever id going to happen to them happen.

[Ann]

Wow - I am a NICU nurse, and you are completely correct - 26 weeks is TOO EARLY; it is a milestone, but no guarantee. Frankly, whenever I get called to a delivery that is under 30 weeks, I get scared. Not panicky scared, and yes, I'm *much* more scared for a 24 weeker, but 26 weeks is not a "sit-back-and-breathe-a-sigh-of-relief" moment, really. I think you said it well.

On the other hand, bedrest is really something doctors tell women to do when they don't know *what* to do - I don't believe there are any studies that definitively prove bedrest does anything to protect a threatened pregnancy. Being on your feet mildly alters blood flow to the placenta, but it's far from clear whether or not it's an important factor in most premature births, preeclampsia, etc.

What is very well documented is how bedrest drives women insane, increases the chances of postpartum depression and so on and so forth. It does provide the comforting feeling that you have a plan to protect the baby and are actively "doing something". But it's not clear that your friend wouldn't be better off going to work and working at her computer from a reclining chair, for example, rather than staying in bed.

I don't know the details of her situation, of course. But generally speaking, bedrest is even less of a guarantee that 26 weeks is.

[blackbird]

I think you did the right thing under the circumstances...
hopefully she will go to 26, 28...or even 30.

[shari]

you made absolute, perfect sense... I so admire how you write and get your thoughts across - can't wait to read your book...what's up w/your U.S. distributor anyway? Good luck w/your dinner party :)

[mpatters]

I'm glad you wrote this. It made me realize that sometimes when faced with people's naive or uninformed optimism, I want to correct them. This reminds me how ungraceful that impulse is. Your response was gentle and true, without being shocking and disturbing.

[Nancy]

Oh my god, yes, give people the information in cases like this! I find it so wierd that our western society has so many taboos over discussing reality like this. Her baby might die, and has a hugely raised possibility of irreversible damage to various body systems if born this early. I think she'd rather get the info ahead of time, even if it made her uncomfortable or even miffed, rather than do the research later and find out once it's too late to have tried anything and to always blame herself.

Even if someone drops you as a friend (it's happened to me!), if they are doing something major that might result in death, permanent injury, or even spending their life savings/going into huge debt on something that they're convinced will work when all evidence says it probably won't, I think it's important to give them an "alternate viewpoint". It just seems to me to be the only ethical thing to do.

[Ute]

Gee, I'm not sure I could have kept my mouth shut about your son. Not at all.

[Suzie-Q.]

I totally disagree. FWIW i think that woman needs to get a reality slap. Those of us who have experienced preemie deliveries and all the problems that are attendant have a responsibility to that unborn baby to inform the mom of the potential dangers. We all thought 26 weeks would "good enough", but, even with my twins making it to 34 weeks there were problems and a stint in the NICU. I would have been much more graphic so that she would have a clear picture of the potential risks of delivering so early.
Perhaps things stick with you, Tertia, for an extra long time and they don't with her. I know i would rather hear the truth, and, i would figure out pretty quickly that the information being given is meant to educate, not upset me. I would process, apply and let it go.
I think most thinking people are like that. I think if you lose a friend because you are being one then the friendship just wasn't meant to be anyway.

[ktjrdn]

I think you did exactly the right thing. This woman has a lot to be worried about. You gently reminded her that she's making some erroneous assumptions. There was no need for you to scare her or to make her feel guilty over forgetting your situation at this point in her life. She's already got enough on her plate. People rarely remember due dates when they aren't their own, so it's likely she doesn't know exactly when Ben was born.

[Lauren]

Tertia, You did the right thing. As a mom of 26 weekers that survived I'm amazed that people think it is the norm. It isn't and I wouldn't think anyone would want a baby in NICU for 3 months. A living baby is better than a dead one but sometimes they have so many more issues like what one poster mentioned.

Like the other poster I'm sure she'll be careful but I who've lost twins before at 18 weeks thought 26 weeks was safe and maybe I could have been even more cautious once I reached viability. Mabye more bedrest would have postponed my PTL another week or two avoiding the open heart surgery my twins went through.

However I seem to be the exception. Most women do go to term and I believe that most don't need to know my scary story. They just need to know that they need to keep that baby inside them as long as they can and use caution if they are at risk for PTL.

I have a cyber friend who just lost her baby at 23.5 weeks. She would have loved to get to 26 weeks. Her baby might have still been alive in a hospital right now but he isn't as he was born too early. I often think how lucky I am that I did make it to almost 26 weeks and had those extra days to give them.

[Orange]

I think you said the right thing.

I have a friend whose daughter was a 26-weeker, and she's healthy now. But she was in the NICU for 4 months, went home with an oxygen tank, and has some ongoing behavior/attention issues that might be related to her prematurity. My son was a 31-weeker, and he has similar issues that I suspect are related to his brain being yoinked out of the womb too soon. (No evidence to back this up, of course.)

Maybe your friend could use a *little* scaring? Yes, I retract my initial response. Remind her that statistical odds that a baby would survive aren't the same as a 100% healthy baby. If she thinks bedrest and time off work is stressful, she should try a stint in the NICU. Really! It's so much fun!

[Judy]

I think the way you handled it was right on - you used what you knew about that situation to let her know that 26 weeks is not the end-all of complications. I think you used the knowledge that you had in a very positive way. Okay, yeah, make it to 26 weeks, but 30 weeks is better, so is 34, and hey, why not strive for the full 38-40?

You rock, girl. To be able to think like that on a lark is GREAT.

[DD]

That's a long ways off. Her doctor will handle it the best, I'm sure. No need to scare her, as you said, or make her paranoid. You just need to nod your head empathetically and ask if there's anything you can bring her while on bed rest. The future is up to her and her physician.

[Sue]

You are a wise woman and a good friend.

[Summer]

Remind your friend about Ben if you must, if it looks like she might start taking unnecessary risks after 26 weeks. The best thing you can do, in my opinion, is just talk to her often and keep checking that she's not planning to do anything stupid. In any case, she could use your support and friendship while she's on bedrest; it's such a boring, lonely, demoralizing thing to have to go through, as you well know. If she starts talking about making marathon shopping trips or hanging shelves in the nursery after she passes 26 weeks, by all means talk about Ben, and remind her how important it is to follow her doctor's advice.

She's lucky to have a friend like you who is so understanding and sensitive.

[Brandy]

Just from my experience, I was sitting in the hospital hoping and praying I made it to 26 weeks. But I only made it to 22 weeks and 6 days. But if I had a friend that had a child at 26 weeks, I would want to know about the situation.

About bedrest. I know there are not many studies done showing that it really helps. But it is better than walking two flights of steps when you are pg with triplets everyday to get to work. It is better because you can watch your diet instead of eating out of the vending machines at work or being stressed out at work or getting into a car wreck or falling down, etc... I truly believe that being on bedrest help two of my boys make it to 22 weeks and 6 days (and they are alive).

[liz]

I think you did the right thing. If, however, you ever hear her mention it again, you could say gently:

"I didn't really want to bring this up, but you seem to continue to think 26 would be fine...and Ben was born at 26 weeks."

And then leave it at that.

[Becky]

Tertia,

I have never commented on your blog, but read it every day. I found it after I lost my son at 38 wks and I read every bit of your story, I couldn't stop.

I agree with you that there is only so much you should tell someone who is going through a similar situation, especially when they are coming to you for an ear rather than for advice. I don't know how many times I have heard "after 36 wks the baby will be fine". I cringe every time because I know that statement is not always true because it happened to me, but I always keep my mouth closed. I know the majority of all babies that make it that far are safe, I was the exception.

Thanks, Tertia, for your wonderful blog! I can't even begin to tell you how much it meant to me last year and how much it means to me know.

Becky

[Shannon]

I'm mom to a 28-weeker who had a grade 4 IVH and now has cerebral palsy. I would have had a terribly difficult time not saying something. There are no guarantees at ANY gestational age, especially not for a 26-weeker.

[KarenD]

Tertia,

This one is a tough call, but I am inclined to agree with Kerry. You certainly don't want to freak your friend out, but she obviously doesn't have enough information about the inherent dangers of a delivery at 26 weeks.

I will never forget reading Ben's story on IVFC. Up until then I was painfully ignorant about the dangers of premature delivery or how common it is. Ben's story was a total eye opener for me, and scared me badly. I conceived twins shortly thereafter, and many of the decisions I made during my pregnancy (choosing a high risk OB practice, resting constantly, leaving work at 25 weeks) were influenced by my now knowing that the worst does sometimes happen. Knowing your story and knowing the risks of a twin pregnancy did not prevent me from enjoying my pregnancy, but did influence me to take every precaution possible to make it to full term. Yes, I was a little paranoid, but I wouldn't change one choice I made during my pregnancy.

[Tessy]

My thinking was along the line of Kerry's too. What if something did happen and her thought was that, "You knew it could happen and didn't warn me. Why not? I would have done things differently had I only known?"

Maybe your story could make a difference as scary as it may be. Sometimes being scared is good if it makes you act in the best interest of that child.

Just my humble opinion.

And, yes, I'm inclined to think that I would want to know the worst case scenario if it may possibly impact my behaviors/decisions.

[Amy]

I think you handled that perfectly. But I wonder if you would have had the same perspective if it had only been a month since Ben was born as was the case you were originally writing about.

Best of luck to your friend. I'm glad she has someone who has been there for support.

[abogada]

I think what you actually said was perfect, and kind.

[Susan]

I'm impressed that you were able to hold back talking about Ben. I look at it from a different, perhaps selfish perspective, that if I were you I would have told her, if only to remind her that she was being completely insensitive. Yes, I'm sure it just slipped her mind and she is completely wrapped up in her own situation, but sorry, that is not always an excuse.

You deserve a lot of credit for putting her feelings first. I guess if I were her, I would have wanted to hear the worst case scenario. To be trite, knowledge is power. Maybe she couldn't change what would/could/will happen with her baby either way, but she would probably want all the information in front of her so she can make the best decision at the time, and not have any regrets. Tough one and kudos for you for trying to be the best friend possible.

[shaynee]

I think you handled the situation gracefully, although I completely understand the impulse to deliver a reality check. I am not directing this at your friend specifically, but I am amazed at the number of people who think 26 or 28 weeks is, universally, such a safe milestone. When I had a brief, and it turns out meaningless, brush with possible preterm labor at 25 weeks, my husband and I had a serious talk about what we would do if our daughter arrived extremely early. He's a pediatrician and has put in training time in the NICU, and he said he would only begin to consider the full-court NICU press (full ventilation, meds, etc.) at 26 weeks or beyond. For any birth before that time, he would opt for comfort care only (unless the baby proved to be exceptionally advanced for gestational age and a real fighter). And even for a birth between 26 and 28 weeks, he would only go the full NICU route if the baby seemed to have a decent prognosis, given the circumstances. This was our choice and by no means a judgment on anyone else's decision. My husband simply said that he had worked with micropreemies who had not done well, and who had gone through a lot along the way, and he didn't want to do that for his own child.

As it was, our daughter arrived at 36 weeks and still spent 15 days in the NICU because she just wasn't "behaving like a baby of that gestational age." All is fine now, but if she had been a 26 or 28 weeker, she would have been in dire straits indeed.

Anyway, I apologize for the lengthy post. Having spent some time in the NICU with a comparatively healthy baby--and I truly appreciate how lucky we are--I am amazed by the casual faith people place in the early-but-often-Ok gestational age milestones. But as I first said, I believe you handled the situation with grace, particularly given your painful personal experience. I hope that everything turns out well for your friend.

[Orenda]

I think you handled that very well. I think the risk of terrifying people is a little more justified when it would potentially change their actions or when they are truly unaware of the dangers themselves rather than merely preferring not to think about them. If it was a friend I talked to regularly, I'd wait 'till she was closer to the end of her planned bedrest to bring it up again so as to not add stress until it could help. I'd ask if she'd talked to her doctor about going off bedrest and what he said the risks were. I can't imagine any doctor would really give the okay for someone on bedrest to go back to work before full term. If she seemed ill-informed, I would recommend she ask the doc a few more questions and tell her my story. If she knows all the dangers, it's really her choice what she does. I cannot fathom anyone choosing something that would likely put them in the NICU. I'm going on the assumption that right now, she just needs to beleive saftey is seven weeks away instead of a few months and when it gets closer she'll reconsider.

[victoria]

Everyone knows, don't they, that it's better to carry a baby as long as you can (though not way past term)? So, when folks say "just let me get to 26 weeks," maybe they're not saying "it's ok to be delivered at that time," but rather, "26 weeks seems possible, I can shoot for that, I will set my sites on that reachable goal, but 40 weeks? FORTY? Boy, that's too much to hope for, I'm not gonna even think about 40 'cause I know hoping for 40 would just break my heart."

[Rachel]

I know what you mean, sometimes being the odd tragic case makes it hard to hear people generalize things. Everytime you talk about it it makes me so sad to think you lost a child like that. It scars you forever, and yet I'm sure made the birth of your twins so delicious (if I can use that word--the ricotta is getting to me), and unlike a joy the average person could ever experience.
When I think of my tragedy and I hear people make comments like that I often realize they just want someone to tell them it will be okay.
So I say that. Maybe it is wrong, but it is what I wish for them.

[Louise M]

You answered honestly and truthfully, without causing her more grief then she already has. You let her know that yes, 26 weeks was ok, but 30 or 34 were even better. You reassured her, but also told her the truth.

[Lisa]

That makes totaly sense now. I was lost yesterday. I have said that same thing when I was pregnant. I didnt have any problems but I think I only said that because I knew there was a chance the baby was viable if I for some reason had her then. It ave me some sense of relief since I was so scared for months thinking I wouldnt make it to that mark. So for me it was just a goal? A date of hope that maybe I would make it. Of course I made it 39 weeks and everything was perfect. I think maybe she just said that because she is hoping to make it that far just because of the high chance the baby could be viable. I am sure she still wants to get to 30, 32, 34, 40 weeks but is just saying if I can just get to there maybe it will be ok. DO you realy think she will give up on bedrest at that point because the baby is viable so screw everything else? If so then I would totally remind her of Ben and that she needs to make sure that baby cooks for as long as possible cause even if it makes it to 26 weeks she would still have to endure the horror of seeing her kid hooked up to a bunch of tubes and all the possible complications!

[Accidental Poet]

Perfect response, Tertia. She's got all those other scenarios in her head already - bringing them to the forefront doesn't help her rest any.

[Ingrid]

You're right - it wouldn't add value to mention Ben at this point. Right now she's probably freaked out and is thinking what she needs to think to get from day to day.

[Anne]

Perhaps you could have said, I have experience in this matter, but don't want to tell you anything you may not want to hear. Just know that if you do decide you want to know, I am here for you.

[kathleen999]

I think you handled it very well. And I don't think there would have been anything wrong with telling her about the week Ben was born, either. Babies born early are at risk for so much more if they even survive, and that is just a fact that a pregnant woman should keep in mind.

I think, though, that as her friend, you should have a very serious discussion with her if she starts doing ridiculous things at 26 weeks. THEN it would be time to scare her.

[Billie]

I liked Kerry and Shannon's comments. I am sure that in a similar situation, I would have reminded my friend in a gentle and sensitive way about Ben. I wish that someone had given me a story like that to make me think whilst I was pregnant. Who knows what I would have done differently, and if it would have made any difference in the outcome, but at least I would have had the information. It would have been especially useful coming from a friend that I loved and trusted.

[Alex]

I think there is a good probability your friend has set 26 weeks as a "goal" because even that must seem a long, long way away for her and very hard to attain.

I trust that as it nears -- and I do hope it will, with her and baby still OK -- she will set additional goals (30 weeks, 32 weeks, etc.), and if she doesn't, I think you would be doing the right thing to remind her then, perhaps...though I also think that really, it is her doctor's responsibility to convince her she needs to do what is best for her PG and your role as a friend to support and humor her.

Also, I think you responded very graciously considering your own loss. And I am sorry to learn that people often make comments that remind you of losing Ben.

[maia]

Frankly my dear I would have told her more specifically why I thought she should heed the doctors advice. I don't think I could NOT have!

[lisa]

I am grateful I had the opportunity to read Ben's story and Charlie's story before I unexpectedly delivered my son at 32w4d after attempts to stop pre-term labor failed. I believe knowedge is a good thing- much better than denial.

[Sami]

Perfect response... and I don't say perfect very often, but you did the right thing. While not terrifying the gal, you gave her information to hopefully hang on until 30+ weeks or more... now hopefully that number in her head will switch from 26 to 28 or even to 30 as the goal she has in her mind.

[Larissa]

On a slightly different tack, I don't understand how pregnant women can be so uninformed about the risks of significantly pre-term labor. Even if they're not interested in reading every book on pregnancy and childbirth ever written, ten minutes on the internet should give you a pretty good idea that you want that baby inside you as long as possible - that "surviving" and having a quality life are not one and the same. I have worked with many individuals with neurological injuries related directly to premature birth - some are devastated with severe handicaps, but many have more subtle problems with behavior and learning that create problems farther down the line, problems that you'd want to avoid putting your child through if there was anything you could do.

[anon]

I agree that you said the right thing, and that you can re-evaluate as she gets closer to 26 weeks. I have a daughter born at 35 weeks, which is obviously much better than earlier, but she has subtle neurological issues that I believe are related to the prematurity. The separation, NICU stay, IVs and other invasive tests were traumatic for both me and my daughter. I would never wish to have a baby born at any other gestational age then full, despite how much I can't stand pregnancy, especially at the end! Of course, I have never been on bedrest, and I can appreciate how that must drive you insane.

[Jo]

Tertia,

You did the right thing not to scare the women. But as a number of other commentors have said, if this lady really does start to believe that she will be getting up and going back to work at 26 weeks, then I think you do need to remind her of Ben. I think she needs to be reminded that 14 weeks premature is not fine and if she can do something to prevent this so much the better

[Rach]

When people say their baby will be fine once they hit the 13 week mark, I want to tell them about all the stuff that can go wrong - the body parts in the wrong place, anencephaly, spina bifida, stillbirth, etc., etc. It would do no good. And they're obviously not thinking about what I went through.
A friend just the other day said, "Well, after you've seen the heartbeat you won't have a miscarriage." Um....ok...whatever. I told her that's not how it happened with me and she looked like she'd been hit by a truck.

I know exactly what you mean.

I am sorry Ben was in the 10%. And I'm sorry you even had to think about this in your conversation with her.
((((Tertia))))

[lulu]

I think you responded perfectly. She wasn't saying that she planned to go skiing or schedule an elective c-section once she reached 26 weeks, and bedrest is not shown to stop preterm labor, and she wasn't asking for medical advice form you, either. YOu answered her as a friend and didn't try to scare her into worrying about something that really, she has no control over, as long as she is listening to her doctor's orders and continues to do so. I think your answer was perfect.

[Anon for this one]

You did great, Tertia -- like a previous commenter said, you told the truth, but gently. And what Lulu said is right on.

Funny, I'm currently experiencing a situation that has parallels. I'm recently diagnosed with some blood clotting mutations that are implicated in a variety of pregnancy complications, including miscarriage, pre-e etc, after a late first-tri loss. My first cousin, on the side of the family where I'm pretty sure this stuff comes from, has been trying to conceive. I e-mailed her info on it, and like you I sort of rolled the ball down the middle -- I told her the truth about it, why I thought it could affect her, and that it was treatable, and easy to test for. What I left out is the details on how bad the complications could be and what the treatment is (daily injections of blood thinners), because I didn't want to freak her out. She didn't respond, but then e-mailed me a few weeks later to tell me she was 14 weeks pregnant and did not mention what I'd told her. So I e-mailed her again with congrats, re-explained what was up, reiterated my concern for her and said some potential complications could affect the fetus later in the pregnancy, lest she get the idea it wasn't something that could cause an issue now.

She hasn't e-mailed me back. At this point, I feel she's sticking her fingers in her ears and going LA LA LA LA. I didn't want to scare her, as having those mutations doesn't necessarily mean that everything will go badly. But still. It sucks to have to deliver potentially bad news, and I didn't enjoy feeling as though I had to do it twice. And, because she still hasn't responded, it still kind of feels as though the onus is on me to make sure she has received this info. Then again, I've told her twice. What the hell else can I do?

[snickety]

Delurking to say--you handled it very well in my opinion.
Both my (living) children were born at 36 weeks. Yes, they're alive. But no, they're not OK. For each of them, I was taken off meds and bedrest at 36 weeks by my high-risk OB because statistically they *should* have been ready for the outside world. If I had it to do over, I would do everything I could to keep them inside for just a few more days, weeks if possible.
Thanks for a wonderful blog, Tertia. You bring a bright spot to every day!

[Karen]

I was in almost the exact situation as your friend - put on bed rest at 19 weeks after an episode of bleeding, which turned out to be due to placenta previa. I asked my doctor what constituted viability and she told me 26 weeks, though obviously it would be much better to make it much further. At the time 7 weeks seemed impossibly far away, and I lived in fear that I wouldn't make it that far. I clung to 26 weeks as a goal that gave me the possibility of a happy outcome, though I was very aware that it was only a good scenario in comparison to where I was now. I never stopped being careful, and am very grateful to be at almost 31 weeks now. I hope to go much, much further. I would bet your friend knows the risks but is focusing on 26 weeks as a manageable goal. I think you responded to her very well, and are a very good friend.