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Premature Birth, Something to Think About

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Expectant mothers have a range of emotions during the nine months they are pregnant. While many of these emotions are comprised of joy and gratitude, there is always a small place reserved for doubt and fear.  “Will my baby be OK?”, “Will I be O.K?” “What will the labor and birth look like?”  Most of the answers will only be revealed in time.  However, educating yourself on the process and expectations may help alleviate some fears.

November 17th is designated as “World Prematurity Day”. 

Social media was transformed with purple profile pictures and local communities held walks.  All of this is a part of an awareness campaign put in place by The March of Dimes and people who have a passion for speaking about the issues surrounding premature birth (birth that occurs before the 37th week of gestation).  In 2016, for the first time in eight years, our premature birth rate has increased and it is listed as the leading cause of death in children under the age of five.

1. Consider it a Possibility

While the percentage of premature births is really low, 9.6 %, it is still a factor for expectant mothers to consider in their prenatal care plan. .  The rate of premature birth is lowest among Asian and Caucasian women. Rates are slightly higher for Hispanic or Native Alaskan/American Indian and followed by 48% higher for black women. (http://www.marchofdimes.org/materials/premature-birth-report-card-united-states.pdf)

I interviewed three mothers who had experienced a premature birth. One resounding similarity was that none of the three had ever considered the possibility of giving birth prematurely, even after they became aware that there were difficulties with their pregnancies.

Leah Roberts was expecting twins.  She was aware her babies would most likely be coming earlier than the average 40 weeks. Her goal was to make it to 37, or possibly even 38 weeks. At 34 weeks she was told that her babies would be delivered immediately due to her having HELP syndrome which manifested with an increase in blood pressure and a crashing of her platelets. Leah says that she wasn’t ready at all. The idea that her babies could come this early had never crossed her mind. She may have had a bag packed, but it wasn’t in the car, and her husband was attending military training five hours away.

While no mother wants to prepare for a premature birth, small preparations can go a long way in making this period more comfortable and easier to adjust emotionally.

  • Consider keeping a small bag in your vehicle packed with hygiene, loose clothing and comfort items for yourself.
  • Develop a support team that can be in place to help if you do experience a preterm labor.
  • Keep their numbers in your phone and on a separate list that other people can use to contact your team.
  • Consider people who can care for your other children, prepare meals, take care of other obligations you have and those that can come and spend time with you once you are hospitalized.
  • Think about hiring a doula midway through your pregnancy. A doula will be able to assist and comfort you during this period. Doulas are also able to stay with you while your partner goes with your baby to the NICU or vice versa, whatever you prefer. The benefit of having someone to ask questions regarding care for yourself and your baby will ensure that you are informed and able to make confident decisions. This is a valuable tool to have in an emotional situation such as pre-term labor. Doulas can provide this service.

 

2. Listen to your body   

Pregnancy is an especially important time to pay close attention to the signals that your body provides. .

  • If you are tired, rather than push through, you should find a way to rest.
  • If you are hungry, pay attention to what foods your body is telling you that you need.
  • If you are thirsty, reach for water and avoid dehydration.
  • If you are experiencing symptoms that are uncomfortable or troubling, pay attention to them and make a point of communicating to your care provider.

This highlights another similarity among the mothers that I interviewed.  They had all begun to notice things that were different and concerning. These symptoms included, swelling, rapid and excessive weight gain, and other signs indicating high blood pressure or Preeclampsia. While multiple pregnancies is an identified cause of premature birth, so are infections and chronic conditions such as diabetes and high blood pressure. (http://www.who.int/mediacentre/factsheets/fs363/en/)

While speaking with a high school friend, Jennifer Fitzgerald, she mentioned that at around 26 weeks she was beginning to notice that she was retaining water and that she was experiencing a lot of swelling.  For her, these symptoms were the start of the realization that she was experiencing preeclampsia.

Along with paying attention to your body, the Mayo clinic lists some actions you can take that may help prevent a premature birth.

  • Eat a healthy diet even before you get pregnant.

While this may not be a guarantee that your pregnancy will be full term, a healthy diet can reduce your risk of a premature birth. Ensure that your diet contains many servings of protein –rich foods, fruits and whole grains. Diets high in fat, sugar and processed foods have been linked to a higher risk of premature birth.

  • Calcium supplements

You can lower your risk of preeclampsia, a serious complication that often leads to premature birth, by taking 1,000 milligrams (mg) or more of calcium daily, especially if your diet is normally low in calcium.

  • Take a daily low dose aspirin

For women with a history of preterm birth or preeclampsia, as well as those women with chronic high blood pressure, taking a daily low dose aspirin (60 to 80 mg) beginning late in the first trimester may help reduce the risk of premature birth

  • Reduce chemical exposure.

While it is not known if reducing your exposure to products containing phthalates (plastics, canned foods, cosmetics, nail polish and hair spray) will reduce your risk of a premature birth, it has been shown that exposure to these chemicals is associated with a higher risk of preterm birth, making it a good idea to avoid exposure whenever you can.

http://www.mayoclinic.org/diseases-conditions/premature-birth/basics/prevention/con-20020050

3. Obtain care and don’t miss appointments

A large part in maintaining your health and the health of your baby is finding a provider you trust and attending all of your prenatal appointments.  Late or no prenatal care is a factor in premature birth. (http://www.cdc.gov/reproductivehealth/maternalinfanthealth/pdf/pretermbirth-infographic.pdf).

Both Leah and Jennifer had their babies via C-section after attending a routine appointment.  These appointments are necessary to ensure that you are continuing to maintain good health and that your child is growing and tolerating the pregnancy well.  For both of these ladies, this appointment picked up on high blood pressure which required further monitoring, a non-stress test and eventually the birth of their children.

These appointments also serve as a good time to discuss any symptoms you have been noticing with your provider.  During Leah’s appointment they asked if she had experienced upper quadrant pain. While she had indeed been feeling that pain, she had convinced herself it was one of the twins making her uncomfortable and that it wasn’t a big enough issue to consider discussing with her provider for fear that they would think she was bringing up frivolous complaints.  The provider you have chosen is your trusted companion during this experience.  It is important that you feel so comfortable with them that you can discuss any concerns or issues you may have.

 

4.  Acknowledge that most likely, everything will be OK, even if you do have a premature birth

Thanks to current medical technology and knowledge, the good news is that even if your pregnancy does end in a premature birth, both you and your child are most likely to be healthy.

The majority of premature births are considered late term and are born between 34 and 36 weeks. Moderately preterm babies include those born between 32 and 34 weeks of age.  Infants born during these weeks are most likely to fare well after extended stays in a NICU dept.

Because premature birth gives the baby less time to develop in the womb some may need even more extended care.

Some of the short term health issues that can emerge in preterm babies include: breathing problems, heart problems, brain problems, temperature control problems, gastrointestinal problems, blood problems, infant jaundice, metabolism issues, and immune system problems.

Long term, premature birth could lead to Cerebral palsy, impaired cognitive skills, vision issues, hearing problems, dental issues and behavioral and psychological problems.  Generally speaking, the earlier a baby is born, the higher the risk is of complications.

Leah’s twins were born at 34 weeks. Their most apparent issue was that the sucking reflex had not yet developed.  Breydon was in the NICU for 9 days, while his sister Jessa stayed for 21 days. Both children are happy and energetic 11 year olds.

Jennifer’s daughter, Reina was born at 29 ½ weeks. Her stay in the NICU was 6 weeks long while they observed her and worked on temperature control, infant jaundice and waited for the sucking reflex to emerge. Today she is an energetic and delightful 10 year old.

Heather Bury is another friend that I interviewed. I was eager to hear her story. Her second pregnancy, she began experiencing pre-term labor at around 16 weeks and was shortly after diagnosed with preeclampsia. Her daughter was born at 28 weeks 2 days and before her birth doctors told Heather that her child had a 5% chance of survival. Angelica did spend 10 weeks in the NICU and 3 weeks on the pediatric floor. She had Group B Strep, Necrotizing Enterocolitis (NEC) (an infection which enflames part of the baby’s intestines), breathing issues, intestinal issues, and eye problems.  At one point Angelica crashed and they were able to revive her. Listening to Heather speak about this period of her life, I hear the pain, confusion and frustration, Yet I also hear the love, pride and joy with which she speaks of her happy, healthy and extremely lucky 15 year old.

5. Reach out

Life as a NICU parent can be tough, really tough….It is such an intense, emotional and demanding time.  The NICU is indeed an entirely different world as you adjust to not being with your baby 24/7, not being the one to care for them full time, to the whole new vocabulary of NICU that you never knew existed.

While premature birth is not a well talked about subject, one thing all three of the ladies I spoke with agreed on was that you need to talk about it.  Find a support system, a support group (online or in person), look for resources and don’t try to go it alone.

For more information and resources about prenatal birth visit my Pinterest page.

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