Something going wrong during a pregnancy is every woman’s greatest fear. Even though we all hope that nothing bad happens to us, being informed about the potential problems is the best way to be prepared in case anything does go amiss. As preterm birth is one of the most common issues affecting childbirth, here is everything you need to know on how to handle the situation.
What are preterm labor and preterm birth?
If you start having regular contractions that cause your cervix to open before you reach thirty seven weeks of pregnancy that is preterm or premature labor. If you do deliver the baby before thirty seven weeks, it’s called a preterm birth –and your baby is considered premature. Going into preterm labor does not necessarily mean you’ll have a premature baby. In fact, up to half of the women who experience preterm labor eventually deliver at thirty seven weeks or later.
Why does premature birth happen?
About a quarter of preterm births are planned. If you, or your baby, have certain complications, your medical team might decide to deliver you before thirty seven weeks. This might happen if you have a serious medical condition, or if your baby has stopped growing. The rest are known as spontaneous preterm births.
There are several reasons why you might have a spontaneous preterm birth:
- If you go into labor prematurely.
- If your water breaks early.
- If your cervix opens prematurely with no contractions.
- If in a previous pregnancy your baby was premature. However, the risk is only slightly higher, and many moms go on to have a baby at term.
- If you lack support during your pregnancy. Especially if you bend over for more than an hour a day.
- If you smoke, take drugs or are above or below a healthy weight.
- If you have a bacterial infection in your vagina.
- If you have experienced heavy bleeding during pregnancy, or have an abnormality of the womb or cervical weakness.
What could happen if my baby is premature?
For the baby, preterm birth can cause serious health problems –or even be fatal. In general, the more mature a baby is at birth, the better their chances of surviving, and being healthy. If you go into labor before thirty four weeks, and there’s no medical reason for an immediate delivery, your medical team may be able to delay your labor for a few days. This means your baby can be given medical support to boost their chance of survival.
Preterm babies are generally at a greater risk of brain hemorrhage, and can have problems with breathing, their nervous system, and their gastrointestinal tract. They are also more prone to infection and jaundice and might have difficulty feeding and maintaining their body temperature.
They can also sometimes suffer long-term health consequences, including chronic lung disease, vision and hearing impairment, cerebral palsy, and developmental problems.
However, there have been many technological advances to help to treat preterm infants. To take advantage of these, a preterm infant is best cared for at a hospital with a Neonatal Intensive Care Unit (NICU).
Signs and symptoms of premature labor
Premature labor is usually not painful, but there are several warning signs and symptoms to look out for:
- Contractions in your uterus every ten minutes or fewer.
- Tightening, or dull aching, in your lower back that may be constant or comes and goes, but changing positions and other comfort measures don’t ease it.
- Menstrual-like cramps, or lower abdominal cramping, that may feel like gas pains, with or without diarrhea.
- Increased pressure in your pelvis or vagina.
- Increased vaginal discharge.
- Leaking of fluid from the vagina.
- Vaginal bleeding.
- Flu-like symptoms such as nausea, vomiting, or diarrhea.
- Less movement or kicking by your baby.
Call your doctor right away if you have:
- Vaginal bleeding.
- Sudden increase of vaginal discharge.
- Contractions every ten minutes, or more often, that do not go away within an hour after changing your position, relaxing, or drinking two-to-three glasses of water.
- If the warning signs listed above worsen, or if pain is severe and persistent.
After discussing your signs of premature labor, your doctor may tell you to go to the hospital. Once you arrive, a doctor or nurse will:
- Put a monitor on your abdomen to check your baby’s heart rate, and your uterine contractions.
- Check your cervix to see if it is opening.
What will happen when my baby is born?
If your baby is born:
Early from thirty four-to-thirty six weeks they may not need any treatment. They may look small, but still be able to go straight to the postnatal ward with you. Or they may be admitted with you to a transitional care ward. It will depend on how they are feeding, and whether they have problems with blood sugar levels, blood pressure or infection.
Moderately early thirty two-to-thirty four babies may need specialized care, as they may have problems with feeding or breathing. Your baby may be able to stay with you in a transitional care ward, or be taken straight to a local neonatal unit (LNU), or special care baby unit (SCBU).
Very early babies, born between twenty eight-to-thirty one weeks, are likely to be cared for in a SCBU or LNU. They will be stronger than younger babies but still at risk of hypothermia, low blood sugar and infection. They may need more specialized care at a neonatal intensive care unit (NICU).
Extremely early, less than twenty seven weeks, babies will need to be cared for in a NICU, which may mean that they’ll be moved to another hospital. They are at high risk of hypothermia, low blood sugar, low blood pressure and infection, and will need help with their breathing.
If your baby needs immediate care, you may only have a brief glimpse of them before they’re whisked away. This can be frightening, and you will need lots of emotional support. However, once your baby is stable, you will be able to see them as often as you like. And depending on the situation, there may be many things you can still do for them, such as change their nappy, stroke them, talk to them, and perhaps even hold and feed them.
Whatever the situation, remember that your baby needs the special comfort that you and their father can give them, just as much as they need medical help.
Dr. Gasser El Bishry MBBCh, MSc, MRCOG
Clinics: 19 El-Shahied Mohamed El-Shibany St, Beside Grand Royal Cafe, El-Nozha St, Heliopolis.
1 Sabri Abu Allam St, Bab el Louq, Down Town – Tel: 23920251