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How Much Do We Know About Premature Births?

How Much Do We Know About Premature Births?

In Ireland, about 4,500 babies a year are born prematurely (that's one every 116 minutes!) And across the Globe, there are over 15 million premature babies born every year. However, there is still comparatively little known about how to safely prevent pre-term labour; and about the developmental problems often associated with premature birth.

A baby is considered to be premature, or ‘pre-term’, if born before 37 weeks. Premature birth is the leading cause of death among newborns and the second biggest cause of death in children under the age of five; though every week of pregnancy increases survival rates:

  • Prior to 28 weeks – extremely premature
  • From 28 to 32 weeks – very premature
  • From 32 to 37 weeks – moderately premature.

According to statistics, babies born at 25 weeks have a 69% chance of survival (70% of them have no disability at age 3), babies born at 26 weeks have a 78% chance of survival (80% of them have no disability at age 3), and babies born at 27 weeks have a 90% chance of survival. After 28 weeks, this moves up to 90-95%; and by 34 weeks, most babies have the same chances of survival as a baby born full-term.

So what are the most common reasons for a premature birth?

  • Multiple Births
  • Obesity
  • Fertility Treatments
  • Infection
  • Pre-eclampsia
  • Gestational Diabetes
  • PPROM (when the Amniotic Sac breaks)
  • Problems with the Cervix, Uterus, or Placenta
  • Problems with baby’s development
  • One or more previous miscarriages or preterm births
  • Previous delivery of 4 or more children
  • High levels of Stress
  • Age: Women below 18 or over 34 years have increased risk
  • Lifestyle: Smoking and Drinking increase chances of premature birth.

Assessing Your Risk of a Premature Birth

Your antenatal checks will keep medical staff informed about the health of your growing infant, and can help determine the risk of a premature birth. If you're at risk; you may be offered additional tests that will help identify potential problems, so a care plan can be put in place for the remainder of your pregnancy.

As part of this, ultrasound scans could reveal factors that have been linked to premature delivery, including:

  • The length of your cervix
  • The size of your womb
  • The size & position of baby
  • Whether you're carrying more than one baby
  • Problems with baby’s development
  • The size and position of the placenta
  • The amount of amniotic fluid.

How to Know If You're in Labour

Any mother experiencing symptoms of labour before 37 weeks should contact a medical professional for advice as soon as possible. However, this doesn't necessarily mean that there's a problem, as symptoms could just be 'Braxton Hicks' contractions. A midwife or doctor should quickly be able to tell whether you're experiencing Braxton Hicks, or preterm labour.

Look out for the following signs:

  • A pink or clear vaginal discharge
  • Cramps similar to those experienced during the period
  • Moderate to severe backache
  • Increased need to urinate
  • Increasing pressure in the pelvis
  • Diarrhoea, nausea, and vomiting.

What to Do If Labour Starts

If you think pre-term labour may be starting; you should immediately contact your doctor/midwife. They will probably ask about contractions, broken waters, and showing. Any there's any likelihood that preterm labour has begun, they will advise you to go in to hospital.

In hospital, staff may check heart rate, blood, and urine; to check for infections, and decipher whether baby needs to be delivered immediately or not. This will depend on the condition of you and your baby, and on how quickly labour symptoms are progressing (if at all.) Doctors may recommend certain medications be given to stop contractions, and steroids might be recommended if they're worried about complications from extremely premature birth. Of course, all this is decided on a case-by-case basis.

Medical Care for Baby

When premature birth is necessary, the team will spring into action. Whether it is a vaginal birth or emergency C section, baby will immediately be examined by specialists; and most premature babies need at least some specialised care in the hours and days following premature birth.

If babies are born extremely prematurely, they'll stay in an incubator in intensive care, and will need intravenous feeding; so even holding them may be impossible for some time. Of course, the closer baby is to their official due date, the less medical intervention will be necessary; but with so many unknown factors, it's best to be prepared for the worst. In some cases, little ones are just too delicate to survive, even though survival rates are better than ever.

How Can I Bond With My Baby While They’re In An Incubator?

With particularly early or unwell babies, you may not even be able to touch them when they are in the incubator, as their skin is so delicate. It's important to take things one day at a time, but there are ways you can start to bond with your baby:

Use your voice: Babies can recognise your voice from inside the womb, so this familiar sound will help them make sense of the new world around them.

Stroking: Though it can be hard for parents to communicate through the incubator; delicately stroking baby can be very reassuring for them.

Cleaning: Once neonatal staff feel that your baby is well enough, you can help with baby's routine. Just the simple process of changing nappies, and washing them can provide invaluable bonding time for you both.

Holding: Even before you can pick your baby up, they may find it comforting to hold onto your finger. Later on, 'Kangaroo Care' (skin to skin time holding baby to your chest) can help them regulate temperature, and heart rate.

Making eye contact: Once they're ready to open their eyes, eye contact can be crucial for bonding. Look into baby’s eyes, and play with different sounds and facial expressions. Gradually they'll learn to respond themselves.

What’s Next?

Parents of preemies have to experience things that other parents take for granted. Even the basics are simply more difficult:

  • Feeding
  • Finding clothing
  • Administering medicines
  • Close observation of development and growth
  • More frequent doctor visits

There is also an increased potential for permanent health problems; which are more likely to be severe, the earlier baby was born. Most of these issues are directly related to baby's body not having had time to fully develop before birth; or because of oxygen deprivation during labour and delivery.

Potential problems include lung problems, cardiovascular disease, cerebral palsy, renal disease, vision and hearing problems, cognitive disabilities, and an inability to thrive.

But remember ...

Though the health risks are much greater for premature babies; many go on to live completely normal lives. It can be a life changing experience, but help is there if you need it ... make sure that you reach out and ask the questions you need to ask, and get the support you need for you and your baby. Whatever the outcome, you can get through it.

Even once you are home, parents tend to have a much easier time when family members pitch in to help; so don't feel guilty about encouraging your closest friends and family to be involved. Whether it is with professionals, or with your nearest and dearest, getting the back-up you need can make all the difference.

To learn more about becoming the mother of a premature baby, read out interview with real mom Yvonne in our article Mom of Preemies Shares Her Amazing Insights. For more information and advice, go to IrishPrematureBabies.com

This article is part of our series looking at the many different challenges parents face. For more, go to our Child Health section.


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