If you've been told you may have a premature birth, it can be hard to know how to react. How is a preterm birth different from a full-term birth, anyway? Experts Dr. Craig Rubens and Kelli Kelley weigh in.
You know your pregnancy is supposed to last nine months, but you're a few months shy of your due date and have been recently told that you're at risk for delivering prematurely. What does this mean? What is the difference between full-term and premature birth?
A preterm birth is one that occurs before 37 weeks of gestation, more than three weeks before the baby's normal gestation period of 40 weeks. Often used interchangeably with the term "premature," there are different levels of premature births -- according to the World Health Organization, a baby born before 28 weeks is considered "extremely preterm," one born after 28 weeks but before 32 weeks is "very preterm" and a baby born after 32 weeks but before 37 weeks is "late preterm."
Premature births are much more common than you'd think. "Worldwide, 15 million babies are born preterm every year, including about 1 in every 9 babies in the United States," says Dr. Craig Rubens, the executive director of the Global Alliance to Prevent Prematurity and Stillbirth. This large number includes some non-spontaneous births, such as those induced due to maternal pre-eclampsia or hemorrhage, but about two-thirds are spontaneous, with the mother going into labor without medical intervention.
Possible causes of a premature birth include infection, premature rupture of membranes, stress, chromosomal abnormalities or multiple gestations. Factors such as obesity, very low or high maternal age, lack of prenatal care, poor weight gain during pregnancy, family history of preterm birth and substance abuse can also increase the risk. The exact connection between these factors and preterm birth are currently being researched, but sometimes there is no obvious reason for why a woman goes into labor early.
So how can you lower your risk? "Some of these things can be modified, such as stopping smoking, but others, such as a family history of preterm birth, cannot be changed," says Dr. Rubens. A woman who had a previous preterm birth may be prescribed the hormone progesterone to reduce the risk, but in many cases this is not an option.
Kelli Kelley, a mother of two children born preterm and the founder of the support organization Hand to Hold, believes the most important tools mothers can use to prevent a premature birth are their own gut feelings. "I am a real advocate for knowing the signs of preterm labor and insisting upon being seen if you see some," says Kelley. "It is really important to be your own advocate. If your doctor is not addressing your concerns, consider seeing another doctor who will."
Concerns of Preterm Births
Babies who are born preterm are at risk for complications, but that does not mean that all premature babies will have serious or long-term health risks. Those who are born closer to the 37-week cutoff are less likely to develop complications than earlier preemies. Doctors are most concerned about the lung development and immune systems of premature babies, which can put them at risk of breathing problems or severe infections.
Other possible complications include brain hemorrhage, intestinal issues, cardiovascular disease, cerebral palsy, renal disease, cognitive disabilities and other health issues. Dr. Rubens emphasizes, however, that most neonatal intensive care units (NICUs) are equipped to treat and care for preterm babies and give them the best chance possible to thrive.
The Birth Process
It is important for parents who are likely to have a preterm infant to be aware of how the birth process may differ from a full-term birth. Kelley emphasizes that preterm labor can go very quickly, so getting to a medical facility as soon as you see possible signs of labor is essential. Timing is critical when it comes to having your baby receive steroid shots and surfactant to help your baby's lungs expand and develop, and in some situations, the doctors may be able to slow down your labor medically.
During labor, you will be surrounded by a full medical team equipped to address your early baby's needs. At birth, you may not hear your baby cry immediately. And after your child is born, there's a good chance that she'll be taken immediately to the NICU. "For moms, it can be really hard that we don't get to hold our baby, nurse or bond right away," says Kelley.
But going into the birth knowing that this is likely can help dampen any disappointment. Make sure that you have someone to stay with your baby when you'll be separated, someone to make any medical decisions for your infant and ensure she receives optimal care.
Keren Perles is a freelance writer who specializes in writing about parenting babies and older children. She has three young sons.