Babies born too early are babies born sick. They are at risk for everything from developmental delays to blindness to lifelong respiratory problems. A premature baby is not simply a tiny baby - a premature baby is a very sick baby, and the earlier they are born, the sicker they are. However, World Prematurity Day poses something of a problem for me. It's one thing to raise awareness for breast or testicular cancer (those can be detected through regular self-exams). It's another thing to raise awareness for a condition that frequently arises spontaneously and for no apparent reason.
So I'd like to focus on the things you can do to help prevent pre-term births. This is important information for any woman who is or may become pregnant, and also important for her partner to know. It's easy to tell yourself you're over-reacting when you're all hormonal, but sometimes a partner's urging to "let's just call the doctor to be safe" can save a pregnancy.
- Carrying multiples
- Conceiving through IVF
- Mother's age - teens and women over 35 are more likely to have pre-term labor
- Smoking, drinking, or drug use during pregnancy
- Poor nutrition
- HELLP syndrome
- Problems with the uterus (PPROM or rupture), cervix ("incompetent" cervix, a judgemental phrase if ever there was one) or placenta (placenta previa or abruption)
- Unknown origin of pre-term labor
Some of these things are preventable, with the exception of the last four items. These are the scary sections at the back of the baby books that you might not get to or might want to avoid. Don't bury your head in the sand - take the time to ask your doctor or read up on the symptoms. One of the other mothers I met in the NICU was in labor for most of a day, but didn't recognize it - pre-term labor is NOT like term labor. She felt nauseous and generally unwell, and had some back pain. That's a far cry from having your water break and screaming through contractions - but she was so far along that her baby was born less than 45 minutes after they arrived at the hospital. If she had known the symptoms and gone earlier, it's entirely possible that the doctors could have stopped her labor.
In my case, I had a placental abruption, where the placenta detaches from the wall of the uterus, depriving the fetus of oxygen and nutrients. I had a sudden, intense pain and immediate bleeding. We were at the hospital within half an hour and the staff was able to stop me from going into labor, buying my daughter a precious week of gestation (in our case, the abruption was not complete, so with hospital bedrest and a lot of drugs, she was safe inside for a while. When the rest of the placenta detached, she went into distress and we had an immediate emergency c-section.). I firmly believe that if she had been born the day of the abruption, she would not have survived.
Unfortunately, it's also possible that we could have bought her even more time. I had been having contractions for two weeks but I didn't know that's what they were until I was on a contraction monitor in the hospital. Contractions are really hard to describe if you've never felt them, and I tried to ask the nurse practitioner about a feeling I had been having, as if the baby was spinning inside of me and therefore rolling across my entire abdomen, at one of my pre-natal appointments, but her response was "oh, you'll KNOW if you're having one". While I try not to dwell on "might have been", I cannot help but wonder what would have happened if we knew there was something wrong weeks before the abruption. I will always wish I had described what I was feeling instead of asking what a contraction felt like.
I don't want to scare pregnant women. Most pregnancies are fine, and most babies are delivered at term (or later!) without complications. But these things have to happen to SOMEONE, so it makes sense to talk to your doctor about your risk factors and learn the symptoms of pre-term labor or an emergent complication backwards and forwards. Below are some infographics about prematurity, if you're so inclined to learn more.
And a quick update on our own little miracle - she is doing very well health-wise. Her lungs are clear and she survived her first ear infection/fever/cold with only one quick trip to the emergency room (ha!). She still does not eat by mouth, and is eight months delayed in gross motor skills - she sits up but doesn't scoot, creep, or crawl. She is ridiculously adorable and cheerful and smart - the reason she is so far behind in moving is that she knows she might fall and has decided that there is nothing on earth she wants bad enough to risk a bump to the head. She's got eight sharp little teeth and a headful of soft hair, and she sleeps through the night all night long. Despite her feeding tube and developmental delays, we are insanely lucky with how well she's doing - a quick look at statistics below will show you just how lucky we are.