Wednesday, November 18, 2009

Prematurity Awareness

November is National Prematurity Awareness Month

(Itty Bitty Baby Becca - her first photo, taken by her dad, John Hill. Used with permission - click on the photo to read about the story of this miracle baby, born 3 months early, weighing only 13 ounces, 9.5 inches long)

Preterm birth is defined as any baby born before 37 weeks of completed gestation. The U.S. scores a "D" on the Premature Birth Report Card. In 2007 the rate was 12.7%. Healthy People 2010 has a goal of 7.6% or less. It's not looking good for meeting that goal by next year.

Utah gets a "C" with a 10.9% prematurity rate. This means that over one in 10 babies born here are premature.
“Although we don’t yet understand all the factors that contribute to premature birth, we do know some interventions that can help prevent it, and we must consistently make use of all of these,” said Dr. Jennifer L. Howse, President of the March of Dimes. She cited smoking cessation programs; health care before and during pregnancy; progesterone supplementation; and improved adherence to professional guidelines on fertility treatment and early Cesarean-sections and inductions.

According to the March of Dimes, quality improvement programs also are key to lowering preterm birth rates. For example, the Intermountain Healthcare in Utah reduced its elective inductions before 39 weeks to about 2 percent from about 30 percent. (March of Dimes)

So, if your doctor says "no" to your induction or planned C-section before 39 weeks' completed gestation, there's a good reason. This guideline is helping reduce NICU admissions due to prematurity. In some cases the health of the mother or baby demands early delivery but many cases are preventable. This is because even our best dating systems with ultrasound and menstrual period dates are still sometimes inaccurate and the pregnancy is not as advanced as was believed. These are sometimes called "late preterm," but these babies often still struggle because they're not done yet. Almost everyone knows a success story of a preemie, but the success comes with great cost - emotionally as well as physically and financially. Anytime we can prevent such a crisis is a true victory. Be patient while you wait for your baby to be ready for life outside the womb.

Of course there are other factors that can help prevent preterm birth in some cases. We know that excessive maternal weight can contribute because of the risk of high blood pressure and glucose regulation problems. We know that inadequate prenatal care contributes because early problems are not detected and there is a greater chance of inaccurate dating of the pregnancy. Infections can contribute to preterm birth. Be sure you take care of your teeth, avoid high risk foods such as unpasteurized dairy products, raw meats, apple cider, etc. We know that smoking is harmful to the baby and contributes to low birth weight. We know that drug and alcohol use contributes, so avoid or break these habits. If you need help, don't hesitate to talk to your doctor. Our common goal is a healthy baby; not punishment for previous choices.

Signs of preterm labor - Call your healthcare provider or go to the hospital right away if you have....
  • Contractions that make your abdomen tighten like a fist every 10 minutes or more often
  • Change in the color of your vaginal discharge, or bleeding from your vagina
  • The feeling that your baby is pushing down (pelvic pressure)
  • Low, dull bachache
  • Cramps that feel like your period
  • Belly cramps with or without diarrhea
Some things that might help - while you wait for a call back or that your provider may suggest...
  • Stop what you are doing and rest on your left side
  • Drink two or three glasses of water or juice (not coffee or soda)
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