Preventing Premature Births
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Pregnancy Terms
• A full-term pregnancy lasts about 40 weeks.
• Premature birth is a birth that occurs at least three weeks before a baby’s due date.
• Preterm birth is 37 weeks of pregnancy.
• Late pre-term is 34-36 weeks.
• Low birth weight means a baby weighs less than five-and-a-half pounds.
• Very low birth weight means a baby weighs three-and-a-third pounds.
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Preterm Labor: Signs, Symptoms and Steps to Take
Preterm labor is any labor that occurs before a woman has completed 37 weeks of pregnancy. Signs and symptoms include:
• Contractions that make your belly feel tight like a fist
• Contractions that occur every 10 minutes or less or more than four times an hour
• A change in the color of vaginal discharge
• Vaginal bleeding
• Pelvic pressure, which feels as if the baby is pushing down
• A low, dull backache that is different from your normal “expectant mommy” backache
• Cramps that feel like a monthly period
• Belly cramps with or without diarrhea
Expectant women who experience pre-term labor symptoms should:
• Stop whatever you’re doing immediately!
• Call your healthcare provider
• Rest on your left side for an hour
• Drink two or three classes of water or juice during this time – but don’t drink coffee or tea
• If symptoms become worse or don’t go away, call your provider again and go to the hospital
• If symptoms stop, take it easy for the rest of the day
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Prenatal Care Goes Long Way in Preventing Premature Births
By Cheryl Stallings, RN
The United States has a higher infant death rate than 27 other countries including Cuba, South Korea, Liechtenstein, and the Czech Republic, according to the U.S. Centers for Disease Control. Since 1960, this nation has seen a steady increase in the number of babies who die before their first birthday.
In Tennessee, about 1,500 babies are born each week. Of those, 230 are born early and about 150 have a low birth weight. Premature birth rates in this state are highest among women ages 40 and older, followed by girls under age 20, according to the March of Dimes. When ethnic backgrounds are considered, the rates are highest among African-Americans, followed by Native Americans, Caucasians, Hispanics, and Asians.
A Growing Crisis
Many experts agree that premature births are a growing national crisis and babies who are born too soon have a significantly higher risk for birth defects than other babies. With each additional week of prematurity, a newborn is at additional risk of having physical and mental problems. Even babies who are born only a few weeks early tend to have more health problems and longer hospital stays than full-term babies.
The most common complications are:
- Anemia
- Chronic lung disease
- Low blood pressure
- Low blood sugar
- Congenital heart defects
- Bleeding in the brain
- Vision problems
- Inguinal hernia
Premature birth also is the leading cause of death among newborn babies. Fortunately, good prenatal health care can make the difference for many, but not all, women and their babies.
Role of Prenatal Care
Prenatal care should begin in the first three months of pregnancy – and the sooner it begins, the better. The major reason is that doctors can often identify and treat health problems early. In some cases, they can alleviate a problem that increases the risk for premature births, and in others, they can prevent it from happening.
Another advantage of prenatal care is that doctors can work with patients to help them make lifestyle changes such as smoking cessation, ending substance abuse, and improving eating habits, if necessary. Later in pregnancy, they may administer medications to delay or stop a patient’s premature labor.
Health problems that put women at increased risk for premature labor include diabetes, heart disease, high blood pressure, kidney disease and blood clotting disorders; certain infections; multiple babies; and preeclampsia, in which the expectant woman develops high blood pressure and protein in her urine after the 20th week of pregnancy. Family history and environmental factors may interact to put some women at greater risk for premature delivery, but more research is needed to understand these interactions.
What to Expect
During the first prenatal visit, a pregnant woman should expect the doctor or nurse to ask about her medical history and family’s medical history; do a complete physical including a pelvic examination and Pap test, blood and urine tests; record her height, weight and blood pressure; determine the due date; and answer questions.
Later visits will typically include checking the baby’s heart rate and the expectant mother’s blood pressure, urine and weight. Ultrasound exams and laboratory tests also may be ordered.
Health Tips for Pregnant Women
There are a number of things pregnant women can do, in addition to getting prenatal care, to protect their health and the health of their unborn babies.
- Take a multivitamin or a prenatal vitamin prescribed by the doctor
- Try to be active for 30 minutes most days of the week unless the doctor limits activity
- Stop smoking
- Eat a diet rich in fruits, vegetables, grains and calcium
- Do not eat uncooked or undercooked meat
- Avoid or reduce caffeine
- Do not take any medicine, including over-the-counter medications and herbs, before asking the doctor
- Avoid saunas and hot tubs
- Avoid having x-rays made
- Avoid chemicals such as paint thinners and insecticides
- Become more informed about pregnancy by reading books, watching videos, or attending childbirth education classes.
Methodist Medical Center offers maternity visits for expectant parents by appointment. During visits, specially trained staff members discuss signs of preterm labor, when to call the doctor, and when to go to the hospital. Lifestyle modifications for a healthier pregnancy, including smoking cessation, are included in the visits.
About the Author: Cheryl Stallings, R.N., B.S.N., is the Family Education Program coordinator at Methodist Medical Center of Oak Ridge. She teaches a number of family classes sponsored by the medical center, coordinates several groups for new mothers, and teaches exercise classes for people of all ages. Stallings also participates in community events to educate parents, grandparents, young children in expectant families, and others about various aspects of family life. She is a graduate of Union University in Jackson, where she earned a bachelor of science in nursing. She has more than 26 years of experience in nursing, including emergency medicine, critical care, nursing management, and staff development, and is the author of a graduate preceptorship program.