Premature Labor

There are things you want to show up early: payday, retirement, your first million. Then there are things you don't want to arrive early. Your baby is one of those. No matter how uncomfortable you are in the final weeks of your pregnancy, you want your baby to stay inside you at least through week 37, when their lungs are fully developed. But about ten percent of babies are born before week 37. They are pre-term deliveries, and thanks to thirty years of advances in newborn intensive care, more and more premature babies go home strong and healthy. Doctors like to prevent preterm labor whenever they can though, and you are their best chance at doing so. Women at highest risk for a pre-term delivery tend to be ethnic minorities, under 18 years old or more than forty years old, underweight prior to their pregnancy, or suffering from a chronic disease like high blood pressure, diabetes, or kidney disease. But more than half of "high risk" mothers do not deliver their babies early. And there are many other causes of premature birth, including carrying multiple fetuses, having malformations of the uterus or cervix, infections of the vagina, cervix, or uterus, and ruptured membranes. There are steps you can take to lower your chance of laboring early.

You should:

• Reduce your exposure to sexually transmitted diseases.



• Take good care of your body, and feed yourself and your baby well.



• Quit smoking, alcohol, and drug use.



• Avoid potentially harmful work conditions.



• Be aware of the signs and symptoms of pre-term labor.

This last is the most difficult. The symptoms of pre-term labor are identical to those of early labor, and similar to many associated with simply being pregnant. They include: three or more contractions in an hour; pain during urination (a possible urinary tract, bladder, or kidney infection); cramps, gas pain, or diarrhea; low back pain; pelvic pressure; and water breaking.

The best way to prepare yourself to avoid early labor is to learn what a uterine contraction feels like so you can identify one if you feel one and call your caregiver. If you think that you're going into labor early, empty your bladder and lie down on your left side and feel for contractions. If you count more than three contractions in an hour: rest on your side for an hour; drink two or three glasses of water or juice; and call your caregiver if your contractions do not become less frequent.

Your doctor will evaluate you and your baby. If regular contractions are accompanied by an opening and thinning of the cervix, you will likely be diagnosed with pre-term labor. You and your doctor may be able to delay labor by a day, a week, even a month or two. Half of all women diagnosed as being in pre-term labor go on to deliver their babies at full term without any treatment, but others do get medical therapies in one form or another. Bed rest and intravenous fluids can help stop contractions in some women, and there are a number of medications that can stop labor, promote babies' growth, or help prevent infection. Tocolytic drugs are a popular option for delaying birth for a few days to a week, allowing mothers to get to fully equipped birthing centers for their deliveries. Steroids may help speed the maturation of babies' lungs so that they can be delivered early, and be ready to meet the world. And antibiotics have been helpful in dealing with ruptured membranes, allowing mothers to carry their babies to term without risk of infection. Once your baby is 37 weeks old, treatment will be stopped and your pregnancy will be allowed to progress into labor. Your baby, once born, will be reward enough for all the nervous moments and medical technology used.