I had a low risk pregnancy but went into labour spontaneously at 29 weeks, 4 days. At the time I had no information about the complications associated with preterm labour and had no idea why it was happening and whether I had done anything to bring this upon myself. I learned that there was not a lot I could have done to prevent it, and it wasn't my fault (though it took me awhile to let go of that guilty voice in my head). I've been told by many other parents that this is just the beginning of the guilt I will feel at every turn as a parent!
The Society of Obstetricians and Gynaecologists of Canada is comprised of over 3000 professional members, including gynaecologists, obstetricians, family physicians, nurses, midwives and allied health professionals. The following is an article on Preterm Labour found on the SOGC website at http://www.sogc.org/health/pregnancy-preterm_e.asp
Preterm Labour
Not everyone understands how important it is to carry a baby to full term. Some women hope for a premature baby, thinking a small baby may be easier to deliver.
In fact, premature labour is one of the most common problems in pregnancy and it is the cause of 75 percent of all newborn deaths in babies born without birth defects. Premature babies are more delicate and can have lifelong problems related to their prematurity. In general, the more premature a baby is, the more severe the problems. Babies born before the 25th week usually do not survive without problems.
It is important to know early whether premature labour is occurring, as it sometimes can be stopped or delayed. This can provide time to give medicine that can help the baby, and to treat conditions causing premature labour.
What causes premature labour?
Why some women develop premature labour, and others don’t, is not well known. What we do know is that about half of all premature labours begin for unknown reasons to women whose pregnancies were otherwise normal. However, certain things seem to increase a woman’s chances of going into early labour.
What you do during your pregnancy can help you carry your baby longer, and give him a better start. Research has shown that the more women know about the signs and risks of premature labour, the lower the rate of premature births.
In France, one long-term study showed a large reduction in overall prematurity rate when the following steps were taken:
- There was public education about preterm labour and the importance of healthy full term babies to society as a whole.
- Special seats on buses and special parking places were set aside for pregnant women.
- Pregnant women were encouraged to keep their own pregnancy record.
These are some of the risk factors for premature labour, and how the risk can be reduced:
Smoking - It is best not to smoke during pregnancy. You can still benefit your baby if you quit smoking before you reach 32 weeks.
Working too hard - Working long hours, doing strenuous kinds of work and being tired all the time can lead to a preterm birth.
Physical and emotional abuse - When someone hurts you, they can also hurt your unborn baby. Even emotional abuse can lead to a preterm birth by significantly raising your stress levels. Please seek the help you need by calling a family crisis centre in your area.
Incompetent cervix – a rare condition in which the cervix dilates (opens) early and is associated with premature labour. This can sometimes be diagnosed during a vaginal examination or by measuring the size of the cervix during an ultrasound. Sometimes this can be treated by sewing the cervix closed with a “drawstring” stitch and removing the sutures when the baby is full term.
Fibroids in and/or on your uterus can cause it to be misshapen. If fibroids large enough to deform the uterus are detected before pregnancy, they may be removed. Small fibroids usually don’t cause problems during pregnancy.
Bleeding during second trimester - A small amount of bleeding can occur if the placenta begins to separate a bit from the lining of the uterus before labour starts. Each case of bleeding should be treated separately and may be treated differently depending on the cause. Always notify your health care provider about bleeding.
Abdominal surgery during pregnancy - Sometimes abdominal surgery is needed when a woman is pregnant (for example, for appendicitis). Surgery that is wanted but not essential (elective) should be avoided until after the baby is born.
Common infections in the mother are vaginal, cervical, kidney or bladder infections. You may have a bladder or kidney infection if you have pain when you urinate, if you have to go often, and when you do only a small amount of urine comes out. You may have an infection in your vagina or cervix if you notice an unusual vaginal discharge, have pain in your pelvis or groin area, or a fever. Notify your doctor.
An underweight mother - Treatment depends on the cause of the problem. Sometimes this problem is helped by eating healthy, good food on a regular basis. Talk to your health care provider if you are underweight and having problems.
Placenta previa – a condition in which the placenta implanted and grew over the opening of the cervix (where the baby must come out). This can lead to hemorrhaging during labour. This problem is usually found during routine ultrasound testing. The mother is often confined to bed for the last few weeks of pregnancy and the baby is usually delivered by caesarean section before labour has a chance to begin.
Premature rupture of membranes – the sac of amniotic fluid breaks or leaks before your baby reaches full term. Some studies link this to infections in the uterus, but further research needs to be done. If your membranes rupture early, treatment depends on how much amniotic fluid is lost and how close to your due date you are. Notify your doctor, or health care provider.
Gestational hypertension (high blood pressure caused by pregnancy) – is treatable in various ways depending on the severity.
Chronic illness in the mother. Some illnesses (diabetes, high blood pressure) may become out of control during the pregnancy, and in some situations the only way to stop the worsening condition is to deliver the baby. Sometimes the labour will begin too early on its own, and in other cases, the labour needs to be brought on (induced).
What you can do to prevent premature labour
There are other basic things which you can do in an effort to try to prevent your baby from being born too soon.
Quit smoking: Try to understand why you smoke, and seek help to learn other ways of dealing with these issues. Ask around in your community about “Quit Smoking” programs. Ask your doctor about programs to help you quit.
Eat properly: Talk to a registered dietitian about your eating habits. Plan your meals around the basic food groups and avoid junk food. Drink plenty of milk.
Get help if you need it: You have a right to feel safe. If you are being abused, call your local women's shelter and ask where you can go for help.
Get plenty of rest: Plan ahead to be sure a certain part of your day will be set aside for you to rest. Don't feel guilty for resting. It is very important during pregnancy.
Learn ways to reduce stress: Talk to people you trust about how you feel. Learn relaxation techniques such as meditation and self-massage to reduce your stress. Consider yoga.
Avoid strenuous work
Avoid overexertion when exercising during pregnancy: Even though you are physically fit, it is important not to increase your workout intensity during certain times of your pregnancy.
Learn to recognize the signs of premature labour: Prenatal classes through your hospital or community are an excellent way to learn. Talk to your doctor.
Learn the steps to take if you think you are in premature labour: Talk to your doctor about what you should do. Write down the phone numbers to call and what your doctor wants you to do if you go into premature labour
Visit your doctor regularly during pregnancy: This is one of the most important things you can do to prevent premature labour because it gives your doctor a chance to find or prevent problems, which may cause your baby to be born early.
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