Premature Birth: Risks, Symptoms, Baby Conditions, and Prevention

Normally, babies being carried to term are born during the 37th week or later. However, due to various reasons, some babies are born prematurely before the 37th week. This is known as premature birth.

Let's explore some reasons and symptoms of premature birth and learn some life hacks on how to prevent it.

Reasons for Premature Birth

premature birth

Under normal circumstances, the fetus is born around 10 months pregnancy, particularly after the 37th week of gestation in the midst of natural labor pain. However, due to various reasons, there could be instances in which the baby is born before the 37th week. This is known as premature birth.

The biggest problem of premature birth is that the fetus isn't mature yet and has difficulty getting accustomed to the world out there. This is especially true for a premature birth whose gestation period is

very short. As the baby's heart, lungs and the gastrointestinal functions are not yet fully developed, its survival rate is very slim.

When the mother is the reason for premature birth

The reason for premature birth may lie with the mother or fetus. If the issue lies with the mother, reasons for premature birth can be any of the following: toxemia (characterized by high blood pressure; swelling of the hands, feet, and face; and an excessive amount of protein in the urine) or polyhydramnios (build-up of excess amniotic fluid during pregnancy) resulting in premature amniotic sac rupture or placenta praevia (a complication in which the placenta grows in the lowest part of the womb and covers all or part of the opening to the cervix). Hence, placenta abruption (one of the pregnancy complications in which the placenta detaches from the uterus before the baby is born) or its underdevelopment can kill the fetus or cause premature birth.

When the fetus is the reason for premature birth

Reasons being: congenital malformations (especially heart abnormalities), chromosomal anomalies and macrosomia (big baby), among others. Especially when uterine contraction occur after the 22nd week, a threatened abortion due to the dilation of the uterus' opening or cervical shortening, there's a possibility of premature birth. When cervical shortening is discovered during an ultrasound scan, the doctor is warned of pre-term delivery tendency. However, the length of the cervix may not show up clearly in an ultrasound scan. Therefore, an expectant mother must inform her doctor of any abnormalities.

Pregnant Women prone to Premature Delivery

1) Expectant mothers with toxemia

When toxemia causes blood pressure to be too high, the placenta is unable to function properly, resulting in fetal death. Hence, before this happens, the fetus will be born prematurely.

2) Expectant mothers with chronic illnesses

Chronic diseases such as diabetes and heart diseases will also impair the placenta's functionality, so the possibility of premature birth is very high. When these high-risks pregnant women enter during the second half of pregnancy, all the more they must go for regular checkups.

3) Women expecting twins

When pregnant with twins or a huge baby, the mother must definitely stay happy and relaxed. It's better to choose a hospital with incubators. As their stomachs will be bigger than most pregnant women, the amniotic sac may not be able to withstand the pressure and rupture. If this happens, there's a likelihood of premature birth.

4) Pregnant women with abnormal placentas

With placenta abnormalities such as placenta praevia or placenta abruption, premature birth is very likely to happen. As placenta praevia can be detected early via ultrasound scans, the expectant mother can check into the hospital for treatment or stay calm and monitor her pregnancy closely.

5) Pregnant women with cervical incompetence

An ultrasound scan can reveal the length of the cervix during the second half of pregnancy. Women with a short cervix should be careful of premature delivery. During the 8 or 9 month pregnancy, the cervix could become loose due to the increasing size of the fetus. This could in turn lead to the rupture of amniotic sac and result in premature delivery.

6) Pregnant women with polyhydramnios

Expectant mothers who have twice the amount of amniotic fluid than normal pregnant women have polyhydramnios. Very often, the amniotic sac bursts when it cannot withstand the pressure of the growing fetus anymore. If it breaks, amniotic fluid and peritoneal fluid (a fluid that accumulates in the gap between the wall of the abdomen and the organs contained within the abdomen) will flow out together. There are many instances of the umbilical cord coming out as well. This endangers both the fetus and mother, so the pregnant mother has to be very careful.

7) Working pregnant women

There are many cases of premature delivery due to the tremendous amount of work and pressure in the workplace. The pregnant mother must have adequate rest after the mid-term. Sleep for another hour more daily and rest a lot.

8) Pregnant women who sustain huge pressure while exercising vigorously

If an expectant mother is exercising during her pregnancy, do note that it may give rise to uterine contraction. During the second half of pregnancy, if exercising hardens and tenses up the abdomen, stop temporarily. Intense activities such as swimming and sexual intercourse will cause uterine contraction, so exercise with care.

9) Expectant mothers with bad colds

If the mother has a bad cold and fever during the second half of her pregnancy, this will adversely affect the fetus and may result in premature delivery. She'll naturally feel pain if the fetus in the stomach is endangered and it'll be born prematurely. Moreover, if her abdomen suffered a huge impact or a bad fall, these will also result in premature delivery. Hence, the mother has to be extra careful in her daily activities during pregnancy.

Symptoms and Process of a Premature Delivery

1) Pain

The expectant mother has to determine whether there's labor pain along with uterine contraction, or pressure on the pelvis, physical pain, abdomen pain or lower abdomen pain.

2) Vaginal discharge

Another good way to determine whether there are symptoms of premature delivery is to look closely at the vaginal discharge. If the vaginal discharge resembles water or blood or has a weird odor, these may be signs of a premature delivery.

3) A bursting sensation

When there's a sensation of detachment in the opening of the uterus or if the bloated feeling in the abdomen feels different from the usual sensation, these are symptoms of premature delivery which an alert expectant mother should take note of.

4) Fetal movement

Premature delivery may happen should there be unusual fetal movement. If the fetus suddenly moves less or becomes quiet, it could be a symptom of premature birth.

5) Process is identical to a normal birth

The process of a premature delivery is identical to that of a normal birth. First, electronic monitoring equipment will be used to carefully monitor whether the fetus' heartbeat is normal in the midst of labor pain. If the mother's amniotic sac has broken, it could mean blood poisoning for the fetus. This calls for more rigorous observation on the expectant mother's end.

General Knowledge in a Box: Will the Premature Baby be alright?

1) Stay in the incubator for some time

A baby is premature when it's born between the 24th and 36th week of pregnancy. Besides being rather tiny and underweight, its body is also underdeveloped. Therefore, if it doesn't have the support of medical equipment, it'll be difficult for it to survive. To keep the premature baby warm, give it nutrition and prevent infections. It should be kept inside an incubator as soon as it's born. Even if a baby is prematurely born and is underweight but its body functions can adapt to the outside world, an incubator isn't necessary. As the premature baby has almost no subcutaneous fat (fatty tissues directly under the skin layers), it doesn't know how to regulate its own body temperature, thus breathing difficulty is common.The premature baby's muscles are not yet fully developed, so it only knows how to spread its limbs straight when it sleeps.

2) Fully normal after two years old

As the premature baby's body isn't fully developed, it's susceptible to illnesses which can lead to complications such breathing difficulty. Within one year of birth, its resistance to illnesses and diseases is still very weak. However, most of its functions will return to normal later on. It's also important to look after the premature baby carefully. It's generally perceived that the underdevelopments of physical and intellectual functions are proportionate to how prematurely the baby is being born. However, the premature baby will be able to slowly catch up with the normal development of a full-term baby and be on par with a full-term baby by the age of two. Therefore, mothers don't have to be too anxious or worry too much.

3) Don't worry if the baby is born after nine months

Being born after 24 weeks is also considered premature. Though the baby has just acquired its lungs' functions at this time and can breathe on its own when it's outside the uterus, breathing will not be smooth. So survival rate is still low. If the mother carries the baby till the 28th week before giving birth, its lungs are fully developed by now and survival rate will be greater. Even if the baby is premature, delivery close to nine months (32nd week) will give the mother greater peace of mind as the baby's lungs are fully developed by now. By the 34th week, the baby will know how to use its mouth to suck milk and digest it.

4) Changes in the mother's condition must also be carefully observed

During childbirth, if the vagina's opening hasn't become loose, an episiotomy (an incision made between the vagina and anus to expand the vagina opening to prevent tearing during delivery) may be needed to create the least resistance for the fetus' head.

Blood-like fluids will flow out and after rhythmic pain in the lower abdomen, the amniotic sac will break and amniotic water will be discharged. The baby is small and if there isn't any other problem, a natural birth will be all right. However, if bleeding or a premature amniotic sac rupture leads to infection and sudden abdominal pain, it'll be quite dangerous for both the mother and baby. Therefore, premature birth happens. As there are various emergencies to be swiftly taken care of, a pregnant woman must give birth in a hospital where there are experts and dedicated equipment around.

5) Care for the mother after premature delivery

As the baby is only slightly smaller and is born before the expected delivery date, premature delivery should be treated in the same way as a normal delivery. A natural birth requires three days of hospitalization, aCesarean delivery requires seven days. Before lochia discharge (the vaginal discharge after giving birth containing blood, mucus, and uterine tissue) stops, the woman should use maternity sanitary pads and keep her body clean to the best that she can. Use hot water that has been cooled with feminine wash added to clean and disinfect the private parts. Only shower when she's feeling better or when she's out of the hospital. Before the body recovers, eat easily digestible food as much as possible. If the mother just had aCesarean delivery, drink more water and avoid constipation.

Rules for Premature Birth Prevention

1) Don't tense or stimulate the abdomen

To prevent premature delivery, the pregnant woman shouldn't let her uterus contract or feel pressurized. Most importantly, never let the abdomen knock against anything. If possible, avoid going out during peak hours or to places where there are crowds. Lifting heavy objects, reaching for things placed on a higher level must also be avoided altogether.

Take note if there's serious diarrhea. This is because the uterus could be irritated during defecation, causing serious uterine contraction and leading to premature birth. It's also best not to stand or stay curled up for a long time as that will easily put pressure on the uterus.

2) Keep tabs on health

Even if it's just a little change in the body, an expectant mother should check up on it, especially if she's down with illnesses that could result in premature delivery. It's important for her to pay extra attention to her health if she has heart diseases, kidney issues, diabetes or high blood pressure. Also be vigilant if she's having a flu or syphilis as these will increase the possibility of premature birth.

3) Stay relaxed and take in nutrition

Keeping a relaxed and quiet mind is the best way to preventing premature birth. Unexpected events, problematic issues and even the occasional noise will result in premature delivery. It's best that the pregnant mother avoids inadequate sleep, burnout or forcing herself to exercise. Moreover, expectant mothers with less-than-ideal nutrition will also run the risk of premature birth. Enjoy foods that are rich in vitamin E and K. To prevent an irritable uterus and urinary tract infection, remember to drink plenty of water.

4) Never miss a check-up

Premature delivery is closely related to the mother's health. Pregnant mothers with diabetes, high blood pressure or toxemia are prone to premature delivery as the placenta providing nutrients for the fetus cannot function properly. During a pregnancy checkup, measure the body weight, blood pressure first before doing a urine examination. Regular antenatal checkups and examination of the uterus and fetus can provide early detection of abnormalities as well as enable faster treatment.

5) Control body weight and don't let it increase suddenly

Rapid weight gain can be a worrying cause for toxemia. Toxemia can destroy the placenta causing oxygen and nutrients supply to be almost impossible and eventually causing the fetus' premature birth or death. The possibility of premature delivery or stillbirth for an expectant mother with toxemia is between two and three times higher than a normal pregnant woman. For an overweight pregnant mother, even if she doesn't have toxemia, the possibility of an early rupture of amniotic membranes or premature birth is also extremely high. A pregnant woman should control her weight carefully and don't let it increase by more than 500g within a week.

6) Avoid sex as much as possible

Into the 8th week of pregnancy, the uterus opening becomes soft and discharge increases – the body is already preparing for childbirth. As vigorous exercises should be avoided, sex between the expectant mother and her husband shouldn't last for too long and penetration shouldn't be too deep. It's best to wear a condom as infection can be prevented and irritable substances in the semen can be stopped to prevent uterine contraction. Sex should be reduced as there's risk of premature birth from the eighth month of pregnancy onwards.

7) Don't exercise if there are signs of premature birth

Exercising during pregnancy can increase muscle strength and the lungs' capacity, all of which are very beneficial to childbirth. However, exercises shouldn't be too intense and should be limited even for a healthy expectant mother. It's best to do gentle pregnancy exercises or go for leisurely strolls. If the pregnant woman experiences abdominal pain or feel it hardening during exercise, stop immediately and rest.

Pregnant women with premature delivery-causing diseases such as toxemia or have past experiences of premature deliveries should avoid exercising as much as possible. If exercising leads to uterine contraction, symptoms of premature delivery may endanger the mother.

General Knowledge in a Box: Antenatal Checkups is the only effective means of Preventing Premature Delivery

After having premature delivery symptoms, the expectant mother cannot assume that it would be premature delivery straight away. It's best to consult the doctor and follow his instructions. Sometimes the uterus opening will open without reason. However, such circumstances are rare. So she must go for her antenatal checkups regularly.

Similar to a normal birth, a premature birth will start from a regular uterine contraction before the real labor pain starts. If it's still very far away from the expected date of birth and uterine contractions are happening repeatedly, the expectant mother must go to the hospital and consult a doctor. There are also cases where the amniotic sac ruptures without any symptoms – these are known as early ruptures of amniotic membranes. In a case of early rupture of the amniotic sac and amniotic fluid leakage, the pregnant woman must prevent bacterial infection and protect her cervix properly.

To prevent premature birth, remember to review the reasons why such happen and take precautionary measures.

Check out about fetal abnormalities ans its prevention.

Sandra Henderson

Editor-in-chief at Babiology and a proud mother of four passionate about sharing pregnancy and baby growth knowledges

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