Prematurity Awareness

In case you don’t read any further, I think it’s important that you walk away knowing the signs of preterm labor:

• Contractions or cramps, more than 5 in one hour
• Bright red blood from your vagina
• Pain during urination, possible urinary tract, bladder or kidney infection
• Sudden gush of clear, watery fluid from your vagina
• Low, dull backache
• Intense pelvic pressure

Part of the problem with prematurity is that we don’t talk about it. ?There are places that are supposed to give out the information, like your doctor or midwife’s office that don’t do quite the job that they should of either letting you know the signs of preterm labor, or listening to you if you think you’re having complications. ?I’ve had more than one mother write me to say that thankfully she when to be insistent. ?One story goes like this:

“I’d been having a lower back ache all day. ?I assumed it was from standing up at work, so I made it a point to put my feet up when I got home. ?I was about seven months pregnant. ?I’m sitting there, watching TV and I start to notice these tiny feelings in my uterus. ?I blew it off at first thinking it was just the baby moving. ?Then I noticed that it was a contraction. ?So I figured it was a Braxton Hicks contraction.

“Before long it was apparent that they were coming at regular intervals. ?So I timed them – every ten minutes. ?I called my doctor. ?30 minutes later he called me back – it seemed like forever. ?He told me that it was probably nothing but stress from work. ?He advised that I drink a lot of water and lay down. ?I tried that but it still didn’t go away, so I called back. ?The next doctor who called me back, advised I try it for longer and with more water, maybe even a glass of wine. ?I was furious!

“I had my husband drive me to the emergency room, even though my doctor told me not to go there. ?When I got there, they rush my up to the labor and delivery ward. ?There they monitored me and checked my cervix. ?I was starting to dilate and my contractions were about every eight minutes! ?When a doctor came in to see me, the third one of the night, he told me how lucky I was to have listened to my body because I was most certainly in labor. ?Thankfully we were able to stop it with some medications and my baby was born healthy at 41 weeks and some change. ?My baby would have died had he been born that night…”

But if you work in the field, you’ll hear plenty just like that one. ?In addition to what you think about as the “typical” preemie, is what is known as the late preterm infant. ?This is a baby born between 34-36 weeks gestation, though often times the mother believes that she is past the 37 week mark.

The point is that unless your body and baby go into labor, past the date you believe to be the 37 week mark – you could be wrong. ?And if you’re wrong, your baby is at risk of a whole host of problems. ?The good news is that you have the ability to stem some of these numbers as well as your own risk – avoid elective induction. ?Do not induce your labor simply because you are tired of being pregnant, unless you’d like to switch tired of being pregnant for tired of being in the NICU with your baby. ?It’s simply not worth the risk.

Here are some places to learn about prematurity:

• Preemies from About.com
• March of Dimes (State by State Report Card Available)

CDC Releases New Report Comparing U.S. and European Infant Mortality Rates

The CDC National Center for Health Statistics (NCHS) released a new report this morning which compares infant mortality rates in the U.S. and Europe.

Authors of Behind International Rankings of Infant Mortality: How the United States Compares with Europe explored what they refer to as the recent stagnation in the U.S. infant mortality rate that has generated widespread concern among researchers, policy makers, health care providers and activists.

Using data from the United States? Linked Birth/Infant Death Data Set and the European Perinatal Health Report, authors Marian F. MacDorman, Ph.D., and T.J. Mathews, M.S. of the CDC National Center for Health Statistics found that the main cause of the United States high infant mortality rate when compared with Europe is the ?very high percentage of preterm births in the United States.?

According to the study, while infant mortality rates for preterm (less than 37 weeks of gestation) infants are lower in the United States than in most European countries, infant mortality rates for infants born at 37 weeks of gestation or more are higher in the United States than in most European countries.

Discussions of the U.S. infant mortality rate are often countered with criticism that the U.S. records data differently than other countries, reporting very premature babies as live births. While this is true for five of the 19 European countries whose data was analyzed, 14 of the 19 European countries require that all live births at any birth weight or gestational age be reported.

The United States remains near the bottom of the rankings.

The report states, ?Reporting differences have little effect on the percentage of preterm births because most preterm births occur well after 22 weeks of gestation. For example, the percentage of preterm births for the United States in 2004 was 12.5% when all births were included and 12.4% when births of less than 22 weeks of gestation were excluded.?

MacDorman and Mathews attribute much of the high infant mortality rate in the United States to the high percentage of preterm births. Using the direct standardization method to apply the U.S. gestational-age specific infant mortality rates to Sweden?s distribution of births by gestational age, the NCHS found evidence that lowering the percentage of preterm births could have a dramatic impact on infant mortality in the United States.

November is also Prematurity Awareness Month.? Considering the risks involved in preterm birth, you may be wondering what you can do as a birth activist or as a parent.? Here are some basic things to consider:

• Let labor begin on its own. Without a valid medical reason, let your baby pick his or her birthday for the safest, easiest birth.
• Choose a practitioner with a low induction rate. If you have a midwife or doctor who rarely sees anyone who goes past their due date, it should be a red flag.? Ask the receptionist for her opinion of how many women go past 40 weeks. The answer might surprise you.
• Know the signs of preterm labor. If you think you’re having any of the signs of preterm labor, call your midwife or doctor immediately.? The sooner you get help, the more likely that premature birth can be delayed or stopped completely.
• Be mindful of the risk factors. Face it, you have responsibility for some of the risk factors.? While there are certainly some risk factors for preterm labor that you don’t control, take charge of the ones you can, including prenatal care, good nutrition, not smoking, etc.