Delivering a Premature Baby

You are probably reading this as your medical team have identified that you may be at risk of delivering your baby early. I have put together some tips for you on the symptoms you may experience if you do go into labour early and some info on the birth and what will happen immediately after it.

What are the symptoms?

If you notice one of the following signs during your pregnancy, you should contact the Emergency Department at your maternity hospital and/or your obstetrician, who will advise you on the best course of action.

  • Sudden show of blood
  • More intense, unpleasant smelling discharge
  • Severe itching or burning in the vagina
  • High Temperature
  • Frequent severe diarrhoea
  • Waters breaking
  • Premature contractions

You may be advised to attend the Emergency Department at your maternity hospital for an examination and monitoring of your symptoms.

What do premature contractions feel like?

Premature contractions can feel like;

  • Severe stomach cramps similar to period pain
  • Tightening in the hip, groin or back muscles
  • Repeated hardening of the lower abdomen at short intervals

If you are suffering from premature contractions, your medical team will admit you to hospital for monitoring and treatment. If your pregnancy is beyond the 34th week you may not receive any medical treatment as your baby’s vital organs are considered mature. If you have not reached the 34th week of pregnancy your medical team will attempt to stop the contractions and delay the birth, using treatment measures which may involve medicines or simply rest.

Can premature contraction be stopped?

The first measure to stop contractions is physical rest, but not necessarily strict bed rest. However, you should try to lie down as much as possible on your side with you pelvis slightly raised to reduce the pressure of your baby on the neck of your womb.

Premature contractions early in your pregnancy (2nd trimester) can be a sign of a shortened or incompetent cervix(neck of the womb), a situation which can result in a premature birth.  A stitch or cerclage can be inserted under local or general anaesthesia in the cervix early in the 2nd trimester to support the pregnancy and removed late in the final trimester by your obstetrician.

A challenge for your premature baby, under 34 weeks of pregnancy, is general immaturity of his/her organs and the most critical issue is immaturity of his/her lungs. Your medical team may decide to use tocolytics (womb relaxants) to delay the birth of your baby for 48 hours to allow the lungs to be matured by treatment with 2 doses of ante-natal corticosteroids (injected into the buttocks) over a 48 hour period.

The birth

If you are likely to deliver your baby early, you will be encouraged to visit the Neonatal Intensive Care Unit (NICU)- the ward where your baby will be cared for after the birth.  Familiarising yourself with the sights, sounds and smells of the NICU will help you and your family prepare for the journey ahead.  As a parent who has spent time in the NICU with my daughter, Amelia (who was born at week 25 in 2006) I would encourage you to take the opportunity to visit the NICU, familiarize yourself with the staff on the ward and the equipment that will be used during your baby’s stay.  It is important to remember that you can still be a parent to your baby in the NICU despite the technical surroundings. The NICU is going to be your baby’s “home” until he/she is ready to be discharged from hospital (at or around the due date) and the better informed and prepared you are to parent in the NICU, the easier it will be for you to be an active member of your of your baby’s caregiving team.

Premature babies can be delivered naturally or by caesarean section and your medical team will discuss the most appropriate delivery options for your baby with you.  Due to the lack of body fat which is laid down on the last weeks of a full term pregnancy, your new baby will not be able to maintain his/her body temperature once delivered, and may be placed in a small polythene bag by the delivery team- not all essential medical technology is high tech!! Your delivery team will ensure that you get to see and/or hold your baby after delivery before he/she is placed in an incubator and transferred to the NICU. In most instances your birth partner can accompany your baby to the NICU and the transfer team will even take short videos and photographs on a smartphone to record the journey from the delivery room to the moment that your birth partner “delivers” your baby to the NICU team.

Once admitted to the NICU, the NICU team will start caring for your baby until you can be brought to the NICU to meet him/her- for mothers who have delivered by caesarean section this can be a few hours after the birth. The NICU team will take photographs of your baby in the NICU and will bring them to you on the Post-Natal Ward.

 

For more information on premature babies visit The Irish Neonatal Healthcare Allience – www.inha.ie