Most women experience mild contractions, backaches and discomfort from mid-to-late pregnancy. These conditions are usually normal and are actually preparing your body for the experience of labor and delivery. But if contractions become consistent or backache is severe, you may be in labor.
Preterm labor is any labor that occurs before 37 weeks of pregnancy. If you've had a premature birth before, your risk of preterm labor increases. It's sometimes hard to distinguish between real labor and Braxton Hicks, or false labor, contractions; Braxton Hicks contractions tend to be mild, not painful and not at regular intervals. When in doubt, consult your doctor right away.
"Each year, 15 million babies are born prematurely around the world, including almost one of every eight babies in the United States," says Michael Gravett, M.D., Scientific Director of the Global Alliance to Prevent Prematurity and Stillbirth (GAPPS), an initiative of Seattle Children's Hospital. "Preterm birth is the leading cause of newborn deaths worldwide, and sadly many preemies who survive are still faced with lifelong health problems."
The most common complications of premature birth include respiratory problems because of immature lungs, jaundice, infection, brain hemorrhages and feeding problems. Premature babies are also at increased risk for blindness and developmental delays.
Moms often express feelings of guilt, but premature birth is rarely caused by something a mother did or didn't do. "Premature birth is extremely complex and can be caused by many different factors, which is what makes it so difficult to prevent," says Gravett. "In most cases, we don't know what causes a premature birth. There are some known genetic and environmental factors, but preterm birth is complex and can result from multiple factors, including intrauterine infection, excessive bleeding, autoimmune syndromes, early placental separation, stress, multiple fetuses (such as twins) and more."
Although we don't entirely understand the causes of preterm birth, there are some things you can do to reduce your risk, says Gravett. He recommends that women give up smoking during pregnancy. Forgo an elective delivery prior to 39 weeks, unless medically necessary.
Make sure you receive good prenatal care and get treatment for urinary tract infections and sexually transmitted infections. In vitro fertilization can increase the risk of preterm birth. To reduce this risk, talk with your doctor about transferring only one embryo to avoid multiple fetuses. The more babies a woman has at one time, the more likely she is to deliver too soon.
Consult your care provider immediately if you experience bleeding, vaginal leaking or frequent, painful contractions. Your doctor may not be able to stop the birth, but the sooner you get to the hospital, the better the outcome for both you and your baby. Stephen A. Contag, M.D., of Sinai Hospital of Baltimore's Institute of Maternal-Fetal Medicine, explains, "The main objective of caring for patients who are imminently at risk for preterm birth is to help prevent some of the complications of prematurity, not necessarily to prevent the preterm birth in itself. That is because trying to prevent a preterm birth in and of itself can occasionally actually be harmful for the mother or the baby."
Moms typically receive medication designed to reduce the complications of prematurity for the baby and babies can be treated quickly in a neonatal intensive care unit (NICU). Premature babies and their families endure many challenges, yet medical technology continues to improve. Today, 75 percent of premature babies can survive, according to the World Health Organization, with proper care, which includes steroid injections, antibiotics and proper hygiene. Kangaroo care, which is the practice of keeping baby skin-to-skin with mom and encouraging frequent breastfeeding, is a fairly new concept showing remarkably promising results.