First of all, what is a preterm delivery? Any delivery prior to 37 weeks is considered preterm, and there are more than 200,000 preterm deliveries each year in the U.S. Some of the risk factors are history of previous preterm birth, multiple gestations (twins, triplets, etc.), short cervix, prolonged standing at work, substance abuse, either younger than 18 or older than 35 at time of delivery and use of assisted reproduction (IVF, etc.) can all predispose to preterm labor. Other medical conditions that can cause early delivery include UTI (please, please, please complete your antibiotics), bacterial vaginosis, STDs, being either under- or overweight prior to pregnancy, vaginal bleeding during pregnancy, previous uterine surgery (removal of fibroid or prior cesarean section), elevated blood pressure or blood sugar, and less than six months between giving birth and the next pregnancy.
So, is there anything to do about it? If your physician notes that you have risk factors for preterm delivery, then he/she may prescribe injectable or vaginal progesterone depending on the situation in order to decrease the chances of delivering early (these aren’t necessarily as effective of the delivery occurred just because mom’s water broke early). Even though a mom may be “over” the whole pregnancy much sooner than 37 weeks, our goal is to help continue a pregnancy to term so that the baby gets to go home with mom. Believe me, it’s really tough for a mother (and family) to leave the hospital without their baby. While we learned a lot about taking care of a baby while ours was in the NICU, there are definitely cheaper ways to learn those lessons ;)
Sometimes, though, delivery early is either indicated or inevitable (or a bit of both). Occasionally, the delivery is so urgent that the absolute best thing is to simply help the baby out of mom and into the NICU for specialized care; however, for those who are urgent without being emergent, we try to maximize the baby’s time in utero. In those cases, we do the best we can by providing steroids (from 23-36 weeks) to help with the baby’s lung development and magnesium (from 23-32 weeks) for prevention of cerebral palsy. Depending on the maternal and fetal condition, we may also use other medications to allow the steroids and magnesium time to take full effect.
Unfortunately, some babies are just in a hurry to get here. When we encounter moms-to-be who have known risk factors, we do what we can to decrease the chance of early delivery, but when we don’t have risk factors, sometimes we have to be content with doing what we can to help the little one be as prepared as possible for life outside of mom. While we personally vouch for great NICU care if need be, it’s usually preferable to bring your newborn home with you. If you have any concerns about preterm delivery, be sure to talk to your provider, and we’ll do all we can to help you and your baby leave the hospital together :)