Having a baby between the 20th and 37th week is considered premature. Most premature births are deliberate, planned attempts by the obstetrician due to some health complication. However a small percentage of pregnancies result in unplanned premature labor. Possible factors responsible for this are:


• Over-distended uterus because there is more than one baby in the uterus or too much amniotic fluid


• Incompetent cervix (your cervix is not tightly closed)


• Early rupture of the membranes of the amniotic sac (water breaking)


• UTI in the mother


• Overwork, stress and some maternal concerns like anemia or malnutrition
With special care preterm babies as young as 24 weeks can survive. By week 30, chances of survival increases by 90% and more than 80% will be fine with some special care.



What you can do..


• If your membranes have ruptured go to the hospital right away.


• You will be monitored closely to watch for signs of infection such as fever; in case of an infection you will be given
antibiotics.


• Labor usually starts after the rupture but if you don't go into spontaneous labor it won't usually be induced until after 37 weeks unless there is an urgent need.


• Once your membranes have ruptured and labor commences, the labor will go on as normal.


• Generally premature labor tends to be shorter and easier than full-term because baby's head is smaller and softer.


• Usually an episiotomy is given; forceps may be used;


• Cesarean delivery is very likely, especially if fetus is in distress.


What your hospital will do..


• If labor starts as early as between week 24 and week 34, labor will be delayed with the aid of steroids. The aim is to allow time to mature the baby's lungs; preterm babies have higher chances of developing respiratory distress syndrome because of the shorter gestation period.


• In a hospital environment, evidence of infection can be detected at the earliest and baby's condition can be monitored; once born the premature baby can be transferred to the intensive care immediately.


• If your hospital doesn't have neonatal facility, you may need to be moved to a hospital which has one.


• If you are over-anxious, a mild sedative will be given to help you calm down



Some friendly pointers if you are at risk


1. Make your pregnancy stress-free: don't attempt anything new. Don't make elaborate plans. Pamper yourself. Overindulgence doesn't equal to being selfish; you are just taking care of you and your baby.


2. Any changes you go through, inform your doctor or clinic.


3. Keep emergency numbers and names in easy-to-see places; carry them in your handbag, stick them on the
fridge or place them near the phone.


4. Don't worry about what others may think about your excessive concerns i.e. the nurse, your doctor.


5. Keep your information-kitty containing books, pamphlets, your mother's notes etc in an accessible place. Store
them such that you can retrieve them easily when you wish to read up on a peculiar side effect or funny feeling.


6. Share your fears with your partner or a friend; don't bottle up.


7. Skip strenuous workouts


8. Don't worry about getting all your chores done in one day; spread them over the days


9. If working, get an early leave of absence form your job; get a note from your doctor as supporting document if
reactions at work bother you


10. Stop lifting heavy objects and bags


11. Spend some time putting your feet up and sit still as often and as long as you can


12. Discuss sex issues with your doctor at your routine visits because your doctor may want you to abstain from intercourse until after the baby is born. High risk mums will be instructed to stay off sex after the fifth month.



Common premie Characteristics


• These babies differ from full term babies in a number of ways but these are usually temporary ways.

• Premies weigh less

• They are small, red, wrinkly and frail with large heads and hands

• Blood vessels can easily be seen under the pale skin since there isn't much fat

• There is a layer of fine hair on the body (lanugo)

• Their motor functions like breathing and feeding are less efficient

• They tend to be irritable in the early days though this can be dealt with soothing care, soft noises and love