Preterm birth is any birth that occurs before the 37th week of pregnancy. It is the cause of many infant deaths and lingering infant illnesses in the United States. Every pregnant woman needs to know about preterm labor and birth—why it happens and what she can do to help prevent it.
Preterm birth occurs in about 12 percent of all pregnancies in the United States, often for reasons we just don't understand. A normal pregnancy should last about 40 weeks. That amount of time gives the baby the best chance to be healthy. A pregnancy that ends between 20 weeks and 37 weeks is considered preterm, and all preterm babies are at significant risk for health problems. The earlier the birth, the greater the risk.
Babies who are born very preterm are at a very high risk for brain problems, breathing problems, digestive problems, and death in the first few days of life. Unfortunately, they also are at risk for problems later in their lives in the form of delayed development and learning problems in school. The effects of premature birth can be devastating throughout the child's life. The earlier in pregnancy a baby is born, the more health problems it is likely to have.
Why Does Preterm Labor Occur?
There are no easy answers. Stress might play a part for some women, personal health history or infection for others, or smoking or drug use for others.
If you have any of these three risk factors, it's especially important for you to know the signs and symptoms of preterm labor and what to do if they occur.
Lifestyle and Environmental Risks
Some studies have found that certain lifestyle and environmental factors may put a woman at greater risk of preterm labor. These factors include:
Late or no prenatal care
Smoking
Drinking alcohol
Using illegal drugs
Exposure to the medication DES
Domestic violence, including physical, sexual or emotional abuse
Lack of social support
Stress
Long working hours with long periods of standing
Medical Risks
Certain medical conditions during pregnancy may increase the likelihood that a woman will have preterm labor. These conditions include:
Urinary tract infections, vaginal infections, sexually transmitted infections and possibly other infections
Diabetes
High blood pressure
Clotting disorders (thrombophilia)
Bleeding from the vagina
Certain birth defects in the baby
Being pregnant with a single fetus after in vitro fertilization (IVF)
Being underweight before pregnancy
Obesity
Short time period between pregnancies (less than 6-9 months between birth and the beginning of the next pregnancy)
Researchers also have identified other risk factors. For instance, African-American women, women younger than 17 or older than 35, and poor women are at greater risk than other women.
Symptoms of Preterm Labor
Remember, preterm labor is any labor that occurs between 20 weeks and 37 weeks of pregnancy. Here are the symptoms:
Contractions (your abdomen tightens like a fist) every 10 minutes or more often
Change in vaginal discharge (leaking fluid or bleeding from your vagina)
Pelvic pressure—the feeling that your baby is pushing down
Low, dull backache
Cramps that feel like your period
Abdominal cramps with or without diarrhea
If you start to have any of these symptoms between 20 weeks and 37 weeks of pregnancy, follow the instructions in the section below "What to do if you have symptoms of preterm labor."
Don't let anyone tell you that these symptoms are "normal discomforts of pregnancy"! If any of them (you don't need to have all of them) happen before your 37th week of pregnancy, you need to do something about it.
What to Do if You Have Symptoms of Preterm Labor?
Call your health care provider or go to the hospital right away if you think you are having preterm labor. Your provider may tell you to:
Come to the office or go to the hospital for evaluation.
Stop what you are doing and rest on your left side for one hour.
Drink 2–3 glasses of water or juice (not coffee or soda).
If the symptoms get worse, or don't go away after one hour, call your health care provider again or go to the hospital. If the symptoms go away, take it easy for the rest of the day. If the symptoms stop but come back, call your health care provider again or go to the hospital.
When you call your provider, be sure to tell the person on the phone that you are concerned about the possibility of preterm labor. The only way your provider can know if preterm labor is starting is by doing an internal examination of your cervix (the bottom of your uterus). If your cervix is opening up (dilating), preterm labor could be beginning.
Subject: thoughts before ending this 
Wed 12 Aug 2009, 10:17 pm
