At full term, a baby is born at least 37 weeks after the date of the mothers’ last period and a baby is considered to be premature when born before the end of week 37. The incidence of premature birth in the UK is currently around 7% (about 45,000 babies every year), and rising. Because premature babies have had less time in the womb to fully develop and mature, they need more intensive care after birth and there is a higher risk of medical complications: the earlier a premature baby is delivered, the more serious the health problems he or she faces are likely to be. Thanks to the medical advances of recent decades even babies born as early as 24 weeks stand a chance of survival, though babies born this early are at high risk of long-term health problems. After this, the outlook for a baby improves with every day spent in the womb and by 32 weeks’ gestation, the health implications of prematurity are likely to be short-term and by 36 weeks, a premature baby may need help breathing initially but many will need no special medical attention.
If preterm labour threatens, rapid medical attention can make all the difference to the outcome and the health of the baby, so it’s important to be aware of the symptoms. If you experience regular contractions (you will feel your abdomen tightening or hardening at regular intervals, not unlike severe period pains), more than five contractions in an hour, or you think your waters may have broken (you have any watery discharge from the vagina) then you should contact your midwife, doctor or the hospital right away. Other signs that may indicate a possible preterm labour include: vaginal spotting or bleeding, low, dull backache and a strong sensation of pressure in the thighs and on the pelvis.
If it looks like labour may be beginning you will usually be advised to rest and drink plenty of water while you wait for an ambulance to take you to the hospital (you shouldn’t drive yourself). At the hospital you will be given a vaginal examination and several tests to establish whether you are truly in labour and to check for infection. If the test results are inconclusive you’ll be kept in for observation.
Before 34 weeks’ gestation, an expectant mother who appears to be going into early labour is usually given two drugs: The first works on the mother to delay, or even stop, the labour and the second, a steroid, works to speed up the development of the baby’s lungs so that they are ready to breathe oxygen after the birth if labour continues. If the drug to delay labour is given early enough it may actually stop a threatened labour and the pregnancy could then go to term. If this is the case then the mother might be given regular top-ups of the steroids to develop the baby’s lungs more quickly while the pregnancy continues. However, if labour is established, the best doctors can do is to delay labour for 24 – 48 hours to give the steroids time to better prepare the baby’s lungs for birth. At 35 weeks gestation or later, doctors will usually let the labour procede.