Preterm Birth

There is a lot doctors and scientists still don’t fully understand about what includes labour, both pre and at term. But we do know that there are treatments that can reduce your chance of having a preterm birth, especially if you have had one in the past. Studies have shown that prenatal education is a key factor in reducing preterm birth rates, which can be crucial in creating a more positive overall birth experience both physically and mentally for mama and baby. So just by listening to this podcast you could be setting yourself upon a healthier journey into parenthood!

Preterm birth can be especially traumatic for those living in remote communities with limited access to specialized healthcare and newborn intensive care units (NICUs). This is why in 2018 Drs. Kirsten Duckitt and Jennifer Kask, our guests on today’s podcast, developed a prevention of preterm birth pathway in Northern Vancouver Island that is spreading to other remote communities. They share with us a moving story of a pregnant individual from a remote community who had her baby in their hospital, and break down the definitions and rates of preterm birth, risks to mama and baby, and how they can be decreased.

What defines preterm birth?

Pregnancy is considered 40 weeks long. Your due date is the day at the start of the 40th week since the first day of your last menstrual cycle, or the date determined by your ultrasound. 

Term is the word we use to describe those five weeks when babies are usually born - between 37 and 42 weeks. A baby born before 37 weeks is preterm (or premature).

The rates of preterm birth do vary depending on where you live. Looking at Canada, about 8% of babies are born before 37 weeks, but there are some regions where 14%-20% of babies are born preterm - much higher than the national average. 

Why does location matter?

Healthcare is very different in different areas and populations. Despite best efforts to provide the same access to medicine and healthcare everywhere, it's often more difficult because of the distance to hospitals. But also due to the accessibility to healthcare professionals that can provide specialized care - both medically, but also with the knowledge of the specific needs of a particular community, culturally and ethnically, and how they can be met. We hope that with the work of She Found Health and professionals such as Drs. Duckitt and Kask this gap will be lessened over time!

What are the risks to baby?

Being born too early is the leading cause of infant death and long-term health problems worldwide. The health risks to the baby are proportionally related to how premature they are: medical issues are much different when a baby is born at 25 weeks versus 35 weeks. But we know that babies who are born at term or after 37 weeks will have:

• more fully developed bodies and they'll be able to physically and emotionally bond better with their parents or caregivers. 
• Babies born at term also tend to have less issues breastfeeding, and;
• less of a chance of short term complications from a longer hospital stay, such as infections or breathing and feeding issues.

What are the risks to parents? 

The biggest risk to the pregnant person and their partner from preterm birth is really the emotional toll that it takes on them. It can increase relationship or financial stressors at an already tumultuous time of change. Communication is key at this often challenging moment. Try to recognize the stressors and reach out for support from friends and family. Social workers are also available at NICUs for support. 

Listen to our podcast on Being a NICU parent!

How do you know if you’re at risk of a preterm birth? 

The following factors may indicate the risk of a preterm birth, with a previous preterm birth being the highest risk factor:

1. Previous preterm birth
2. Second trimester loss
3. Medical issues (ex. people who may have had procedures on their cervix)
4. Infections during pregnancy (ex. bladder, kidney)
5. Influenza or viral infections during pregnancy (ex. COVID-19)
6. Adolescent pregnancies
7. Lifestyle choices (ex. smoking)

How can you decrease risk of preterm birth?

If you suspect you may be at an increased risk of a preterm birth, taking the following actions can help: 

1. Attending regular prenatal visits
2. Being screened for infections and having them treated
3. Taking care of your overall health: good diet & exercise, and avoiding toxins such as cigarettes, marijuana, drugs and alcohol.
4. Good dental health (fixing cavities as they are actually small infections)
5. Vaccination against influenza and COVID-19 
6. Timing of pregnancies: after 18 months up to 5 years is recommend
7. Progesterone, a hormone treatment (discussed more in the podcast episode!)

What are the signs of preterm labour?

This is a really important thing to pay attention to as we can't always stop preterm labor, but sometimes we can delay it enough so that we can help support baby to do better if they’re born early. Unfortunately the signs of preterm labour aren't always obvious and many pregnant people with similar symptoms aren't actually in preterm labor. If you were experiencing the following symptoms, reach out to your care provider - sometimes we can prevent things from progressing! Symptoms can include: 

1. Increasing or unusual lower back or pelvic pain
2. Menstrual type cramps happening regularly that don't go away with rest
3. Ongoing fluid leaking or bleeding from the vagina 
4. Bladder infection or unexpected diarrhea

As always, reach out to your healthcare provider if you have any other questions, if you feel you may be at risk of, or experiencing preterm labour. With the right support in place, both the risk of preterm birth and its after effects can be mitigated, and we are here to guide you through to your best possible labour and delivery experience.

As a thank you for listening, download our Free Birth Plan designed to work through with your partner and provider, and leave you feeling less anxious and more prepared for the big day!