When is a premature birth?
Premature birth is when the child is born before the end of the 37th week of pregnancy (SSW). Doctors divide premature babies into three groups according to either the length of pregnancy or the birth weight:
- Extremely preterm babies: 27th week of gestation completed or weight less than 1,000 grams
- Very preterm babies: 30th week of gestation completed or weight less than 1500 grams.
- Moderately early preterm babies: 36th SSW completed or weight below 2500 grams
In Europe, about six percent of all births are preterm.
Signs of preterm birth
The maternal body initiates preterm birth via premature labor, premature rupture of the membranes, and/or premature cervical shortening with simultaneous softening and widening of the cervix (cervical insufficiency).
Causes of premature birth
The causes and risk factors for a premature birth are manifold, but not always clearly identifiable. Experts assume that it is a so-called multifactorial event, i.e. several factors together can lead to a miscarriage.
Maternal causes and risk factors for miscarriage are:
- General diseases such as (vaginal) infections or hormonal disorders
- Malformations of the uterus or fibroids (growths) of the uterine muscle layer
- pregnancy-related diseases such as high blood pressure, pre-eclampsia or gestational diabetes
- Weakness of the placenta (placental insufficiency)
- socially or economically difficult circumstances, psychological stress
- maternal age below 20 or above 35 years
- high consumption of nicotine or alcohol
- previous miscarriages
Infant causes of preterm birth are:
- deficiency development
- Chromosomal defects
- Malformations
- Multiple pregnancy
The risk of premature birth can be reduced if women avoid alcohol and nicotine, underweight and overweight, and stressful situations. If a pregnant woman’s daily work routine is too stressful for her, she can be given a precautionary rest period or even be banned from work. Regular medical examinations also reduce the risk of premature birth.
Preterm birth prevention: Medical measures
The medical measures taken in the event of a threatened premature birth depend on the duration of the pregnancy and the possible risks for mother and child. If possible, an attempt is made to maintain the pregnancy, because it is better for the child’s development if the child can remain in the womb longer as intended.
Premature labor
Premature rupture of the membranes
In cases of premature rupture of the membranes, the doctor will weigh up the risks of infection for mother and child against the risk of premature birth. Depending on this, he or she will induce the birth or try to delay it somewhat. The precautionary administration of antibiotics (against possible infections) is advisable. If the mother has a fever, a rapid delivery is attempted.
Premature birth: induction
If a premature birth can no longer be stopped, delivery is induced. The length of pregnancy and the position of the baby determine the type of delivery (vaginal or by cesarean section). In the case of a vaginal delivery, an episiotomy is often performed to protect the baby’s head, which is still very soft, from too much pressure.
As a general rule, all premature births before the 34th week of gestation should take place in a perinatal center. There, they specialize in the delivery and care of premature babies.
After premature birth
Premature infants are examined and, if necessary, treated for the following risks:
- Immaturity of respiration
- Immaturity of the central nervous system
- Immaturity of the eyes
- Immaturity of the skin
- Immaturity of the kidneys
- Immaturity of the intestine
How can parents help their premature baby?
Mostly unprepared, parents have to learn to cope with the new situation: the child is born much too early and it lies vulnerable, connected to many cables and tubes, in an incubator. Strict hygiene regulations, the multitude of medical equipment and a clinical environment make the situation more difficult for parents who want to give their child as much security as possible. Additionally stressful are the worries about the premature baby’s state of health. Last but not least, the visits to the hospital – which usually last for weeks – require a lot of organization from the parents.
But even if the situation is difficult and the parents feel helpless – they can still do a lot for their child.
Spend a lot of time with your child, tell him stories, read to him. A lot of closeness and loving attention helps him to develop healthily and well.
You can build up a particularly intensive emotional bond through the so-called kangaroo method and thus compensate somewhat for the early “separation”. In this method, the premature baby, who is only dressed in a diaper, is placed on the bare chest of his mother or father for a few hours. It hears your heartbeat, smells your skin, hears your voice. The child feels secure.
The often very delicate skin of premature babies is particularly sensitive to skin touch. It is therefore possible that the very small premature baby will find stroking uncomfortable. Therefore, it is better to gently hold the baby’s head with your hand or place your hand on his back or around his feet. This will also give the baby a feeling of security.
Breastfeeding attempts welcome
Do not forget yourself
Over the many visits to the hospital, you should not forget to think about yourself as well. Allow yourself plenty of time to relax and recharge your batteries. Because if you are relaxed and rested, this will be transmitted to your child.
Limits of medicine
Medical care has achieved a great deal in recent decades. But the earlier the child leaves the womb, the lower the chances for healthy development or even survival. This is because born before time, the child’s organs are not yet mature.
Premature babies born before the 22nd week of gestation, unfortunately, usually have no chance of survival.
Infants born before the 23rd week of gestation can survive, in some cases with significant health problems. The decision for life-sustaining or end-of-life measures is made jointly by the parents and the attending physicians.
Premature infants born before the 25th week of gestation have a good chance of survival. Life-sustaining measures are therefore the rule. Only in cases of severe health disorders do parents have to decide about life-sustaining or end-of-life measures.
Difficult decision for parents
It is very stressful for parents to let go of a premature baby because of severe health problems or expected consequential damage and to go the death-sustaining way together. The trained clinic staff can support the parents or recommend professional help. After all, grieving after a premature birth and the shared dying situation is important and necessary in order to ultimately develop a new zest for life.
