DOES EVERY BABY COME EARLY?
Q:
I’m 33 years old and pregnant with my fourth baby. My first son was born at 40 weeks, my second son at 37 weeks and my third son at 34 weeks. I also miscarried in 2013. I have been on semi-bedrest since 24 weeks (I’m now 30 weeks). Is it true that every baby you have delivers earlier? I’m so anxious.
A:
Preterm labour (PTL) has many causes and triggers, and we still don’t fully understand all the factors involved. As a general rule it is not true that each subsequent baby will be delivered earlier than the last, but having had a previous preterm delivery does significantly increase your risk of another preterm delivery. A possible cause in this case is a mild cervical weakness or incompetence. In severe cases, cervical incompetence causes a mid-trimester miscarriage, typically with a very rapid and fairly painless labour. Early into pregnancy, a cervical cerclage (or stitch) reduces the chance of a preterm delivery. At 30 weeks a cervical cerclage is not recommended. I would suggest bed rest. This helps to relieve the pressure on the cervix and relax the uterus. Get up only to go to the bathroom and for meals. Exclude a bladder infection if uterine contractions increase at any point. An early bladder infection can make the uterus niggle. Discuss progesterone use with your healthcare provider. This may help to relax the uterus and delay delivery. Request a vaginal swab. Studies are suggesting that certain bacteria found in the vagina may be linked to PTL and treating these may reduce the chance of early delivery. Avoid having sex. Most babies born after 34 weeks do extremely well – so that’s your aim. After that every day is a bonus.