Month 7 Hold on baby!
Sometimes, babies come into the world before your 40 weeks of pregnancy are complete. Here’s how to spot pre-term labour and what you can expect.
Doctor Trudy Smith, an obstetrician at Charlotte Maxeke Johannesburg Academic Hospital, stresses the importance of good antenatal care and recognising the signs of early labour so that you can get help. “Sometimes, spontaneous labour can be stopped or controlled long enough to mature the baby’s lungs to minimise complications,” she says. “But when the mother’s life is at risk, because there’s no way of stopping vaginal bleeding or controlling any pregnancy-induced hypertension, we have no choice but to deliver the baby early.”
Labour that begins before 37 weeks is called preterm labour. Babies born before 28 weeks or weighing as little as 500g can and do survive – but at a cost. “Although we can’t always identify the cause of premature labour, we know who’s at risk, so we can monitor these women throughout pregnancy to help prevent or minimise complications,” Dr Smith says.
Premature labour may begin with the baby, the womb, hormones or circumstances. For example, a big baby (either because of genetics or gestational diabetes) can overstretch the womb, as does a multiple pregnancy. Polyhydramnios – too much amniotic fluid – can also cause premature labour. The cervix may be weak and unable to “hold” the baby beyond six months. Infections, leaking amniotic fluid and vaginal bleeding are all associated with early labour.
“Women with pregnancy-induced hypertension may need to have their babies delivered early because of the complications of the condition,” Dr Smith says. “Pregnancy-induced hypertension is more common in first-time mothers and in women who carry twins or have other diseases such as diabetes.”
IS THIS EARLY LABOUR?
So what can you do to minimise the risks? “It’s important to go to your doctor or clinic regularly during pregnancy and to report anything abnormal,” Dr Smith advises.
Signs of early labour include regular contractions with low abdominal cramping (like period pain) or constant backache. You often instinctively feel that something is wrong – especially if you have diarrhoea and a pink or blood-stained vaginal discharge. Once assessed, you may be admitted to hospital and put on a drip to try stop or delay labour long enough to help the baby’s lungs mature. If labour is stopped, you may be allowed to go home, providing you rest and report any changes or signs of labour.
Once the womb has started to open (when the cervix starts to dilate) and the waters have broken, labour is inevitable. Then a paediatrician and high care will be alerted to be on standby when the baby is born.
WHAT TO DO IF YOU EXPERIENCE SIGNS OF EARLY LABOUR
Premature labour shouldn’t be confused with Braxton-Hicks contractions – which are irregular, painless, “practice” contractions that come and go throughout pregnancy. True premature labour contractions are constant and associated with other signs of labour. Because it’s not practical (and stressful) if you’re always phoning your doctor or midwife, or rushing off to the hospital, monitor contractions for at least an hour or have a relaxing bath before you panic. If you’re feeling worse after the hour, get medical help. If symptoms disappear with rest, it was a false alarm.
PREVENTING PREM LABOUR
To minimise complications during pregnancy and birth, first prize is when you’re in peak health before conceiving. Your body must adapt to enormous changes throughout the nine months, and providing your hormones are in sync, your lifestyle is balanced, and there are no pre-existing medical conditions, your body will cope remarkably well.
So start exercising and eating well as soon as you can after conception if you haven’t started doing so before. Gentle exercise is always recommended, but if you haven’t been exercising before conceiving, as always make sure you are cleared to start doing so with your doctor. Fortunately, pregnancy is possible for most of us – including women with heart conditions, physical disabilities or existing illnesses that may already tax important organs like the kidneys, pancreas and liver. These pregnancies need specialised monitoring, specific medications, special diets, and regular blood and other antenatal tests, such as scanning and non-stress tests.
If you have miscarried more than twice during the second trimester, you may need hormonal treatment or a special stitch in your cervix to prevent another miscarriage or premature labour.
If your pregnancy profile fits into the
“at risk” category, you will be advised to take extra precautions such as minimising sex, temporarily down-scaling work responsibilities so that you can take more rest days, and seeing your doctor more often. Most women experience a few anxious moments sometime during the pregnancy when contractions hurt and you worry about early labour. Happily, for most, these are false alarms that serve the useful purpose of reminding you to take it easy while you’re pregnant! ●
If you have miscarried more than twice during the second trimester, you may need hormonal treatment or a special stitch in your cervix to prevent another miscarriage or premature labour.