Q&A Preemies are in the family
I need some urgent advice on how to prevent a premature birth. Early labour seems to run in my family, even in my community, it feels like. Apparently I came early, says my mom, and all my sisters also gave birth early, but the babies were all fine after a stay in the NICU. Two years ago, my baby was stillborn at 22 weeks, and I live in absolute fear, keeping my eye on that viability deadline. Is there anything at all that I can do to keep my baby in?
A PROF LUBBE ANSWERS: Prematurity can be the result of medical conditions in both mom and/or baby, due to lifestyle and environmental factors, multiple pregnancies, and in 40 percent of cases, we just do not know why babies arrive early. Medical conditions may include high blood pressure in the mother, also known as PET or pre-eclampsia. It can also be the result of intrauterine growth retardation, premature rupture of membranes, placenta abruption and foetal abnormalities. Lifestyle and environmental factors include long working hours, especially if it is also physically challenging, stress, smoking (also when the partner is smoking), and using drugs and alcohol. In some cases, mothers can lower the risk for pre-term delivery, but it cannot be prevented altogether. If you have a history of pre-term births, you may need to have extra care to prevent pre-term labour. Your healthcare provider may recommend progesterone therapy during pregnancy or having a cerclage, a stitch to keep the cervix closed, placed.
SOME PRECAUTIONS TO TAKE
TAKE CARE OF YOUR HEALTH
Make sure that you get good prenatal care. See your healthcare provider even before you are trying to fall pregnant. Micro-nutrient health at this point is very important to ensure optimal growth and development of the foetus. Keep regular prenatal appointments with your doctor or midwife, even if you feel fine, since they can help screen for pre-term labour and treat it as early as possible. If you take prescription drugs, ask your healthcare provider if it is safe before or during pregnancy. When you experience problems such as high
blood pressure and diabetes, ensure that the medication is monitored and controlled through antenatal care. If you are using herbal supplements, stop their use before you are trying to fall pregnant. Check with your healthcare provider on the safety of any supplements before using them.
MAKE LIFESTYLE CHANGES
If you smoke – quit. Smoking increases the risk of pregnancy complications, such as premature birth. Avoid second-hand smoke. Partners should also stop smoking, since the nicotine inhaled through passive smoking is not good for you or Baby and has been shown to lead to intrauterine growth restriction. Avoid alcohol while you are trying to fall pregnant or during pregnancy. In the same line, do not use illegal drugs or over the counter drugs. Always check with a licensed healthcare provider to ensure that medication is safe. Medication can be especially dangerous during the first three months of pregnancy. A pregnancy massage may help you carry your baby to full term, since it helps to decrease stress hormone levels. This is a wonderful way in which your partner can be involved in the pregnancy. Mothers who received massage therapy during pregnancy feel less anxious after a massage session, and a foot massage has shown to lower the heart rate, blood pressure and respiration.
HYDRATE
When you become dehydrated, the concentration of oxytocin can rise in your blood, causing contractions, so remember to take lots of fluids, especially during the summer. If you become thirsty, you are already dehydrated, so set yourself a good routine of taking in fluids, such as water, and reduce the intake of caffeine.
EAT WELL AND STAY ACTIVE
Eat a well-balanced diet that includes fruits, vegetables and whole grains. Do not skip
meals. Consider adding fish to your diet. It may reduce the risk of pre-term birth, but stay away from raw fish and meat. Stay active during your pregnancy. Your healthcare provider can give you exercise guidelines. Avoid long periods of standing and high levels of stress and anxiety.
PREVENT & TREAT INFECTIONS Vaginal and urinary infections can all cause premature labour. Have any symptoms checked out and treated. For example, if you feel burning or pain when you urinate, tell your healthcare provider. You may have a bladder infection. Go for regular dental check-ups and ensure good mouth hygiene, since gingivitis is common in pregnancy.
OXYTOCIN & PROSTAGLANDIN Oxytocin initiates contractions and is also released with breast or nipple stimulation, semen and having an orgasm. If you are at risk for pre-term labour, use a condom during sex or avoid it all together.
YOUR MENTAL HEALTH
Learn strategies to reduce stress. Yoga or meditation are great for relaxation, but even just a few minutes per day “me time” will be very beneficial. Take a relaxing bath, or enjoy tea in a garden or a quiet place. Physical and emotional abuse is harmful to you and your baby. If you are in an abusive relationship, seek help from your healthcare provider, family or friends.
WATCH FOR THE SIGNS
To reduce the risk of pre-term labour progressing to pre-term delivery, call your healthcare provider right away if you have: headaches, stiff hands with tight rings and swollen feet, burning urine, pain in stomach and back, vaginal bleeding, don’t feel the baby kick, feel tired and weak, an itchy vaginal discharge and waters that have broken before baby is due.