World Prematurity Day is observed on 17 November, This is to raise awareness of preterm births and the complications and issues experienced by preterm babies and their families.
Every year, according to the WHO, 15 million babies are born preterm which is defined as before 37 weeks. This works out to approximately 29 babies born per minute, annually. In South Africa, it is estimated that at least 8 out of 100 babies are born prematurely. Babies that survive can have serious long-term health consequences which can include visual and hearing impairments, neurodevelopmental disabilities, and cardiovascular disease. Despite potential complications, many preemie babies survive and go on to thrive, often against all odds. Famous preemie babies include Stevie Wonder, Albert Einstein, Charles Darwin and our very own Rio 2016 Olympic 400m track gold medallist, Wayde van Niekerk.
There are several risk factors for preterm birth including short intervals between pregnancies, smoking and preeclampsia. However, in approximately half of cases the cause is unknown. Further research is needed to find the unknown causes of preterm birth and new ways to prevent it.
It is important to create awareness surrounding pre-term labour and pre-term birth, as many families are faced with this and do not need to feel alone or face this challenge in isolation. Today we share the story of a family that has experienced the journey of pre-term labour and pre-term birth.
“We were very lucky as compared to some of our friends, we got pregnant relatively quickly after we started trying. We were over the moon when we saw the two blue lines and I couldn’t wait to start decorating the baby room. During the first trimester I had the normal pregnancy niggles and the nausea finally disappeared at 13 weeks. I don’t think anyone who hasn’t experienced morning sickness can explain the feeling. I still get flash backs when I see or smell some things.
At our sixteen weeks scan we found out that we were having a little girl. I could finally decorate the baby room in all things pretty and pink with rainbows and unicorns. The pregnancy progressed well, and my baby bump started to grow. I felt relieved that I started to look pregnant, it started feeling real.
The weeks passed quickly, and the excitement started to turn into slight nerves. Were we ready for our little princess? What do we still need? Are we going to be good parents? Will we know what to do when she arrives? All those questions that you think of in the middle of the night when you can’t sleep because you had to get up to go to the loo for the 10th time. Madam had quite a little kick, usually aimed at my bladder in the middle of the night.
Due to this I didn’t take much notice at first when I started having light “twitches” one early evening when I was 28 weeks pregnant. After a while it started to become more uncomfortable, but I was still not worried as a lot of my friends told me they started getting pains at this stage, but it was mostly ligaments stretching trying to make space for the baby. I took a warm bath and went to bed, thinking that warm water and some rest would help. I woke up that night at about 23h00 in pain, with regular cramping. I woke my husband and said, ‘something just didn’t feel right, we must go to the hospital’. We took our bag and made our way straight to the hospital. On the way to the hospital, I phoned the labour ward and explained my situation. They recommended that I went straight to the labour ward when I arrived at the hospital and that they would let the Gynae on call know that I was on my way. I still remember thinking that they are probably just going to tell me that I’m just bloated from the spicy food I had for dinner, we’d all have a good chuckle and be back on our way home.
On arrival, they put me on a monitor to check the baby’s heart rate and for contractions. The doctor examined me and admitted me to the ward. My cervix was getting shorter, and I was having contractions. They told me that I was in preterm labour. I requested that they explain this to me in more detail, as I didn’t understand what it meant. They said that I was in the early stages of labour and that if they didn’t stop the contractions that there was a high possibility of my baby being born in the next few days. I was very confused as my baby still needed to develop inside me for 12 more weeks. I kept thinking, ‘She is too small! She isn’t ready yet!’. I began to panic and could feel my heart racing.
They administered the medications required to stop the contractions and a steroid injection for the baby’s lungs.
I am not sure if it was the medication or the idea that my baby could be born at any moment, but it felt like my heart was going to jump out of my chest. I could not think clearly and kept wondering if my baby would be okay if she arrived at 28 weeks? They continued to monitor our baby girl and me and the doctor seemed worried. The doctor expressed his concern about the wellbeing of our daughter and me and said that he needed to administer a different medication via the drip. After 2 days this seemed to have brought the contractions to an end and after a day of monitoring me, they discharged me. The doctor advised that I try and stay as calm as possible and remain on bedrest. This was a huge relief for me! I got to go home with my baby still safely inside me. The doctor precautioned that this could recur, but every day that we are able to keep our baby inside and she is developing and getting stronger. I asked what caused the sudden labour and the doctor said that I had no risk factors that it is sometimes inexplicable.
I stayed home the next few weeks, trying to do as little as possible and staying as calm as possible for our baby’s sake. At 32 weeks I felt ‘a bit off’ for a day or two and then had that familiar sinking feeling when I felt contractions again. I phoned my husband who quickly came to collect me and take me to the hospital. When we got there, they examined and monitored us again. I was 5cm dilated. The doctor said that there was not much that they could do to stop our baby girl arriving, as I was in labour. Our precious little girl was born and weighed just over 1,6kg. She was so so tiny and struggled with her breathing. She was taken to neonatal ICU before I could even hold her. It broke my heart to see her surrounded by all the monitors, her eyes being covered and being fed by a tube. But, she was perfectly formed. I expressed breast milk and they tube fed her. She started gaining weight and looked a little less jaundiced every day. There were a few other babies in the neonatal ICU that had even more machines next to them. All the mothers had the same worried, but proud faces. I made some really great friends, and we still keep in touch.
We were very happy when the doctor told us 9 days later that we could take our little girl home. It was beautiful to see her in the car seat, looking like a tiny little doll and then in her own little bed at home. We were very vigilant the first few weeks, not allowing friends and family over. It was quite an adjustment, and we had many sleepless nights. She thrived and started filling out her skin. She started to look like a ‘real baby’.
Four years down the line and she is a happy, clever little busy bee that keeps us on our toes. She is still small compared to other 4-year-olds, but what she lacks in size she makes up in wit and personality.
Reflecting on this journey, I learnt that all you can do is remain calm and trust the experts to do what they specialise in. Support systems are vital, so make friends with people who are going, or have been, through the same struggles and reach out for support and offer support whenever you can. You can only do your best and that at the end of the day is good enough.”
Let’s join hands and wear purple on 17 November 2021 to celebrate our preemies on World Prematurity Day and to support this important awareness day.