Our Baby News

WHAT HAPPENS TO PREMATURE BABIES?

Doctors today talk more of pre-term babies (ones born before 38 weeks) than premature babies.

Prematurity is defined by weight; a baby under 2-5 kilogrammes (5 1/2 pounds) is treated as premature whatever the length of the pregnancy which produced him. However the point must be made that length of pregnancy is most important – a baby who is small but was in the uterus for the full term is less of a worry to the doctors than a bigger one born before term.

The causes of pre-term births are many, and not always understood. Twins (and triplets or more) are usually pre-term. Preeclampsia can lead to a pre-term baby as can problems of the placenta during development. If the placenta lies between the baby and the opening of the birth canal, this means delivery is very difficult – the condition is called placenta praevia – and in a few cases the placenta may separate from the wall of the uterus. In this case early caesarian section may be needed and so the baby may be pre-term. Other causes may include illness in the mother,such as anaemia, or fibroids in the uterus.

If it is possible to delay a pre-term birth, the doctors will do so – with bed-rest and sedation and in a few cases with hormone treatment, and sometimes with alcohol, given in an intravenous drip. In other cases it is not possible to do this, and in some, of course, the pre-term delivery is deliberate, for example in severe pre-eclampsia.

The correct word for a miscarriage – the loss of a pregnancy before the baby is able to survive on his own, that is before the twenty-eighth week of the pregnancy – is abortion. Unfortunately this word has over recent years come to be used by many people to mean primarily deliberate termination of a pregnancy, and a woman who greatly wants her baby and has a miscarriage may be very upset if she hears hospital staff use the word abortion to describe her condition. But she shouldn’t be -no-one is suggesting she deliberately ended her pregnancy just because they use this word.

What are the causes of spontaneous abortion or miscarriage? There are many, some understood, some not. It is certainly a very common happening – it has been estimated that about one in every five pregnancies ends in miscarriage and that the commonest time is during the first three months. One cause of miscarriage at around the tenth to twelfth week is the ‘blighted ovum’. Instead of developing normally, the cells fail to start the proper growth into a baby, and the body recognizes this because of differences in the hormone responses, and discards the pregnancy.

This, many people feel, is something to be grateful for rather than to mourn. Better surely to lose a pregnancy than to suffer the birth of a severely handicapped child. There is no suggestion that there is anything wrong with either parent if this happens; the growth needed to make a baby from two tiny cells is so incredible that the remarkable thing is that so many develop normally rather than that a few don’t.

This is one of the most vexed of questions since it tends to be clouded by individual views of ‘morality’ rather than by sensible consideration of medical facts.

The facts are that in most cases regular sexual intercourse is harmless, and indeed healthy. A loving couple would feel sadly deprived if it were forbidden for three-quarters of a year.

However, there are a few exceptions to this; women who have a fragile pregnancy, in which there is a threat of miscarriage, may need extra rest. Sexual intercourse, since it burns up a great deal of energy and involves contraction of many muscles, is hardly restful.

So for such women abstention at the times of greatest risk is usually advised . For the rest of the time there need be no problems.

This common symptom is once again due to the higher levels of progesterone in the blood. This is the hormone, remember, which causes muscles to relax, and when it acts on the muscles at the top end of the stomach, it allows the valve there to open and let stomach contents bubble back into the gullet. Stomach contents are high in acid – it is needed for the digestive process – and this acid can damage the delicate lining of the gullet, leading to the hot, searing pain behind the breastbone commonly called heartburn. Another cause, as pregnancy develops, is the way the enlarging womb presses upwards on the abdominal contents and makes it all a bit crowded, with resulting pressure on the stomach, which increases the tendency towards regurgitation. This is obviously more of a problem in the later months of pregnancy.