Pregnancy is a time of joy and celebration, but that doesn’t stop a mum-to-be from having her own unique set of worries. After all, growing and nurturing a human being inside of you can put a lot of pressure on a person.
One of the most common worries that sends almost every pregnant mum into mini-panic mode at some point is the fear of going into preterm or premature labour. For a baby to be born healthy, doctors (and nature) recommends that the foetus be carried for the entire gestational period, which lasts 40 weeks.
By medical standards, anything between 37 weeks and over is also considered full-term and healthy for baby, notes SmartParents expert Dr Christopher Chong, an obstetrician-gynaecologist at Gleneagles Hospital. “Anything before 37 weeks is considered preterm labour,” he adds.
Giving birth too early comes with a host of complications for both mum and bub. Dr Chong explains, “Danger for the mother depends on the reasons she went into premature labour ― not the labour per se.” For example, she could have gone into labour because of high blood pressure, which could be life-threatening for her.
“Their [preemies] organs may not be well formed, there is higher risk of respiratory disorders, poor growth, poor feeding and it may also affect their level of intelligence.”
For baby, the health complications depend on how premature he or she is. “Their organs may not be well formed, there is higher risk of respiratory disorders, poor growth, poor feeding and it may also affect their level of intelligence,” says Dr Chong. Preemies have lower immunity levels, which makes them more prone to infections, and are also at higher risk of jaundice.
Who is at higher risk of preterm labour?
Less than 20 per cent of women go into preterm labour, but your chances of experiencing one is much higher if you have any of the following conditions:
· A lower genital tract infection.
· Pregnant with multiples.
· High blood pressure.
· Badly-controlled diabetes.
· Chronic smoker.
· Growths in the womb, such as fibroids.
· An incompetent cervix.
· An abnormal or septic womb.
· A bicornuate (“heart-shaped”) uterus.
· If you’re 18 years old and younger.
· If you’re 40 years old and older.
· Patients who are malnourished.
· Patients who have had poor antenatal care.
· Bleeding from the placenta.
Signs you might be experiencing early labour
As long as you’re unwell or feel that something is “off” with your body, talk to your doctor at once. Unfortunately, preterm labour can happen at any point, and the earlier it does, the more you put yourself and your baby at risk.
Keep an eye out for the following symptoms…
1. Dull lower backache
Like most women, you might have been experiencing back pain for the better part of your pregnancy, but if the pain becomes unbearable, it could be sign of “back labour”. In a normal full-term labour, the baby presents or makes its way down the birth canal with its face against the mum’s spine. “However, in this case, the foetus is presenting onto the rectum and back area,” says Dr Chong, which explains the excruciating back pain.
2. Change in vaginal discharge
You might notice a watery mucus discharge or a bloody show. “If it’s yellow, greenish, brownish or pinkish, it may indicate a vaginal infection, which can lead to labour if not treated,” adds Dr Chong.
Braxton Hicks happens randomly and goes away, whereas labour contractions will happen at regular intervals (such as every few minutes) and won’t stop.
3. Abdominal pressure or more than four regular contractions in an hour
This may be a bit tricky, notes Dr Chong, as feeling pressure in your lower belly is a common side effect of pregnancy, especially as your foetus grows bigger. You will also, at some point, in your pregnancy experience Braxton Hicks ― the sudden tightening of your belly. That’s your body’s way of preparing you for labour, but it’s not a sign of the actual thing. Here’s how they differ: Braxton Hicks happens randomly and goes away, whereas labour contractions will happen at regular intervals (such as every few minutes) and won’t stop. “If the pressure progresses to pain, it could also be a sign of labour,” he adds.
4. Vomiting or diarrhoea
This is usually due to an infection caused by food poisoning or stomach issues. When it’s mild, there’s no reason to worry. But if it gets to point where you can’t tolerate liquids for more than eight hours, it could lead to labour.
5. Your water breaks
“Once this happens, labour progresses naturally within the next 24 to 48 hours if nothing is done,” explains Dr Chong. “And we may need to deliver the foetus soon.” However, delivery is not always the only option, especially if the foetus is severely premature. Baby might be kept inside the womb and his or her condition assessed daily. Every minute inside the womb makes a huge difference to how well bub will thrive after birth.
“Every day, we will assess if the foetus is safer in the womb or outside the womb and how good the care will be at the neonatal ICU,” adds Dr Chong.
If your preterm labour symptoms can’t be managed or stopped, delivery is usually the only option. The mother can still have a vaginal birth, unless the foetus is not in the head down position as the labour is so early. “Then, we will need to do a C-section,” notes Dr Chong.
As a rule of thumb, Dr Chong says that a baby can be safely delivered after 34 weeks of gestation. However, the aim is to keep the foetus inside the womb up until they are at least 37 weeks. so that their organs can mature.
If you’re experiencing any of symptoms we’ve mentioned, seek medical help early. “We need to treat the root cause immediately to try to stop the labour, while injections will speed up the foetal lung maturity,” says Dr Chong. “You will also need close monitoring and complete bed rest.”
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