What to watch for and how to help lessen the negative effects of pre mature birth
The good news? Preemies are fighters, and modern medical technology can keep incredibly tiny babies alive. The survival rate for infants born at 26 weeks is now 80 percent; at 32 and 33 weeks, 98 percent; and between 34 and 36 weeks, 99 percent. A recent report on a study following two of the smallest preemies on record — born weighing less than 10 ounces each — found that both children have experienced normal motor and language development at 3 years old as well as hit developmental milestones at appropriate age levels.
I'm Having a Preemie — What Now? If you go into labor or need a C-section early, you may be transferred to the nearest hospital that can accommodate your needs. (Hospital nurseries offer different levels of care: Level I nurseries are for healthy, full-term babies; level II for babies born at 32 weeks and older; level III are for the smallest, youngest preemies, with specially trained medical staff and high-tech equipment.) If you know you're going to deliver early, Scott Berns M.D., senior vice president at the March of Dimes, recommends visiting the NICU beforehand. “It can feel intimidating,” he says. In the NICU, babies are in enclosed incubators, often with feeding tubes, IV lines and heart rate and oxygen monitors attached to their tiny bodies. Visitors are limited, and they must scrub in upon entering the unit.
“There are 30 to 50 beds in some NICUs filled at one time; you're seeing other families come and go, and it can be very stressful,” says Kelli Kelley, executive director of Hand to Hold (handtohold.org), a support organization for parents of preemies. Once you deliver, don't be afraid to quiz the doctors and nurses about unfamiliar equipment, terms and procedures, says Burbank, California, dad Steven Worley, who has been through the NICU experience twice — with Maggie, now 5, and Sam, now 3. “You really need to educate yourself on what it means to have a premature baby,” he says. “It's OK to ask, ‘Can you explain exactly what that means?’”
Why Me? There's no single cause of preterm birth. Risk factors include smoking, obesity, chronic medical conditions (diabetes, high blood pressure) and having had a previous preemie. Medical reasons include pre-eclampsia, infection and placental abruption. Women carrying multiples (who compete for space and nutrients and become stressed) are also much more likely to give birth early. However, a large percentage of babies are born early for no known reason. “You can do everything right and still have a baby born too soon,” says Dr. Berns. “Almost half the time, we don't know why it happens.”
Bonding, Interrupted It's a tricky business with preemies — usually, you can't even hold your baby at first. Parents often feel shock, numbness and disappointment. “You have this image in your head about how the perfect birth and bonding should be,” says Beth Maclin of Hazel Crest, Illinois, whose son Carter was born at 29 weeks. “The worst thing about having a preemie was the feeling of the rug being pulled out from under you. You feel so helpless.” Still, there are ways to get to know your newborn.