Many people think of preemies as those teeny, cute babies that happened to be born early. But though they’re often teeny and soon get cute, premature babies are small because they haven’t finished growing all their parts before they need them to survive. That lack of development in utero is often life-threatening and demands special care.
For a modern industrialized country, the US has a very high premature birth rate: 1 in every 10 births. The risk varies among ethnic groups, with African-Americans having a 50% greater chance of giving birth early.
Surprisingly, 50% of all premature births in the US were to women with no risk factors for pregnancy or even a family history for prematurity.
What’s wrong with being premature?
Pregnancy is a miracle time that blends two tiny chromosomes and develops them into the amazingly complex biological system that is the human body. Full development takes at least 37 weeks of gestation. Being born before that increases a baby’s risk of having a body that can’t meet the challenge of life.
Prematurity is the number one factor contributing to newborn death or suffering.
Babies need as much time in utero as possible to develop all their body’s systems. But the lungs, liver, and brain need the most time and are the last to fully develop.
These parts are at risk for not being able to do their job, leaving baby with potential lifelong problems for
- Breathing difficulty
- Feeding problems
- Cerebral palsy
- Developmental delay
- Vision problems
- Hearing problems
As well, a premature baby’s skin (the largest organ in the body) is undeveloped and inefficient at providing protection against disease, chemical damage, and infection. Nor can it function well to maintain his body temperature, a critically important survival factor.
Preemies will take 2-3 weeks to develop the effective skin barrier that full term babies have.
If your baby is born premature, you and your healthcare team will decide on the right care for her, according to her condition and your preferences. As baby’s response and conditions change, that care plan will also change.
You may want to consult with clergy, social workers, family or friends before you make decisions.
Depending on how premature she is,
- she’ll probably need a breathing tube. As her lungs mature that tube will be removed.
- she may not be able to eat on her own and will have intravenous tubes feeding her through needles in her skin. As she matures, you may be able to breastfeed her.
- she’ll probably be in a heated incubator to keep her body temperature stable. You can reach inside and pat her gently so her super fragile skin doesn’t tear. Once she’s capable of maintaining a healthy temperature and her skin thickens, you’ll be able to snuggle skin to skin with her in the NICU.
If she’s just too small to make it, even with the help of technology and expert attention, you and your team will decide when to withdraw life-saving care. Baby will be kept warm and comfortable. NICU staff will help you take pictures or get keepsakes like footprints.
If you have risk factors or family history for premature birth, find the social services during pregnancy that you can turn to for support, if you need it.
Premature babies may not survive, may need help all their lives, or may sail through developmental milestones like their full-term peers. Babies are so individual that each family will go on its own journey and make the decisions that are right for them.
 Hamilton B, Martin JA, et al. Births: Final Data for 2014. National Vital Statistics Report. Center for Disease Control and Prevention. 2015; 64:2.
 Dr. Lee Shulman, OB-GYN, FACOG, video #4 0:24 minutes, https://www.pretrm.com
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Published: December 26, 2017 | By SP Turgon, Certified Labor Doula | Reviewed by: The Best Ever Baby Expert Team | Last reviewed: December, 2017