Small beginnings: Delivering prematurely, realities and rates

30th December 2013   ·   0 Comments

By Nayita Wilson
Contributing Writer

“You may feel ready to meet your baby, but your baby may not be ready to meet the world. Important developments occur throughout pregnancy—especially in the final months and weeks.”
—CDC & National Center for Chronic Diseases Prevention and Health Promotion

Preterm birth factors are present in about 500,000 U.S. births annually according to the Centers for Disease Control (CDC). A sobering experience that places intense pressures on babies, the families and medical teams involved, many medical experts stop short at identifying any primary cause of preterm births, as the contributing factors can range from the unknown, to insufficient understanding of preterm labor to life inhibiting factors such as smoking, drug and alcohol use or insufficient prenatal care during pregnancy, according to the CDC.

Angell Simmons of Laplace gave birth to her son Jekhi in July of this year. Jekhi was born six weeks earlier than expected.

“I guess he just decided to come early. I wasn’t doing anything strenuous like hard exercise. The doctor doesn’t know why he came early. No one knows,” Simmons said.

The day her son was born, Sim­mons began having contractions at about midnight. The pain intensified, and she later went to the hospital at 3 a.m. on the morning of July 13, 2013. Upon arrival, she learned that she was four to five centimeters dilated. The physician’s staff did not want to induce labor and opted to let the process run its course.

After more than seven hours of labor, Simmons’ water bag broke at11:50 a.m., and Jekhi was born within minutes, weighing in at five pounds, 3 ounces.

Simmons said her son was rushed to the Neonatal Intensive Care Unit (NICU) at Tulane Lakeside Hospital in Metairie, La., after he was delivered. He was immediately placed on oxygen, IVs and a respirator and remained in the unit for one week.

“I cried like a baby. I was just nervous because I didn’t know if I did something wrong for him to come early,” she said. “It was a trying week.”

During that week, she worked closely with a lactation doctor and a physical therapist to address nursing and bonding challenges that are common in preterm births.

“A lot of times with babies that are sick because they are so premature and have so many tubes and so many things going on, the mom doesn’t get that bonding time with the baby. That comes weeks or months afterwards,” explained Registered Nurse Aireal Hobbs.

Hobbs, a home health nurse, has worked in several children’s pediatric hospitals in New Orleans and Atlanta. She specializes in pediatric intensive care unit work, and has worked in various NICU units on occasion.

She says working NICU is an emotional experience, as all parties involved deal with the highs of having a premature child discharged as well or the lows of seeing a deceased infant taken to the morgue.

“Nobody can say what is going to happen to your premature baby, but obviously the longer they stay in utero (the womb), the better their chances are for survival without serious complications,” she said.

This is why NICU is designed to create womb-like conditions with low lighting, a quiet environment, warm temperatures and minimal contact, according to Hobbs.

“You are doing everything that you can not only to save this baby’s life and support the family, but to also facilitate bonding between the baby and the family. Once the baby is stabilized and grown, your next step is to socialize with the baby and help the baby reach developmental milestones,” Hobbs said.

Prematurity Rates

Preterm or premature labor occurs when a baby is delivered earlier than 39 weeks and when key organs, such as the lungs and brain are still developing.

“You may feel ready to meet your baby, but your baby may not be ready to meet the world. Important developments occur throughout pregnancy —especially in the final months and weeks,” the Centers for Disease Control Prevention (CDC) and the National Center for Chronic Diseases Prevention and Health Promotion advise expecting families in the agencies’ “Your Baby Grows throughout Your Entire Pregnancy” fact sheet.

According to the fact sheet:

• 32 weeks pregnant is too early. Baby’s lungs are still developing.

• 35 weeks pregnant is too early. Baby’s brain development occurs most rapidly at this stage.

• 37 weeks pregnant is close, but not quite ready.” Baby is adding weight quickly.

• 39+ weeks pregnant. Healthy pregnancy.

The March of Dimes of recently released its 2013 Premature Birth Report Card, which provides national and state-based data on premature births based upon the following selected factors: uninsured women, late preterm births and women who smoke.

Louisiana received an “F” letter grade for having a 15.3 percent premature birth rate. The U.S. as a whole received a “C” for having an 11.5 percent premature birth rate among the select group.

March of Dimes’ goal is to reduce the state and national rate to 9.6 percent.

In Louisiana, March of Dimes is working with the Department of Health and Hospitals and other partners to reduce those numbers, said Dr. Joseph Bocchini, chairman of the Department of Pediatrics at LSU Health in Shreveport.

“This is a statewide effort, but obviously we have a long way to go,” Bocchini said.

Small Beginnings is a multi-part series that will take an in depth look at prematurity.

This article originally published in the December 30, 2013 print edition of The Louisiana Weekly newspaper.