Coping following a preterm birth

Maternity

Tuesday, October 3, 2023

While pregnancy is a powerful and magical journey for some, others may experience difficulties and tragedy throughout their pregnancy.

If you should experience a preterm birth, understanding what your body is going through and knowing that you aren't alone are important parts of the healing and recovery process.

What causes preterm labor?

A preterm birth is the delivery of a baby before 37 weeks gestation, and preterm births account for about one in every 10 babies born.

Preterm babies are more prone to hearing, visual and cognitive impairments than those born full term. Studies have shown that preterm babies may experience developmental delays in language and speech, cognitive processing and fine motor skills. These developmental delays can make it harder for preterm babies to learn and meet developmental milestones on time.

"Preterm birth is the leading cause of death in children under five. It's also a major public health problem, with more than 13 million babies born prematurely each year," says Denise Wilks, DNP, CNM, a board-certified nurse midwife at Riddle OB/GYN Associates, part of Main Line Health.

Healthcare disparities in preterm birth among African American women in the United States result in higher rates of preterm birth and infant mortality compared to women of other racial and ethnic backgrounds. According to the Centers for Disease Control and Prevention (CDC) the preterm birth rate among African American women is over 14%. They have almost a 50% higher chance of having a pre-term birth compared to Hispanic and white women.

"Addressing these disparities requires efforts to improve access to quality prenatal care, address racial biases in healthcare and address socioeconomic factors," says Dr. Wilks.

The causes of preterm labor are not always known. However, there are some known risk factors that you can reduce or eliminate in your life to help prevent preterm birth:

Increase in maternal age

As advancements in fertility and reproductive technology continue to grow, the age of maternal parents is also increasing. However, this increase in maternal age has led to an increased likelihood of preterm births.

As women age, their bodies undergo a variety of changes that can have an impact on pregnancy outcomes. For instance, older mothers tend to have less elasticity in their cervical muscles, making it more difficult for them to carry a baby full term. Additionally, the aging of the uterus may lead to decreased blood flow to the fetus, increasing the likelihood of preterm labor.

Pregnancies through fertility or reproductive methods

Furthermore, when assisted reproductive technologies are used, they often involve the use of medications that can cause hormonal changes in the body. These changes can make the uterus more susceptible to contractions and may even cause cervical changes that can lead to preterm labor. Additionally, the implantation of multiple embryos during in-vitro fertilization can increase the likelihood of preterm labor and premature birth.

Moreover, certain procedures such as amniocentesis and chorionic villus sampling can increase the risk of preterm birth. Both procedures involve the insertion of a needle into the amniotic sac or placenta, which can trigger preterm labor or lead to infections.

Infection

An infection in the uterus can cause contractions and lead to premature delivery. There are many different types of infections that may be responsible for this complication. If you have any signs or symptoms of an infection during pregnancy — such as vaginal discharge with an unpleasant odor — you should see your doctor immediately for treatment.

Smoking

Smoking during pregnancy increases the risk for several health problems in both mothers and babies including low birth weight infants who were born prematurely (<37 weeks gestation), stillbirths (death after 20 weeks' gestation) and sudden infant death syndrome.

"It also increases blood pressure levels which could develop into preeclampsia later on in pregnancy if a mom continues to smoke," says Dr. Wilks.

How to cope following preterm birth

When you're going through a preterm birth, it's important to remember that you're not alone. There are many resources available to help you cope with the stress and anxiety that come with this difficult experience.

Support groups

These support groups can be found online or in person, depending on where you live. They offer people who have been through similar experiences an opportunity to share their stories, learn from each other's mistakes and find comfort in knowing they aren't alone.

Counseling

If talking about your feelings with others doesn't help enough for you — and it might not — there are other options available. A psychologist or psychiatrist will be able to help explore how your preterm birth affects every aspect of your life and determine which coping strategies work best for each individual person.

Coping with miscarriage, stillbirth or neonatal loss

Coping with miscarriage, stillbirth or neonatal loss can also be a difficult process. You may feel overwhelmed by your emotions and find it hard to deal with other people's reactions. But there are ways to help you with your grief, in addition to the resources mentioned above.

Talk about what happened. If you don't want to talk about it, that's okay too. But if there are people around who know what happened, they may be worried about how they should act around you and whether there is anything they can do for you right now — and that can make them feel helpless and frustrated in turn. Tell them what their support means to you, whether through words or actions (or both).

Don't try too hard not to think about it. This can just make things harder on yourself later on down the road when those thoughts come back out of nowhere without warning again anyway.

Know that you aren't alone

It's normal to feel shocked and overwhelmed by the loss of your baby. You may feel sad, angry, confused or numb. You may be worried about how you will cope with this new reality or if you will ever be able to have children again.

"You might also have a lot of questions about what happened and why it happened to you. The midwifery team at Riddle OB/GYN works collaboratively with the clinical care team for all patients to develop personalized plan of care, and they can answer any questions you have along the way," says Dr. Wilks.

If you're struggling with the loss of a baby, Main Line Health has resources to help. Our Women's Emotional Wellness Center, which provides outpatient mental health services to women before, during and after pregnancy. The team helps women work through trauma, depression, grief and loss, parenting issues and more.