Premature Infant
Delivery of Your Premature Infant
Preparing for the premature birth
A premature delivery may happen suddenly or after days or weeks of waiting and worrying. If you know you may deliver early, you, your partner, and your doctor can prepare for a premature birth.
- Use a hospital with a neonatal intensive care unit (NICU). If you deliver in a hospital without an NICU, your infant may need to be moved to the closest hospital that has one.
- Get to know the NICU. If you can't visit the unit, someone from the NICU can visit or call you to discuss your questions.
- The doctor may suggest corticosteroid shots for you. When given within the week before you give birth, this medicine can help mature your baby's lungs. A tocolytic drug also may be given, to delay labor while the corticosteroids work. Corticosteroid treatment helps prevent infant complications of prematurity. For more information, see the topic Preterm Labor.
If you deliver after 36 weeks of pregnancy, your infant's risks of problems are very low. Most 36- and 37-week newborns won't need extra help. But a special medical team is usually ready to help if problems arise.
The premature delivery
You and your premature infant (preemie) are considered high-risk during preterm labor. As a result, you will have less freedom, both to make birth-related decisions and to move about freely. You can expect the following:
- Your birth plan and birthing choices will be less useful during this birth. You can refuse medicines such as painkillers during preterm labor. But other treatments such as antibiotics or corticosteroids can be important to ensure your infant's chances of good health after birth. Be sure to ask as many questions as you can think of about your medical care. The more you understand about your doctor's decisions, the less anxious you will feel.
- You will be on intravenous (IV) medicines and fluids. (For more information about medicines, see the topic Preterm Labor.)
- You will be on constant electronic fetal heart monitoring. You also will be checked regularly for changes in heart rate, body temperature, and uterine contractions.
- You will probably deliver vaginally, rather than by cesarean section (C-section), as long as you and your fetus show no signs of distress.
A childbirth (obstetric) team and a new baby (neonatal) team will be present for your delivery. The neonatal team will bring special equipment with them, including a bed with an overhead heater and resuscitation equipment for your infant. You may deliver in a surgical room that is ready for cesarean delivery, or you may deliver in your hospital room.
After the premature birth: The infant
As soon as the umbilical cord is cut, the neonatal staff will watch over and stabilize your infant. If your infant is less than 36 weeks' gestation at birth, they may move him or her to the NICU for observation and specialized care. If you deliver in a hospital without an NICU, your infant may need to be taken to another hospital. This typically requires a specially equipped ambulance.
At birth, little can be predicted about how well or how poorly your baby will do. If there are no signs of problems, you can feel cautiously hopeful. But during the first hours and days, your infant will adjust to living outside of the maternal “life-support system.” This is a time when birth defects and complications of prematurity often become apparent. For more information, see The Premature Newborn and The Sick Premature Infant sections of this topic.
If your infant is born between 22 and 25 completed weeks of pregnancy (extreme prematurity), you likely will be faced with some difficult medical decisions during the first month after the birth. These personal stories may help you make your decision.
After the premature birth: The mom
While the neonatal staff attends to your infant, the obstetric staff will care for you. Depending on your condition, your postpartum care and recovery time will take at least a few hours. Meanwhile, your birth partner may want to accompany your infant to the NICU.
Before your breast milk comes in (3 or 4 days after childbirth, or postpartum), you will be asked to decide whether you plan to breast-feed or bottle-feed your premature infant. If you decide to breast-feed, expect at first to pump milk for feedings until your infant is mature enough to feed orally. Providing breast milk for and later breast-feeding a premature infant can be an emotional and logistical, yet rewarding, challenge. You may have mixed feelings about it and worry that it may be too hard. Before making your final decision, consider the following.
- Breast milk contains antibodies that help protect your vulnerable infant against early, serious infections, including sepsis and necrotizing enterocolitis, as well as ear and upper respiratory infections during early childhood.
- The benefits of breast milk over formula include better nutrient absorption, digestive functioning, and nervous system development.
- Both specialized formula and breast milk can offer your infant excellent nutrition.
- Pumping and breast-feeding can be one of the most beneficial and rewarding things you do for your premature infant. But it may also be exhausting and difficult. If you cannot breast-feed, decide not to breast-feed, or find that you have to discontinue doing so, formula feeding will meet your infant's nutritional needs.
Because formula does not give your infant added protection from early infection, your hospital may strongly encourage you to pump milk for your infant during the first weeks of life, at a minimum. Your hospital's lactation consultant can be very helpful with pumping and breast-feeding questions and problems, both before and after the birth. For more information, see the topic Breast-Feeding.
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| Author: | Debby Golonka, MPH | Last Updated: May 5, 2009 |
| Medical Review: | Michael J. Sexton, MD - Pediatrics Jennifer Merchant, MD - Neonatal-Perinatal Medicine | |
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