In Australia, approximately 1 in 10 births are premature. Sometimes premature births are unexpected, but in some cases, you may be aware of a heightened risk of premature birth beforehand. If that is the case, then using time during pregnancy to prepare emotionally and practically for your premmie’s arrival could make the first few weeks or months easier on your family.
What to expect when you’re expecting a premature baby
A birth that occurs before 37 weeks of pregnancy is considered preterm. Generally, babies born between 32 and 37 weeks can grow to develop as normal with the right care and professional advice but this will depend on the degree of prematurity and birth weight.
The causes of premature labour aren’t fully understood, so prediction and prevention are difficult. However, you may have been told of an increased risk to expect premature labour if:
- You’re expecting to have twins or multiples.
- There is a complication with your uterus or cervix.
- You’ve had a premature birth in the past.
- You have a medical or health condition such as pre-eclampsia, diabetes or high blood pressure.
- You have an infection.
- You are a smoker throughout pregnancy. Talk to your doctor if you need extra support quitting smoking.
If you have any signs of premature labour contact your doctor or local hospital immediately.
Premature labour may involve some extra medicines or injections, so ask your doctor if you’d like to know more about what could happen during labour. Mum may receive medication that slows down contractions – any extra day in the womb helps. During pregnancy, doctors may suggest steroid injections to improve the baby’s lung maturity.
What will my premature baby look like?
A premature baby might not look like other newborns you’ve seen – they will be small and are likely to look very fragile. Looking up images or asking your doctor for resources may help prepare you for the ways premature babies can look, for example:
- The skin may seem shiny, translucent, or dry and flaky, as it needs more time to develop.
- Eyelids may not be ready to open yet and could look fused shut.
- ‘Lanugo’ or soft body hair which grows in the womb may not have fallen off yet. Your premmie may have no head hair but a lot of body hair!
- Genitals may be underdeveloped and look quite small.
As with any pregnancy and childbirth, parents can expect to feel all sorts of emotions. It’s natural to feel anything from ecstatic to depressed the first couple of weeks. If you experience feelings of anxiety, loneliness, overwhelm, or anything else unusual and challenging for more than two weeks, consult with your GP or therapist.
Raising a premature baby sometimes comes with an extra set of emotional challenges. Your little one may need to stay in the neonatal intensive care unit (NICU), which means you may not be able to take them home as soon as you’d like. Remember, this is the safest place for them to be for now.
Consider electing a contact person to act as a middle man between you and concerned or curious loved ones. Any new parent will likely be swarmed with questions and warm wishes, and this could increase with people wanting to know the status of your premmie.
Distributing your contact person’s details well before you give birth means you won’t have to deal with responding to a pile of loving but emotionally draining messages. Your contact person can send out updates and compile a list of people that may wish to call you or catch up when you feel ready.
Develop some relaxation techniques. This could mean practising mindfulness, breathing exercises, pregnancy-safe yoga, developing a personal mantra, or whatever it is that calms you down and resets your headspace. You’ll be dealing with a lot, but you’re not alone, and it is important to look out for yourself and learn how to find some calm when you need it.
If your baby is spending lots of time in the NICU, you will be too. Plan ahead, assuming that these first few days or weeks won’t have much spare time for anything other than caring for your newborn. Stock up the freezer with meals, and delay household chores – this is a time to focus on yourself and your baby.
Remember to pack a NICU bag with snacks and perhaps a novel or activity book to keep yourself occupied during any waiting-room stints.
If you have children already, try to organise care for them ahead of time. Keep your older children in the loop about who will be minding them, and why you’ll be away. Some NICUs don’t allow children to visit, so it may be a while before your little ones can meet. Try showing your older child photos from the NICU, or asking them to draw a picture or write a letter to take back to your newborn so that they might feel connected.
Baby clothes range from size 00000-0. You may want to grab 1-2 garments of a few sizes under 0, so you’re prepared, but not so many that you’ve got clothes your baby is already too big for. Chat to your birth team about what kind of clothes they recommend you already have at home. Some hospitals have clothes to dress newborns during NICU stays.
The first two years
While premature babies often have a higher risk of developmental issues, this is not always the case. With regular check-ups, many issues can be avoided or managed.
Paediatricians talk about premature babies in terms of their ‘corrected age. That is their age minus the number of weeks they were born early. For example, if your baby was born at 33 weeks (or a month early), then their ‘corrected age’ on their first birthday would actually be 11 months. Consult with your doctor first, but it is often recommended that you measure your child’s developmental milestones against their corrected age up until their second birthday.
Modern medicine is well equipped to support premature babies and their parents. If you have any pressing anxieties about preterm birth, ask your doctor for information. Keep an eye on your little one’s development and chat to your doctor if you’re ever unsure or in need of advice!