After rounds of fertilization treatments, Dr. Jen Gunter became pregnant with triplets. Twenty-two and a half weeks into her pregnancy she suddenly went into labor and delivered her first son, Aiden, who died just three minutes later. Then something unexpected happened-she stopped delivering. Nearly four weeks later, at week twenty-six, Jennifer delivered her sons, Oliver and Victor-weighing one pound eleven ounces and one pound thirteen ounces, respectively - and became a parent of preemies.
Approximately 500,000 (about 1 in 8) babies are born prematurely every year in the United States. Prematurity is the leading cause of death and disability for newborns.
Normal pregnancy lasts about 40 weeks. Preterm is defined as less than 37 weeks of gestation, late preterm 34 to 36 weeks, and early preterm less than 34 weeks.
What causes so many premature births each year?
Dr. Gunter: There are many causes of premature birth. About 50% of the time an infection is somehow involved. Medical conditions, most commonly pre-eclampsia, also called toxemia, a potentially serious medical condition with high-blood pressure, can require an early induction for either the healthy of the mother or baby. In the United States, premature delivery is also associated with lack of medical care during pregnancy. About 508% of the time smoking is a cause.
Why is premature delivery such a big cause of health problems for babies?
Dr. Gunter: A baby needs the full 37 weeks to develop. While most structures are formed by 4 months, final development, fine-tuning, and growth happen in the last trimester. When a baby is born early they are short changed of that precious time. The nervous system is not ready for our environment and can be damaged, immune system is not fully operational, so infection is a big risk. The lungs, liver, most organs are just not ready to go prime time. Also, preemies have very little or even no body fat, because all those nice chunky rolls grow in the last trimester. It is harder to gain that weight outside of the uterus, so preemies are often behind on their growth.
What Kinds of disabilities are most common in premature births?
Dr. Gunter: It depends on how early the birth and the birth weight. Babies who weigh less than 1500 g, about 3 lbs, at birth are at greatest risk, My sons were 1 lb 11 oz and 1 lb 13 oz. The common health problems and disabilities are lung issues, impaired vision, problems with fine motor skills, cerebral palsy, and digestive problems. A baby born at 26 weeks, like my sons, has a 25% chance of a moderate or sever disability and a 25% chance of mild disability, but even babies born a couple of weeks early are more likely to face challenges than their peers born at term. A baby born between 34 and 36 weeks has a 4 percent moderate or severe disability and a 15 percent risk of a minor disability.
What has been your experience and how did it prompt you to write the book?
Dr. Gunter: It has been a hard road.. Burying a son while worrying my other two might not make it home from the hospital. Even as an OB/Gyn who had delivered many premature babies I was naive about the whole experience. Not the in hospital intensive care, but the fact that the ramifications would persist and persist. Most parents think the neonatal intensive care unit is like a marathon, because it is long and grueling, but unfortunately it is only the first leg of a much longer race. I wanted parents to have the book I wished I had. One that covers everything. Not just the intensive care unit, but afterwards in addition to very practical information, like the best car seats to dealing with your insurance. This is really the ultimate guide book for prematurity. Not only have I lived it, but I provided all the medical behind the scenes information as well as had all my information fact checked by leading experts from around the country. The Preemie Primer is basically a parent friendly textbook that is doctor recommended and mom approved.
Who is the book for?
Dr. Gunter: Any one with a premature baby and anyone who knows someone with a preemie, so they cam learn. Because it is hard when you are struggling to cope with your fears in addition to caring for a medically fragile child to explain while your baby is still having on going health problems. Each time to have to explain why your son still hasn't walked yet, or why your baby is still in the hospital, and yes, you know he has been there a long time already, it rips at a wound. So if family and friends read this book they will be more educated to help.
Do you have any recommendations for anxious family and friends? How can they help someone with a premature baby?
Dr. Gunter: I recommend you ask how you can help. That may be different for different people. Some advice I give in the book is get vaccinated in their baby's honor or donate blood. Drop off food to eat or volunteer to take care of the pets. I had a friend who would leave bags of groceries on our front steps.
What about the big number birth cases like Octamom and Kate Goselin ... and media coverage how does this distort the issue for pregnant women in general...
Dr. Gunter: I think it gives the impression that a multiple pregnancy is easy, and may even get you a reality show and on Dancing With The Stars. It doesn't. 50% of twins deliver prematurely and the numbers just go up from there. Multiple pregnancies are very high risk for babies and for mom. If you manage to get 6 or 8 babies home you are a lottery winner, that's all. I also think the media need to emphasize that these higher-order multiples are essentially the product of bad medical care and escaping tragedy is the exception, not the rule.
What about prenatal care? Why is it so important?
Dr. Gunter: We know that good prenatal care reduces prematurity. At Kaiser our rate of premature delivery is significantly lower than the National average, the result of good, regular prenatal care and adherence to National Guidelines.
Featured in this segment:
Jennifer Gunter MD, FRCS(C), FACOG, DABPM
Director Pelvic Pain
Kaiser San Francisco
Book: "The Preemie Primer: A Complete Guide for Parents of Premature Babies - From Birth Through the Toddler Years and Beyond"
>> Buy the book on Amazon
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