The preterm birth rate in the United States is high, and alarmingly so for African-American women in particular. Despite the upward mobility of women and specifically African-American women, the disproportionate increase in preterm birth has not dissipated. Preterm birth not only takes a physical toll on the infant but an emotional toll on the entire family, beyond the hospital stay.
Many women do not realize they are at risk for preterm birth. I certainly did not think I was. I am a physician that worked in a hospital in the Department of Obstetrics and Gynecology. I exercised three times a week, stopped eating junk food while on a healthy diet. I took folic acid daily, did not smoke and even stopped social alcohol consumption. In short, I did everything I thought I should to ensure a healthy baby.
Nothing could have prepared me for the challenges associated with delivering a preterm infant. My life changed when I myself delivered a baby boy 16 weeks too early.
The roller coaster ride lasted 6 months, 22 days, 12 hours and several minutes. My son had seven surgeries and countless procedures. My husband and I met with numerous doctors, went to the Neonatal Intensive Care Unit (NICU) daily (sometimes twice a day) while working full time. We met other families in the same situation as us, eventually go home. We experienced the anguish of being told our little boy could not be weaned off the ventilator and later the elation of being told that our son was doing well and might go home in a few weeks. As wonderful as the nurses were in the NICU, particularly my son's primary nurses, I often felt helpless and not like a mother at all. We sat on pins and needles any time the phone rang not knowing if the hospital was calling to warn of another setback.
One of my dearest friends now is a young woman who had a premature infant around the same time as me. Our sons' isolettes were usually in the same room. We bonded over fears and tears, good days and bad days.
Our journey, like that of many other families, ended when my son passed away in the NICU. Despite our hopes, prayers and preparations, he never made it home.
This is an experience I would never want another family to go through. Yet, even with all the preventative knowledge and interventions that can prevent this, premature birth occurs daily. As I see women on a daily basis, assessing their pregnancy risks, I do so from the perspective of a one who has had a child in the NICU. I try to use my experience to help others. I remind women, "You would much rather stay pregnant than have to come to the NICU every day." They say, "You are right, doc."
I thank the March of Dimes for bringing attention to the issue of preterm birth and also to the disparities that exist for African-American women. Despite the rise in African-American women who have obtained a college education and have more stable financial means, the rates of preterm birth are higher than among their equally matched counterparts.
UMDNJ-The University Hospital in Newark, where I currently work, provides obstetrical and pediatric care to a diverse and often high-risk group of families. We are working closely with the March of Dimes to reduce preventable preterm births.
The March of Dimes and Johnson & Johnson launched the Healthy Babies are Worth the Wait® program with the help of many Newark partners earlier this year. Healthy Babies are Worth the Wait is a community-based initiative that promotes best practices to reduce preterm birth. The program educates patients, providers and the community at large on measures to reduce unnecessary preterm births, and to encourage women not to deliver before 39 weeks unless medically recommended.
I recommend the following ways to reduce preterm births to my patients:
- Arrange a preconceptional checkup with your doctor to make sure you are in the best health you can be.
- Make sure you take a multivitamin with folic acid.
- Quit smoking. Smoking is a major risk factor for preterm birth.
- Get to a healthy weight. Being over or under weight can be problematic.
- Wait at least six months after the birth of a baby before getting pregnant again to allow your body time to recover.
- Stress is a part of life and while we can't avoid stress, we can modify our response to stress. Stress plays a role in preterm labor and birth. Read or meditate for 5 to 10 minutes a day, listen to some relaxing music or take a yoga class. Do something for yourself to reduce stress daily.
- Listen to your body. If you feel like something is not right--pelvic pressure or pain, spotting, bleeding, particularly not relieved by usual comfort measures--don't ignore them. Bring those symptoms to the attention of your medical provider.
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