Updated April 2014, next review April 2017

Giving birth to your premature baby

Delaying a premature birth

If it is established that you are in labour, the healthcare team will try to prevent the birth of your baby if possible and if it does not endanger the baby. This is so that they can do their best to prepare you and your baby for her premature birth.

Why delay the birth?

If you are over 35 weeks or if the baby or you are in danger, the healthcare team will most likely allow the birth to go ahead, or induce the birth. If you are under 35 weeks, you may be given treatment to slow down labour or delay the birth. There are a few reasons for this:

  • so you can take a course of corticosteroids (see below), to help your premature baby's lungs develop in order to reduce the risk of breathing problems
  • so you can be transferred to a medical unit that can offer the right level of care for your baby's stage of development.

These two steps have consistently succeeded in reducing the deaths and health problems that can result from premature birth.

Treatment once you are in premature labour

Babies born prematurely are more likely to have health problems. To help reduce the risks, you may be offered medication during or after labour.

Tocolytic drugs slow down contractions

To delay, stop or slow down the labour. Tocolytic drugs slow down contractions. Usually they delay the birth by a couple of days, giving the team time to transfer you to a hospital with the facilities you need, and to give you corticosteroids or antibiotics (see below) to help your baby stay as healthy as possible.

Corticosteroids help your baby develop

To help your premature baby mature. Corticosteroids help your baby's lungs and brains develop more quickly. They are injected into your arm or leg, and work within about 24 hours.

Once you've been given corticosteroids your baby will be far less likely to develop respiratory distress syndrome and some other complications. These drugs have no known side effects, for either you or the baby.

If you are considered at risk of having your baby prematurely, you may be offered corticosteroids from about 23 weeks. If the tocolytics succeed in delaying your labour, you may be given another dose of corticosteroids at a later stage if you are still at risk.

Protecting the baby from infection

To reduce the risk of your premature baby developing an infection. A common cause of infection in newborn babies is a type of bacteria called group B streptococcus (GBS).

Premature babies are particularly susceptible to infection. If your membranes have ruptured prematurely, the sac that holds your baby will not be properly sealed, so you may need antibiotics and corticosteroids to protect him from infection. 

Bringing on labour/ inducing labour

To bring on labour/induce the labour. If there is a risk to your baby's health or your health, labour can be induced (started artificially). Common conditions that lead to premature inducing of labour include pre-eclampsia or fetal growth restriction where your baby is not developing as he should in the womb.

Induction is planned, so you'll be able to talk about it to your healthcare team.

If the team needs to, the midwife or doctor will put a pessary or gel into your vagina, or a drip in your arm, or both. Once it starts, an induced labour may proceed naturally, though it might take 24 hours or more to get going.

If induction does not work, your doctor and midwife will assess your condition and your baby's wellbeing. You may be offered another induction, or a caesarean section – your midwife and doctor will discuss all the options with you. Read more about the birth here.

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Sources

Behrman RE, Butler AS (2007) Preterm birth: Causes, Consequences, and Prevention, Institute of Medicine (US), Committee on Understanding Premature Birth and Assuring Healthy Outcomes, The National Academies Press, Washington DC p289

RCOG (2010) Antenatal Corticosteroids to Reduce Neonatal Morbidity and Mortality, Green-top Guideline No 7, Royal College of Obstetricians and Gynaecologists, London

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Why delay the birth

Treatment once you are in premature birth



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