Tommy's PregnancyHub

My premature baby’s development in the womb – week 25

If you have been told you are at risk of a premature birth, you may be feeling anxious. Here’s some information about your baby’s development this week.

This information is for women who have been told that they are at risk of a premature birth

If you are not at risk of having a premature baby, we have information for you in our pregnancy calendar - our week-by-week guide to the stages of pregnancy.

Your baby's development this week

Your baby’s lungs are still immature and it will be several weeks before they can breathe on their own. But this is the time when they start making and practising their breathing movements.

Your pregnancy symptoms

Stomach pain

During the second trimester, you may get a few twinges and aches in the lower abdominal area. This is probably the ligaments supporting your uterus, which are stretching to accommodate your baby. 

But it’s important to trust to your own instincts. If you are worried about any pains you’re having, or you just feel like something is wrong, contact your midwife. Don’t be concerned about wasting anyone’s time. It’s always best to get things checked out.

If you are having persistent stomach pain (pain that won’t go away) or cramping, or if the pain comes on suddenly it should be checked by a doctor or midwife immediately.

Find out more about stomach pain or cramps in pregnancy

Antenatal appointments

It’s important to keep going to all your antenatal appointments so your healthcare professional can monitor you and your baby as your pregnancy progresses. 

You may have an appointment at 25 weeks if this is your first baby. Your midwife or doctor will use a tape measure to measure the size of your uterus and measure your blood pressure and test your urine.

If you have risk factors for diabetes, you’ll also be tested for gestational diabetes between 24 and 28 weeks. If you've had gestational diabetes in a previous pregnancy, you should have been tested earlier in your pregnancy and you will get another test now if the first test was normal. 

Other symptoms

If you are at risk of giving birth early, it’s important to take care of yourself. There are also some things you can do to try and reduce the risk of giving birth early.

Tell your midwife or doctor if you have any symptoms that you are worried about. Do not worry if you've talked about it before and don't be concerned about whether you're wasting anyone's time. This is your pregnancy and it's important to trust your own instincts if you feel something isn't right.

You can also call the Tommy’s midwives on 0800 014 7800 (Monday to Friday, 9am to 5pm), or email us at [email protected]

Symptoms of early labour

Call your midwife or hospital maternity unit straight away if you think you are in early labour. It may be a false alarm, but it’s best to get checked out. Find out more about the symptoms of early labour

Your mental health

If you have been told that you are at increased risk of giving birth early, it’s important to try and reduce stress and take care of your emotional health. Find out more about coping with the idea of a premature birth.

What may happen if your baby is born this week

Some of this information may be difficult to read. If you have any questions about your pregnancy or risk of premature birth please talk to your doctor or midwife.

You can also call the Tommy’s midwives on 0800 014 7800 (Monday to Friday, 9am to 5pm), or email us at [email protected]

Babies born before 28 weeks are described as being extremely preterm. Approximately 7 in 10 babies will survive if they are born now. 1 in 7 babies born at this time will have a severe disability, such as cerebral palsy. 

When talking about babies who have been born extremely prematurely, the term severe disability can include: 

  • not being able to walk or even get around independently (this includes conditions such as severe cerebral palsy) 
  • being unable to talk, or see or hear properly 
  • difficulties with swallowing or feeding safely 
  • having multiple health problems with frequent visits to hospital
  • needing to attend separate school for children with special educational needs 
  • being unable to care for themselves or live independently as they grow up. 

What does this mean for your baby? 

Every baby is different and it is important to talk with your doctors and midwife. They will give you specific information about your own and your baby’s condition. 

Research shows that for babies born before 27 weeks of gestation it is best, whenever possible, to be born in a specialist maternity unit with a specialist Neonatal Intensive Care Unit. If you are in labour and are not at a hospital with these facilities, you may be taken to one as soon as possible. This is known as in utero transfer.

Babies born now will need help with their breathing. The medical team may put a breathing tube passed through their mouth or nose and into their lungs (known as intubation), which is connected to a machine called a ventilator. This machine does most or all of the breathing for the baby. 

Some babies may not need a ventilator and instead they will have small prongs into their nostrils or a mask over their nose connected to a machine (called ‘CPAP) that provides air or oxygen with pressure to make the effort of breathing easier for them.  Your baby will be given some medicine into their lungs, called surfactant, to help with their breathing. 

The healthcare team will recommend caffeine treatment to help reduce or treat apnoea. Apnoea is a common condition where a baby may pause their breathing for a variable amount of time.  

Babies born at this stage are at risk of hypothermia (an abnormally low body temperature). When they are born, they will be placed into a clear plastic bag up to their neck to help keep them warm and protect their fragile skin. On the neonatal unit, they will be placed in an incubator that is humidified to keep them warm.    

They will need a thin tube passed through their nose or mouth into their tummy that milk can be given through. They will also need fluids or nutrition (a ‘drip’) through a thin tube into a vein (intravenous or IV line). This will often be into one of the veins in their umbilical cord. Find out more about feeding your premature baby in hospital.

Babies born now may have low blood pressure so the healthcare team may also need to raise your baby’s blood pressure with extra fluids or medicines.

Babies born now are also at risk of infection and will be given antibiotics until blood tests confirm they do not have an infection. 

Your healthcare team will monitor your premature baby closely to make sure they receive the best possible care.

Regan, Lesley (2019) Your pregnancy week by week, Penguin Random House, London

NHS. Gestational diabetes. https://www.nhs.uk/conditions/gestational-diabetes/ (Page last reviewed: 6 August 2019 Next review due: 6 August 2022) 

British Association of Perinatal Medicine. (2019) Perinatal Management of Extreme Preterm Birth before 27 weeks of gestation. British Association of Perinatal Medicine. https://hubble-live-assets.s3.amazonaws.com/bapm/attachment/file/182/Extreme_Preterm_28-11-19_FINAL.pdf
  
Bamat N et al. (2019) Positive end‐expiratory pressure for preterm infants requiring conventional mechanical ventilation for respiratory distress syndrome or bronchopulmonary dysplasia. Cochrane Database of Systematic Reviews 2019; Issue 2. Art. No.: CD004500. DOI: 10.1002/14651858.CD004500.pub3.
  
NICE (2019) Specialist neonatal respiratory care for babies born preterm. NICE guideline 124. National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/ng124

Moschino L et al. (2020) Caffeine in preterm infants: where are we in 2020? ERJ Open Res. 2020; 6(1): 00330-2019.

Ballout RA et al. (2017) Body positioning for spontaneously breathing preterm infants with apnoea. Cochrane Database of Systematic Reviews 2017; Issue 1. Art. No.: CD004951. DOI: 10.1002/14651858.CD004951.pub3.

Wyllie J, Ainsworth S, Tinnion R (2015) Resuscitation Council Guideline: Resuscitation and support of transition of babies at birth. www.resus.org.uk/resuscitation-guidelines/resuscitation-and-support-of-transition-of-babies-at-birth/ 

McCall EM et al. (2018) Interventions to prevent hypothermia at birth in preterm and/or low birth weight infants. Cochrane Database of Systematic Reviews 2018; Issue 2. Art. No.: CD004210. DOI: 10.1002/14651858.CD004210.pub5.

NICE (2021) Neonatal infection: antibiotics for prevention and treatment. NICE guideline NG 195. National Institute for Health and Care Excellence. https://www.nice.org.uk/guidance/ng195