Tommy's PregnancyHub

My premature baby’s development in the womb – week 27

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 brain, lungs and digestive system are formed but are still developing. They may also be changing position in the womb quite a lot at this point. 

Your pregnancy symptoms

Your emotional health

It’s important to look after your mental health. Pregnancy can be a very emotional experience and it can be even harder if you are worried about or having an early labour. Being on high alert for symptoms of preterm labour and needing to attend extra hospital appointments can cause additional anxiety and stress. 

Many parents-to-be feel ashamed or guilty about feeling low. But the reality is that mental health problems can affect anyone at any time. These feelings are common and they do not mean you are a bad parent.

Don’t hide your feelings or suffer in silence. You are not alone. Tell your partner, family or friends how you feel, as well as your GP and midwife. They will help you access the support you need. 

Find out more about coping with the idea of a premature birth and your mental health before, during and after pregnancy.

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

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 still described as being extremely preterm and 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. Instead, they will have small prongs put into their nostrils or have a mask put over their nose that is 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.  Find out more about breathing support for premature babies

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. 

NHS. You and your baby at 27 weeks pregnant. https://www.nhs.uk/pregnancy/week-by-week/13-to-27/27-weeks/ (Page last reviewed: 17 October 2019 Next review due: 17 October 2022)

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

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.

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