When you get pregnant, the world congratulates you. Mothers share their labor stories with you. They will mostly tell you about the pain which is always so much, words cannot describe it. They will tell you about the not so wonderful regular vaginal examinations that you will be expected to endure. They will advise you about where to go for your antenatal clinic, what to eat and what to avoid, where to buy your maternity and baby clothes, how much pain you should anticipate et cetera. Nobody will ever talk to you about going into labor pre-maturely. Nobody will talk to you about giving birth to a one kilogram child. Because it is never expected. Everybody assumes you will get pregnant, have an uneventful pregnancy, deliver at term to a bouncing baby boy or girl and everything will just be normal.
But sometimes, you will give birth pre-maturely for one reason or another. While a normal pregnancy is assumed to last for forty weeks, some women may deliver at late second trimester or early third trimester. A child born before term is usually under-weight, has immature lungs, is unable to regulate their body temperature, has fewer stores of essential vitamins and minerals and has reduced or no native reflexes. These are children whose suckling reflex is either absent or not well developed hence cannot attach on the breast. They need to be fed via a naso-gastric tube, need to nursed in a warm environment. They may need to be put on oxygen, especially during the first days of life.
Some of the reasons why a pregnant woman may go into labor prematurely include;
– Multiple pregnancy– most twin or triplet pregnancies will rarely get to term.
Mothers carrying multiples should be psychologically prepared to deliver before term
– Hypertensive disease in pregnancy– severe cases are normally induced at thirty four weeks
– Preterm rupture of membranes– followed by drainage of liquor “water”
This is mostly caused by infections
– Third trimester bleeding– may be due to placental separation or abnormal placentation. If the bleeding is massive, then delivery may be done before term.
Going into labor before term is actually a nightmare, the child comes when you are just not ready for them, both emotionally and psychologically. One minute you are pregnant and the next minute you are holding a tiny little thing on your hands who is then quickly snatched from you and rushed to a nursery. Then you literally become a prisoner, living in the hospital waiting for your child to grow to at least two kilograms. Every three hours of the day or night, you are seated before your child, who happens to be sharing an incubator meant for one with four other pre-terms who look extremely like your own.
So you live in the hospital waiting. Your child adds three grams in three weeks and loses five grams in a day. Sometimes you leave them well only to come back and find cardiac monitors sticking from an impossibly small chest, and nasal prongs inserted into the tiny nostrils, with oxygen being literally driven into those tiny lungs. But they live through such days and so do you.
When you have your child too early, the temptation to leave and quit the whole motherhood thing is strong. But then you draw strength from your pre-term child every time you see them work their muscles so hard in a bit to breath. Every time you see their eyes open and they gaze at you, you learn that the gaze is just as genuine, just as penetrating as any other and that alone is enough to push you through the rainy days!
Children born before term, if they receive good care, grow. They grow up normally, attain normal milestones and become as normal as those born at term. No, prematurity doesn’t cause intellectual disability or short stature. I have seen big men and women whose birth weights were as little as one kilogram. I know a doctor who was born pre-maturely, a university student pursuing engineering and as teacher. With pre-maturity, once you grow past the neonatal age, then you can grow on and conquer the world with your smallness!