Preparing for the premature birth

A premature delivery may happen suddenly or after days or weeks of waiting and worrying. If you know you may deliver early, you, your partner, and your doctor can prepare for a premature birth.

• Use a hospital with a neonatal intensive care unit (NICU). If you deliver in a hospital without an NICU, your infant may need to be moved to the closest hospital that has one.
• Get to know the NICU. If you can't visit the unit, someone from the NICU can visit or call you to discuss your questions.
• Mature your fetus's lungs over a 24-hour period by taking a course of corticosteroids. A tocolytic drug also may be used, to delay labor while the corticosteroids work. Corticosteroid treatment is considered the single most effective measure for preventing infant complications of prematurity.¹ For more information, see the topic Preterm Labor.

If you deliver after 36 weeks of pregnancy, your infant's risks of problems are very low. Although a special medical team is usually nearby for such a delivery, most 36- and 37-week newborns aren't treated any differently than full-term newborns.

The premature delivery

Unlike many full-term or near full-term childbirths, you and your premature infant (preemie) are considered high-risk during preterm labor. As a result, you will have less freedom, both to make birth-related decisions and to move about freely. You can expect the following:

• Your birth plan and birthing choices will be less useful during this birth. You can refuse medicines such as painkillers during preterm labor. But other treatments such as antibiotics or corticosteroids can be important to ensure your infant's chances of good health after birth. Be sure to ask as many questions as you can think of about your medical care. The more you understand about your doctor's decisions, the less anxious you will feel.
• You will be on intravenous (IV) medicines and fluids. (For more information about medicines, see the topic Preterm Labor.)
• You will be on constant electronic fetal heart monitoring. You also will be checked regularly for changes in heart rate, body temperature, and uterine contractions.
• You will probably deliver vaginally, rather than by cesarean section (C-section), as long as you and your fetus show no signs of distress.

A childbirth (obstetric) team and a new baby (neonatal) team will be present for your delivery. The neonatal team will bring special equipment with them, including a bed with an overhead heater and resuscitation equipment for your infant. You may deliver in a surgical room that is ready for cesarean delivery, or you may deliver in your hospital room.

After the premature birth: The infant

As soon as the umbilical cord is cut, the neonatal staff will watch over and stabilize your infant. If your infant is less than 36 weeks' gestation at birth, he or she will then be moved to the NICU for observation and specialized care. If you deliver in a hospital without an NICU, your infant may need to be taken to another hospital. This typically requires a specially equipped ambulance.