Experiencing a preterm birth for the first time can be a scary, stressful experience. Whether you delivered at 24 weeks or 34 weeks of pregnancy, bringing a baby into the world sooner than you were mentally prepared for can really make thinking about future pregnancies somewhat frightening.
Fortunately, there are some steps you can take when it comes to preventing a second (or third) preterm delivery, including:
- Don’t get pregnant again too soon. When a woman becomes pregnant 18 months or less after she just gave birth, her risk of preterm birth increases. This may be due to not having quite recovered from the previous birth, or that mom’s nutritional stores haven’t replaced themselves enough before having to grow another baby again. Make a plan with your doctor or midwife on how best to space your pregnancies, especially if you are high-risk from having given birth to a preterm baby before.
- Quit smoking! We know that smoking is bad for a number of reasons, and women who smoke are at a higher risk of delivering early, including in the very preterm time period when risks to baby are highest (before 32 weeks). If you smoke, talk to your doctor or midwife ASAP about how you can get on track to cut down or quit.
- Get to a healthy weight before getting pregnant, and stay on track. Being underweight or overweight can also cause pregnancy complications that can lead to a preterm birth. Not yet pregnant? Have a preconception visit to make sure you start out in a healthy range and know what your weight gain goals for pregnancy are.
- Get other medical conditions under control. Before you become pregnant, go through your health history with your doctor or midwife. If you have any issues like thyroid disease, diabetes, or high blood pressure, get these tuned up before you try to conceive. Doing so will decrease your chance of delivering early. We know these pregnancy complications may sometimes mean a woman needs to deliver early in order to protect her own health.
- Have a plan about how to manage your pregnancy … even before you are pregnant. The things you may need to do in a future pregnancy to give yourself the best chance of delivering a healthy full-term baby may seem daunting: early ultrasounds, progesterone injections (17-hydroxyprogesterone caproate), frequent doctor’s visits, and maybe even a stitch around the cervix. Rather than waiting to get this all sorted out once you are pregnant, meet with your obstetrician or high-risk OB/GYN to make a plan together before you start trying to conceive. This will make sure you have a good plan in place and can be ahead of the game even before you see those two pink lines.
- It’s normal to be concerned about future pregnancies if your last one was complicated by a preterm delivery.
- Luckily, there are some things you can do to decrease your chance of delivering preterm again.
- One of the best things you can do is have a preconception visit to address any risk factors for premature birth.
Does everyone with one pre-term birth in their history need a high-risk OBGYN? Seems like some women have them for lesser reasons than others… Just wondering when a high-risk OB is recommended as a rule of thumb?
The short answer is yes, probably – but it’s never that straightforward (of course!). Women who delivered early because they had a short cervix or experienced preterm labor should at the very least have a consult with a high-risk OB so an appropriate plan can be made. This may include extra ultrasounds to monitor the cervical length, progesterone in the form of a shot or vaginal medication, a stitch around the cervix, and more frequent check-ins regarding symptoms of preterm labor. Some OB’s may want those kinds of patients to only be seen by their high-risk OB partners, while others will still care for them but just have them check in with a high-risk doc a few times during the pregnancy – it all depends on all the details of the previous delivery and the access to resources and experience of the doctor.