Premature Birth

By Jennifer Margulis

When my friend Nora’s son was born the team of doctors went into Code Red. She and her husband Frank only glimpsed the baby before he was whisked away for tests. It looked like one of his lungs was collapsing, the doctors explained. They were so concerned they sent Danny immediately to a larger hospital with a neo-natal intensive care unit. Instead of drinking champagne and counting toes, Frank found himself riding in an ambulance beside his newborn son, who was hooked up to so many life supports you could barely see his tiny self.

“Do ya think it’s possible they cut me open too early?” Nora, who is a doctor herself, asked a few months later. She was ostensibly talking to me but really musing to herself. “Full term babies don’t usually have lung problems. I keep wondering if we got the dates wrong…” Because they were concerned about uterine rupture, the doctors scheduled a C-section for Danny at 38 weeks, two weeks before Nora’s due date. But if the baby’s due date had been miscalculated by two weeks, it might mean that Danny was born at 36 weeks instead of 38.

The difference is not just semantic. A 36-week-old Danny would be considered a preemie. The March of Dimes defines premature birth as any birth occurring before 37 weeks of gestation. And preterm babies often suffer from a host of health problems, the most common caused by premature lung capacity. Disturbingly, the numbers of babies born prematurely in America has been rising steadily in the past ten years.

In 2004 12.5% of live births, or one in eight babies, were premature. That translates into half a million babies. This number is even more striking if we take a longer view: “The incident of preterm birth was 12.1% in 2002, which is up 27% from 1982,” says Dr. Siobhan Dolan, M.D., an assistant professor of Obstetrics and Gynecology and Women’s Health at the Albert Einstein College of Medicine in New York. “The rate is high and it’s rising. It’s going in the wrong direction.”

While doctors and researchers are not exactly sure why, several reasons that premature birth is on the increase have been identified. One major culprit is the use of fertility drugs like Chlomid, which results in a much greater likelihood of becoming pregnant with multiples, and which doctors are prescribing with increasing frequency to help couples conceive.

“Fifty percent of mothers who have a twin gestation have babies born prematurely,” says Durlin Hickok, M.D., who specializes in preterm birth. Hickok also says that African American women are twice as likely to give birth prematurely than white women: “Poverty, poor access to prenatal care, lack of health insurance, low pre-pregnancy weight, and poor lifestyle habits—drinking, smoking, drug use—can all contribute to preterm birth.” Scientists also believe that pregnant women who work long hours standing up, women younger than 17 and older than 35, and women who don’t receive adequate prenatal care are at higher risk.

My friend Sara was carrying twins when her water broke unexpectedly four years ago. She was 41 years old and pregnant after seven years of trying. The doctors wanted to keep the babies in utero as long as possible to allow them more time for their lungs to develop. At 35 weeks, 11 days after she was hospitalized, Sara went into labor. Her son was born weighing 5.5 lbs, her daughter was much smaller. At 3.75 pounds and 14 inches long, Maya could only wear doll’s clothes.

Having her twins in the NICU was the most emotionally devastating and draining experience of her life. “All you want to do is hold those babies and nurse them and have them home,” she told me. “Instead they’re hooked up to bells and whistles and wires and IVs through their heads and IVs through their belly button.”

Frank’s mom came to care for their older son while Nora was in the hospital and Frank stayed at a Ronald MacDonald House nearby. I drove her to see Danny. He looked big and healthy compared to the micro-preemies who weighed only one or two pounds, tiny babies in heated incubators whose lives, for whatever reason, started too soon.


A version of this post was originally published in the Ashland Daily Tidings