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Some pregnant people may know that they have a higher chance of giving birth early. For example, if you have been cared for in the Preterm Prevention Clinic. For others giving birth early is a complete surprise and very unexpected.
Hear midwife Sasha describe the signs of preterm labour.
Different Types of Neonatal Unit
Babies that are born early need to have the right care in the right place. This is in a neonatal unit, which are usually alongside the maternity unit. Although your local maternity hospital will have a neonatal unit, there are different types of neonatal unit in the NHS.
Special Care Baby Unit (SCBU)
Neonatal Unit (NNU)
Neonatal Intensive Care Unit (NICU)
Why are babies born early?
We do not always know why babies are born prematurely. Often preterm birth happens unexpectedly and is a surprise. Sometimes a preterm birth is planned because it is safer either for mum/baby or both to be born earlier. This might happen because of a health condition such as pre-eclampsia, or because of an infection.
Lifestyle choices, such as smoking or drinking alcohol can cause premature labour, as well as some medical conditions such as diabetes.
We do know there are things that can increase your chance of premature birth.
If you know you have a greater chance of having an early birth you can download the free My Prem Baby App.
Signs of preterm birth
- Tummy or back pain, especially if you have period-like pains or uncomfortable cramps that come and go regularly
- If you are leaking any fluid or unusual discharge from your vagina
- If you have bleeding from your vagina
- Pressure in the vagina area
- Backache that is not common for you
You may not be looking for signs of labour if you are early in your pregnancy. They can be harder to spot, or you may dismiss them. Remember that your maternity unit is open 7 days a week, 24 hours a day, and you can call at any time. Even if you feel unsure, call for advice.
Do not go to your GP or emergency department instead as it can take longer to get you and your baby the right care.
The maternity and neonatal services are open 24 hours a day, and are always happy to take your call.
Hear Sophie talk about her premature labour
What happens when I arrive?
- Checking your blood pressure
- Checking your temperature
- Testing your wee
- Checking your baby’s heartrate
You may also be offered:
What happens next?
Early labour – what will happen?
Your midwife will begin to complete a document called the PERIPrem passport. This is a record of everything that needs to be done for a preterm baby. It will follow your baby to the neonatal unit where staff will continue to record the care.
Your maternity team may try to slow down or delay the birth until later in your pregnancy. They can do this by offering you a medication called tocolysis. It will depend on how quickly your labour is progressing. Tocolysis medication is not usually offered if you are having more than one baby because there is not proof that.
Types of medication
Magnesium sulfate
Corticosteroids (steroids)
Steroids probably will not be offered after 35 weeks as your baby’s lungs are likely to be ready for breathing on their own.
Antibiotics
Transferring to a neonatal unit
It means that when you give birth there will be immediate access to the equipment and expertise your baby may require. You will travel to the hospital in an ambulance and an experienced midwife will go with you. If you have a partner or birth supporter, they can meet you at the hospital.
If the maternity team believe that a transfer is the best thing to do for your baby’s health they will discuss all the options with you. They will make sure you understand all the advantages and disadvantages to help you to decide. You cannot be transferred without your permission.
You can ask the team any questions you need to, such as:
- Why is a transfer the best thing for me and my baby?
- How long will the transfer take?
- Who will come with me?
- What happens if I give birth on the way?
- What are the risks if I don’t want to go?
All these discussions should be fully documented in your maternity notes.
This video was published by the Southwest Neonatal Network and will explain more about a stay in the neonatal unit.
If there is not an opportunity to transfer you before the birth, your local neonatal team will work with a specialist neonatal transfer team to transport your baby after birth to a hospital with a NICU. If this happens, we will support you to be there with your baby as soon as possible. Your baby will be cared for in the NICU until they are ready to come back to your local hospital, who will continue their care until they are strong enough to go home.
Transitional Care
Your postnatal care
Your baby’s care may stay with a midwife for a short while, depending on baby’s age, health and how your local team is set up. You will meet your health visitor, who is a nurse or midwife who specialises in supporting families with babies and young children. Your health visitor will be with you and your family for the next five years and will be an invaluable source of support.
Health visiting services
In Suffolk and north east Essex, the health visiting service works closely with maternity and neonatal services. Once your baby is born the neonatal unit will contact the health visitor to let them know that you have given birth. Your health visitor will contact you to see if you would like a visit either at the neonatal unit or at home. They will work closely with the neonatal team to plan how they will continue to care for you and your baby.
You will be offered three extra development checks for your baby by the health visitor.
They also work alongside other services such as speech and language specialists, nutritionists, and physiotherapists to offer support until your baby is two years old.
Where can I get support?
You may have questions about what happened during your birth. You can book a birth reflections appointment to discuss your experience with a midwife.
Watch our main film on preterm birth
Finding support
Looking after your physical and emotional wellbeing after birth is important. Finding support for yourself or you partner can seem overwhelming.
Below is a list of local support groups, online advice and people to talk to
- Your Emotional Wellbeing – Suffolk and North East Essex Maternity and Neonatal Services (sneewellbeing.org.uk)
- Bliss offers emotional and practical support to parents of premature babies Emotional and practical support | Bliss
- The Twins Trust is a charity supporting families with twins and triplets Twins Trust | Twins Trust – We support twins, triplets and more…
- More information for parents here Parents & Carers – East of England (eoeneonatalpccsicnetwork.nhs.uk)