Today is....

Prematurity Awareness Day. We have many friends having babies now so I have debated on weather I wanted to post anything about this as I don't want to scare anyone. But what is awareness day if you try to keep the facts away from people. You don't see woman not talking about breast cancer awareness because their friends have breasts do you? So... I have decided to post on this topic today.

This is some information that I found on the March of Dimes Blog.

In the United States, more than half a million babies are born preterm each year. Preterm birth, birth before 37 weeks gestation, is a serious health problem that costs the United States more than $26 billion annually, according to the Institute of Medicine. It is the leading cause of newborn death, and babies who survive an early birth often face the risk of lifetime health challenges, such as breathing problems, cerebral palsy, intellectual disabilities and others. Even infants born just a few weeks early have higher rates of hospitalization and illness than full-term infants. The last few weeks of pregnancy are critical to a baby because many important organs, including the brain, are not completely developed until then.

For some women, labor starts too early, before 37 completed weeks of pregnancy. One out of eight babies in the United States is born too soon. This can lead to serious health problems for the baby. So it’s important to know the signs of preterm labor.

I was at a prenatal care appointment 5 days before having Ethan. She gave me a sheet that had one paragraph to read about the signs of preterm labor. I looked at it and put it in my purse without reading it. My thought "preterm labor... yeah that's not going to happen to me."

Weeks after having Ethan I went to a follow up appointment with the Dr that delivered Ethan. He happened to be the specialist in preterm births. He told me that I went into labor due to an incompetent cervix. He said that it was probably caused by a test I had done when I was 18 years old. I had an abnormal pap smear so they scraped my cervix to do a biopsy. This could have been done a little too harsh for my cervix to handle.

He also informed me that if we chose to have more children in the future that he will use a cerclage. He said that it is almost 100% gaurantee that I would be able to carry full term. If we do have another one (which is still up for debate) he said that I would have to have a c-section due to the way he had to deliver Ethan. Funny thing is before I had Ethan I thought "I am going to have my baby naturally and with no drugs. I will not need a c-section." Now my thoughts are "Hmmm c-section... that means I most likely will know exactly when I am going to have the baby and living in the middle of no where this is a plus. The recovery from the c-section was loooong but Mark liked watching the delivery and I felt no pain." So if the Dr. ruined my chances of having a natural birth because of the way he had to deliver Ethan I am totally ok with that. Especially since I have Ethan in my arms doing very well.

Here is the information on the March of Dimes blog:

Cervical insufficiency

The phrase "cervical insufficiency" (CI) refers to a cervix that opens too early, before the baby is full term. This condition is also called incompetent cervix. The cervix is the opening at the base of the uterus.

When the cervix is healthy, it thins out and opens at the end of pregnancy when labor begins. The baby then moves through the cervix and birth canal (vagina) to be delivered.

With CI, the cervix opens without labor starting. Usually the woman has no symptoms. Few women know they have cervical insufficiency until they have a miscarriage or premature birth. The woman may deliver the baby without feeling contractions.

For women who have had a pregnancy affected by CI, the condition is likely to happen again in later pregnancies.

Causes
Medical experts do not always know why incompetent cervix occurs. Theories include damage to the cervix during surgery, injury during a previous birth, and exposure to certain drugs.

Cervical length appears to be a factor. The shorter the cervix, the more likely the woman is to have cervical insufficiency.

Screening and diagnosis
Medical researchers have not found a reliable way to routinely screen women for cervical insufficiency. If a woman has previously lost a pregnancy in the second or third trimester, vaginal ultrasound exams during the next pregnancy may help predict whether a woman is at risk of preterm birth.

Treatment
Doctors sometimes recommend:

• Bed rest and reduced physical activity. While these methods are common, medical research has
  not proven them to be effective.
• Pelvic rest. The woman should not douche or use tampons. She also should not have sexual
  intercourse.
• Cerclage. The doctor puts a stitch in the cervix to keep it from opening too early. The
  stitch is removed when it is time for the baby to be delivered.

While spending a lot of time in the NICU I talked to other mothers and asked what caused them to have their baby early and a lot of them said preeclampsia so I decided to copy what March of Dimes had on that too since I don't know a lot about it.

Preeclampsia

High blood pressure and preeclampsia
Chronic hypertension is high blood pressure that is diagnosed before pregnancy, or before the 20th week of pregnancy. This type of high blood pressure does not go away after delivery. Medical experts do not fully understand what causes chronic hypertension. Genes, diet and lifestyle may play a role.
Hypertension may narrow or tighten the blood vessels in the uterus that supply the baby with oxygen and nutrients. Hypertension during pregnancy can create severe risks for both mother and baby, including:

• Health problems for the mother, such as heart attack and stroke
• Slow fetal growth and low birthweight
• Increased risk of preterm delivery
• Placental abruption (separation of the placenta from the uterine wall during delivery; this can cause heaving bleeding and shock, placing both mother and baby in danger)

The good news is that with proper prenatal care, serious problems associated with chronic hypertension can usually be prevented. In fact, most women with high blood pressure have healthy pregnancies. However, about 1 in 4 develops a dangerous condition called preeclampsia.

Preeclampsia
Preeclampsia is a potentially serious illness marked by high blood pressure and protein in the urine. If untreated, it can become a rare, life-threatening condition called eclampsia. Eclampsia can cause seizures and, in some cases, coma. Fortunately, eclampsia is rare in women who receive regular prenatal care.

After delivery, a woman with preeclampsia may need to stay in the hospital longer than usual. This is done for the safety of both her and her baby. To learn more about the risk factors for preeclampsia, see the fact sheet High Blood Pressure During Pregnancy.

Pregnant women should be on the lookout for these warning signs:

• Headaches
• Vision trouble
• Quick weight gain
• Swelling of the hands and face
• Pain in the right upper belly

What you can do before pregnancy
If you have hypertension, see your health care provider before trying to get pregnant. He or she can help you get your blood pressure under control before you're pregnant. Your provider can also check to be sure that the drugs you're taking are safe to use during pregnancy. He or she can tell you whether you need to change any of the drugs before becoming pregnant.

Here are some other things you can do before becoming pregnant:

• Work with your provider to lower your blood pressure.
• If losing weight will help control your blood pressure, use diet and exercise to help meet your weight-loss goals.
• Take your blood pressure medicine as prescribed.
• Quit smoking. Smoking damages blood vessel walls. It is especially dangerous for people with high blood pressure. Smoking also harms your baby.

What you can do during pregnancy
To protect your health and the health of your baby during your pregnancy:

• If you have high blood pressure, tell your health care provider early in your pregnancy.
• Go to all your prenatal care visits.
• If your provider tells you to, check your blood pressure and weight at home.

For those of you wondering... Ethan is doing awesome. He is now off of all of his medications. He is breathing great, moving around, gabbing, sleeping through the night, a-dor-a-ble, reaching for things, follows things with his eyes, loves books, loves to sit and stand with our help and smiles when he hears our voices. Of course he is also doing the things that most people take for granted that were huge things in the NICU... eating, peeing, pooping, keeping his temperature, and pink in color (no jaundice). We always think Ethan is right on track with the "schedule" but then we meet up with a therapist and they say "yeah, he is right on track... with his adjusted age." They say it takes up to 2 years for premature babies to get back on track with the schedule. Heck, that is a-ok with me. After everything that he has overcome and achieved he is doing spectacular in our eyes!