Monday, June 22, 2009

lpod - what we don't know about childbirth

I know it's been a while since I did one of these, but this was my learning point for today.

Because I'm a sad person (or so my family tells me), I listen to talk radio when I have the car to myself. Today was one such day and I listened to a programme about premature babies (the link will be available for 7 days - apologies if the BBC link doesn't work outside the UK). Comparatively little research is done in this field and there are still huge areas of blankness.

Unless a woman has already miscarried or given birth to one premature baby, there is still no way of knowing whether she is at risk of doing so. So a couple will have to have dealt with all the associated difficulties at least once before they are referred to a unit which will monitor subsequent pregnancies. The interviewer asked the expert what starts a woman off in early labour and (and this is where the learning point comes in) it transpires that we still don't know what starts labour at any point, early or otherwise. No-one knows yet what the catalyst(s) is/are that start the process.

The immediate instinct when a woman goes into early labour is to try to stop it. Very few effective means exist to achieve this. Quite often, it transpires that the uterus has become a hostile and/or toxic environment for the child and the risks of early birth may be less than the risks of a prolonged stay in that environment. So it's a trade-off and we don't know enough to be able to make that decision quickly and reliably.

Rather tellingly, it has only been in the last few years that UK birth records have begun to record gestation instead of just birth weight, so there is precious little recorded data to go on prior to that. As a result, it isn't possible to compare the statistics around premature births with other countries.

Interesting, huh?

Okay, so it's just me. Sorry.

The programme kicked off and ended with an interview with a woman called Sarah and her daughter Isobel who had been born at gestation 27 weeks (so 3 months early) in 2001. I was stunned when Sarah shared how people immediately assume that the early birth of her daughter was somehow her fault: as if she hadn't looked after herself properly, or had engaged in substance abuse of some sort. I have known many people with preemie babies and have never heard anyone respond to them with such an assumption.

What was utterly heartwarming, though, was Sarah's evident pride in her daughter's ability to walk, something she was expected never to do. Issy has a catalogue of disabilities, but Sarah takes pride in the things she is able to do, instead of bewailing the things she cannot. As the programme ended with the joyous laughter of mother and daughter as Issy bounced on a trampette, I chastised myself for my disappointment when my boys don't live up to my expectations.

We also heard from a couple whose (as yet unnamed) son was born two-and-a-half weeks ago at gestation 25 weeks. Their whole world has reduced down to the size of the neonatal intensive care unit. They hover over his incubator and celebrate things like a 20g weight gain. As the mother tried to explain how she treasured things like being able to change his tiny nappies, and gave up as her voice failed her, I realised again how very, very fortunate I was to have given birth to three live, healthy, term babies.

Go give your kids a quick squeeze. I did as soon as I got home.

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