In 2017, Detroit was ranked the second-worst city in the nation for its premature birth rate by the March of Dimes (1). This rating gave the city an “F” grade. The city’s premature birth rate would be at a 13-year high in 2019, according to the latest statistics from the State of Michigan.
Premature birth is one of the leading causes of neurological disability such as cerebral palsy, which is frequently caused by a lack of oxygen in a baby’s brain. Examples of injuries that can deprive a baby’s brain of oxygen are hypoxic ischemic encephalopathy (HIE) and periventricular leukomalacia (PVL). Sometimes, the oxygen deprivation occurs when an event during labor and delivery is mismanaged by doctors and/or the doctors do not deliver the baby quickly enough when they are in distress (2). Other times, the baby’s breathing is not properly managed after birth, causing the baby to suffer problems such as long-term oxygen deprivation and low heart rates.
Premature babies are at a high risk of having breathing and other problems after birth, which is why it is very important for doctors to closely monitor a woman through pregnancy through prenatal tests and do everything possible to prevent premature birth. A developing baby experiences very important growth during the final months and weeks of pregnancy. Organs such as the lungs, brain, and liver need the last weeks of pregnancy to mature. Premature birth places a baby at a higher risk of developing breathing problems, feeding difficulties, vision and hearing problems, developmental delays, and the aforementioned cerebral palsy, hypoxic ischemic encephalopathy, and periventricular leukomalacia (PVL).
What causes premature birth?
Some women are more likely than others to go into preterm labor. Risk factors for premature birth include the following (3):
- High blood pressure during pregnancy and preeclampsia
- Infections such as herpes simplex virus (HSV), chorioamnionitis or villitis, bacterial vaginosis (BV) and a urinary tract infection (UTI) which can cause premature rupture of the membranes (PROM)
- The mother has an incompetent/insufficient cervix
- Prior preterm birth
- Carrying more than one baby (twins, triplets or more)
- Late prenatal care
- Low or high maternal age
Doctors must pay attention to these risk factors in their patients. When a mother is at risk of going into preterm labor, the doctor must monitor her and the baby more closely and make efforts to prevent premature birth.
What can be done to prevent premature birth?
A doctor must take a thorough history of their patient, and they should discuss ways for their patient to reduce the chances of having a premature baby. Patients should also seek immediate medical attention when there are any warning signs or symptoms of preterm labor.
Patients should also be closely monitored for any signs of infection. It is the standard of care to test all pregnant women for urinary tract infections, and some doctors test all of their pregnant patients for bacterial vaginosis. It is the standard of care to do a test for bacterial vaginosis on all pregnant women who have had preterm labor.
Pregnant women should have their cervixes measured at weeks 19-24. If a cervix is short or the doctor determines that the cervix is insufficient or incompetent, progesterone treatments and cervical cerclages (a stitch or stitches to help reinforce the cervix) should be considered. If a mother has a history of preterm birth, the mother should have an ultrasound performed at least every 2 weeks from week 15 of pregnancy through weeks 24-26.
If doctors think there is a possibility that the baby will be born prematurely, a drug called magnesium sulfate can be given to you within 24 hours of the expected delivery. The medication typically is administered when the baby is between 24 and 32 weeks of gestation. Magnesium sulfate should be administered to mothers with preterm premature rupture of membranes (PPROM), preterm labor with intact membranes, or indicated preterm delivery.
What are the warning signs Of preterm labor?
Just like regular labor signs, the signs of preterm labor include the following:
- Change in vaginal discharge (fluid leaking or bleeding from the vagina)
- Contractions (the abdomen tightens every 10 minutes or more)
- A low, dull backache
- Pelvic pressure/a feeling that the baby is pushing down
- Cramps such as those experienced during a menstrual period
- Abdominal cramps
Detroit Birth Injury Lawyers
The award-winning lawyers at ABC Law Centers (Reiter & Walsh, P.C.) have been helping children born prematurely in Detroit and throughout the nation for over two decades. Jesse Reiter, the firm’s president, has been focusing on birth injury cases his entire 25+ year career, and most of Jesse’s cases involve helping children who have cerebral palsy and hypoxic ischemic encephalopathy (HIE). When Jesse and the rest of our team take a case, they spend a lot of time getting to know the child and family they are helping so they can fully understand the child’s needs.
Jesse has won many awards for his advocacy of children. He has been recognized by U.S. News and World Report’s “Best Lawyers,”, as well as Super Lawyers magazine, and Leading Lawyers. ABC Law Centers is also recognized by U.S. News and World Report in their publication “Best Law Firms.”
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- Kat Stafford, J. (2019, November 07). As Mayor Mike Duggan touts Make Your Date’s success, Detroit’s preterm birth rate spikes. Retrieved January 09, 2021, from https://www.freep.com/story/news/investigations/2019/11/07/detroit-preterm-birth-rate-make-your-date/4156777002/
- Michigan Cerebral Palsy and Premature Birth Lawyers. (2020, December 22). Retrieved January 09, 2021, from https://www.abclawcenters.com/practice-areas/prenatal-birth-injuries/premature-birth-and-prevention/
- What are the risk factors for preterm labor and birth? (n.d.). Retrieved January 09, 2021, from https://www.nichd.nih.gov/health/topics/preterm/conditioninfo/who_risk