A PREMATURE BIRTH, occurs when a woman gives birth to a baby before the end of the normal period of pregnancy. The normal period of pregnancy ranges from 37 to 42 weeks after a woman begins her last menstrual period prior to becoming pregnant. Births that take place between 20 and 37 weeks of pregnancy are said to occur preterm. At one time, a birth weight of less than 5 1/2 pounds (2.5 kilograms) was the only measure for determining prematurity. Today, it is understood that a baby can weigh more than 5 1/2 pounds and still be functionally immature, while an infant of less than 5 1/2 pounds can be functionally mature. Most premature infants that weigh more than 3 1/3 pounds (1.5 kilograms) at birth grow up as healthy as babies born after a normal pregnancy. Premature babies weighing less than 2 1/5 pounds (1 kilogram) at birth have the poorest chance of survival.

In many premature infants, certain organs--especially the lungs--have not developed sufficiently for the baby to survive without medical assistance. Hyaline membrane disease, also called respiratory distress syndrome, ranks among the most serious lung disorders that strike these babies. Some infants with this condition are attached to a respirator. Other common problems include the inability to digest normal-sized feedings and the body's lack of adequate control over its temperature. If the baby can suck and swallow, special formulas may be given by bottle. Some premature infants must be fed by means of a tube passed through the nose and into the stomach. Others may need to be fed entirely through a tube inserted into a blood vessel. Most premature infants are placed in an incubator to assure a constant body temperature.

Premature births occur least frequently among healthy women who receive periodic medical care. A woman can help assure a normal birth by following a well-balanced diet and by avoiding the use of tobacco, alcohol, and all drugs except those recommended by her physician. In the United States, about 7 per cent of white babies and 14 to 15 percent of nonwhite babies are born prematurely. The cause of preterm births are still poorly understood. A variety of factors involving the mother, the unborn baby, and the placenta an organ that develops during pregnancy, joining the mother and the unborn baby can result in preterm delivery. Many women who give birth prematurely have a medical condition associated with premature birth. Such conditions include abnormalities of the uterus, drug addiction, high blood pressure, and being pregnant with more than one baby. A woman who has had a premature baby or a miscarriage has about a 20 per cent chance of again giving birth prematurely. Scientists have developed a number of drugs that can help stop preterm labour before it results in premature birth.

Premature birth is one of the greatest health hazards of humankind. In fact, prematurity is the single most common cause of sickness and death among newborn babies worldwide. In addition, it imposes major financial costs on the family, health care system, society, and economy. Who is affected? Of every 100 babies born in the United States, 6 to 7 are born before the full term of pregnancy, for a total of 250,000 each year. Of these, 75,000 babies - almost 2 percent of all babies - are born more than 6 weeks early. These babies are so premature that their chances of life and good health are poor. Pre-maturity accounts for 75% of all deaths in the first month of life and 50% of long-term handicaps. Many will have disabilities that will affect them throughout their lives.

You may have been told by your health care provider that you are "at risk" for pre-term labour. This can be frightening to hear -- especially when you are aware of the health problems your baby could have if born prematurely. No one can predict who will go into labor too early, but some women seem to have preterm labor more than others. Women at highest risk include: Women younger than 17 years old or older than 35. Women who are carrying twins or any multiple pregnancy. Women who have had more than 3 abortions. Women who have already had a preterm baby. Women who have strenuous activity at work. Remember, many women who have none of these risk factors deliver before they are at full term. All women should be aware of the warning signs for preterm labour.

Whether or not you have been told you are at high risk for preterm labour, you should know what you can do to prevent it. Many women give birth too early even if they are not at high risk. Be prepared. Know what to look for and follow these precautions: See your health care provider for a pre-pregnancy visit. Get early and regular prenatal care. Become aware of the signals your body gives you. Learn the steps you can take to ease preterm labour symptoms should they occur. Understand which activities might be contributing to the symptoms of preterm labour. Look at how you can change your daily activities to reduce or avoid preterm symptoms.

Think about what you were doing when the symptoms began. Stop what you were doing. Lie down on your left side for one hour. Drink 2-3 glasses of water or juice. Call your health care provider or go to the hospital if the symptoms get worse during that hour. Return to light activity if the symptoms go away after that hour. Do not do what you were doing when the symptoms began! If the symptoms come back after an hour of rest, call your provider. Never ignore your symptoms or assume they aren't important. Be sure to tell your provider at your next prenatal visit what symptoms you had and what you did about them.

No two women are alike when it comes to preterm labour, and there is no formula for preventing it. While some women can do almost anything while pregnant and never feel any symptoms, othes have to be more careful. When reading the following advice, Keep in mind that you only need to change those activities that bring on preterm labour symptoms. For example, if climbing stairs is not a problem, you don't need to do anything differently. If, however, it brings on any of the symptoms listed earlier, you need to figure out how to change your routines to avoid this activity as much as possible. If you have questions about what you can nad can not do, your health care provider can help you figure out which activities are alright.

Waching out for the signs of preterm labour is just one thing you can do to protect your baby. It's important that you get enough rest, seek early and regular prenatal care and make sure that you and your baby get food nutrition. Even though nutritional factors do not usually cause early labour, It is important to get the right amount of healthy foods so your baby can grow and gain weight. Pregnant women should eat a variety of vegetables, fruits, breads, meat, milk and other protein foods. Women of average height and weight should gain 25 to 35 pounds during pregnancy. If you are having problems eating or are not gaining weight, talk to your provider. Health care providers recommend that women between the ages of 15 and 44 consume 0.4 miligrams of folic acid (a B-vitamin) daily to reduce the risk of neural tube defects like spina difida that can develop in the fetus early in a pregnancy. Since it is hard to get enough folic acid from foods, you can make up the difference by taking a multivitamin.

Preparation Some health care providers suggest that the breasts be toughened up for breastfeeding. Your provider may have told you to use techniques such as nipple rolling to prepare your breasts. If you notice preterm labour symptoms while you're doing these exercises or just after, take these steps: Stop breast preparation until you talk to your health care provider. Resume preparation after 37 weeks of pregnancy when the danger of delivering preterm is past.

Rest is very important for all pregnant women, especially those at risk for preterm labour. Sit with your feet up every morning and afternoon. Lie on your left side for one hour if you experience any preterm labor symptoms. Get extra rest, if possible.

Standing can bring on symptoms in some women. If this is true for you, try some of the following: Plan your day so you can sit with your feet up several times each day. Lie down each morning and each afternoon for 15-30 minutes. If you work outside the home and have to stand most of the time, take 15-minute breaks in the morning and afternoon when you can put your feet up. Sit down while you work or when preparing meals. You might try keeping your feet on a box under your desk.

Most women can work without problems throughout their pregnancies. For some, the physical activity of work can bring on preterm labour symptoms. Pay special attention to any symptoms that happen at work. This is especially important if you perform hard physical work or if your work involves vibrating machinery. Check with your employer to see if any of the following steps might be possible Change to a different department while you are pregnant where the work is not so physically difficult. Work part time for a few months. Change your hours so you don't have the stress of commuting during peak traffic times. If you do have to stop work because your preterm labour symptoms are occurring frequently, your health care provider can provide a note explaining your need for disability time off.

Heavy Lifting: Carrying groceries or laundry baskets or toting heavy toddlers can start preterm symptoms in some women. Ask someone to help you. Avoid carrying your toddler by using a stroller, asking the child to walk, or sitting rather than standing with him or her in your arms.

Heavy Housework: Scrubbing floors, washing walls, or any other strenuous housework has to wait until after the baby is born. Lighter housework can be adjusted if you feel any symptoms. Try sitting down when you iron or fold clothes, or prepare food for cooking.

Walking Walking is a good form of exercise for most pregnant women. For some, however, walking briskly or carrying heavy bags while walking can bring on preterm labour symptoms. If you notice pelvic pressure, cramping, or other discomfort: Slow your pace. Don't carry heavy packages while you walk.

Long car and airplane trips can bring on preterm labour symptoms in some women. If you notice this happens to you: Don't take long trips until after the baby is born. Tell your health care provider about the symptoms you had. If you must travel, stop at least once each hour to get up and walk around.

Running for the train or bus can cause extra stress for a pregnant woman. To avoid preterm symptoms: Leave home a little earlier than usual allow extra time to get to the bus or train stop. Don't run if you see your bus or train coming! Wait for the next one instead.

Sexual Activity Most pregnant women don't need to restrict their sexual activity unless they experience preterm symptoms during or after sex. If you have cramping, contractions or any other symptoms after sexual activity: Don't have sex again until you talk to your health care provider. Talk about your symptoms with your partner. See if both you and your partner can talk to your provider about your symptoms and what sorts of sexual activity might be alright.

Alcohol and Drugs Using alcohol and drugs of any kind can increase your chances of having your baby too early. While you are pregnant do not use: Alcohol. Tobacco. Street Drugs (crack, cocaine, marijuana, heroin, etc.) Drugs of any kind, including over-the-counter, except those specifically prescribed for you by your provider.

llnesses. Certain infections can cause symptoms of preterm labour. Many times, a woman doesn't realize she has an infection. For that reason, your health care provider will probably do a special test or culture of the lower part of your womb (cervix) sometime during your pregnancy. Infections in your urinary tract can also cause preterm labour. To avoid the problems caused by infections, take the following precautions: Get early and regular prenatal care. Drink at least six glasses of water each day. If you notice burning or pain when you urinate or feel the need to go to the bathroom all the time, tell your health care provider. If your provider gives you medicine for any infection, take it all as directed and check back to make sure the infection is gone.