Provider-initiated preterm birth is when early birth is planned because staying pregnant is considered to be less safe for māmā/person and/or pēpi.
The most common reasons for provider-initiated preterm birth are preeclampsia, fetal growth restriction, whenua/placenta and pito/umbilical cord abnormalities, heavy bleeding and medical conditions in pregnancy.
5 ways to prevent provider-initiated preterm birth
ONE: Book in with a midwife early in pregnancy (ideally before 12 weeks) and let your GP know that you are pregnant.
You may find it helpful to call the community midwifery team at your local hospital or go to findyourmidwife.co.nz
Your midwife will be able to ask the right questions to see if you need extra care to reduce your chance of the conditions that may lead to provider-initiated preterm birth.
TWO: Keep in touch with your midwife and attend all your appointments, scans and tests.
This will allow you to share any concerns with your midwife and they can continue to assess your chance of conditions that may lead to provider-initiated preterm birth.
THREE: If you have had preeclampsia or fetal growth restriction in a previous pregnancy, use an evening dose of aspirin from 12 to 36 weeks to reduce the chance of this happening again.
Aspirin is safe to use in pregnancy and has been shown to reduce the chance of preeclampsia or fetal growth restriction. It is also likely to reduce the severity of these conditions and so reduce the chance of provider-initiated preterm birth.
FOUR: If you are smoking cigarettes in pregnancy, try to become smokefree.
Talk to your midwife/doctor about nicotine replacement therapy and ask for a referral to your local smokefree programme to help you achieve this goal.
Becoming smokefree, reduces your chance of fetal growth restriction and bleeding in pregnancy.
FIVE: At the beginning of your pregnancy let your midwife know about your previous pregnancy, medical and family history. They may refer you to your local hospital for additional care.
Your local hospital will arrange for review by a doctor. They may consider some additional treatments (such as aspirin, calcium, diabetes treatment, blood pressure medicines) and may recommend some extra scans to check on pēpi growth.
Although it is not always possible to avoid all provider-initiated preterm births, they can sometimes be safely delayed until pēpi is older and, when it is required, there is lots that can be done to prepare and help pēpi survive and be healthy and well.