Prematurity

The baby was born premature. 

What do you think of when you read that sentence? Does it make you ask questions like who and where and why? What happens if I show you this picture...

They say a picture is worth a thousand words. In this case I would guess it is at least more emotional. Really though does it answer any of your questions about who and where and why?

So let me tell you a little of his story. This little baby is David Anugerah. He was born two months early at 32 weeks. He was Natalia's third baby. For about a week, we at Bethesda Hospital struggled to help him survive. We helped him breathe, eat, and stay warm. We tried hard to protect him from infection. It was his immature lungs however that we couldn’t help. There were none of the newer drugs such as surfactant available. So we wrapped him in warm blankets and in his final moments his mom held him. He passed away just 8 short days after his life began. This left his mom, Natalia, with just one child. I don't know why he was born early. His death was one of those that helped me realize that there was more that I could do if I knew more and had more training. This led me to return to school and become a nurse-midwife. My hope is that as a nurse-midwife I can help prevent women like Natalia from having their babies so early.

In recent years, there has been an increasing focus on preterm birth and its effect on countries around the world, rich and poor. A recent report by 50 international organizations is shedding new light on the topic and giving us current research. Here are some of the fascinating facts I found when reading the report:

• Preterm birth rates are increasing in almost all countries with reliable data.
• Prematurity is the leading cause of newborn deaths (babies in the first 4 weeks of life) and now the second-leading cause of death after pneumonia in children under the age of 5.
• Half of the babies born at 24 weeks (4 months early) survive in high-income countries, but in low-income settings, half the babies born at 32 weeks (two months early) continue to die due to a lack of feasible, cost-effective care, such as warmth, breastfeeding support, and basic care for infections and breathing difficulties.
• 15 million babies are born too soon each year. Over 1 million children die each year due to complications of preterm birth. 

The map above shows which countries are struggling the most with high rates of preterm birth. Indonesia is in red, which indicates that for every 100 babies born more than 15 of them are born early. There are several known causes of preterm birth and many that are not fully understood. There are several simple interventions that can help decrease preterm birth, even in places with less resources like Indonesia. For example:

• Decreasing the rate of adolescent pregnancies and increasing the time interval between children.
• Prevention and treatment of infections such as malaria and HIV before or early in the pregnancy. 
• Improve the health of women suffering from chronic illness like diabetes, asthma, and thyroid disease before they get pregnant. 
• Improve the nutritional status of women before they get pregnant and early in the pregnancy by helping them gain or lose weight as appropriate. Help those with nutritional deficiencies like iron-deficiency anemia get the nutrients they need.

There is a lot of work to do in places like Indonesia, but also in places like the United States. You can read a lot more and the report here, if you are interested.