Delivery of Your Premature Infant

A premature delivery may happen suddenly or after days or weeks of waiting and worrying. If you know you may deliver early, you, your partner, and your doctor can prepare for a premature birth. For more information, see the topic Preterm Labor.

The premature delivery

You and your premature infant (preemie) are considered high-risk during preterm labor. This means that you will have less freedom, both to make birth-related decisions and to move about freely. You can expect the following:

• You may need to adjust your birth plan and birthing choices during this birth. You can refuse medicines such as painkillers during preterm labor. But other treatments such as antibiotics or corticosteroids can be important to ensure your infant's chances of good health after birth. Be sure to ask as many questions as you can think of about your medical care. The more you understand about your doctor's decisions, the less anxious you will feel.
• You will be on constant fetal heart monitoring. You also will be checked regularly for changes in heart rate, body temperature, and uterine contractions.
• You will probably deliver vaginally, rather than by cesarean section (C-section), as long as you and your fetus show no signs of distress.

After the premature birth: The infant

As soon as the umbilical cord is cut, the neonatal staff will watch over and stabilize your infant. If your infant is less than 36 weeks' gestation at birth, they may move him or her to the neonatal intensive care unit (NICU) for observation and specialized care. If you deliver in a hospital that has no NICU, your infant may need to be taken to another hospital.

During the first hours and days, your infant will adjust to living outside of the maternal "life-support system." This is a time when birth defects and complications of prematurity often become apparent. For more information, see The Premature Newborn and The Sick Premature Infant.

If your infant is born between 22 and 25 completed weeks of pregnancy (extreme prematurity), you likely will be faced with some difficult decisions during the first month after the birth. These personal stories may help you make your decision.

After the premature birth: The mom

While the neonatal staff attends to your infant, the obstetric staff will care for you. Depending on your condition, this will take at least a few hours. Meanwhile, your birth partner may want to go with your infant to the NICU.

Before your breast milk comes in (3 or 4 days after childbirth), you will be asked to decide whether you plan to breast-feed or bottle-feed your premature infant. Formula does not give your infant added protection from early infection, so strongly consider pumping milk for your infant for at least the first weeks of life. If you decide to breast-feed, expect at first to pump milk for feedings until your infant is mature enough to feed orally.

• Breast milk contains antibodies that help protect your vulnerable infant against early, serious infections, including sepsis and necrotizing enterocolitis, as well as ear and upper respiratory infections during early childhood.
• The benefits of breast milk over formula include better nutrient absorption, digestive functioning, and nervous system development.
• Both specialized formula and breast milk can offer your infant excellent nutrition.
• Pumping and breast-feeding can be one of the most beneficial and rewarding things you do for your premature infant. But it may also be hard and exhausting. If you cannot breast-feed, decide not to breast-feed, or find that you have to discontinue doing so, formula feeding will meet your infant's nutritional needs.

Your hospital's lactation consultant can be very helpful with pumping and breast-feeding questions and problems, both before and after the birth. For more information, see the topic Breast-Feeding.