On June 30, 2010, the March of Dimes released a new survey entitled "SPEAKing About Preterm Birth," in cooperation with Babycenter.com and Ther-Rx. The study, which looked at communication between expectant moms and their health care providers, found that too few women are talking with their doctors and midwives about their risk for preterm birth and how to prevent premature birth.
After the survey was published, I was fortunate enough to interview Dr. Alan Fleischman, medical director of the March of Dimes, about its results.
How were you involved with the "SPEAKing About Preterm Birth" survey?I am the Medical Director of the March of Dimes, which conducted the survey with BabyCenter, in conjunction with Ther-Rx Corporation. We worked closely with our partners to develop the survey so we can better understand how women and health care providers discuss preterm birth. The March of Dimes is the leading organization for pregnancy and baby health. We launched our national prematurity campaign in 2003 and since then, with our chapters nationwide, we have worked to improve the health of babies by preventing birth defects, premature birth and infant mortality. The SPEAKing about Preterm Birth Survey is another great opportunity for us raise awareness and to help educate women about this important issue.
SPEAKing About Preterm Birth is a survey looking at moms' awareness of preterm birth, focusing on the communications between new and expectant moms and their health care providers. Why do you feel like it is important for moms and their health care providers to have an open dialogue about preterm birth?SPEAKing About Preterm Birth found that the majority of new or expectant moms and almost half of moms who have already delivered preterm have not discussed preterm birth in their current pregnancy with their health care provider; however, an open dialogue can help address any modifiable risk factors, and bring up other health conditions that may put a pregnant woman at increased risk of delivering preterm. There are things a woman can do to lower her risk of delivering her baby too soon, including controlling chronic medical conditions, such as diabetes and high blood pressure, maintaining a healthy weight, eating healthy, taking a multi-vitamin containing folic acid, and getting early prenatal care.
Also it's important that a woman's health care provider know if she has had a preterm baby, because it's an important indicator she may be at increased risk for delivering a second premature baby. The March of Dimes recommends women who have delivered their baby too soon should ask their health care provider if progesterone treatments might be a good choice for them. Preterm birth is a serious health issue in the U.S. and the leading cause of infant death, so it's important that moms and their health care providers take all necessary steps to help prevent it - and that includes communication.
What facts about preterm birth are most important for moms and their health care providers to discuss?It's very important for moms and their health care providers to discuss the risk factors associated with preterm birth. Although the causes of spontaneous preterm birth are often unknown, a leading risk factor for preterm birth is a history of prior preterm birth, so it's important that a woman who is thinking about getting pregnant or who is already pregnant alert her health care provider of her past medical and pregnancy history. Other risk factors for preterm birth include: being pregnant with multiples, such as twins or triplets, African American ethnicity; high blood pressure or diabetes; being over or underweight; high levels of stress; smoking, alcohol consumption or use of illegal drugs; infections or vaginal bleeding; and having a short time between pregnancies.
It's also important for moms to understand the potential consequences associated with preterm birth. Not only are babies born preterm more likely to have feeding or breathing problems, but also lifelong consequences such as cerebral palsy and mental retardation. Preterm birth can take a significant emotional toll on moms and their families - our survey found that 9 out of 10 moms who have experienced preterm birth worry about whether their baby was going to be okay as an impact of delivering preterm. Understanding potential consequences can help a mother cope and prepare if necessary.
Lack of options for treating preterm birth is a leading reason why health care providers may not discuss preterm birth with their patients. What viable treatments options do you feel are most important for doctors to discuss with their patients?First and foremost, discussing proactive prevention of preterm birth is very important. This can include things like advising a patient to quit smoking and maintain a healthy weight, reducing unnecessary inductions or cesarean deliveries before 39 weeks, preventing multiple births that result from fertility treatment and providing more women with access to health care so that they can start prenatal care early in their pregnancy, and controlling chronic conditions such as diabetes and high blood pressure.
Additionally, the American College of Obstetricians and Gynecologists (ACOG) issued a written opinion in October 2008 stating that progesterone supplementation for the prevention of recurrent preterm birth should be offered to women with a singleton pregnancy and a prior spontaneous preterm birth. The March of Dimes advises pregnant women to discuss with their health care provider whether they are a candidate for this treatment.
