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Premature Birth; Silent Thief of a Mother’s Joy

World Prematurity Day is commemorated today; 17th November, every year worldwide as a key moment to generate global attention on the leading cause of death of children under 5 years old. The theme for this year’s celebration is, “Give them Tomorrow”.

A preterm baby shortened, preemie is a baby born less than 37 completed weeks of gestation.

The World Health Organization (WHO) Global Health Observatory, 2014 indicates that 80% of newborn deaths are small babies in the highest burden settings with 35% of all neonatal deaths resulting from complications of preterm birth. According to the Born Too Soon report (2, 3), prematurity is the number one cause of under 5 mortalities. In 2015 alone, preterm birth claimed more than one million young children worldwide.

Preterm births are increasing globally with unacceptable high rates of mortality. It is estimated that 15 million babies are born prematurely every year which means, more than one in ten babies around the world. The 2017 March Dimes premature birth report card shows the United States of America’s preterm birth rate increased for the second year in a row from 9.6 to 9.8% in 2015 and 2016 respectively.

In Ghana, a report from the National Newborn Stakeholders Meeting (28-30th July, 2015) held in Accra revealed that, Ghana is ranked 25th in the world in preterm deliveries, 14.5% (128,000) of all deliveries are preterm and accounts for 7,200 neonatal deaths every year.

The causes of preterm birth among others include; premature rupture of Membranes (PROM), Antepartum haemorrhage, hypertensive disorders, and incompetent cervix.

However, several risk factors have been identified to increase preterm delivery. These include history of previous preterm birth, multiple pregnancy, poor nutrition, teenage pregnancy, less interval between pregnancies, smoking or illicit drug use during pregnancy, physical injury or trauma and infections during pregnancy among others.

Interestingly, 71% of newborn deaths are preventable. Antenatal corticosteroids, preterm labour management, essential newborn care and kangaroo mother care (KMC) as well as case management of sepsis with antibiotics and early initiation/exclusive breastfeeding are proven medical interventions targeting the causes of mortality.

The day of birth is supposed to be a day of rejoicing, but in case of preterm birth, it is the time of greatest risk of death, disability and psychological trauma. Their survival is threatened due to their immature anatomic and physiologic systems causing problems of thermo-regulation, breathing and increased risk of infection. The preemie mother, do not only face the above mentioned challenges but a wide range of stress.

The frail preemies mostly face rejection from family and partly from parents due to loss of hope in their survival. Hence, caring for such babies especially in the hospitals are very challenging. Awareness creation through both print and electronic media is therefore imperative to sensitizing the general public on the survival rates of preemies.

The infrastructure, equipment, and human resources necessary for holistic care of preemies in Ghana are woefully inadequate. The First Lady’s (H.E Rebecca Akuffo Addo) commitment in championing newborn care through the putting up of Babies and Mothers Unit (BMU) at KATH is a step in the right direction. The Government should show more commitment in setting up well equipped newborn care units especially in the deprived facilities, policy formulations, and expansion of training for specialist Doctors and Nurses to enhance the care of preemies.

The increasing trend of adolescence pregnancies is alarming and thus, promoting girls’ education and enforcement of changes in cultural norms to delay marriage and early childbearing is key. Rapid progress is possible if the right actions are taken, especially when applying integrated strategy that links key interventions like Focus Antenatal Care (FANC).

This year, advocacy groups will as well call on the media to raise awareness on prevention and treatment, highlight innovations and simple measures that can help mitigate risks associated with preterm birth and care. More importantly, everyone can play a role in helping prevent preterm births, ensuring accurate diagnoses, and caring for women in preterm labour and babies born too soon.

Health facilities should also strengthen their efforts in referral processes when necessary to save the lives of preemies. Social welfare systems should be established in all district hospitals and existing ones strengthened to include counselling sessions for women at risk of preterm delivery as well as mothers nursing preemies. This will help lessen the psychological impact of nursing a preemie

The new global target, ending preventable newborn and child mortality by 2030 (SDG 3.2) cannot be met without reducing preterm deaths.

Put on purple today to save the life of a preemie!

I am a mother of a preterm baby and my daughter is all grown up, 28 years old and a lawyer. But I still remember how really distressing it is when they are born. The nurses would ask you for breast milk and you express, and express and nothing comes….” –Dr. Gyikua Plange-Rhule.

BY JOHN ANABA ATINGANE

The writer is a Senior Staff Nurse with interest in child health at Margret Marquart Catholic Hospital, Box KD 97, Kpando-Volta Region.

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