If you've previously experienced premature labour or have been told you're at risk of delivering prematurely, you'll be aware of the potential risks and you'll no doubt be worried about the health of your baby. Prenatal care is often handled by community midwives, but when there's a risk of premature labour, it can be beneficial to have your prenatal care carried out in a hospital setting by an obstetrician.
Your obstetrician will keep a closer eye on you and your baby during the course of your pregnancy than is possible in a community care setting with a midwife. You will be offered extra ultrasound scans to check how the baby is developing and check on the condition of your uterus and placenta. You may also be offered regular blood and urine tests to check for the presence of underlying conditions that can make premature labour more likely, such as gestational diabetes, a urinary tract infection and hypertension. If there are signs that premature labour is starting, your obstetrician can offer the following two options to slow down labour:
If your obstetrician discovers your cervix is opening up too early during one of your check-ups, they can offer to perform a cervical cerclage. The aim of this procedure is to keep the womb closed for as long as possible and involves stitching the cervix. Cervical cerclage is a supportive procedure that can be carried out as a day case, but your obstetrician may want to monitor you in hospital for a day or two to ensure labour is not progressing. They may also advise you to go on bed rest for the remainder of your pregnancy to ensure the stitches aren't compromised.
If a vaginal ultrasound scan identifies that premature labour is occurring due to a short cervix, your obstetrician may offer you vaginal progesterone suppositories. This hormone treatment can prevent preterm labour by encouraging cervical thickening and can help the cervix to stay closed. The treatment will have to be administered daily for the remainder of your pregnancy, but you can administer it yourself at home.
These are just a couple of examples of how obstetric care can help prevent premature labour. If you feel you would benefit from the extra monitoring and support offered by an obstetrician, ask your GP for a referral. During your first appointment, you can ask any questions you have and you and your doctor can decide together if obstetric care is the best option for you and your baby.
Reach out to a local obstetrician if you have any additional concerns about their services.