Shedding Light on Preterm Births
Cleveland Cavaliers player J.R. Smith III and his wife, Jewel Harris, recently revealed their baby, Dakota, was born prematurely. She was five months “early” and weighed only about one pound. “We know we’re not the only family going through this, who has been through this or who will ever go through it. That’s why we decided to share what we’re going through with you guys,” said Jewel Harris. Since the story came out, I have been asked by several friends about preterm birth and whether this type of situation can result from medical negligence.
The answer, of course, is complicated. I do not have any of the details about what happened in the case of Dakota’s birth, and I would not presume to discuss what happened to them. What I can say is that preterm birth is a serious problem in the United States and in the rest of the world. According to various sources, somewhere between one in eight and one in ten babies in the United States is born prematurely, which typically is defined as birth before the 32nd week of gestation.
Preterm birth can lead to death or permanent disability. Such disabilities include things like developmental delay, vision problems, or cerebral palsy.
Risk factors for preterm birth
Unfortunately, it is impossible to predict which pregnancies will result in early labor and preterm birth. There are, however, some risk factors that seem to be associated with preterm birth. These include having a previous preterm birth, having a short cervix, a short interval between pregnancies, multiple simultaneous gestations, and some “lifestyle factors” such as smoking or substance abuse during pregnancy.
What can be done to stop or slow down the birthing process?
Once a woman goes into labor prematurely, not much can be done to stop a preterm birth. Steroid medications can be used to try to accelerate the maturation of the baby’s lungs. Other medications called “tocolytics” may be used to try to delay delivery (by up to about 48 hours) in order to give the baby a bit more time to develop and to give the steroids an opportunity to work. Magnesium sulfate can also be given to a pregnant woman who is at risk of delivering prematurely within seven days, though usually this is not done before 24 weeks of gestation. Magnesium sulfate is thought to help provide neuroprotection for the baby, reducing the risk that the premature infant will later develop cerebral palsy.
Preventing premature birth
Because premature birth can be so devastating, it is important for any woman at increased risk for premature birth to get early prenatal care from a specialist in high risk pregnancies called a “maternal-fetal medicine” specialist. This means that women with a history of preterm birth or with a short cervix (identified during prenatal ultrasound examinations) should be referred to a specialist early in her pregnancy for further evaluation and management. In appropriate circumstances, medications (such as progesterone) can be used to reduce the likelihood that a pregnant woman will go into labor prematurely.
Most cases of preterm birth are not preventable and are no one’s “fault.” But failure to make a referral to a maternal-fetal medicine specialist and failure to properly treat preterm labor once it begins can increase the risk of serious injury to the baby. These kinds of failures – depending on the circumstances — can be the basis for successful medical negligence lawsuits, which in turn can ensure that victims of this negligence will have the resources necessary to obtain whatever care is needed in the future.
Our prayers are with J.R. Smith and his family at this time. We know how devastating preterm birth can be, and we applaud their courage in discussing this matter publicly. By sharing their story, they are bringing attention to premature births.
Advances are being made (albeit slowly) in reducing the number of preterm births in the United States and worldwide. We are hopeful that one day this problem will be a thing of the past. Until then, however, we urge all pregnant women to get early prenatal care and to follow the recommendations of their physicians for prenatal wellness.