5 Things You Need to Know About Preemies

It started 2 months before my due date.  The contractions hit during breakfast and I had to let my 6-year-old take the reigns.  As she made toast and bananas for her siblings, I laid on the couch to relax and breathe through them.

what to know about preemies

It took about 5 days for them to totally go away.  I thought they were Braxton Hicks and maybe they were.  Several doctors and midwives told me that I could have contractions everyday until my due date and that they might be worse than with my previous births.  It was totally normal.  But I didn’t have them with my previous pregnancies so I had nothing to compare them to and I took the professionals’ words as law.

A month later the contractions started again.  They were the same as before, so I laid down and tried to relax.  This time, the kids weren’t cooperating and as I tried to discipline and reconcile them, the pain was getting worse.  Finally, I asked my husband to take over and went to lay down upstairs.  Not understanding the difference between these contractions and the one’s that I had a month earlier, after an hour my husband came upstairs to check on me.  He needed me to go downstairs and watch the children so he could start working.

That switch never happened because my water broke!  It was NOTHING like my previous birth experiences so I was in a panic.  4 weeks before my due date and I had done little to prepare other than setting up the bassinet in our room.  Luckily, we had just bought a bigger car literally a few days before or we wouldn’t have been able to fit all the kids in the car!

5 Things You Need to Know About Preemies

I never dreamed I would have a Preemie, only unhealthy, first-time-moms have preemies, right?  Wrong!  1 in 9 births are premature.  That is a huge percentage and the medical community still doesn’t understand why.  There are some risk factors that may increase your chance, but I didn’t even have one of those!

what to know about preemies

Prevention may not be possible, but preparation can.  Whether it is your first pregnancy or your 6th, here are 5 things you need to know!

1.  The Truth About Braxton Hicks

These contractions are virtually painless.  They may cause some discomfort, but if you are experiencing frequent menstrual-type cramping, don’t take a chance.  Call your doctor right away or get medical help if you are less than 37 weeks pregnant and have 4 or more contractions in an hour, even if they aren’t very painful.

You might feel embarrassed about going in and it ends up a false alarm, but caring about the well-being of your child is nothing to be ashamed about.  Don’t be like me and end up wishing you would have went in earlier.

2.  Fast and Furious

Your pain is likely to transition from bearable to excruciating in minutes.  Because baby is smaller, it can start to enter the birth canal before you’re fully dilated.  What does that mean?  There could be no transition phase!  That’s why it is so important to be prepared.

The sooner you can get things ready for baby the better.  Pack your bag months in advance.  Research labor online before going to your birthing class.  And start touring hospitals and asking about their policies soon after your 20th week.   Some hospitals do not have the capabilities to care for premature babies and that means your baby would have to be transferred.  I’ve even heard of some hospitals (mainly in the UK) that will not give care to babies born before a certain gestation or who don’t weigh a certain amount.

3.  The NICU

Even if your baby isn’t premature, they could end up in the NICU if you have any complications during labor.  This intensive care unit is very unique.  Once admitted into the NICU, your child cannot leave unless discharged by leading pediatrician.  Of course it is probably in the best interest of your baby, it can also be a point of contention if you are not happy with the care your child is receiving.

about nicu

Another thing you need to be prepared for is the lack of rooms for parents.  My baby was lucky in that he only had to stay in the NICU for 5 days.  I was able to stay close by in my postpartum room and then in an extra room in the NICU.  For some parents, their baby spends months in the NICU and they have to leave their baby and travel to and from the hospital.  If you live far away from the hospital you can check for a Ronald McDonald house close to the hospital where you can stay for free as long as your baby is admitted.

I believe that feeding my baby frequently and just being there to hold him, helped him recover quickly.  So, you’ll want to try and be with your baby as much as possible.  This is extremely stressful when you can’t stay in the hospital, so try to find people to help and support you.  Graham’s Foundation offers care packages for parents of preemies that will help with information and encouragement whether you are in the NICU or transitioning home.

One more thing you need to know; it is a depressing place.  I know there were little miracles all around me and my baby was one of the healthiest ones, but I couldn’t help but cry all the time I was there.  My baby’s nurse had had a preemie herself and comforted me by telling me she did the same thing.  The atmosphere is one of struggle and heartache.  Help yourself overcome the fear and anxiety with lots of prayer, get outside for fresh air, you might even invite some friends out to lunch or a happy movie to allow yourself to relax.

4.  The Cost

The NICU is expensive.  Each day in the NICU may almost be triple the cost of regular postpartum care, so the bill can quickly become life-changing.  Make sure you understand what you will be charged for, how much everything is, and what your insurance does and doesn’t cover.  Don’t be afraid to ask the price, but don’t be surprised if no one knows.

One tip that I have is to try and be discharged from your postpartum room as soon as you can, as each day is about $1000.  Take advantage of the free meals that NICU parents get, and try to pump or nurse as much as possible.

If you don’t have insurance, make sure you know the hospital’s policy because some may send you home before your baby is ready if you can’t pay the bill.

5.  The Bright Side

Thanks to medical advances if your baby is at least 26 weeks, his chances of survival are very good (80%).  New discoveries are making this percentage rise each year.  By being proactive and doing research even if you are not at risk, you can try and prevent, or more importantly, be prepared for preterm labor.

Everyday your premature baby gets older, your worries will fade and he will be just like any other baby – a little miracle worth all the stress in the world.

parents need to know about preemies

Are you a parent of a preemie?  I would love to hear your experiences and advice.  Please leave a comment!

If you know a new parent, please share this post with them!

Photo credit: Harshad Sharma / Foter / Creative Commons Attribution-NonCommercial 2.0 Generic (CC BY-NC 2.0)


  1. says

    Wow, thank you for sharing! We tried to be prepared ahead of time for kiddo #1, but with this second pregnancy, I’ve been slacking a little bit on “arrival” preparations. Thanks for sharing the signs and how the contractions felt, that is very helpful …especially the tidbit about baby being smaller thus no transition.
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  2. lyss says

    My second child was born 2 months early. I had no risk factors, and I was totally unprepared. I just woke up early one day to painful contractions. Like you, I passed them off as braxton hicks. He had been kicking all night, it seemed, and I was so exhausted I could hardly think clearly. Then when I realized I had to breathe hard through them, it clicked with me that it felt like real labor, and that something was wrong! It all happened very fast. I was fully dilated by the time I arrived at my birth center, and was rushed to the hospital.
    Long story short, our son was born via emergency c-section just a few hours after feeling the first painful contractions. The reason for my preterm labor was placental abruption. What caused that, no one knows.

    I hesitate to tell my story to expectant moms, as I don’t wish to provoke unnecessary fear. But I found that you just never know! I had no problems with my firstborn. If something feels “off”, don’t hesitate to call your doctor/midwife! They may be able to alleviate your fears, or tell you to come in for a checkup. Be in tune with your body. I should have realized that his kicking was not normal. It was constant and frantic because he was in distress. For me, though, going in earlier would not have changed the outcome. He had to be born. But some preterm labor can be stopped, depending on what is causing it, so if contractions hurt, call!

    I am so thankful for the great care we received. That is so sad that some babies are left to die, or are sent home when they need care. Mine was in the nicu for 5 weeks, even though we had no insurance. We did qualify for medicaid, which we accepted. But even had we not, I assume they would have cared for him, and we would have been paying for the rest of our lives, but I suppose I could be wrong. Yikes. So sad, because insurance is ridiculously expensive. Whatever happened to doctors who cared about life more than making $?
    Ok, enough ranting. Our son is now a happy, healthy 4 year old. I am so thankful that God took care of him, and I think He used that time in my life to teach my how much I need to depend on Him. God is good. : )

    • says

      Thank you so much for sharing your experience! I wonder why doctors/mid-wives don’t go over what to expect if you do go into preterm labor? I think it should just be protocol for every pregnancy to go through what could happen because so many are experiencing it.

      I agree with you, God is very good! Thanks again!

    • says

      I clicked on this post because I am a NICU nurse with 15 years experience and I was curious to see what it was about. I thought there might be some information I could share with parents I encounter everyday. I am happy that your child did okay, but not sure what you mean about babies that “are left to die or sent home when they need care”. I can assure you that I have never seen this happen. The only time a baby is “left to die” as you say, is when that infant is simply too immature at birth to be able to survive. These would include infants who are less than 24 weeks gestation or weigh less than 1 lb at birth. Typically if an infant is born vigorous at birth, meaning they are making some effort to breathe, than care is provided. Any time a mother comes into our hospital in preterm labor, our neonatologists are consulted to talk with the family to let them know what to expect. Parents of micropremies (26 weeks and under) are allowed to make the decision on what care they would like provided at the birth. Some parents make the decision that because the prognosis does not look favorable, then they would rather not put their child through a traumatic resuscitation and a very lengthly and expensive hospital stay. And I have never known a child to be sent home that still needed care, regardless of a family’s ability to pay. I am pretty sure that would be illegal, at least in America! I know that all NICUs are NOT created equal, and they can be quite overwhelming. I am very fortunate however to work at a NICU who focuses on family-centered care. That means we have private rooms for most of our families, we focus on skin-to-skin care to be provided by parents, we encourage parents to provide as much of the infant care as possible (within reason, depending on the fragility of their baby), and we have a developmental team who helps care for the emotional toll on the family. Is it expensive? YES! But it is also intensive care and in most cases for a very prolonged period of time. Unfortunately healthcare costs in America are through the roof, but thankfully it is some of the best healthcare in the world. The doctors and nurses don’t get that money by the way, it goes toward services provided, equipment, medications, tests, procedures, etc.

      • says

        Hi Angela,

        Thank you so much for your input from a nurses perspective. I know that those statements that you pointed out about babies being left to die and babies being discharged to early are shocking but they DID happen and I have linked to those incidences. Your hospital sounds wonderful and I know that most are, but it is better to know the policies than to regret it afterward. I hope that you did find some useful things to think about and to send parents to like the Graham’s foundation and Braxton Hicks experiences that I mentioned as well as others have written about in the comments. Thanks again for your input.

  3. says

    My first was born at 36 weeks. My water broke while I was at work. Everyone said that your firstborn will probably be late. I was NOT ready for her to come. Her room was ready and her diaper bag was packed but my hospital bag wasn’t. Fortunately, she didn’t have to spend any time in the NICU.

    My second baby (6 years later) came at 32 weeks. I was hospitalized a few times before that for labor and they were able to stop it. But at 32 weeks, my son announced, loudly and emphatically, that he wanted to be born (and the nurses and drs tried a lot to stop him)! He spent 27 days in the NICU. We did stay at Ronald McDonald House which was an amazing blessing especially with our 6 year old. He’s now a very healthy, happy almost 3 year old. Despite the big age difference, he and his sister are best of buds. And she did a great job sitting for hours sometimes in the NICU, only rarely getting to hold him.

  4. Kara says

    I just had a preemie 5 weeks ago, and she was due yesterday!! I was 34w 6d and our little girl was in the NICU for 10 days. It was one of the hardest experiences of my life!! My husband and I lived at the hospital, but we slept on the chairs in her room, we didn’t have a real space to stay. Her arrival was totally unexpected, as a first time mom with a very healthy pregnancy I didn’t anticipate a baby until I was 41 weeks per statistics. My bag was partially packed and hers was the same…it didn’t really matter since none of her clothes or diapers fit anyway :) I felt so confused when I went into the doctor to see if I was leaking amniotic fluid, and I was!! I thought they’d just send me home as a paranoid first time mother like you said, but I wasn’t paranoid, I had a high leak. So glad I went, but so shocking to be told you will have a baby the next day when you plan on having over a month! I think they only thing you didn’t mention that I experienced was taking time to mourn your pregnancy. I was so excited to be pregnant, and enjoying it since it was my first time. Even today at the grocery store I thought about how I anticipated still having a nice big belly…mine never really got all that big before she came. I know it sounds silly, but it’s something I dealt with along with a few other things. Just remember you are doing your best for your baby, even if you can’t hold them as much as you’d like, just being there to pump/feed/kangaroo any little bit is helpful for your little one and each case is different! So happy that we have a thriving little girl at home now :)

  5. Crystal Beyer says

    My twins were born at 27 weeks after my water broke unexpectedly. My daughter was born feet first and vaginally weighing only 1 pound 10 ounces and my son was born via c-section weighing 2 lbs 5 oz. They spent 2 months in the NICU in Charleston, SC. They came home on Oxygen and heart monitors and spent their first 2 months at home on both! They are now 4 years old and as healthy as it gets!

    NICU bills were OUTRAGEOUS! The first bill we got was 6 figures!!! We wouldn’t have traded the time or experience or level of care for anything.. but it’s outrageous how much it costs!

    They spent the first 3 years of their life with Physical, Speech and Occupational therapists but are now in PK-4 and no issues! We are beyond blessed and lucky to have such great results from all the early interventions.. not to mention the fact that they were not only preemie, but micro-preemie!

  6. Rochelle says

    My 4th was born 10 weeks early. The rest were all late so it was completely unexpected. I lived from hour to hour for 7 weeks until I could bring him home. It was still hard, but at least I had him with me all the time.

  7. says

    Wow, I wish I’d found a post like this when I was searching for info about premies after my 3rd was born at 35 weeks. (Or maybe it was after my fourth was born fifteen months later, also at 35 weeks. Those two years or so are a fuzzy blur in my memory.) Everything I did find was about health issues that didn’t apply to our situation — nothing was about the nuts and bolts of the NICU.

    Before hurrying to check out, find out what your insurance coverage is. Our HMO covered all costs for my stay for three days after my c-section, but the doctor tried to push me out early with threats of infection if I was at the hospital instead of at home. It took a NICU nurse who knew how things worked to explain to me that I was going to be there anyway, I might as well be having someone else keep track of my painkillers and meals.

    We got very lucky with baby #3 and the hospital let NICU moms camp out in empty hospital rooms as long as the babies were there. So ask and find out what the options are.
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  8. Mindy says

    Our son was born at 29 weeks 2 days – weighing 2 pounds 7 ounces. He was in the NICU for 2 months, and it was quite a learning experience for us. Thankfully he made it through his time there with only a few setbacks and bumps in the road. We are blessed with a wonderful, busy, energetic 6 year old.

    I think my advice for families is to ask questions (doctors, nurses, support staff – no dumb question!!), take time to feel, accept help that is offered, and take time for yourself (sleep, eat, time away).

  9. elizabeth bailey says

    my second son was born 2 months early i thought my contractions were also false labor went to the hospital an they tried to stop the labor with some pills and because baby was still early the gave me steroid shots to make sure his lungs were developed. the thing that stopped the labor was an epidural because the pain was so bad. one week later while i was in the hospital on strict bed rest they couldnt find his hertbeat so they did an emergency c section an he went to the nicu right away. but they did such a horrible job on my c section that i was high on something because i felt them cutting me and in so much pain after that i dont remember anything. the nurse didnt want to give me a full dose of pain meds after i came to. but my son was in the nicu for 3 weeks luckily we lived nearby, but i was still so hard i cried everytime i went as well. an i was breastfeeding so i had to pump an then take them the milk so they could give it to him. it was very hard for us but he made it through an is now 4 yrs old. an thank goodness we were so broke we qualified for medicare.

  10. C.P. says

    Four years ago in May, I was blissfuly pregnant with my first child. I knew she was a girl, I knew she was due at the end of the July, I knew her room was not quite ready, and I knew everything the books told me I should know about the immanent change about to happen in our lives. What I didn’t know was that on May 26th, I would be having that little girl nine weeks too early and that the beginning of the scariest months of my life were about to begin. They took a purple, lifeless, 4lb baby who was not breathing away from us and the room I had her in because unbeknownst to my hubby and I the first attempt at intubabtion had failed. Her airway was just too small. As they walked away they told me they would know where we stood in the next hour. The longest hour of my life. Needless to say I was in shock. Even on the way to the hospital I would never have believed you if you told me I was having a baby that day. But I did and I was in shock and I was afraid. Then I was angry and hurt. They would not let me hold her and apart from letting me take her picture I was not even allowed to touch her for four more days. Each day they told me “well, maybe tomorrow…” I know some mothers have had it worse, but those four days were extreme torture for me and everything I thought I knew about having a baby was gone. Even calling her a miracle made me angry. Sure, it was a miracle I made it to the hospital, maybe it was a miracle we left when we did, but I kept thinking a miracle would be if I wasn’t in this situation … a miracle would be getting to take her home. Instead of getting to take my baby home, I got to be the only mom in the maternity ward whose baby was not rooming in with me, I got to watch them put my baby on life support and stick needles and IV’s into her little arms and legs until there were no fresh veins left, I got to hear innocent but insensitive people suggest I use the time to relax while my baby was in the NICU, I got to make decisions and sign consent forms for risky surgical procedures that may or may not be needed in the next few precious hours, and I got to have an emotional breakdown every time she turned purple and stopped breathing and nurses rushed over to the sounds of alarms going off and shouting for someone to help them. So, no, I did not “get” to have a full term pregnancy that some mothers complain about, but most of all I did not get why this was happening to me! I didn’t understand why I felt so cheated and sad or that I was mourning a pregnancy that ended too soon and that all these feeling were normal. I needed help too and I prayed a lot! And God answered me. Besides the miracle of being allowed to stay in the rented rooms after being discharged and almost sent home without my baby, I did “get” a few things in all those weeks of heartache and fear and uncertainty. I remember the nurse who had been looking for me found me at midnight in the hallway as I was walking back to my room after the 10th milk delivery of the day and asked if I would like to hold my baby tomorrow… I almost collapsed and I remember letting out this uncontrollable sob as if there was any other answer but yes!! I found out the next day, the moment I was finally allowed to hold my daughter, that it didn’t matter that there were more wires than baby, it felt amazing. I found out that I was capable of so much more love, strength, courage, and commitment than I ever thought possible. I learned that bonding can take place even when touch is impossible. That I could I get up every two hours and endure the pain of hunching over an isolette to sing, pray, or just look (never touching, looking or talking all at once) That I could stand in one spot with legs long since asleep and two arms stuck through plastic holes in the incubator wall cupping the top of my DD’s head with one hand and her bottom with the other. That I could speak up when I disagreed with a doctor or nurse because my mom instincts were stronger than their opinions. I learned that saying goodbye to the NICU did not mean it was over. Even when your baby is healthy the affects of the NICU stayed with us for a long time. I learned that proudly bringing a baby home who still may forget to breathe occasionally, who must sleep at an incline for a year and be on adult
    medication for reflux and whose future was uncertain made for an intense mixture of joy and fear. I heard the ringing of alarm bells for months after making the transition home. I slept fitfully with her by my side for months and called the NICU at all hours just to talk or cry and ask if it was normal that I stood at her bedside counting her breaths night after night. I experienced the isolation of spending fall, winter and early spring camped out at home with few or no visitors, not being able to attend church or just going out to show her off. The isolation of needing support while needing to stay away from people and their germs. I learned to find new milestones to celebrate, even if it was a single gram gained after too many grams lost. I learned to ignore statistics because preemies are capable of amazing feats of strength and endurance. And finally, because even thought this all sounds so brutal and intense, my miracle was so much more than any one thing I learned or experienced. Truly believing with all my heart that my baby was here to stay, knowing that my baby girl has accomplished more and overcome more than I could ever imagine in the first few months of her life alone is a humbling and a precious gift most mothers do not receive, and for that I am truly grateful.

  11. Sarah says

    I have 2 preemies! My oldest was born at 36 weeks after a 10 day antipardum stay because I stopped producing amniotic fluid. I got steroid shots for her lungs and even though she was blue and not breathing well at birth, she never went to NICU and was able to come home on time.
    My second miracle was born at 35 weeks when I started not producing fluid. I was on bed rest with him at 24 weeks and got steroid shots as well. He was also able to come home on time.
    We have a third miracle who had no complications during pregnancy and was delivered via c-section at 39 weeks when I went into labor. Every pregnancy can be different!

  12. Tricia says

    Our baby was born 6 weeks early. My water broke at 30 weeks with no warning. No contractions. Was hospitalized for four weeks. On strict bedrest. At 34 weeks i was induced. The fluid level was very low for the baby. He was born with a weight of 4lb 12oz. He was in the NICU for two and a half weeks. He had respiratory problems and was on a c-pap. I cried many times watching him feeling helpless. Only being able to hold his free hand. I was able to hold him at 4 days old. Was the best feeling ever. I still tear up thinking about it. I held him skin to skin. His heart rate regulated to normal. When otherwise was all over the board. I’d heard the benefits of skin to skin before. It really is amazing how it works. Once home I’m very careful with washing hands. And the hands of anyone who is around. The care and nurses in the NICU are very caring and understanding.
    I had never had a baby come so early. This was my first out of six babies. They were very strict in the NICU with washing. You had to scrub from elbows down and take off any jewellery. Finger nails had to be short. We were told to be careful with a preemie for up to a year. Chances of RSV are really high. Our little blessing is now almost 5 months old and doing well. We are all enjoying him.
    Thank you for letting me share our story.


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