Preventing Premature Births

Preventing and Addressing Prematurity
By Yvonne Freeman, RN

Posted online with permission from She Shines, a publication of YWCA Northern Rhode Island. The article appeared in the magazine during the Spring of 2009. For more information, visit

PROVIDENCE, RI – Prematurity. Who would have guessed that this simple word would have a meaning so profound and significant to the lives and futures of our babies?

But what is prematurity?

Prematurity is when an infant is born before 37 weeks and weighs less than 2500 grams; if possible, a woman should carry her baby for up to 40 weeks. Babies that are born premature (or preterm) are so fragile that they require immediate emergency care and numerous specialized treatments.

Prematurity is known to be a killer of babies in their first month of life as well as into the first year. These babies are born too early, and, put simply, have not finished developing fully.

The long-term medical care needed for these babies can be extensive and bring financial costs well beyond families’ abilities and incomes. Other health problems associated with preterm births include cerebral palsy, mental retardation, and learning disabilities. It is an important public health issue that impacts the well being of communities of all cultures and across all nations.

Who is truly affected by premature births?

In the United States it is the leading cause of death in the first month of life, and the second in the first year. African Americans are disproportionately affected by premature births, as well as by very preterm births. And according to the Department of Health, Native American women have the highest percentage of babies with low birth rate. Across cultures prematurity and infant mortality rates have continued, despite targeted efforts toward prevention.

The mystery of preterm births is that it can happen to any mother and infant. In fact, it is the country’s leading obstetric problem impacting both mothers and babies according to March of Dimes, a nonprofit dedicated to resources on pregnancy and baby health. However, there are factors that have been identified, that may provide warnings to women at risk for delivering a premature baby. They include drug and alcohol use, smoking cigarettes, poor weight gain and domestic violence – especially during pregnancy.

What can we do? What should we do?

One strategy is engaging media, to appeal to the targeted population. This could be achieved, for instance, through television and radio ads and billboards on highways and local streets.

But education and policy-changes have to happen as well. Cessation programs for smoking and alcohol and drug use will need to become part of the prenatal reimbursement packages that most vehicles for health coverage lack. Public health organizations and advocates must also provide information and resources on early prenatal care to women of childbearing age and communities. They must also emphasize awareness of the factors that place mothers at greater risk for delivering a baby prematurely.

And since smoking and drugs can also damage the father’s sperm – and what he passes on during fertilization – education should take place in settings that include young men. Lessons should include awareness about how use of alcohol, nicotine, and illicit drug use can compromise a fetus when pregnant, and should focus on comprehensive sex education.

And even after all of that there will still need to be more, because it is time to fight for the futures of our babies.


Yvonne Freeman, RN, was recently announced as a 2009 Women of Achievement Award Winner, a distinction extended by YWCA Northern Rhode Island. She is being recognized on Wednesday, September 30 in the category of “Increasing Access to Healthcare,” and it is, in part, for her work at Neighborhood Health Plan of Rhode Island as a medical management team lead. She also educates young women on healthcare issues and advocates for prenatal care, and her specialty as a nurse is in obstetrics. Prior to building her career and social standing, Freeman gave birth to a preterm son while living with her family on the streets and in abandoned buildings of Providence. To learn more about her, visit


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