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Every year, more than 470,000 infants in this country are born prematurely — before 37 weeks’ gestation. Although great strides have been made in neonatal intensive care, prematurity is the leading cause of death within the first month of life and the second-leading cause of all infant deaths.

Every year, more than 470,000 infants in this country are born prematurely — before 37 weeks’ gestation. That’s about 12% of all births and an increase of more than 29% since 1981. Although great strides have been made in neonatal intensive care, prematurity is the leading cause of death within the first month of life and the second-leading cause of all infant deaths.

Premature babies who survive aren’t out of the woods, either. According to the March of Dimes, about 100,000 children develop health problems each year because of their early birth.

The March of Dimes is investing $75 million in research, education, and awareness programs to find the causes of premature birth and develop ways to prevent it. The organization also is advocating for an additional $50 million to support prematurity-related research at the National Institutes of Health.

Many factors — smoking, poor nutrition, domestic violence, infection, and stress — contribute to prematurity, but half of all premature births are still unexplained.

“Prematurity obviously has multiple causes, and we need to come at it from a variety of ways,” says Margaret Comerford Freda, RN, EdD, FAAN, professor of obstetrics, gynecology, and women’s health at the Albert Einstein College of Medicine of Yeshiva University-Montefiore Medical Center in Bronx, N.Y. “In an odd way, that is good news because we don’t need to wait for a major break in the research. We know some of the things that cause prematurity. Nurses can look at these things and try to do what we can about each of them.”

One of the most effective — and simplest — things nurses can do is educate women about the symptoms of premature labor. (See “Warning signs of preterm labor.”)

“A lot of women have symptoms of premature labor but don’t know it, so they just wait,” Freda says. “Nurses can teach every single patient they come in contact with what those symptoms are and what to do if you have them. I’d also like nurses to stop telling patients about Braxton Hicks contractions, because it confuses them.”

“We have to encourage women to be checked when they aren’t sure,” says Barbara Peterson Sinclair, RNP, MN, FAAN, professor emeritus and chair of health science at California State University, Los Angeles. “Women are reluctant to do that. They are embarrassed and made to feel bad. We need to educate the whole medical community, because one woman coming in and avoiding preterm labor is worth having many women come in early.”

Knowledge is power

“One of the most expensive beds in a hospital, by and large, is in NICU,” says Mary Brucker, RNC, DNSc, program director for women’s health education at the University of Texas Southwestern Medical Center at Dallas, department of ob/gyn. “And prematurity has so many long-term health ramifications. We have to strike a happy medium between women trusting their bodies, yet being aware something isn’t quite right so they come in. We empower women with knowledge of what is normal and what is not.”

Nurses can provide this education no matter what type of patients they see. “Nurses work everywhere in health care,” Sinclair says. “They also work in their families and neighborhoods and among their friends. They can provide information about premature labor and its symptoms to all women.”

Nurses also can talk to women about domestic violence, which increases during pregnancy and is known to increase the risk of preterm birth.

“We can try to find out which women are involved in these situations and talk to them about how to get out of the situation,” Freda says. “That won’t solve all the preterm problems in the world, because thank goodness not all women are beaten, but it will solve some.”