Finding out you’re pregnant is the most magical, joyous experience. After eight months of trying, I remember looking at my positive pregnancy test and being so elated I could hardly string a sentence together when sharing the news with my husband.
For many women, this elation comes to an abrupt halt when things start to go wrong. In Australia, one in 130 pregnancies ends in stillbirth, and the number of children lost at birth each year is sadly higher than the national road toll.
Professor Sue Walker, Director of Perinatal Medicine at Mercy Hospital for Women, wants to change those statistics. As a Maternal Fetal Medicine Specialist and clinical researcher, Sue provides care for complex pregnancies and leads research projects that focus on ending premature birth and preventable stillbirth.
I caught up with Sue to talk about perinatal health and how we can all do our part to support healthy mums and babies.
You are quite passionate about women planning ahead for pregnancy. Why is it so important?
I encourage all women to come in for a pre-pregnancy visit three to six months before they start trying to conceive so we can work together towards achieving a healthy pregnancy. It gives us a chance to optimise any medical conditions that could impact on the health of her or the baby. If their Body Mass Index (BMI) is above the healthy weight range, we can look at improving their diet, lifestyle and exercise habits. We can also assess any pre-existing conditions they may have or any medications they may be taking. If they smoke, we can help them quit and sometimes that takes time. The more I do of this, the more I would trade 10 pregnancy visits for one visit before someone falls pregnant.
There is so much conflicting advice about what you can and can’t eat or drink during pregnancy. Is the occasional glass of wine a big no-no? And should we be avoiding those lattes?
No amount of alcohol is known to be safe. Do we think the risk of one glass of champagne on New Year’s Eve is small? Yes we do, but it’s still best to abstain. There is no strong data linking coffee to small babies or early birth so I’m happy for women to have caffeine in moderation. One area of concern is the increasing use of prescription medications during pregnancy. Often women have been given Panadeine Forte or Oxycontin for things like back pain before they fall pregnant and they continue to take it during pregnancy. My advice? Let your doctor or midwife know whatever you’re taking during pregnancy so we can make sure it’s safe.
Let’s talk supplements. What should we be taking to support a healthy pregnancy?
All pregnant women should take folic acid to reduce the chance of spina bifida (or neural tube defects). It’s also important to take a prenatal vitamin that contains iron, calcium and iodine. Some women will need higher doses of folic acid and extra calcium supplementation depending on their circumstances and medical history. If you’re deficient in Vitamin D, you’ll need a Vitamin D supplement too.
What causes pre-term birth?
Pre-term birth has two components to it. There is spontaneous pre-term birth where your waters break or you go into early labour. Then there are cases where the medical team takes over and says that the baby needs to be born early. For example, if a mum is very sick with pre-eclampsia, the only remedy is to deliver the baby. There are also fetal reasons for bringing on early birth. If the baby is not doing well – if it’s small and sick and not getting enough oxygen and calories from the placenta – the baby is safer being cared for in the Neonatal Intensive Care Unit (NICU).
Looking at gestation, at what number of weeks is it likely that the baby will be OK if born early?
We are always striving to get to 40 weeks but we do have what we call ‘golden weeks’ in obstetrics. Most of us would consider anything under 22 weeks to be a non-survivable gestation and the number of survivals between 22 and 23 weeks is extremely small. Between 23 and 24 weeks, things are looking up and the chance of a baby surviving can approach 40 percent. It increases to about 60 percent once you get to 24 weeks and then it can get up to over 90 percent once you get to 28 weeks. This is the general curve but gestation is only one piece of the Rubik’s Cube. You also need to look at the baby’s size and condition at birth.
Can you tell me a bit about the challenges that babies face when born prematurely?
It’s a battle for health and survival when you are born prematurely. For babies who are born at 550g at 24 weeks, it’s a pretty long journey towards health and maturity when they need everything done for them in terms of breathing support, blood pressure support, temperature support, skin integrity and making sure they don’t get an infection and receive good nutrition. As much as we love our amazing neonatal colleagues, we would all love to keep our babies away from NICU! We want to make the whole nine months inside as safe as possible because it’s the perfect environment for babies to grow and develop. That’s why events like Pram Jam are so important because they support vital research that will prevent babies being born prematurely.
Tell me a bit more about Pram Jam and why it’s so important to you.
Pram Jam is a really important event because a healthy pregnancy benefits us all. A healthy nine months in utero foreshadows the future, it’s an investment in someone’s health and wellbeing for the rest of their life. If you are born small you are more likely to suffer from a variety of conditions later in life so we need to do everything we can to ensure as many babies as possible are carried to term.
With Pram Jam, we’re asking mums, dads, grandparents, family and friends to walk, run or push a pram for a week in November. They need to walk as far as they can and ask for donations to support their efforts. All proceeds go towards Mercy Perinatal to support ongoing care, research, education and treatments so we can end preventable stillbirth, and help those who have complications around babies born prematurely.
What message do you have for people out there who are going through a challenging pregnancy?
You may think it’s a situation without hope but there is almost never a situation without hope. Focus on getting the grams that you need and the weeks that you need for your baby to come home. A couple came in recently to see me with a big double pram carrying their six-month old twins. They had to have fetal surgery early on, where we operated on the babies while they were still in the womb. It was enormously stressful with the risk of losing the babies during the procedure or the mum going into early labour following the procedure. The family went through days and weeks of anxiety but fast forward and there they were, with this pram full of gorgeous babies who are completely healthy. There is hope.
Pram Jam runs from Monday 20 to Sunday 26 November. You can get involved by pushing your pram, clocking your kilometres and asking family and friends to donate.
No pram? No problem! Anyone can clock their kilometres by walking, jogging, running or even cycling. Register and start raising funds today.
Did Professor Walker answer all your questions, or do you have any more? Join the conversation in our comments section below.
This content was created with thanks to our brand partner Mercy Health Foundation.
Stillbirth is and the complications from premature birth are tragic and far too common in Australia. Greater awareness and funding is essential to reduce this heartbreaking reality.
Through Pram Jam, Mercy Perinatal is finally making ground in research that can turn the tables on stillbirth and difficult pregnancies.
Pram Jam invites mums and dads to push their pram and clock their kilometres from 20-26 November 2017 and ask their peers to sponsor them. No pram? No problem! Anyone can track their distance and call on their friends, family or workmates to donate.