~1Call your health care provider right away if you have any ofthese warning signs:.Contractions that make your belly tighten up every

10 minutes or more often. These contractions do not

always hurt, they can be painless.

. Change in the color or amount of your vaginaldischarge, or bleeding from your vagina..The feeling that your baby is pushing down. Thisis called pelvic pressure..Low, dull backache, or aches in your thighs.

.Cramps that feel like your period.

.Belly cramps with or without diarrhea.

www.prematurityprevention. org

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""This brochure is provided by Herlltby Babies are Worth the wait; a prematurity preventionpattnership of the March of Dimes, Johnson & Johnson Pediatric Instirute, LL.C., and theKeotucky Department for Public Health, The goal of this partnership is to help moms-to-be in Kenrucky have healthier, fuJI-rerm babies.

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ARE W 0 R T H THE W A I T'M,-

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,Important things are happening in the last weeks before yourbaby is due:.For example, the brain of a baby at 35 weeks weighstwo-thirds of what it will weigh at 40 weeks. During the last few

weeks of pn:gnancy, your baby's brain grows a lot and adds newconnections that are needed for coordination, learning, and otherimportant functions.

Baby's .Br.ai:tLGrJJ.1Jlt1l,,-The .brain 06 a 35-weeR:-o'l:~

much less developed than uheitt

~35 Weeks -_/

The last few weeks of pregnancy are also important for yourbaby's lung development. The brain and lungs are the last organsto mature. Babies born just a few weeks early are more likely tohave breathing problems and die of SIDS (Sudden Infant DeathSyndrome). New research shows that there are possible long-termeffects for these babies such as increased risk of learning, behaviorand breathing problems like asthma. For all of these reasons, it isbest for your baby to be born around 40 weeks. Babies born lessthan 37 weeks are called premature. Premature birth is a seriousand growing problem in Kentucky and in the United States.

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Recently more women are having inducrions or

c-sections to deliver their babies before 39 weeks for1/II,

,f,convenience, even if there is no medical reason.

Studies are finding that inductions and cesareans in

a healthy pregnancy can cause problems now and in

your future pregnancies if they occur too early. In

addition, if there is no medical reason for induction

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,IA vaginal birth around 40 weeks is usually the best way "

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to deliver your baby. But if your pregnancy is high risk,

or if you or your baby develop problems, your provideror delivery before 39 weeks, you may need to undergo

an amniocentesis to show the baby is ready to be

delivered. An amniocentesis is a medical proceduremay suggest starting your labor (induction), often with II

medications, or delivering your baby by cesarean section to remove fluid from around the baby through a

needle placed inside the womb and it has 'risks.(also called c-section). Any induction or c-section before

39 weeks should have a medical reason: either your baby You should not undergo that test merely for convenience.

So if you are considering scheduling your delivery for

convenience, make sure that you understand the possibleis having problems or you have a medical condition

which will improve with delivery. risks and problems and at least wait until you are around

40 weeks.

Pre1er._-

.Labor induction does not always work. When

this happens you may need to have a c-section.

.A c-section is major abdominal surgery. It can

cause serious complications, including infection,

bleeding, problems with the incision and your

bowels or bladder, and a longer hospital stay.

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. Babies delivered by c-section have more breathing

and other medical problems compared to those

delivered vaginally.

.Mter a c-section, it takes longer to get back to

normal, and there is more discomfort than after

vaginal delivery. This may make it harder to take

care of your newborn.

t.Once you have a cesarean delivery, you are much

more likely to deliver all fmure babies by cesarean,

and the risks to you and your baby increase with

each cesarean you have. These risks include problems"

with the placenta in future pregnancies, and increased

complications from the surgery.

.Babies delivered just a few weeks early (at 34-36

weeks gestation) are much more likely to have

problems, such as with feeding, breathing and

jaundice (yellow discoloration of the skin and whites

of eyes due to build up of bilirubin in the blood).

These babies are also more Ekely to stay in the

hospital longer and need to go back to the hospital

after they are sent home than babies born near40 weeks.

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Here are questions you can ask your health

provider to get more information:

.Is there a problem with my health or the health ofmy baby that may require me to deliver early beforeI go into labor on my own?

.Can I wait to deliver my baby when I'm closer to40 weeks?

Here are questions you can ask about inductionof labor:

.Why do I need to have labor induction?.Will induction increase the chance that I will

need a cesarean delivery?

.How will my labor be induced?

Here are questions you can ask aboutcesarean delivery:

.Why do I need to have acesarean (c-section)?.What are the risks for me and for

my baby of having a c-section?.Will I need to have a c-section

in future pregnancies?

There are things you can do before and throughout yourpregnancy to lower your chances of having a premature baby.

Once you are pregnant:0 Go to all your prenatal care visits.

0 Take a prenatal vitamin that has folic acid in it every day.

0 Don't drink alcohol or use illegal drugs.

0 If you smoke, get help to quit. Stay away from otherpeople's smoke (secondhand smoke), which can be

harmful to you and your baby.

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0 Tellyour providerall medicationsyou are talcingincluding prescription drugs, over-the-countermedications and home remedies.

0 Talk to your providerabout the right foodsto eat,how much weight you should gain, and the rightamount of exercise for you.

0 Somedentalproblemsmay increaserisksfor you andyour baby. Take good care of your teeth and visit a dentist.

0 Always wear your seat belt.

0 If you're stressed, feel anxious or depressed, tell yourprovider.

0 If someone is hurting you emotionally, physically or

sexually, talk to your provider.

0 Let your provider know if you or someone in your

family has had a premature baby.