What Moms Can Do and Should Know About Preventing Preterm Birth

The journey to motherhood is often envisioned as a smooth, predictable path, yet for many, the reality of pregnancy can bring unexpected challenges. A common pressure point for expectant mothers is the fear of preterm birth (delivery before 37 weeks) and the pervasive cultural expectation of being a “Supermom,” which can lead to significant guilt if things don’t go “according to plan.”

Dr. Barbi Phelps-Sandall, an integrative OB-GYN, emphasizes the need to reframe the narrative around pregnancy. While mothers are often hyper-vigilant and take all recommended precautions, she stresses that outcomes are often outside of their control. Her insights highlight both the medical and lifestyle actions mothers can take, as well as the critical importance of emotional and community support.

Unpacking Maternal Guilt and the “Supermom” Myth

In today’s high-pressure society, Dr. Phelps-Sandall notes that the expectations for mother, whether they are high-powered professionals or stay-at-home parents, are “almost unrealistic.” This pressure fuels the “Supermom” mindset, which can be detrimental when facing unforeseen complications like preterm labor.

The desire for control clashes sharply with the unpredictable nature of pregnancy. “Those people that are use to making a plan and always having their plan go right are really challenged by pregnancy,” Dr. Phelps-Sandall tells BlackDoctor. “…Mother Nature doesn’t always fit into our plans… that is where I think moms feel a lot of guilt. ‘I should have control over this. What have I done wrong?'”

However, it is rare that an expectant mother has actually done anything wrong to cause a problem if one occurs. “…When things go wrong, it’s totally beyond anybody’s control. That’s where the confusion sets in, that’s where the blame sets in,” Dr. Phelps-Sandall adds.

Concrete Actions to Lower Preterm Birth Risk

While some risk factors are unavoidable, Dr. Phelps-Sandall highlights several proactive steps and emerging tools that can help mothers reduce their risk of preterm birth, especially after being identified as high-risk through tests like the PreTRM® test.

She advocates for making the PreTRM Test a standard part of prenatal care to give equitable access to risk-reducing services.

“PreTRM needs to become standard of care,” Dr. Phelps-Sandall explains. “Once that is the case, another care barrier will be removed. The ease of doing the test, makes it easier than ever to get done. But if doctors are unaware of the benefits PreTRM has to offer, they won’t order it. Patients can advocate for themselves, but doctors really should take the lead. Those population groups innately known to be at higher risk, are in dire need of PreTRM and services to reduce risk. As a profession, OBs need to offer PreTRM to all patients, but test acceptance should not be dependent on income. Standard of care can help level the playing field for those known to be at potentially higher risk.”

In addition to advanced testing, she recommends three key areas of proactive management:

1. Embrace Mind-Body Wellness

Research supports the role of relaxation and movement in promoting a healthy full-term pregnancy. “There have been some compelling studies that show that pregnant ladies who practice prenatal yoga throughout pregnancy have a lower risk of preterm labor… There seems to be something about the stress reduction and the relaxation that goes along with yoga,” Dr. Phelps-Sandall explains.

2. Prioritize Oral Hygiene and Vitamin D

These simple practices have a systemic impact on overall health, which includes pregnancy outcomes.

Good Oral Hygiene: Oral diseases like periodontitis or gingivitis are low-grade infections. Dr. Phelps-Sandall explains that this “low-grade infection can have a systemic effect, which can get to the uterus and can cause preterm labor.” She advises patients to get professional cleanings and ensure they are brushing and flossing daily.
Vitamin D: Vitamin D has a positive impact on helping to reduce preterm labor risk.

3. Medical Interventions and Monitoring

For patients identified as high-risk, specific medical steps are taken to help prolong the pregnancy:

Vaginal Progesterone: This is a key medical tool. According to Dr. Phelps-Sandall, the administration of “vaginal progesterone once somebody does have a high-risk result… can prolong pregnancies.” This intervention is also empowering, as “patients can do it at home… So, it gives them some involvement.”
Increased Surveillance: High-risk mothers are scheduled for more appointments for frequent vaginal exams, non-stress tests, and vaginal probe ultrasounds to monitor the cervix.
Reduced Workload: Sometimes, women are advised to take time off work or reduce their workload to eliminate a stressful environment and help prolong the pregnancy.

Shifting the Narrative: From Blame to Empowerment

A crucial part of preventing preterm birth involves educating mothers on what is happening in their bodies and giving them “permission” to be vigilant without feeling guilty.

“We educate them on the symptoms of preterm labor, and we also work hard to let them know that if they are suspicious of something, they need to come in, they need to call the office… We do work to give people permission to feel fine about that, that they’re being responsible. They don’t need to feel guilty about it; they should feel good about it,” Dr. Phelps-Sandall says.

She also touches on the pressure to stick to a rigid birth plan, encouraging flexibility instead. “Trying to get people to realize that a pregnancy and a baby are not a plan… you have to keep in mind that things may take a turn in a different direction, and you’re going to have to be resilient and make another plan,” Dr. Phelps-Sandall adds.

The Critical Role of Support Systems

Preterm birth, especially one resulting in a NICU stay, impacts the entire family. Dr. Phelps-Sandall advocates for a more inclusive approach to maternal mental health, which includes partners and loved ones.

Mental Health Support

“I think that we could do better, once we have that diagnosis, at getting a patient plugged in with a therapist or a counselor that they would meet with before they actually have that baby on a weekly basis,” Dr. Phelps-Sandall shares.

Including Partners and Loved Ones

Dads and partners are essential in mitigating the mental toll on mothers. “I really think we need to include the dads in this… the pregnant women that have a high-risk pregnancy are probably at higher risk for abuse [and mental health issues]… So I think we need to be perhaps more inclusive,” Dr. Phelps-Sandall adds.

The Power of Sleep

The number one thing loved ones can do is ensure the mother is getting adequate rest, before and after birth. “If there is something that they could do for a mom to help them out, would be to give them the opportunity to just sleep… It can certainly help reduce the symptoms of depression, too… Supermoms need sleep. Humans can’t do it all. They need to learn to depend on that baby’s father, or their mother, their sister,” Dr. Phelps-Sandall notes.

Ultimately, Dr. Phelps-Sandall affirms that with tools like the PreTRM Test and proactive management, the goal remains achievable: “We can alter that original plan to get a healthy baby here.”