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Pregnancy After Premature Delivery – What to Expect


I’ve already written a little about how your second pregnancy will differ from your first, but what if your first pregnancy resulted in a premature delivery?

For me, that’s exactly what happened.  My beautiful son was born at 34 weeks 6 days.

We were incredibly lucky that he was healthy from the very beginning, but others are not so lucky.  A friend from high school delivered her second son at just 27 weeks.  His road was a very steep, uphill climb from the moment he was born.

If you’ve experienced a premature labor and delivery, you may be hesitant to become pregnant again and risk repeating that stress.  With my doctor’s assurance that things should be fine the second time around, my husband and I decided to conceive baby number 2.

Now with our “Dumplin” on the way, I’ve learned a lot of things about how pregnancy after premature delivery differs from pregnancy without that risk playing in the background.

Vaginal Ultrasounds

No matter how much you think you lost your dignity when you had a baby the first time around, there’s still a certain level of discomfort when someone comes at you with that laughable wand when you thought you showed up for an ultrasound.

“Your doctor requested a vaginal ultrasound,” I was told.  What do you say to that?  Great, that sounds like fun, let’s do it!

Don’t get me wrong, the first time, okay – the pregnancy is still in it’s early stages and they want to get the closest look possible.  What better way than by using a phallic shaped object?  That’s how we got this baby in there in the first place, after all.

What I wasn’t prepared for was that same experience again, and again…and again.  Finally, I asked at my 20 week ultrasound what the deal was.

Apparently, every ultrasound after prematurely delivering a baby is a vaginal ultrasound.  At least that’s the way it is for me, and I’m a midwife patient.  I don’t even get cervical exams because they’re so conservative with intervening in the pregnancy process and with introducing unnecessary germs.  This is not the case when it comes to ultrasounds, I’ve learned.

Progesterone Injections

Since there is no real physiological reason that any doctor has found for my Nugget coming prematurely, I was offered progesterone injections to help maintain the pregnancy.

These shots are administered weekly from weeks 16 through 36.  My husband actually does them for me.  The midwives at our birth center gave me the first shot as he watched, he gave me the second while they supervised, and week 3 we were on our own.

Progesterone shots or 17-P as I often hear them called are great for women who have experienced premature delivery, especially those who delivered micro-preemies.

The downside to these shots for me are the migraines that I get from taking them.  It’s a small price to pay to maintain a healthy pregnancy for our little Dumplin’, but it’s also a heavy cost for our 15 month old when he has to spend all day alone at home with his migraine-ridden mama.  Luckily, I finally found a solution for my migraines during pregnancy, but until I found that amazing drug combination, life was hell for about 2 days a week.

Risking Out

Depending on your situation, having had a premature delivery may “risk you out” of certain birth scenarios.

For example, if you hoped to have an at home water birth with baby number 2, you may not find a midwife willing to attend if you are considered too high risk.

A birth center separate from a hospital may not even be an option depending on the reason you delivered prematurely.  For me, this luckily wasn’t the case.

It remains to be seen whether pregnancy number 2 will go far enough to allow for a birth center delivery, but so far, we’re more than welcome at our local birth center when the big day arrives.

If you are required to deliver at a hospital (or if you choose to), you should still have most of the same options you would have at a birth center.  You can still opt for a natural birth, you just have to lobby for yourself and research.

Hospitals are typically much quicker to suggest interventions than a stand-alone birth center or a home delivery midwife.  If you had hoped for a more natural experience, do yourself a favor and hire a doula.

A doula is a support person who can argue your case for you with your care providers in a hospital, be the steady hand when you and your spouse are stressed with excitement of a pending birth, and be the reasonable person you need to help you make decisions.


This is the one I struggle with the most.  After delivering prematurely, you are likely going to worry that it will happen again.  In some cases, this worry might be completely justified.  It’s still something that you need to learn to regulate to maintain your sanity.

Recently, my husband and I drove the 7 hours home to Pittsburgh while I was 27 weeks pregnant.  I was a stressed out mess the entire trip worrying about every ache and pain and even researching NICUs along our route.

Then, a week and a half later we drove from our home in North Carolina to visit a friend in Louisiana.  Our first night there, I convinced myself I was having back labor and we spent 5 hours in the ER.  What a way to start our vacation!

Don’t be like me.  If you’re planning a trip, take your sanity with you.  Contact your healthcare provider and tell them you’ll be traveling and get their advice about whether or not it’s a good idea.  Ours gave us the go-ahead, but gave me copies of my medical records to take with us – just in case.

In most cases, I think the worry that comes after having a preemie is something you end up having to live with.  Arm yourself with knowledge and know what premature labor signs to look out for.  If you sense something might be going on, call your doctor.  Better safe than sorry is always the best practice when you’re pregnant.


A final thought about natural childbirth after premature delivery…

If you have already delivered a baby much earlier than expected but hope to have a natural delivery the second time around, there are some precautions you can take to help your chances of accomplishing your goal.

Usually during week 36 of your pregnancy, you will be given a Group B Strep Test to see if you test positive for Group B Streptococcus or GBS.  25% of women test positive for this and are given antibiotics during labor to ensure the baby isn’t affected.

I was very anti-IV and wanted nothing to do with having any needles or tubes during my delivery.  Because my son came early, I hadn’t had my GBS test yet and was given the antibiotics via IV as a precaution.

If you’d like to avoid this same scenario, you should ask your healthcare provider when the earliest is that you can have your strep test.  I told my midwife that I would be willing to pay for a second strep test should the pregnancy go far enough that the first test was no longer accurate.  Anything to not be tied down to anything at all during labor!


Even with the vaginal ultrasounds, shots, and possibly some extra doctor’s appointments, pregnancy is always worth the extra headache to bring a beautiful new life into the world.  Especially after having a premature delivery, the worry can seem to take over and take away some of the joy of your pending arrival.  Doing your best to arm yourself with knowledge is the best tactic, in my opinion, to combat your past and enjoy your present and future.

If you’d like to read about Nugget’s early debut in detail (seriously, WAY too much detail!) you can find Part 1 and Part 2 here.  Getting pregnant the second time around wasn’t easy.  I talk about what worked for me to get pregnant with a PCOS diagnosis, what my doctor recommended when we were trying to conceive, and then the guilt I felt when I finally did get pregnant with my second baby because I just wasn’t ready for my son to not be the sole focus of my attention anymore!

Have you carried a baby to term after having a premature delivery?  What advice would you give to other moms in the same situation?  Let me know in the comments!

P.S.  Don’t forget to subscribe to Simple Living Mommy for my 8 Ways to Live More Simply download, weekly newsletter, and exclusive SLM content!

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Wednesday 8th of June 2016

[…] immediately as soon as we got to the hospital and I realized I had overreacted.  After having a preemie with my first pregnancy, I was terrified of every ache or twinge that felt even remotely like I felt just before having my […]

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