Premature birth: Cesarean section or natural delivery?

Written by Liu Wen Li
Obstetrics
Updated on January 17, 2025
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Whether to opt for cesarean or vaginal delivery for preterm birth needs a comprehensive grasp of the pregnant woman's entire condition before assessing and deciding on the mode of childbirth. First, it's necessary to check if the woman has any complications and the severity of these complications, as well as whether her physical condition allows for vaginal delivery. Additionally, the changes in fetal heart rate must be considered. If the fetal heart rate is particularly poor, and the duration of vaginal delivery is long such that the child cannot endure it, then a cesarean section may be needed. Beyond these conditions, it is also important to evaluate the state of the pelvis, the size of the fetus, and the condition of the cervix. Generally, if vaginal delivery is possible for preterm births, it is still encouraged.

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Written by Zhao Li Li
Obstetrics
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What are the signs of premature birth?

Under normal circumstances, during preterm labor, there may first be regular uterine contractions accompanied by continuous cervical dilation. This situation should be considered a possible onset of preterm labor. Generally, the period from after 28 weeks to before 37 weeks of gestation is considered the possible range for preterm labor to occur. Therefore, if there are symptoms like regular abdominal pain, backache, or a feeling of heaviness, it is necessary to seek medical attention promptly. When needed, local physical therapy, symptomatic treatment, or administration of medications to sustain the pregnancy can effectively alleviate the symptoms.

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Written by Zhang Lu
Obstetrics
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What are the symptoms of premature birth?

Premature birth refers to delivery occurring between 28 and 36+6 weeks of pregnancy. The symptoms of premature birth primarily include the following aspects: First, regular uterine contractions occur. These contractions can lead to the descent of the fetal head and exert pressure on the cervix, which is necessary for the delivery of the fetus. It generally manifests as pain every three to five minutes, with each episode of pain lasting more than one minute, and both the frequency and intensity of the pain gradually increasing. Second, the appearance of "bloody show" occurs. As the fetus descends, it can cause the rupture of capillaries at the edge of the membranes, leading to bloody show. Third, there is a noticeable feeling of heaviness or pressure. Gynecological examinations can reveal dilation of the cervix and shortening of the cervical canal. When these symptoms appear, an assessment for premature birth should be conducted, and preparations for premature delivery should be made.

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Written by Liu Wei Jie
Obstetrics
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What is the earliest gestational week that a premature baby can survive?

Preterm infants, how many weeks can survive, first let's talk about the concept of preterm birth. The concept of preterm birth is more than 28 weeks but less than 37 weeks, this is called premature birth. However, with the improvement of neonatal resuscitation technology, in China, if it’s after 26 weeks, the vast majority of newborns can also survive. But after survival, the cost is quite high. For instance, if it's in a top-tier hospital, the cost for newborns born between 26 and 28 weeks can be around several hundred thousand yuan. So, even after some medical insurance policy reimbursements, you would still have to spend around tens of thousands of yuan on your own.

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Written by Liu Wei Jie
Obstetrics
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Do contractions easily lead to premature birth?

There are two types of contractions. The first type is false labor contractions, which occur in the late stages of pregnancy. They generally happen more in the evening or afternoon and disappear in the morning. The true labor contractions are regular and intensify in waves, accompanied by an increase in vaginal discharge or spotting. If it's false labor, rest can usually improve the condition, and it's not a concern. However, some people, due to extreme anxiety, may experience frequent false labor contractions. In such cases, our general approach is still to recommend treatment for pregnancy maintenance. If it's true labor, there is definitely a possibility of premature birth.

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Written by Du Rui Xia
Obstetrics
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How to care for premature infants

The care of premature babies is very important. Since the physical resistance of premature babies is weaker than that of full-term infants, premature babies generally need to be placed in incubators to maintain body temperature. If an incubator is not available, methods such as using a hot water bottle for warmth can be employed, or putting cotton hats on the babies. During feeding, breastfeeding is an option. For very small babies who have poor sucking ability or uncoordinated swallowing functions, or for babies who are ill, the mother can express her milk, which can then be fed to the baby via a tube through the nose. Artificial feeding is also an option.