(646) 355-8777

Herman & Wallace Blog

Preventing Pre-term Delivery: What Do Women Want?

Preterm birth can have deleterious health effects not only for the child, but also for the mother. A child may be born so early that various health systems are not matured, leading to susceptibility and delay in development and growth. Maternal health may also be severely impacted, with conditions such as anxiety and psychological stress. Managing the prevention of a pre-term delivery can be stressful and challenging for a pregnant woman, and authors Ha & McDonald (2016) report that this issue is not well studied. A cross-sectional survey was completed to find out not only what a woman’s preferences and concerns are, but also to find out which recommendations were likely to be followed by the patient. This is important, the authors state, because women who are actively involved in medical decisions are more likely to feel satisfied with their childbirth experience.

The survey was completed by 311 women at a median of 32 weeks gestation. Mean age was 30.9, and the majority of them identified as European/White-Caucasian. Most of them were married or in a common-law relationship and had received some level of post-secondary education. The majority of women who were told they were at increased risk of preterm labor (PTL) preferred close-monitoring rather then PTL prevention. Of interest is that the majority of women reported they would use other sources of information besides their primary provider, with the most reported source being the internet or family and friends. This point begs the question of how high is the quality level or accuracy of the available information on the internet or in the general public? Common available options for prevention included progesterone, cerclage, and pessary use. If a woman is not interested in using recommended prevention strategies, the goal of the rehabilitation clinician should be to, on a constant basis, monitor for symptoms and signs of early labor, and encourage the patient to keep any recommended provider appointments, and stay in close contact with her provider so that close-monitoring may be carried out.

An additional goal for rehabilitation is to provide the mother with strategies that may assist her in managing her anxiety, stress, movement dysfunctions, sleep, and other activities. Prior research has validated the benefits of relaxation training in pre-term labor: a cost-effective, low risk and easily implemented strategy. Training women in such a tool during pregnancy fits well into the rehab provider’s scope, and can be instructed in the clinic (or home!) for home program implementation. Larger newborns, longer gestations, and higher rates of prolonged gestations have been recorded when using relaxation training training for pre-term labor.Janke et al., 1999) Chuang et al. (2012) have documented fewer admissions to neonatal intensive care unit, decreased rates of extreme pre-term birth, and shorter stays in hospital with use of relaxation training. Meditation, mindfulness, deep breathing, visualization, and movement within recommend medical limits may all be valuable tools that make up a part of a patient’s rehabilitation experience. In an article describing how prenatal meditation influences infant behaviors, yoga, singing, and massage therapy are all cited methods for improving maternal and/or fetal health.Chan, 2014

The Herman & Wallace Institute offers a three part series on pregnancy and postpartum. Get started by attending either Care of the Pregnant Patient or Care of the Postpartum Patient. You may also be interested in any of the Mindfulness & Meditation courses, including Holistic Interventions and Meditation, Mindfulness-Based Pain Treatment, and Mindfulness for Rehabilitation Professionals.


Chan, K. P. (2014). Prenatal meditation influences infant behaviors. Infant Behavior and Development, 37(4), 556-561.
Chuang, L.-L., Lin, L.-C., Cheng, P.-J., Chen, C.-H., Wu, S.-C., & Chang, C.-L. (2012). The effectiveness of a relaxation training program for women with preterm labour on pregnancy outcomes: A controlled clinical trial. [Article]. International Journal of Nursing Studies, 49, 257-264. doi: 10.1016/j.ijnurstu.2011.09.007
Ha, V., & McDonald, S. D. (2017). Pregnant women’s preferences for and concerns about preterm birth prevention: a cross-sectional survey. BMC pregnancy and childbirth, 17(1), 49.
Janke, J. (1999). The effect of relaxation therapy on preterm labor outcomes. Journal Of Obstetric, Gynecologic, And Neonatal Nursing: JOGNN / NAACOG, 28(3), 255-263.

Breast Oncology: Not “One-Size-Fits-All” Rehab
Using Transabdominal Ultrasound to Assess Pelvic F...

Upcoming Continuing Education Courses

Jun 22, 2018 - Jun 24, 2018
Location: The George Washington University

Jun 22, 2018 - Jun 24, 2018
Location: Franklin Pierce University

Jun 22, 2018 - Jun 24, 2018
Location: Asante Rogue Valley Medical Center

Jun 23, 2018 - Jun 24, 2018
Location: Mercy Outpatient PT

Jul 13, 2018 - Jul 15, 2018
Location: Providence Holy Cross Medical Center of Mission Hills

Jul 14, 2018 - Jul 15, 2018
Location: Husson University

Jul 15, 2018 - Jul 17, 2018
Location: Rutgers University (Newark Health Sciences Campus)

Jul 20, 2018 - Jul 22, 2018
Location: Wesley Medical Center

Jul 20, 2018 - Jul 22, 2018
Location: Rocky Mountain University of Health Professions

Jul 23, 2018 - Jul 25, 2018
Location: Touro College: Bayshore

Jul 27, 2018 - Jul 29, 2018
Location: Legacy Health System

Jul 27, 2018 - Jul 29, 2018
Location: Princeton Healthcare System

Aug 4, 2018 - Aug 5, 2018
Location: Virginia Hospital Center

Aug 10, 2018 - Aug 12, 2018
Location: Metro West Medical Center

Aug 10, 2018 - Aug 12, 2018
Location: Dupage Medical Group

Aug 17, 2018 - Aug 19, 2018
Location: Truman Medical Centers- Lakewood

Aug 17, 2018 - Aug 19, 2018
Location: Columbia St. Marys

Aug 18, 2018 - Aug 19, 2018
Location: Advantage Physical Therapy

Aug 24, 2018 - Aug 26, 2018
Location: Loyola University Stritch School of Medicine

Aug 24, 2018 - Aug 26, 2018
Location: The Sage Colleges

Aug 24, 2018 - Aug 25, 2018
Location: Princeton Healthcare System

Aug 24, 2018 - Aug 26, 2018
Location: Princeton Healthcare System

Sep 7, 2018 - Sep 9, 2018
Location: Franciscan Health System

Sep 7, 2018 - Sep 9, 2018
Location: Viverant

Sep 8, 2018 - Sep 9, 2018
Location: Stanford Health Care- ValleyCare

Sep 8, 2018 - Sep 9, 2018
Location: St. Joseph Hospital Rehabilitative Services

Sep 14, 2018 - Sep 16, 2018
Location: Mercy Hospital

Sep 14, 2018 - Sep 16, 2018
Location: Memorial Hermann Health System

Sep 14, 2018 - Sep 16, 2018
Location: Mary Free Bed Rehabilitation Hospital

Sep 15, 2018 - Sep 16, 2018
Location: Sports Medicine Institute