1. Freda, Margaret Comerford EdD, RN, CHES, FAAN, EDITOR

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For the past 20 years I've been working with the issue of preterm labor and birth. I've been doing research, studying the literature, giving lectures, and taking care of women at especially high risk for preterm birth. When I was younger and much more naive, I actually thought we'd have found a cure for prematurity by now. But I know better now. Prematurity is the most difficult problem we face in the specialty of perinatal nursing. The rate of preterm birth in the United States has reached an all-time high (12.1%), and despite research by some of the best minds in the country, we can't seem to make a dent. There are many reasons for this, and you can read about them in the myriad of review documents about preterm birth. I especially recommend the March of Dimes nursing module on the topic, which, aside from being comprehensive, also offers you nursing CE as independent study (Freda & Patterson, 2003).


Nurses have been central in the fight to defeat prematurity (Freda, 2003). Perinatal nurses, NICU nurses, and pediatric nurses are confronted by prematurity daily. You take care of women during pregnancy, or you care for the sick neonates, or for the children who have lingering health problems because of their preterm birth. The March of Dimes is currently sponsoring a 5-year Prematurity Campaign, subsidizing research and professional education programs, and working with the media so that the public will understand that prematurity is a common, serious problem. I'm very proud that this issue of MCN is a special issue on prematurity. Five of the articles are written by members of the March of Dimes National Nurse Advisory Council (Moore, Moos, Corrarino, Tiedje, Simpson, Bakewell-Sachs, Gennaro) as a part of their effort to help educate you about the issue of prematurity.


When I first went to work for Dr. Irwin Merkatz at Albert Einstein College of Medicine 20 years ago, he used to say that prematurity is not polio. Polio was curable with a vaccine; the March of Dimes led the way to find that cure. Prematurity is, unfortunately, different. There are multiple causes of prematurity, and therefore there must be multiple routes to preventing it. This means, then, that all of us can participate in the effort to reduce preterm birth. We can't wait for the one amazing study that will find "the" cause. That probably won't happen. We can all work toward prevention of preterm birth in our own way, today. One essential role for nurses in this effort is teaching, a powerful tool that we wield very effectively. Think about SIDS. The rates of SIDS have been reduced dramatically in the past decade. Why? Because, of course, we taught our patients about "back to sleep." The power of patient education cannot be denied. In that effort there were no machines, no medications, no technology. Just teaching. What can we learn from that? Well, we can, each of us, make it our mission to teach pregnant women about the symptoms of preterm labor. The average person simply does not know that prematurity is a problem, or what the symptoms are (Massett, Greenup, & Ryan, 2003). And your teaching doesn't have to be limited to your patients. You can teach your pregnant neighbors, friends, sisters, and cousins. Join in the effort to make sure that every woman knows the symptoms of preterm labor so she can get help when she needs it. Read about the symptoms in this issue.


Use the power you have as an expert to teach all the women you know about the symptoms of preterm labor. The March of Dimes has a pat ient education video/DVD available, in Spanish and in English, called Take Action. Call your local chapter to get it for your patients. It's true; preterm labor and birth is not polio. It won't be cured with a vaccine, but each of us can do our part to decrease its incidence. Please, start today.




Freda, M. C. 2003. Nursing's contributions to the literature on preterm labor and birth. Journal of Obstetric, Gynecologic and Neonatal Nursing, 32, 659-667. [Context Link]


Freda, M. C., & Patterson, E. T. (2003). Preterm birth: Prevention and nursing management (3rd ed.). New York: March of Dimes Birth Defects Foundation. [Context Link]


Massett, H. A., Greenup, M., & Ryan, C. E. (2003). Public perceptions about prematurity: A national survey. American Journal of Preventive Medicine, 24(2), 113-208. [Context Link]