We interviewed Professor Mark Johnson, Consultant Obstetrician based at Chelsea and Westminster Hospital NHS Foundation Trust. Mark is part of the Chelsea and Westminster High Risk Pregnancy Team. He holds a strong belief in holistic care and empowerment of women throughout pregnancy, labour and delivery.
Tell us a bit about the wonderful initiative, Borne and why it’s so important.
Borne is a collaboration between Chelsea and Westminster Health Charity and the maternity team at Chelsea and Westminster Hospital. It aims to make childbirth safer for mothers and their babies.
It will do this through research and education.
In terms of research, Borne is focussed on premature birth.
In the UK alone almost 80,000 babies are born prematurely of whom over 1000 will die and those that survive have a high risk of a permanent disability. Being born too soon is responsible for 70% of disability and death in newborn babies. Worldwide, 15 million babies are born early and over 1.1 million will die as a direct consequence of their premature birth.
We at Borne want to change this, we are supporting research into new ways to prevent premature birth, which we hope will make a big impact, reducing the risk of premature birth and protecting babies that are born too soon.
In terms of education, Borne aims to ensure that maternity teams here and abroad are aware of the latest information and techniques that can be used in emergency situations. We have sent teams to Uganda, Ethiopia and South Africa to train maternity attendants, midwives and obstetricians. Our follow up shows that we make a lasting difference, improving the care given to pregnant women in these countries. Our aim now is to focus our effort to develop a template that others can use in resource poor settings to save lives of the women and babies when they are at their most vulnerable.
What is classed as a premature baby, and what are the different levels of prematurity?
Any baby that is born before 37 weeks (12% in the UK). However, the most worrying group are those babies born before 32 weeks (1.5% in the UK) as these babies are at the highest risk of lasting problems.
What are the known causes of premature birth and how common are they?
Premature birth is commonly associated with infection, multiple pregnancy (twins) and bleeding, but we actually don’t know nearly enough about the causes, which is why our research is so important. We can translate our understanding of the causes into possible preventions and treatments.
How can a mother help prevent a premature birth at the different stages of pregnancy – from preparing her body for pregnancy, and during each trimester?
It is always good to start pregnancy in good health, eating well and keeping fit. This is true for most women throughout pregnancy, although for some exercise may be advised against, for example women who have had more than three miscarriages.
There are, as yet, no proven, specific measures that a woman can take to reduce the risk of preterm labour. We are: trying to solve this at Borne.
- working on dietary measures
- trialling treatments that may prolong pregnancy – each additional week is vital to improving the baby’s life chances.
- trying to introduce universal screening to identify those women who are at high risk of preterm birth, so we can offer them the best possible ante-natal care.
Describe what happens during a premature baby’s time in hospital right from birth.
A very premature baby, before 34 weeks, will be taken virtually immediately to the neonatal intensive care unit where the doctors and nurses will assess how well the baby is breathing, whether the baby is able to maintain its circulation and whether antibiotics should be given. Some babies need a lot of help to keep them stable, others less so. For example some are able to breast feed while others need to have a tube passed to their stomach via their nose to feed them directly. Generally babies will be kept on the unit until they are able to breath for themselves, maintain their body temperature and feed without a tube.
What support is there for mothers during this time, and when the baby is finally allowed home, what extra care is needed?
The nurses and doctors on the units are very helpful and supportive to the parents while they are on the unit and parents should feel free to ask any questions that they have to help them understand what is happening and why.
Once home, most babies are completely fine and need no more care than normal. Occasionally, a baby may need more support; help with breathing or feeding problems may occur.
We now offer a post-natal car app for smartphones that will offer mothers advice and guidance in how best to look after their babies.
Is there anything our readers can do to help Borne in the UK?
Readers can support Borne in so many ways. The easiest way is to donate here. We always need additional support for our life saving research and education efforts. Readers can also attend an event or volunteer to raise funds – for instance, we have a wonderful group of supporters who, led by ex-England rugby legend, Will Greenwood – will be climbing Kilimanjaro later this year in aid of Borne. Further information can be found on www.borne.org.uk. Here you will also find our new film about Borne.