Too Small Too Soon (1984)

Oh, I remember when I was a teenager, early teens, I thought that eight kids would be nothing. It would be wonderful to have all these little children because I came from a small family and to have a lot of children and it would just be fun and games and the station wagon and the whole bit. And I thought it was going to be easy. Until 6 and 1/2 months, I really would have uh commented that pregnancy was effortless. Uh I couldn't believe that it had gone so easily and that why not sign up for 10 more. Uh my attitude has changed somewhat over the past 6 weeks. I was somewhat apprehensive when I was pregnant with Robbie, but I was assured by my physician that I was everything will be okay. And I was happy. about being pregnant. [Music] They thought it was going to be easy, but the awful reality threatening these women and many others is premature birth. A baby born too soon, long before the full 9-month term. [Music] Prematurity is the major obstetrical challenge of the 1980s, but until recently, it has been a losing battle for decades. And despite all efforts, the nationwide rate of prematurity has remained a stubborn 7%. It causes the death of up to 90% of all otherwise normal babies. And many who survive face problems which plague them all their lives. [Music] But a breakthrough came at the University of California in San Francisco in an experimental program funded by the March of Dimes and headed by Dr. Robert Cesy. is that if there's an underlying anomaly, the risk is increased. The success of the program depends on the constant involvement of doctors and nurses with the patient. It also requires the earliest identification of women who may be in danger of having a premature birth. But as so often happens, you don't find out about that until after she's pregnant. Uh we introduced the program uh in early 1978. In 1979, we had a most significant reduction uh down to about a third the number of pre-term births that we were having before. And in 1980, roughly about half the number of pre-term births that we were running before. Bed rest is an essential precaution for patient Gail Weaver at risk of having a premature baby because her mother was given the drug dees when she was carrying Gail. when we established uh that we were pregnant in late January and we went in shortly thereafter for our first visit, uh the history that's taken on each individual woman is then subjected to a scaling system uh to see whether according to certain factors in in one's life uh one might be termed high risk. I had enough of those factors to cause me to fall into that particular classification. Well, we look at a number of different risk factors. Some of them are socioeconomic, such as um whether or not you may be from a very low or a low socioeconomic group. We look at the age. We look at your previous medical or obstetric history. Uh whether or not you are a dees daughter. We also look at what's going on in your lifestyle. Do you smoke? What type of a job do you have? Is it a stressful job or not? And we also look at what may be going on during this pregnancy itself. And what we do is each of these different factors are giving us given a score and we take each of the factors and add them up. And if they do come to um up to 10, we do consider you to be at risk. And being dees is a common. It is considered a perhaps a higher risk factor than perhaps your socioeconomic status. The way we look at the factors here and so it's not a 10 automatically or no it's five for dees and five for the uh T-shaped uterus. So that is actually my 10. That's your 10. Okay. What I'd like to do is have you lie down. Can you lie down for me? Let me just put this out to support your legs, okay? Because I'm hoping to create a contraction when you do lie down, okay? And if you find they're coming every 10 minutes or closer together, you give us a call. Many women have no idea what a contraction really is. Many women associate labor with pain. I think the biggest element is teaching them correctly to detect contractions. And this is one of the most important parts of the program is teaching them the signs and symptoms. Your feet, right? Okay. Okay. Let me help you up. All right. Dr. Cesy really wanted to know everything you felt. Wanted you to call him all the time. One of one of the cardinal rules that you just didn't break was apologizing for bothering him or any of the doctors. Dr. Creie ordered immediate hospitalization after he received an urgent call from Linda Brown who was having early contractions. Hi, Linda. Hi, Dr. Creasy. How are you doing today? I'm feeling much better since the the contractions have have stopped. Have they really stopped completely? Well, they're a little better. Are you having any more of those little tightenings that you were having uh before you came into the hospital? Every once in a while, but not very often. Not very often. Okay. When can I go home? Ah, the famous question. And when can I go home? Well, what we'll plan to do is if your uterus stays nice and quiet on the oral pills today, then out the door and home, back to see me in a week in the office. Okay. Now, the only thing is you're going to have to take the pills every 2 hours or 3 hours or every four hours, round the clock, day and night. Mhm. Well, how's the baby? Is the baby okay? As far as I'm concerned, your baby's just fine. As long as I like to keep him inside that uh tummy of yours for another what? Another two months or so. Okay. And then if we can do that, then I think we've got a really healthy baby. Okay. Great for you. Okay. That's right. Going home means endless hours of constant bed rest, an annoying but necessary precaution that demands the husband's full cooperation. I think I'm in a stage now where it's uh it's reaching a peak of frustration. I'm normally a person who's terrifically active and that's demanded both in my job and in my personal life and I've had to relinquish a great deal of the control over both my personal and professional life. It's hard to turn from being a very independent person to being a totally dependent person. Well, it's been very difficult uh just logistically. I've had no appreciation up until this point or very limited appreciation of what it's like to coordinate a whole household. Did you get to the bank today? Didn't get to the bank today either. Tomorrow maybe. And the tires have not been changed. Uh the post office. I haven't gotten to the post office either. In fact, I haven't gotten to any of the things that were on the list, which I seem to have lost. For the Weavers, all the bother, worrying, and waiting was worth it. Gail went full term and delivered a healthy baby girl, but it was touchandgo in the final stages. At the beginning of the seventh month of our pregnancy, uh when we were having difficulties with pre-term contractions, the doctors prescribed ritadrin, which inhibits uh contractions and helps to stabilize people who are experiencing preterm labor difficulties. I was put on the ritadrin and took the uh the dosage every four hours, morning, noon, and night uh for for 12 weeks uh two and a half days before Jessica was born. I had ceased taking the uh the ritadrin and of course we attribute uh Jessica's birth at almost 38 weeks to the fact that I was on a steady program at bed rest which was complemented by the ritadrin. The fact that we've had such a positive outcome makes me a staunch and firm believer in everything that we learned as part of the preterm program. Luke Duke, huh? Thanks to the new Creasy program, Jerry Dto also had a healthy child, Anthony, the last time around. She was not so fortunate with her oldest son, Nicholas. Born prematurely before the program got underway. Nicholas suffered neurological damage. He is warm and affectionate, but slow for his age. His birth made his mother all the more concerned when she got pregnant again. And so, she joined Dr. Cesy's program. I'm one of these type of people that doesn't like to bother anybody. So, they really had to pound it into me at any time, day or night. You call us and you get in here, you know, you've got that baby's life at stake. By the time um I delivered Anthony, it was at 36 weeks. So, I had been held off for 10 weeks. Um 10 very important weeks. Um I was relieved when Anthony was born. He was a perfectly healthy baby. He got to come home with me, you know, in the set amount of time, 3 4 days. it that to me was like a story book, you know, it was it was a fairy tale. He was all mine. And it really brought to mind to me the contrast between the two deliveries and between the two births and how important it was to hang on as long as you possibly could to to have that healthy baby. Look at what's this. Laura Reky is another mother who knows firsthand the difference made by the Creasy Prematurity Prevention Program. She is one of its strongest supporters. Can you tell me what that is? Tuba. That's a tuba. That when you look at a baby like Robbie who was born at 26 weeks is suffering from you know cerebral pausy will suffer for the rest of his life when I was so easily controlled on bed rest and oral medication. I took one little itty bitty pill every three hours and it made all the difference between a lifelong suffering and a healthy little girl. Allison wouldn't be here if it wasn't for Dr. Cesy. The fact that the March of Dimes is funding Dr. Cesy's program I think is wonderful. Wonderful. As a result of Dr. Creasy's success in reducing prematurity. The March of Dimes is testing the program in five other medical centers to see if it will work nationwide. One place is Nashville, Tennessee under the direction of Dr. Frank Bow. Well, Miss Mack, you do have a higher chance of having another baby prematurely because you've had one before. And therefore, I would put you in what is called a high-risisk group for having a pre-term pregnancy. Well, what should I do if I notice anything wrong? You might try to lie down for a little while, 30 minutes, no more than an hour. If it doesn't change, if your contractions don't go away or you still have symptoms, then you're to call and we will have you come in right away. We'll be examining you. We will be looking um mainly for signs of premature labor and hopefully if that's what it is, treat you early enough. Do you think the baby will be okay? And I will be okay. Oh, well, I certainly hope so. So, I'm excited about this project because finally we seem to be doing something about this problem that has been uh in existence ever since I started my training and before then. The delivery of of premature births is something that has not changed over the last 10 15 years that we've kept reasonable data on this. It was 8 to 10% 15 years ago and it's the same today. If it works, it'll be one of the most exciting preventive medical aspects that I've seen since I've come into the field of obstetrics some 15 years ago. The parents in Dr. Ces program have not forgotten that the March of Dimes made it possible. They come together with their children in San Francisco's Walk America for the March of Dimes. They are joined by nurse Marie Herren who saw them through the program. Hello. Do you remember Gordon? Gordon, you remember? How could you forget? The greatest satisfaction comes from seeing a couple take their baby home after they've given birth rather than to have the baby stay in the intensive care nursery for a month to two months so that the baby can grow. And I I know of a lady who turned and said, "Out of all my seven children, this is the first baby I've ever carried out." And I think that that was that's where the satisfaction comes from. You feel like you're a part of these women's pregnancies, the couple's pregnancy, and it's a very rewarding feeling. Nothing more I could say. [Applause] Being born, given the chance to walk your own way and relieve your special set of footprints on the sands of time. Being born, given the chance to choose your mountain from all the other mountains you could climb, that's what life's all about. But if you still have doubt, just hold your baby, then let him go. Watch him sit up and watch him grow. He'll take a step and then he'll run a bit. You'll ask him a question and he'll answer it and you'll see him slow. It makes it all worthwhile being born. Now we're there at the beginning when you need us most of all. The March of Dime. The March of Dime. The March of D. [Music]