Citizenship not the only care for preterm babies in US

U.S. immigration policy changes prompt concerns; Indian parents seek preterm births, but doctors warn of severe health risks for newborns.

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Citizenship not the only care for preterm babies in US

Recent developments in U.S. immigration policy have led to significant concerns among expectant parents, particularly within the Indian community residing in the United States. On January 20, 2025, President Donald Trump issued an executive order aiming to end automatic citizenship for children born in the U.S. to non-permanent residents. This policy was set to take effect on February 20, 2025. In response, there has been a notable increase in requests for preterm caesarean section (C-section) deliveries among Indian women in the U.S., especially in states like New Jersey. These expectant mothers are seeking to ensure their children are born before the policy’s implementation date to secure U.S. citizenship for them.

However, medical professionals Dr. Geetu Gaba, Consultant—Obstetrics and Gynaecology, Manipal Hospitals Dwarka, New Delhi, and Dr. Nancy Nagpal, Consultant Gynaecologist,Salubritas Medcentre has expressed concerns about the health implications of elective preterm deliveries. Preterm births can pose significant health risks for newborns, including respiratory issues, developmental delays, and increased susceptibility to infections. Obstetricians are advising against scheduling early deliveries solely for the purpose of securing citizenship, emphasising the importance of prioritising the health and well-being of both mother and child. It’s important to note that on January 23, 2025, a federal judge in Seattle temporarily blocked President Trump’s executive order, citing potential violations of the 14th Amendment’s citizenship clause. This ruling prevents the policy’s enforcement for 14 days while further legal arguments are considered.

The Justice Department has indicated plans to appeal the decision. Given the evolving legal situation and the health risks associated with preterm deliveries, expectant parents are encouraged to consult with their healthcare providers and stay informed about the latest developments in immigration policy. What is a preterm birth? About 1 out of every 10 births in the U.S. is premature. A baby born before 37 weeks of pregnancy is considered a premature or preterm baby. The earlier the birth, the greater the possibility of serious health risks to the baby. These risks include breathing problems and trouble maintaining temperature. Preterm infants may need special care in a NICU.

A preterm baby may have underdeveloped organs like the brain, lungs, and liver. They may have trouble staying warm or feeding and may be at risk for developmental delays later in life. As per the World Health Organisation, prematurity is the leading cause of death in children under the age of 5 years around the world. In low-income settings, half of the babies born at or below 32 weeks (2 months early) die due to a lack of feasible, cost-effective care such as warmth, breastfeeding support, and basic care for infections and breathing difficulties. Babies may be born preterm because of spontaneous preterm labour or because there is a medical indication to plan an induction of labour or caesarean birth early. health consequences of preterm birth for the baby “As gynaecologists, we always try to prevent a premature delivery unless it is absolutely essential for the health of the mother or baby. Preterm delivery can have significant short-term and long-term consequences for the baby,” says Dr. Astha Dayal, Director—Obstetrics and Gynaecology, CK Birla Hospital, Gurugram.

 

In some cases, preterm delivery may be medically indicated, such as in preeclampsia or high blood pressure of the mother during pregnancy, placental abruption—a condition where the placenta separates from the uterus, depriving the baby of oxygen and nutrients. It can also happen in cases of foetal distress where the baby is not receiving enough oxygen and nutrients, requiring immediate delivery. Sometimes, in cases of twins or multiple pregnancies, the risk of preterm delivery may increase. “For most other conditions, we try to prolong pregnancy at least up to 37 weeks,” says Dr. Dayal. “Preterm babies, born before 37 weeks of gestation, are at risk of various health challenges due to their underdeveloped organs and systems. The severity of these risks depends on how early the baby is born, with extremely preterm infants (born before 28 weeks) facing the highest risks,” says Dr. Abhishek Chopra, Consultant Paediatrician and Neonatologist at Cloudnine Group of Hospitals, New Delhi Punjabi Bagh.

“Preterm and low birth weight babies are at a higher risk of SIDS, especially in the first year of life. Safe sleep practices, such as sleeping on their back and using a firm mattress, are crucial,” adds Dr. Chopra. Preterm babies, born before 37 weeks of gestation, are at a higher risk for various health complications. These risks can be categorised into short-term and long-term complications. short-term complications: In respiratory distress syndrome (D): Underdeveloped lungs can lead to breathing difficulties, requiring oxygen therapy in the neonatal ICU or even mechanical ventilation. Needing problems: Preterm babies may have difficulty sucking, swallowing, and digesting milk, leading to nutritional deficiencies. n hypoglycemia or low blood sugar: This can occur due to immature liver function and inadequate glucose stores.

In hypothermia: Preterm babies may struggle to regulate their body temperature, leading to hypothermia. Infections: Preterm babies are more susceptible to infections, such as sepsis, pneumonia, and meningitis. These complications may be managed by good neonatal care, but long-term complications are not always predictable and manageable. These include: Neurodevelopmental delays: Preterm babies are at a higher risk for cognitive, motor, and behavioural delays. Cerebral palsy: Preterm babies are more likely to develop cerebral palsy, which affects movement, balance, and coordination.

 

In vision and hearing impairments: Preterm infants face a higher risk of issues like retinopathy of prematurity and hearing loss. Chronic Lung Disease: Preterm babies are more prone to chronic lung conditions, resulting in recurring respiratory challenges. an increased risk of adult Diseases: Conditions such as hypertension, diabetes, and cardiovascular diseases are more prevalent in individuals born preterm. caring for a preterm baby Neonatal intensive care units (NICUs): Preterm babies require specialised care in NICUs equipped with advanced technology and expert teams. In developmental follow-ups, regular check-ups are essential to monitor growth and promptly address any complications. In parental support: Counselling and education empower parents to navigate the challenges of caring for a preterm baby.

Advances in neonatal care have improved outcomes for preterm infants, but early interventions remain crucial to reduce long-term risks. Managing return to preventive measures and are: rest, reduced stress, and avoiding heavy lifting. A healthy diet and abstaining from smoking or alcohol. n Regular prenatal checkups to monitor health and detect early signs of complications. medical interventions: n Progesterone Supplements: Reduce the risk of preterm labour. n Cervical Cerclage: Recommended for shortened cervical length. n Corticosteroids: Aid in lung maturation when preterm labour is imminent. risks associated with premature birth or others: Increased risk of high blood pressure, postpartum haemorrhage, and cardiovascular diseases. or abies: Respiratory and digestive issues, developmental delays, vision and hearing problems, and long-term chronic conditions. safety and monitoring During pregnancy, frequent check-ups, including ultrasounds and cervical length monitoring, are essential. Early detection and management of complications significantly improve outcomes. emergency protocols Immediate response: Neonatal resuscitation, maternal stabilisation, and prompt medical intervention.

Nost-irth are support for feeding, breathing, and temperature regulation in a NICU. Support services for parents Emotional and psychological counseling. Peer support groups and guidance on newborn care. n Financial assistance, if necessary. Delivery planning Choose a facility with a Level III/IV NICU. Collaborate with healthcare providers to create a birth plan tailored to the baby’s level of prematurity. Most births are for reterm babies. Monitor feeding, temperature, and respiratory needs. In a parental role: Provide skin-to-skin contact and adhere to NICU protocols to prevent infections. After Discharge: Regular follow-ups with paediatric specialists to track growth and address developmental concerns. Preterm birth requires a comprehensive approach involving medical expertise, parental involvement, and continuous monitoring to ensure the best outcomes for both mother and baby.

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