The great ideas behind Warhorse, Jerusalem, even Les Miserables, came from long gestation supported by stable public funding.
Women who receive progesterone therapy early for early pregnancy support (prior to 16 weeks gestation) in the current pregnancy will be eligible for trial inclusion.
Two 90-minute group sessions were offered, 3 weeks apart, at around 32 and 35 weeks' gestation (Supporting Information Appendix S2, Outline of intervention sessions, and Appendix S3).
In a recent paper which suggests combining stillbirths plus neonatal deaths into one outcome, it is demonstrated that such a metric finds the risk of perinatal death to rise beyond 35 weeks of gestation, supporting possibly earlier induction of labor.
"As marsupial lineages evolved with nipples, and eutherians later adopted a longer gestation period supported by intrauterine development and placental support," he says, "MLP was not needed".
Most extremely preterm infants (<32 weeks gestation) require support with parenteral nutrition, metabolic 'immaturity' may limit nutrient intake, and enteral feeds take time to establish.
In line with NICE guidance [ 15], women were offered the new records from 28 weeks gestation to support the provision of information about plans and needs following the birth of their baby.
The intervention will be provided between 24 and 34 weeks gestation and support women to examine the origin of childbirth fear, reconcile any impact from a previous birth experience, be informed of their birth options and develop strategies for a positive birth experience regardless of the ultimate mode of birth.
Saliva samples are collected by the support worker at 28 weeks gestation, 36 weeks gestation, 2 days post delivery and amongst women reporting cessation, at 6 months post delivery and analysed by a nationally accredited laboratory for cotinine concentrations.
In addition, ACS alone cannot be a magic bullet; the preterm infant still requires a minimum of supportive care including warmth and feeding support, and if <32 weeks gestation is more likely to require oxygen therapy and respiratory support.
