Premature Birth

Causes, Signs, and What to Expect After Childbirth.

Text last updated: 2026-08-25

An Overview of the Most Important Facts About Premature Births

  • A birth is considered premature if a baby is born before the end of the 37th week of pregnancy.
  • The earlier a child is born, the more medical support they need in the first weeks of life.
  • Thanks to modern neonatal medicine, the chances of survival and healthy development for very premature infants have improved significantly over the past 20 years. 
  • Premature birth often has multiple causes. Risk factors include infections, multiple pregnancies, or maternal illnesses.
  • Warning signs such as regular contractions, bleeding, or premature rupture of the membranes should always be evaluated by a doctor.
  • Thanks to treatment in a neonatal intensive care unit (neonatology), preterm infants can continue to develop outside the womb. 
  • The development of a premature baby is highly individual and depends on various medical and therapeutic factors. Most premature infants develop well and catch up completely or partially on developmental differences by the age of 8.

When a baby is born prematurely

The news that your baby is on the way much sooner than expected causes great worry and uncertainty for many expectant parents. Questions about the child’s health, what to expect at the hospital, or the time after birth suddenly take center stage. The good news: A premature birth does not automatically mean that your child will have long-term health problems. Thanks to modern medical care, even babies born very prematurely have significantly better chances for healthy development today than they did just a few years ago. 

On this page, you’ll find an overview of what constitutes a premature birth, its causes and signs, what to expect around the time of birth, and what support is available to families in North Rhine-Westphalia.

Ein Vater besucht mit seiner Tochter das frühgeborene Geschwisterchen auf der Neonatologie.

When is a birth considered premature?

A child is referred to as a “premature baby” or “preemie” if it is born before the end of the 37th week of pregnancy.

Grafik zur zeitlichen Einordnung Frühgeburt: Schwangerschaftswoche (SSW) 22-27: extrem frühgeboren, SSW 28-31 sehr frühgeboren, SSW 32-33 mäßig frühgeboren, SSW 34-36 spät frühgeboren

The earlier a baby is born, the less developed its organs are. That is why babies born very prematurely often require intensive care in a specialized neonatal unit (neonatology). 

Depending on the week of pregnancy, doctors distinguish between different degrees of prematurity. As a general rule, the child’s chances of healthy development increase with each additional week in the womb.

Good to know: Thanks to advances in neonatal medicine, even babies born very prematurely—as early as 24 weeks of gestation—now have a higher chance of survival; from 28 weeks of gestation onward, the survival rate is already over 95 percent. How your premature baby develops depends on many individual factors, such as lung maturity and birth weight.

What are the causes of preterm birth?

It is not always possible to determine why a premature birth occurs. Often, several factors are involved. Possible causes or risk factors include:

  • Infections during pregnancy
  • Maternal conditions, such as high blood pressure or diabetes
  • Multiple pregnancies
  • Problems with the placenta or cervix
  • Previous preterm births
  • Severe physical or psychological stress

Important: Even if one or more risk factors are present, this does not necessarily mean that a premature birth will occur.  

Sometimes the baby must be delivered early for medical reasons, such as when the baby’s supply of nutrients in the womb is severely limited or other complications endanger the mother and baby. This is the case in about one-third of all preterm births.

How can I recognize the signs of a preterm birth?

Not every complaint during pregnancy is a warning sign. However, if you experience the following symptoms, you should contact your OB-GYN, midwife, or a hospital immediately: 

  • regular tightening of the abdomen, contractions before the end of the 37th week of pregnancy
  • severe lower abdominal or back pain
  • Downward pressure in the pelvis
  • Bleeding
  • Leakage of amniotic fluid or suspected rupture of the amniotic sac
  • Significantly reduced fetal movements (Pregnant women can usually assess this well starting at 28 weeks of gestation) 

An early medical examination can help better assess risks to the mother and baby and, if necessary, take appropriate measures.

What does a premature birth mean for me and my baby?

A premature birth presents a special challenge for parents. Many mothers initially need medical care themselves after giving birth, as well as time to recover. Depending on the premature baby’s level of maturity, a stay in an incubator—often called a “incubator”—may be necessary, as it mimics the conditions inside the mother’s womb. In this special, enclosed heated bed, the baby is medically monitored and cared for. And, of course, concerns about the child’s development are often significant.

The health risks involved depend primarily on the week of pregnancy in which the baby is born. 

  • Before the 28th week of pregnancy: The baby always requires intensive medical care. Organs such as the lungs, brain, and intestines are not yet fully developed and still need time to mature.
  • 28th to 31st week of pregnancy: Here, too, treatment in the neonatal unit is usually required. Many children develop well thanks to appropriate support.
  • 32nd to 36th week of pregnancy: These children often require only temporary medical support, such as assistance with feeding or temperature regulation.

The survival and developmental prospects for preterm infants have improved significantly in recent years. Most children catch up completely or partially on developmental delays during their first few years of life.

Maternity Leave Periods in the Case of a Premature Birth
In the case of a premature birth, the postpartum maternity leave period is extended from 8 to 12 weeks. In addition, the 6-week maternity leave period prior to the due date is not forfeited. The days lost due to the earlier birth are added to the postpartum period, so that mothers of premature babies always have a total maternity leave period of 18 weeks. Many health insurance providers offer an online maternity leave calculator that allows you to easily check your personal leave duration.

When parents and baby are separated at first

After a premature birth, the baby may need to remain in the neonatal unit (neonatology) for some time, even after the mother has been discharged from the hospital. Many parents find this physical separation particularly distressing. Concerns and feelings such as helplessness, sadness, or guilt are not uncommon in this situation. Parents often need some time to adjust to the environment in the neonatal unit. Even though the medical equipment and tubes supporting your baby’s care may seem unsettling at first: they ensure that your child has the best possible conditions to feel comfortable and develop safely.

Even if you can’t have your child with you at all times, you’ll have the opportunity right from the start to be there for your child and build a bond. Touching your baby in the incubator, skin-to-skin contact during kangaroo care, your voice, and your closeness strengthen the bond with your child and give them a sense of security. Generally, parents can visit their baby daily and are actively involved in their care by the hospital.

Don’t hesitate to ask questions or accept support. The staff in the neonatal unit not only support you in caring for your child but are also there for you as parents. If you’re feeling emotionally overwhelmed, talking to mental health professionals, your midwife, or a counseling center can provide relief.

What does “kangaroo care” involve?
In kangaroo care, your baby—wearing only a diaper—lies on your bare chest and is covered with a blanket or cloth to keep them warm. Mothers and fathers can keep their child very close to them this way. The close skin-to-skin contact strengthens the bond between parents and baby. At the same time, kangaroo care can stabilize the child’s breathing and heart rate, reduce stress, and promote well-being.

Frequently Asked Questions About the Period Following a Premature Birth

What are the potential long-term effects of a premature birth?

The later a child is born, the lower the risk of long-term effects. Many premature infants develop well and catch up fully or partially on developmental delays by the age of 8. 

Some children require targeted support, for example through:

  • early intervention, 
  • physical therapy, 
  • occupational therapy, 
  • Speech therapy, 
  • more regular pediatric checkups. 

Some conditions, such as heart, lung, and eye diseases, may not become apparent until young adulthood. That is why it is particularly important for premature infants to undergo regular preventive checkups even later in life.

What kinds of (financial) assistance are available to families with a premature baby?

In addition to parental allowance and maternity benefits, various other benefits may be available depending on your personal situation. These include, among others:

  • Benefits from statutory health insurance, such as (in some cases partial) coverage of the costs of therapy, medications, and medical aids, or for household help/childcare for an older child during a hospital stay
  • Long-term care insurance benefits if there is a corresponding need for support
  • Early intervention
  • Early Intervention

Seek advice early on about what benefits you are entitled to in your specific situation.

Where can we find help and advice?

If you have questions about premature birth, your OB-GYN, your midwife, and the neonatology team treating your baby are here to help. You can also get support from pregnancy and family counseling centers. You can find information about local resources through our Family Guides here on the family portal.  

A premature birth and the often intense period that follows can be a major emotional and psychological strain. On the University Hospital Bonn website, you’ll find a self-assessment test that can help you assess your emotional state and determine whether there may be signs of postpartum depression. You’ll also find comprehensive information for those affected and their loved ones there.

Many parents find that talking with other families going through the same experience is a relief and helpful. At the Bundesverband Frügeborene e.V. (Federal Association for Premature Infants), you’ll find a selection of self-help initiatives.

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