There are a number of known factors that put a woman at a higher risk for premature birth. One of the most significant is a prior premature birth. Dr. Alan Fleischman, medical director for the March of Dimes, says the increased risk to a second or subsequent pregnancy following a premature birth is estimated to be 20 to 25 percent.

The good news is that forewarned is forearmed. If a woman has given birth prematurely in the past, that is a signal to her and her doctor to be very proactive about her health and about monitoring subsequent pregnancies. The key, says Dr. Fleischman, is to start early – not when you get pregnant again, but as soon as you give birth to your first preemie.

Kara Glad of Amesbury, Mass., was having a perfectly normal pregnancy when she went into labor at 24 1/2 weeks. Her tiny son lived only four days. Although her doctor has a few theories about what caused her preterm labor, they don't know for sure. But she says that in spite of her heartbreak she was determined to try again and to learn all she could about the causes, signs and symptoms of premature labor – something she didn't know much about until it happened to her.

"It was tragic for us to get to that point and not come home with a baby, but almost as soon as I got home I was determined to learn as much as I could and try again," says Glad. "I had faith that we would be successful."

That's the right attitude, says Dr. Fleischman, as knowledge is definitely power. He recommends the following proactive approach to a second pregnancy after a preterm birth:

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