Patient education: Preterm labor (The Basics)

What is preterm labor? — "Preterm labor" is labor that starts before 37 weeks of pregnancy (3 or more weeks before the due date).

Pregnancy normally lasts about 40 weeks, counting from the first day of your last period. Going into labor before 37 weeks of pregnancy can be dangerous. This is because babies who are born preterm, or "premature," can have serious health problems.

What causes preterm labor? — It is often hard to know why preterm labor happens. Some things that might cause preterm labor are:

●Bleeding or other problems in the uterus

●Being pregnant with twins, triplets, or more babies

●Infection in the uterus or other part of the body

Who is at risk for preterm labor? — It is usually not possible to tell who will go into labor early. Black people are more likely to give birth early than people of other ethnicities.

You are at highest risk of preterm labor if:

●You had preterm labor and birth in the past.

●You are pregnant with more than 1 baby (such as twins or triplets).

●Your "water breaks" before 37 weeks of pregnancy.

●You have an ultrasound showing that your cervix is short – The cervix is the bottom part of the uterus that leads to the vagina.

●You have a problem called "placental abruption" – This is when the placenta separates from the uterus and causes vaginal bleeding. (The placenta is the organ that forms between you and your baby during pregnancy.)

Other things that might increase the risk of preterm labor are:

●Using illegal drugs, such as cocaine

●Smoking

●Certain infections (including bladder and kidney infections)

●Being underweight

●Vaginal bleeding during early pregnancy

●Having pregnancies close together

●Previous surgery on the cervix

●An abnormally shaped uterus

What are the symptoms of preterm labor? — The symptoms of preterm labor are the same as with normal labor:

●Tightening of the uterus, also called "contractions" – These can make your belly feel hard while they are happening. They eventually become painful.

●Change in the fluid that comes out of your vagina – It might be watery, thick, or bloody.

●Pain or pressure low in your belly or in your thighs

●Pain in your lower back

●Belly cramps, sometimes with diarrhea

●Your water breaks – This can feel like just a trickle or a big gush of fluid from your vagina.

Some people have something called "Braxton-Hicks contractions." These are contractions that happen several minutes apart. They are usually not too painful and don't get stronger or more frequent over time. They often go away when you lie down or rest. Braxton-Hicks contractions are sometimes called "false labor contractions." That's because they don't really mean that you are going into labor.

Should I see a doctor or nurse? — Yes. If you think that you might be in labor, call your doctor, nurse, or midwife. You should also call if you have:

●Blood or fluid leaking from your vagina

●More than 6 contractions in 1 hour (this means that the contractions are 10 minutes apart)

It is hard to know if you are actually in labor without being seen by a doctor or nurse.

Your doctor or nurse will be able to tell if you are in labor by examining your cervix and checking to see how often your contractions are happening. There are also tests that they can do to find out what is going on. It might take an hour or 2 to figure out whether you are in preterm labor.

Does preterm labor mean that my baby will be born early? — Not always. Some people who have preterm labor end up having their baby at the normal time.

How is preterm labor treated? — There are different treatments for preterm labor. The right treatment for you will depend on:

●What is causing your labor

●How far along you are in your pregnancy

●How healthy you and your baby are

Depending on your situation, your doctor might give you medicines such as:

●Medicines to try to stop or slow down your labor – These are called "tocolytic drugs."

●Steroids – You might get steroid medicines, especially if you are less than 34 weeks pregnant. These medicines will speed up the growth of your baby's lungs. This will help your baby breathe if they are born early.

●Magnesium sulfate – You might get this medicine if you are less than 32 weeks pregnant. It can help prevent a brain disorder that could affect the baby called cerebral palsy.

Medicines used to stop preterm labor do not always work. Or they might work for a while, but then labor starts again. If you do give birth early, your health care team can take steps to protect the health of your baby.

Sometimes, the doctor or nurse will decide that it is better for the baby to be born early than to try to stop your labor. What is right for you will depend on your individual situation.

Can preterm labor be prevented? — There is usually no way to prevent preterm labor. If you have a short cervix, your doctor might give you a hormone (called "progesterone") to lower the chance of preterm birth.

Pay attention to how you are feeling during pregnancy. Call your doctor, nurse, or midwife right away if you think that you might be in labor.

More on this topic

Patient education: Preterm prelabor rupture of membranes (The Basics)
Patient education: Pregnancy loss (The Basics)
Patient education: Cervical insufficiency (The Basics)
Patient education: Labor and childbirth (The Basics)
Patient education: What to expect in the NICU (The Basics)
Patient education: When a baby is born premature (The Basics)
Patient education: Having twins (The Basics)

Patient education: Preterm labor (Beyond the Basics)
Patient education: Pregnancy loss (Beyond the Basics)