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Understanding Preterm Labor: How to Recognize It and What to Do
Updated on
September 7, 2024

Understanding Preterm Labor: How to Recognize It and What to Do

You may be worried about your baby coming early, so here're the facts, signs and treatments for preterm labor.

By Amylia Ryan | Fact Checked by Shannon Vestal Robson
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Understanding Preterm Labor: How to Recognize It and What to Do.

Pregnancy can be an exciting time filled with anticipation and happiness. But it’s also completely normal to have lots of questions—and even a few worries along the way, like “What if my baby comes early?”

Although the chances of preterm labor and birth are low—according to the CDC, about 10% of babies are born premature—knowing the risks, signs and symptoms can be key in recognizing and minimizing complications. 

What is preterm labor?

While a normal pregnancy lasts about 40 weeks, sometimes things happen a little differently. Preterm labor is defined as labor that begins early, when you’re between 20 weeks pregnant and 37 weeks pregnant. It’s important to understand that the term “labor” doesn’t mean you’re just having sporadic contractions—like Braxton Hicks contractions, which are a normal part of pregnancy, especially later in the third trimester—but rather that you’re having regular contractions that cause changes to your cervix, namely effacement (thinning out) and/or dilation (opening up).

Preterm labor can lead to premature birth, which is when a baby is born before 37 weeks of pregnancy (which is considered full-term), but not always. “Preterm labor specifically refers to when the body is preparing to give birth to the baby too early,” says Al Bradlea, Dona-certified doula and lactation consultant. “But that doesn’t mean that the baby is actually born too early.”

Although babies born prematurely do face more health concerns than those born full-term, baby’s gestational age plays a big role in things too: A baby born at 34 weeks or later faces fewer risks than one born before 34 weeks.

And the all-around good news is that there are treatment options for preterm labor, as well as ways to minimize the risks.

What causes preterm labor?

It’s unclear what exactly causes spontaneous premature labor, but “there are known factors that can increase the risk of experiencing preterm labor,” says Dr. Barbi Phelps-Sandall, an ob-gyn in Mountain View, CA. 

You’re at a higher risk of preterm labor, she says, if you have:

  • A previous history of preterm labor or preterm birth 

  • A pregnancy when you’re younger than 18 years old or older than 35

  • A multiples pregnancy, like twins or triplets 

  • A short time span between pregnancies (less than six months)

  • High blood pressure

  • Preeclampsia

  • Diabetes

  • Autoimmune disease

  • Vaginal bleeding

  • A pregnancy through IVF

  • Previous cervical surgery

  • A short cervix

  • Uterine abnormalities

  • Untreated STDs

  • Poor lifestyle habits like lack of sleep, lack of exercise, poor diet, poor oral hygiene and too little or too much weight gain during pregnancy

  • Mental health conditions like depression, anxiety or experiencing high stress

  • Use of substances like cigarettes, alcohol or drugs

Keep in mind that even without any risk factors, some people still experience preterm labor. In fact, “up to half of all pregnant women who deliver prematurely have no known risk factors,” Dr. Phelps-Sandall says. And you may not know whether or not you have some of these risk factors, like preeclampsia, a short cervix or untreated STDs. 

“Luckily, there are now ways doctors can help predict the risk of preterm birth prior to labor,” Dr. Phelps-Sandall says. She specifically points to the PreTRM Test, which can predict the risk of preterm birth even in singleton pregnancies with no symptoms. “[The test] measures and analyzes proteins in the blood that are highly predictive of preterm birth. Physicians can identify, during the weeks 18 through 20 of pregnancy, which women are at increased risk for preterm birth and its complications,” she says. If preterm labor is something you’re worried about, you might consider asking your doctor to order the PreTRM blood test for you. (Keep in mind that not every doctor offers this test, but it’s still worth asking.) 

Preventing preterm labor

When it comes to preventing preterm labor, there are several things you can do to reduce your risks. “Taking good care of yourself, like maintaining good physical health and optimizing your mental health, throughout pregnancy is the best defense against preterm labor,” Dr. Phelps-Sandall says. 

Specifically, the Minnesota Department of Health recommends maintaining a healthy weight, managing your stress level and avoiding drugs and alcohol. “If you’re a smoker or you use other drugs, you need to be brave and talk about it with your doctor,” Bradlea says. “They need to know about it so they can monitor you more closely.”

And just as important: stay on top of your prenatal appointments. Getting regular prenatal care will help you (and your doctor) stay on top of any health conditions that may develop throughout your pregnancy. It’s extra important to have good communication with your doctor about how your body is feeling. “The next best defense is to be on the lookout for preterm labor symptoms and report them immediately to a healthcare provider,” Dr. Phelps-Sandall says.

Signs of preterm labor

It’s pretty common to feel some strange symptoms throughout your pregnancy, and even if your risk of preterm labor is low, you might wonder if what you’re feeling means that labor is near. If you feel any of the below symptoms before you’ve reached your 37th week of pregnancy, it could be a sign of impending preterm labor—and catching it early gives you a better chance to possibly prevent it. 

According to the medical experts at UCSF, signs of preterm labor include:

  • Five or more uterine contractions per hour

  • A gush or more-than-normal amount of watery fluid leaking from your vagina (it might feel like you’ve accidentally peed yourself)

  • An increase or change in vaginal discharge

  • Strong pelvic pressure (the sensation that baby is pushing down)

  • Menstrual-like cramps in your lower abdomen, either constant or intermittent, or a constant, dull backache

  • Abdominal cramps

When should you see the doctor?

Since preterm labor can sometimes be stopped, it’s important that you contact your healthcare provider immediately if you’re having any of the signs and symptoms listed above. “The earlier preterm labor is diagnosed, the better the chances of preventing preterm birth,” Dr. Phelps-Sandall says. Even if you’re unsure of what you’re experiencing, it’s always better to be on the safe side and contact your doctor anyway. 

Preterm labor treatment

When you arrive either at your healthcare office or the hospital, your provider may do a pelvic exam or a transvaginal ultrasound to check if your cervix has started to dilate. You also might get hooked up to a monitor to check the strength and regularity of your contractions. 

If it turns out that you’re in preterm labor, Dr. Phelps-Sandall says there are several medical treatment options available: 

  • Medication to stop contractions (oral, vaginal or intravenous)

  • Antibiotics

  • Steroid injections to help mature baby's lungs

Again, just because your body has gone into preterm labor doesn’t mean your baby will be born right away. The goal of the treatment(s) is to slow down or stop labor that may already be in progress. “Once preterm labor is stabilized, you may be sent home to bedrest with close follow up with your obstetrician, or you might be kept hospitalized until the birth of the baby,” Dr. Phelps-Sandall says.

No one wants to think about the possibility of preterm labor or having a premature baby, but it’s not all bad news. By understanding your risks, what to look out for and which treatments are available, you can hopefully rest assured that your healthcare team will do everything they can for your baby to be born only when they’re absolutely ready.

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