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Preterm labor

  • Preterm labor can happen to any pregnant woman.
  • Some women have a higher risk than others.
  • Learn the signs of preterm labor.
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Treatments for preterm labor

Preterm labor is labor that happens too early, before 37 weeks of pregnancy. If you have preterm labor, your health care provider may recommend some treatments that may help stop your contractions and prevent health problems in you and your baby. 

These treatments are not a guarantee to stop preterm labor. But if you’re having preterm labor, they may help you stay pregnant longer. Talk to your provider to find out if these treatments are right for you.

What kinds of medicines are used during preterm labor?

There are three kinds of medicines your provider may give you if you’re having preterm labor:

  1. Antenatal corticosteroids (also called ACS). These speed up your baby’s lung development. They also help reduce your baby’s chances of having certain health problems after birth. These include a breathing problem called respiratory distress syndrome (also called RDS); bleeding in the brain called intraventricular hemorrhage or IVH); and a condition in your baby’s intestines called necrotizing enterocolitis or NEC.
  2. Antibiotics. These kill infections caused by bacteria. You may need antibiotics to help prevent infections in you and your baby if you have Group B strep infection or if you have preterm premature rupture of membranes (also called PPROM). PPROM is when the sac around your baby breaks before 37 weeks of pregnancy. 
  3. Tocolytics. These slow or stop labor contractions. Tocolytics may delay labor, often for just a few days. This delay may give you time to get treatment with ACS or to get to a hospital with a neonatal intensive care unit (also called a NICU). This is the nursery in a hospital where newborns get medical care. One kind of tocolytic called magnesium sulfate shouldn’t be used for more than 5 to 7 days. Using this medicine for a longer time may lead to low levels of calcium and bone problems in your baby. And if you have a health condition, like a heart problem or severe preeclampsia, some tocolytics may not be safe for you. Preeclampsia is a condition that can happen after the 20th week of pregnancy or right after pregnancy. It’s when a pregnant woman has high blood pressure and signs that some of her organs, like her kidneys and liver, may not be working properly. Some of these signs include having protein in the urine, changes in vision and severe headache.

Are there other kinds of treatments for preterm labor?

Yes. Your provider may recommend these treatments:

  • Progesterone. This is a hormone that plays a key role during pregnancy. Treatment with progesterone may help prevent premature birth for certain women. Talk to your provider to see if progesterone treatment may be right for you. 
  • Cerclage. This is a stitch that your provider puts in your cervix. The stitch may help keep your cervix closed so that your baby isn’t born too early. Your provider removes the stich at about 37 weeks of pregnancy. A cerclage is only used for certain women. For example, your provider may recommend a cerclage if you have a short cervix. Talk to your provider to see if a cerclage may be right for you. 
  • Bed rest. Providers don’t know if bed rest can help you stay pregnant longer, even if you have signs of preterm labor. Bed rest means that you take it easy until your baby’s born and stay calm and still. Your provider may want you to rest just a few times each day. Or she may want you to stay in bed all day.

Do medicines used during preterm labor have side effects for mom and baby?

Sometimes. A side effect is an effect of a drug or medicine that is not the intended result. For example, a side effect of some cold medicines is that they make you sleepy. Medicines used to during preterm labor may do what they’re supposed to do to help you or your baby, but they may have side effects, too. Side effects can be different for every woman and depend on the kind of medicine you get. Talk to your provider about what kind of medicine is right for you.

Antenatal corticosteroids, including betamethasone and dexamethasone. Possible side effects for mom for both of these medicines may include fluid build-up in the body and increased blood pressure. There are no side effects for your baby. 

Tocolytics. Several kinds of tocolytics may be used during preterm labor, each with different side effects. 

Beta-adrenergic receptor agonists, like terbutaline. Possible side effects for your baby may include having a fast heartbeat. Possible side effects for you may include:

  • Chest pain; fast or irregular heartbeat
  • Breathing trouble; fluid in the lungs
  • Diarrhea, nausea (feeling sick to your stomach), throwing up
  • Feeling dizzy; shaking or feeling nervous; seizures
  • Fever, headache
  • High blood sugar
  • Low blood pressure; low blood potassium 

Calcium channel blockers, like nifedipine. There are no side effects for your baby. Possible side effects for you may include: 

  • Constipation, diarrhea, nausea
  • Feeling dizzy or faint
  • Headache
  • Low blood pressure
  • Redness of the skin

Magnesium sulfate. Side effects for your baby may include:

  • Being tired and drowsy
  • Slowed breathing
  • Weak muscles
  • Low levels of calcium and bone problems, if the drug is used for more than 5 to 7 days

Side effects for you may include: 

  • Breathing problems, fluid in the lungs
  • Dry mouth
  • Fatigue (being very tired), weak muscles
  • Headache, double vision, slurred speech
  • Heart attack
  • Nausea or throwing up
  • Redness of the skin, heavy sweating

Nonsteroidal anti-inflammatory drugs (also called NSAIDs), like indomethacin. Side effects for your baby may include: 

  • Bleeding in the brain or heart
  • Patent ductus arteriosis, also called PDA. This is a heart problem that’s common in premature babies. 
  • Jaundice. This is a common condition caused by the build-up of a substance called bilirubin in the blood that makes a baby’s skin and the white parts of his eyes look yellow.
  • Kidney problems, like making too little urine
  • Necrotizing enterocolitis (also called NEC). This is a problem in a baby’s intestines.
  • Rising blood pressure in the lungs

Side effects for you may include:

 Last reviewed July 2014

See also: Premature babies

Signs of preterm labor

  • Contractions every 10 minutes or more often
  • Change in vaginal discharge
  • Pelvic pressure
  • Low, dull backache
  • Cramps that feel like your period
  • Abdominal cramps with or without diarrhea

Frequently Asked Questions

Am I at risk for preterm labor?

No one knows for sure what causes a woman to have preterm labor. But if you have certain risk factors, you're more likely than a woman without risk factors to have preterm labor. Risk factors include: having already had a premature baby or getting pregnant again too soon after having a baby; being pregnant with twins or more; and having problems with your uterus or cervix. You're more likely to have preterm labor if you're underweight or overweight or if you have health problems, like high blood pressure, diabetes or certain infections. Things in your life like stress, smoking, drinking alcohol and using drugs also put you at risk. Talk to your provider if you have any of these risk factors. You may be able to reduce your risk and have a better chance for a healthy pregnancy.

How do I know I’m in labor?

You'll know you're in labor if:

  • You have strong and regular contractions that last 30 to 60 seconds and come 5 to 10 minutes apart.
  • Your water breaks. Your baby has been growing in amniotic fluid (bag of waters) in your uterus. When the bag of waters breaks you may feel a big rush of waters or you may feel just a trickle.
  • You bleed a little from your vagina. This is called bloody show.

If you think you're in labor, call your health care provider, no matter what time of day or night.

How early can a baby be born and live?

There is no set timeline for survival for babies born early. Babies born earlier than 23 weeks have a much smaller chance of survival than babies born after 23 weeks.

About 9 out of 10 babies born at 28 weeks survive. But many have serious health problems. Any baby born before 37 weeks of pregnancy is considered premature. Premature babies have less time to develop in the womb than babies who arrive on time. This puts them at greater risk of medical and developmental problems. Every extra day in the womb helps the baby develop and mature and probably improve his or her health and development later in life. Between 23 and 26 weeks, every extra day in the womb increases a baby's chance of survival by 2 to 4 percent.

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