Thinking about pregnancy after preterm birth

If you’ve already had a pretern birth, can you reduce your risk for preterm birth in your next pregnancy?

Even if you do everything right, you can still have a preterm birth. Premature birth is birth that happens too early, before 37 weeks of pregnancy. Preterm babies can have health problems at birth and later in life. They’re also more likely to spend time in the hospital after birth than babies born on time.

We don’t always know what causes premature birth. Sometimes labor starts early without any warning. We do know that certain risk factors can increase your chances for premature birth. A risk factor is something that makes something else likely to happen. Some risk factors are things you can’t change, such as having a premature birth in a previous pregnancy. Other risk factors are things you can do something about. For example, you can reduce your risk of premature birth by quitting smoking or by getting treatment for medical conditions. Talk to your health care provider about what you can do to help reduce your risk for premature birth to help you stay pregnant longer next time.

Can leaving time between pregnancies help reduce your risk for premature birth in your next pregnancy?

Yes. It’s best to wait at least 18 months between giving birth and getting pregnant again. This means your baby is 1½ years old before you get pregnant with your next baby. This time lets your body recover from one pregnancy so it’s ready for your next pregnancy. The time between giving birth and getting pregnant again is called birth spacing or interpregnancy interval (also called IPI).

What you can do: Use birth control, like an intrauterine device (also called IUD) or an implant, to prevent pregnancy so you don’t get pregnant again too soon. IUDs and implants work well and are low-maintenance. This means that once you have one, you don’t have to do anything to make it work. If you’re pregnant, talk to your provider before you give birth about getting an IUD or implant right after you have your baby. If you don’t get an IUD or implant right after giving birth, talk to your provider about getting one at your postpartum checkup. This is a medical checkup you get about 6 weeks after you have your baby.  

Can taking low-dose aspirin to prevent preeclampsia help reduce your risk for premature birth?

If you’re at risk for preeclampsia, your provider may recommend that you take low-dose aspirin (baby aspirin) to help prevent it. Preeclampsia is a kind of high blood pressure some women get after the 20^th week of pregnancy or after giving birth. If not treated, it can cause serious problems during pregnancy, including premature birth. If you have risk factors for preeclampsia, like you’ve had it before or you have high blood pressure or other health conditions, your provider may want you to take low-dose aspirin during pregnancy.

What you can do: Learn about risk factors for preeclampsia and talk to your provider to see if low-dose aspirin is right for you.

Can getting treatment for health conditions before your next pregnancy help reduce your risk for premature birth?

Yes. Being as healthy as possible when you get pregnant can help you have a healthy, full-term pregnancy. This includes getting to a healthy weight, getting treatment for health conditions, preventing and treating infections and reducing or managing stress. A full-term pregnancy is one that lasts between 39 weeks, 0 days (1 week before your due date) and 40 weeks, 6 days (1 week after your due date).

If you’re overweight or don’t weigh enough. Weighing too much or too little when you get pregnant can increase your risk for premature birth.

What you can do:

• See your provider for a preconception checkup. This is a medical checkup you get before pregnancy to help make sure you’re healthy when you do get pregnant. At your checkup, talk to your provider about getting to a healthy weight.
• Eat healthy foods and do something active every day.
• When you do get pregnant, talk to your provider about how much weight to gain during pregnancy.

If you have health conditions, like depression, diabetes or high blood pressure. Depression is a medical condition in which strong feelings of sadness last for a long time and interfere with your daily life. It needs treatment to get better. Diabetes is a medical condition in which your body has too much sugar (called glucose) in your blood. This can damage organs in your body, including blood vessels, nerves, eyes and kidneys. High blood pressure (also called hypertension) is when the force of blood against the walls of the blood vessels is too high. This can stress your heart and cause problems during pregnancy.

What you can do:

• See your provider for a preconception checkup. Tell your provider about any health condition you have and any treatment you get or medicine you take.
• Get treatment for any health condition you have so it’s under control before you get pregnant again.  

If you have infections, like the flu, food poisoning and sexually transmitted infections (also called STIs), like HIV and syphilis. Preventing and treating these infections can help prevent premature birth.

What you can do:

• Ask your provider about vaccinations you need to help protect you from infections, like the flu, chickenpox, measles, rubella and pertussis. Vaccinations make you immune from these infections. If you’re immune, it means you can’t get the infection. This can help keep your baby safe when you do get pregnant. 
• Handle foods safely. Don’t eat raw meat, chicken, fish and eggs. Cook them until they’re done. Wash your food before you cook and eat it.
• Wash your hands well with soap and water after using the bathroom, blowing your nose, being around small children or touching raw meat, chicken, fish or eggs.
• Call your provider if you feel burning when you go to the bathroom. You may need treatment for a urinary tract infection (also called UTI).
• Brush and floss your teeth and keep your dental appointments to help prevent infected gums.
• Get tested and treated for sexually transmitted infections (also called STIs), like HIV and syphilis. Ask your partner to get tested and treated, too. If you have sex, have sex with only one person who doesn’t have other sex partners. Use birth control that can help prevent STIs, like condoms. 

If you have a lot of stress. Stress is worry, strain or pressure that you feel in response to things that happen in your life.

What you can do:

• Eat healthy foods and do something active every day.
• Ask friends and family to help out around the house.
• Get help if your partner abuses you. Abuse can be emotional, like yelling at someone or calling them names. It also can be physical, like hitting, kicking or punching. Tell your provider if your partner abuses you.
• Talk to your boss about how you can lower your stress at work.
• Talk to your provider if you feel overwhelmed or if you need more help to reduce your stress.

Can quitting smoking, drinking alcohol, using street drugs and abusing prescription drugs help reduce your risk for premature birth?

Yes. All of these can put your health and your baby’s health at risk and make you more likely to give birth early. Quitting or getting help to quit is the best thing you can do.

What you can do:

• Set a quit date. Mark it on your calendar.
• Ask your friends and family to support you. Ask them not to smoke, drink alcohol or use drugs around you.
• Get rid of all your cigarettes, alcohol and harmful drugs. Get them out of your home and car.
• Stay away from situations or places, like parties or bars, where you may smoke, drink alcohol or use drugs.
• Talk to your provider about programs that can help you quit.

Can scheduling a c-section or induction too early increase your risk of premature birth?

Yes. A c-section (also called cesarean birth) is surgery in which your baby is born through a cut that your doctor makes in your belly and uterus. Induction (also called inducing labor) is when your provider gives you medicine or breaks your water to make you start labor. If you have certain conditions during pregnancy, you may need a c-section or to have your labor induced to protect your health or your baby’s health.

What you can do:

• If your pregnancy is healthy, wait for labor to begin on its own.
• If you’re scheduling a c-section or induction, talk to your provider about waiting until at least 39 weeks of pregnancy. This gives your baby time to fully develop before birth. Having a c-section or induction before 39 weeks should only be for medical reasons.

Can having treatment for a short cervix help reduce your risk of premature birth?

Yes. Your cervix is the opening to the uterus that sits at the top of the vagina. The cervix opens, shortens and gets thinner and softer so your baby can pass through the birth canal during labor and birth. If your cervix is short, it’s less than 2 centimeters long. Having a short cervix increases your risk for giving birth early.

What you can do: Talk to your provider about:

• Cerclage. This is a stitch your provider puts in your cervix to help keep it closed. Your provider removes the stitch at about 37 weeks of pregnancy.
• Vaginal progesterone. This is a kind of progesterone that you insert into your vagina each day. It may help prevent premature birth if you have a short cervix and you’re pregnant with just one baby.

Can single embryo transfer help reduce your risk for premature birth?

Yes. Single embryo transfer (also called SET) is a kind of fertility treatment called assisted reproductive technology (also called ART). Fertility treatment is medical treatment to help you get pregnant. ART is a kind of fertility treatment where both the egg and sperm are handled in a lab. SET is when you have just one embryo (fertilized egg) placed in your uterus. This can help prevent getting pregnant with multiples (twins, triplets or more). Being pregnant with multiples increases your risk for premature birth.

What you can do: If you’re thinking of having ART to help you get pregnant, talk to your provider about SET to help you get pregnant with just one baby.

Can learning the signs and symptoms of preterm labor help reduce your risk of premature birth?

No. Learning the signs and symptoms of preterm labor doesn’t reduce your risk of premature birth. But if you know them and know what to do if you have them, you can get treatment quickly that may help stop your labor. Preterm labor is labor that starts before 37 weeks of pregnancy.

What you can do:

• Learn the signs and symptoms of preterm labor.
• If you have any signs or symptoms, call your provider right away or go to the hospital. 
• Ask your provider about bed rest. This is when you take it easy and stay calm and still. Your provider can tell you how long each to be on bed rest. We don’t know for sure if it can help you stay pregnant longer, but it may.
• Ask your provider about taking antenantal corticosteroids (also called ACS). This medicine doesn’t stop labor, but it does help speed up your baby’s lung development. It also helps reduce your baby’s chances of having certain health problems after birth.

If you’ve already had a premature baby, do you need to go to a special health care provider when you get pregnant again?

When you’re ready to get pregnant again, talk to your provider about seeing a specialist, like a maternal-fetal medicine specialist, who’s trained to care for women who are at risk for having pregnancy complications, including premature birth. Your provider can help you find a specialist. 

Where can you find women like you who are thinking about pregnancy after premature birth?

Visit the March of Dimes online community Share Your Story to talk to other women who have had a premature baby and are thinking about getting pregnant again.

More information

• bedsider.org
• Centers for Disease Control and Prevention (CDC)
• CDC birth control
• Show Your Love Preconception Health
• womenshealth.gov

Last reviewed: August, 2017