Thinking about pregnancy after preterm birth

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

Even with the best care, preterm birth can still happen. Preterm 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.

The exact causes of preterm birth aren’t always clear, and sometimes labor begins early without warning. We do know that certain risk factors can increase your chances of preterm birth. Some risk factors, like having a history of preterm birth, can’t be changed. Other risk factors you can do something about. For example, you can reduce your risk of preterm birth by quitting smoking or managing health conditions. Talk to your healthcare provider about steps you take to help reduce your risk for preterm birth and help you stay pregnant longer next time.

Can spacing pregnancies help reduce your risk for preterm birth in your next pregnancy?

Yes. It's recommended 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 gives your body time to get healthy before your next pregnancy. The time between giving birth and getting pregnant again is called birth spacing or interpregnancy interval (also called IPI).

To help you space out your pregnancies, use birth control until you’re ready to start trying for a baby. There are many options including:

• Long-acting reversible contraception (LARC), such as an intrauterine device (IUD) and implants. These work for several years without daily maintenance.
• Birth control pills or shots.
• Condoms.

Talk to your healthcare provider about the best option for you.

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

If you’re at risk for preeclampsia, your provider may recommend that you take low dose 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 preterm 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.

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 preterm 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 (one week before your due date) and 40 weeks, 6 days (six days after your due date).

Here are some other things to keep in mind:

• 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.
• If you’re overweight or don’t weigh enough, talk to your healthcare provider about getting to a healthy weight range..
• Eat healthy foods and do something active every day.
• Talk to your provider about how much weight to gain during pregnancy.
• If you have health conditions, like depression, diabetes or high blood pressure, get treatment for them.
• Consider working with a doula for added support during pregnancy and birth. Doulas provide emotional and physical support, help you understand your options, and can advocate for your needs during labor. Some studies suggest that having a doula may help reduce the risk of preterm birth and improve birth outcomes.

Can infections put you at risk for preterm birth?

Yes. Certain infections, like the flu, food poisoning and sexually transmitted infections (also called STIs), like HIV and syphilis increase the risk of preterm birth. Preventing and treating these infections can help prevent preterm birth. 

Here’s what else you can do:

• Ask your provider about vaccinations you need to help protect you from infections, like the flu, chickenpox, measles, rubella and pertussis. 
• Handle foods safely. Cook meat, chicken, fish, and eggs until they’re done. Wash fruits and vegetables before you cook and eat them.
• 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. This can be a sign of 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 STIs, like HIV and syphilis. Ask your partner to get tested and treated, too. Use birth control that can help prevent STIs, like condoms. 

What role does stress play in the risk for preterm birth?

High stress levels can affect your overall health and may increase your risk of preterm birth. Stress can come from work, relationships, problems with paying your bills, or major life changes. Finding healthy ways to manage stress can help support a healthier pregnancy and may lower your risk of pregnancy complications, including preterm birth.

• Take care of your body. Eat whole foods and stay active to help improve your mood and overall well-being.
• Seek help if you’re in a relationship or home that isn’t safe. If you’re experiencing emotional or physical abuse, talk to your provider or reach out to local support resources.
• Manage work-related stress. Talk to your employer about making changes at work to help you feel less overwhelmed.
• Talk to your provider. If stress is affecting your daily life, talk to your provider about ways to cope, or talk to a mental health professional for regular support.

Can quitting smoking, drinking alcohol, using street drugs and abusing prescription drugs help reduce your risk for preterm 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.

Here are other steps you can take:

• 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 preterm birth?

Yes. A c-section (also called Cesarean birth) is a 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.

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 preterm 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. Having a short cervix increases your risk of giving birth early. If you had a short cervix in a previous pregnancy, talk to your provider about:

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

It’s also worth asking your provider about taking antenatal corticosteroids (also called ACS). This medicine doesn’t prevent preterm birth or 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.

Can single embryo transfer help reduce your risk for preterm 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 preterm birth.

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.

If you’ve already had a preterm birth before, do you need to go to a special healthcare 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 people who are at risk for having pregnancy complications, including preterm birth. Your provider can help you find a specialist. 

Learning the signs and symptoms of preterm labor doesn’t reduce your risk of preterm birth. But if you know them and know what to do if you have them, you can get treatment quickly.

If you experience any of these symptoms, call your provider or go to the hospital right away:

• Change in your vaginal discharge (watery, mucus or bloody) or more vaginal discharge than usual.
• Pressure in your pelvis or lower belly, like your baby is pushing down.
• Constant low, dull backache.
• Belly cramps with or without diarrhea.
• Regular or frequent contractions that make your belly tighten like a fist. The contractions may or may not be painful.
• Your water breaks.

More information

• bedsider.org
• Womenshealth.gov
• National Domestic Violence Hotline
• It Starts With Mom: Get to know doulas

Resources for Dads and Partners

Get ready for fatherhood with resources to keep you, your partner, and your baby healthy. Learn more about Becoming a Dad.

Last reviewed: February 2025