What do I need to know about preterm labor?

KEY POINTS

  • Preterm labor is labor that begins before 37 weeks of pregnancy.  This is too soon for your baby to be born.

  • Premature babies may need to stay in the hospital longer after birth or be at risk for certain health problems.

  • No one knows for sure what causes preterm labor, but there are risk factors that you and your health care provider can be aware of to help prevent preterm labor.

  • If you have any signs and symptoms of preterm labor, call your provider.  She may be able to give you treatments for preterm labor. 

What is preterm labor?

Even if you do everything right, you can still have preterm labor.  Preterm labor is labor that begins too soon, before 37 weeks of pregnancy. Babies born before 37 weeks of pregnancy are called premature.  Premature babies may need to stay in the hospital longer or have more health problems than babies born later. Learning about preterm labor may help keep your baby from being born too early.

Am I at risk for preterm labor?

No one knows for sure what causes preterm labor. But there are some risk factors that may make you more likely than other women to give birth early.

These three risk factors make you more likely to have preterm labor and give birth early:

  • You’ve had a premature baby in the past.
  • You’re pregnant with multiples (twins, triplets or more).
  • You have problems with your uterus or cervix or you’ve had these problems in the past.

Medical risk factors include:

  • You’re underweight or overweight before pregnancy or not gaining enough weight during pregnancy
  • You have a family history of premature birth
  • You have certain infections or health conditions, like diabetes, high blood pressure or depression
  • You’ve had complications during pregnancy, like bleeding from the vagina or your water breaks before labor starts
  • You got late or no prenatal care
  • Being pregnant with a baby who has certain birth defects, like heart defects or spina bifida
  • Getting pregnant again too soon after having a baby

Risk factors in your everyday life include:

  • Smoking, drinking alcohol or using harmful drugs
  • Being single
  • Having a lot of stress in your life, including:
  • Having a partner who abuses you
  • Having little education or income
  • Being unemployed
  • Not having support from family or friends.
  • Being exposed to harmful chemicals, like:
    • Radiation
    • Some paint and plastics
    • Secondhand smoke

Risk factors related to your age and race include:

  • You’re younger than 17 or older than 35
  • You’re African-American. African-American women are at higher risk for preeclampsia than other women. There are many reasons behind this, including social, economic and environmental factors just to name a few. Together these factors make up what are known as social determinants of health— conditions in which you’re born and grow, work, live and age that affect your health throughout your life.

What are risk factors for preterm labor?

Talk to your provider. You may be able to reduce some of your risk for preterm labor.

If you smoke, drink alcohol or use harmful drugs:

  • Take steps to quit like listing why you want to quit, marking a date to quit in your calendar, asking your friends and family for support, avoiding triggers like parties or bars and getting rid of any cigarettes, alcohol or drugs you have.
  • Ask your provider about programs in your area that can help you quit.

If you were underweight or overweight before pregnancy:

  • Talk to your provider about your weight. Ask how much weight you should gain during pregnancy.
  • Find out about healthy foods to eat when you’re pregnant.

If you have health conditions, like diabetes, high blood pressure or depression:

  • Ask your provider about treatments for your health conditions.

If you have an infection during pregnancy:

  • Wash your hands well with soap and water after using the bathroom or blowing your nose.
  • Call your provider if you feel burning when you go to the bathroom.
  • Don’t eat raw meat or fish.
  • Have safe sex.

If you have a lot of stress:

  • Be active and eat healthy foods.
  • Ask friends and family to help out around the house.
  • Get help if your partner abuses you.
  • Talk to your boss about how to lower your stress at work.
  • See a counselor to find out about other ways you can reduce stress.

What are the signs and symptoms of preterm labor?

Call your provider if you have even one sign or symptom:

  • 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

When you see your provider, she may check your cervix to see if you’re in labor.  If you’re in labor, your provider may give you treatment to help stop labor or to improve your baby’s health before birth.  If you have preterm labor, getting help is the best thing you can do.

Are there treatments for preterm labor?

Yes. Ask your provider if these treatments are right for you:

  • Progesterone. Progesterone is a hormone that helps your uterus grow and keeps it from having contractions. There are two kinds of progesterone treatment: Vaginal progesterone may help reduce your risk for premature birth if you have a short cervix (shorter than normal) and are pregnant with just one baby.  The second is progesterone shots may help reduce your risk for premature birth if you’ve had a premature birth in the past and you’re pregnant with just one baby now.  If you’re pregnant with twins, triplets or more, progesterone treatment isn’t for you. It’s only for women who are pregnant with just one baby.
  • Cerclage. A cerclage is a stitch that your provider puts in your cervix. The stitch may help keep your cervix closed so your baby isn’t born early. Your provider removes the stitch at about 37 weeks of pregnancy. A cerclage is used only for certain women. For example, your provider may recommend a cerclage if you have a short cervix.
  • Antenatal corticosteroids (also called ACS). These medicines help speed up your baby’s lung development. They also help reduce your baby’s chances of having certain health problems after birth, like breathing and stomach problems and bleeding in the brain.
  • Antibiotics. These medicines kill certain infections that you or your baby has.
  • Tocolytics. These medicines help slow or stop contractions. They may help delay labor, even for a few days. This delay may give you time to get treatment with ACS or to get to a hospital that can take care of you and your baby if you give birth early.
  • Bed rest. Providers don’t know for sure if bed rest can help you stay pregnant longer. But it may. Bed rest means that you take it easy and stay calm and still. Your provider may want you to rest just a few times each day, or you may need to stay in bed all day.

 

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