Preterm Labor: What to Know and What to Do If It Happens

As you near your due date, you may experience painless contractions, but that doesn’t mean baby is ready to make his arrival. Preterm labor, however, is when regular contractions occur as a result of your cervix opening between weeks 20 and 37 of your pregnancy. The difference between false contractions, such as Braxton-Hicks, and preterm labor is that in preterm labor, contractions are often paired with changes in your cervix (e.g., thinning or dilation). Preterm labor can result in premature birth.

What Causes Preterm Labor?

Unfortunately, the exact cause(s) and reason(s) behind preterm labor are still unknown. However, there are a few risk factors that can cause early labor:

• A previous preterm labor experience
• Being underweight or overweight before pregnancy
• Carrying multiple babies
• Health conditions such as diabetes, high blood pressure, and/or an infection
• High levels of stress
• If you are above 35 years old
• If you had just given birth to another baby less than 6–9 months prior to this pregnancy
• Little or no prenatal care
• Smoking, alcohol, and drugs
• You were a preterm baby yourself
• Your pregnancy is a result of fertility treatment(s)

Keep in mind that if you have one or even all of these risk factors, it doesn’t mean you will definitely experience a preterm delivery. Pregnancy is unpredictable, so don’t stress too much about it.

Are Preterm Births Common?

About 12 percent of births in the United States are preterm. They are getting a little more common as more women are using fertility treatments and/or giving birth at a later age.

Since the rate of preterm births is increasing, there are tests to determine if you will give birth earlier than your due date. However, the American Congress of Obstetricians and Gynecologists (ACOG) does not recommend testing all women as they are only effective if you have risks or symptoms.

1. Measuring your cervix with an ultrasound: At around week 20 of your pregnancy, your sonographer will measure the length of your cervix. If it is short, it can mean you’re at a higher risk for a preterm birth.
2. Fetal fibronectin screening: Fetal fibronectin (fFN) is a protein produced by fetal membranes. If the amount of this protein from your sample doesn’t raise any flags, it means that you are highly unlikely to deliver in the next two weeks.

What are the Symptoms of Preterm Labor?

See your healthcare provider right away if you feel like you are experiencing even any one of the following symptoms:

• Regular or frequent contractions
• A dull backache that is consistent
• Abdominal cramps
• Pressure on your pelvis or lower abdomen
• Vaginal discharge
• Vaginal spotting/bleeding
• Leaking fluids

It can be hard to tell if you are experiencing false contractions or real ones, so don’t let it slide! Your healthcare provider won’t be upset with you for coming in with a false alarm. They would much rather you come in and nothing happen than to miss getting medical attention for an actual emergency.

What Can Help Prevent Preterm Labor?

Preterm labor can’t always be prevented, so don’t hold yourself accountable or feel guilty if you experience it. For 30 percent of women, preterm labor will actually stop on its own. You can, however, do the following to increase your chances of a full-term pregnancy as much as possible:

• Keep up with your prenatal appointments. Consistent visits to your healthcare provider means your health and your baby’s health are consistently monitored. Bring up even the smallest concerns or discomforts you have.
• Eat a balanced diet. Ensuring you’re getting all the nutrients you need means your baby will develop healthily and you will deliver at the right time.
• Drink as much water as possible during the course of your pregnancy. Dehydration can cause contractions, so drink up to try to minimize the risk of false contractions.
• Stop smoking, drinking, and doing drugs. If you feel it’s impossible to do so, talk to your provider to see if they can prescribe something.
• Take care of your teeth. This might seem like an odd one, but pregnancy hormones make you more vulnerable for periodontal diseases, which in term can trigger preterm labor. So, practice good oral hygiene.

How Is Preterm Labor Treated?

It is the healthiest option for your baby to be in your womb as long as possible. This will give your baby ample time to develop his weight and organs healthily. Your healthcare provider may recommend any of the following courses of treatment to keep your baby in there as long as possible:

• Corticosteroids to accelerate your baby’s lung development in case they decide to come out early
• Tocolytics to slow down or stop contractions
• Antibiotics, if there is an infection
• IV fluids to hydrate you and see if the contractions were false

If it appears that it’s best for your baby to be delivered, your provider will make that call. Babies born after week 32 have high survival rates and low risks for long-term complications. If you deliver in a hospital with a Neonatal Intensive Care Unit (NICU), the chances of positive results for your baby will be much higher.

Try not to stress too much over the idea of preterm labor, but don’t ignore your contractions either. Also, remember that experiencing preterm labor doesn’t always mean you’ll be giving birth to your baby early. Correct and immediate medical attention can help you carry your baby to full term. Even if you do give birth preterm, not all babies will experience complications. Your healthcare providers will do as much as possible to encourage a baby’s healthy development.