Being pregnant is an exciting time, filled with anticipation and happiness. But it’s also completely normal for pregnant women to have lots of questions, and even a few worries along the way. Like “What if my baby comes early?”
Although the odds are in your favor that this isn’t something you’ll have to deal with—according to the American Pregnancy Association 1 , premature labor occurs in about 12% of all pregnancies—being knowledgeable about preterm labor can have a major upside. Knowing the risks, signs and symptoms can be key in recognizing and minimizing early labor’s impact.
What Is Preterm Labor?
While a normal pregnancy lasts about 40 weeks, sometimes babies have their own plans. The Mayo Clinic 2 defines preterm labor as when labor begins early, between 20 weeks pregnant and 37 weeks pregnant. It’s important to note that the term “labor” is defined not just as sporadic contractions—like Braxton Hicks contractions, which can be a normal part of pregnancy, especially in the weeks leading up to delivery—but as regular contractions that cause changes to the cervix such as effacement (thinning out) or dilation (opening up).
Preterm labor can lead to premature birth, which is when a baby is born before 37 weeks of pregnancy. Although babies born prematurely do face more health concerns than those born full-term, not all preterm labor leads to premature deliveries. (More on that later.) And baby’s gestational age plays a big role in things too (a baby born before 34 weeks of pregnancy faces more risks than one born between 34 and 37 weeks).
“Preterm labor specifically refers to when the body is preparing to give birth to the baby too early,” says Al Bradlea, Dona-certified doula and lactation consultant. “But that doesn’t mean that the baby is actually born too early.”
There are treatment options for preterm labor, as well as ways to minimize the risks (more on that below).
What Causes Preterm Labor?
It’s unclear what exactly causes spontaneous premature labor, but there are certain factors that increase your risk. The Mayo Clinic cites the three biggest ones as:
Having a premature baby in the past or a family history of premature birth
Being pregnant with multiples
Having uterine or cervical abnormalities
Other risk factors for premature labor include:
Being underweight or overweight at the time you got pregnant
Health conditions such as: diabetes, preeclampsia, hypertension (high blood pressure), a connective tissue disorder, ICP (a common liver condition that happens during pregnancy) or thrombophilias (a blood clotting condition)
Being pregnant with a baby with certain birth defects
Being older than 35 years of age
Experiencing vaginal bleeding in the second or third trimester
Being pregnant after in vitro fertilization (IVF)
A prior pregnancy less than 6-9 months ago
Smoking, drinking or using drugs
Little or no prenatal care
High stress levels
Keep in mind that even without any of the above risk factors, some women still experience premature labor.
Signs of Preterm Labor
It’s pretty common to feel some strange symptoms throughout your 40 weeks of pregnancy. And even though worrying about preterm labor shouldn’t be on the top of your to-do list, it is important to learn about some of the warning signs so you’ll know what to look out for—and be able to possibly prevent it.
According to UCSF Health 3 , signs of preterm labor include:
Five or more uterine contractions per hour
A gush or more-than-normal amount of watery fluid leaking from your vagina
An increase or change in vaginal discharge
Strong pelvic pressure (the sensation that baby is pushing down)
Menstrual-like cramps in your lower abdomen, either constant or intermittent, or a constant, dull backache
Abdominal cramps
When should you see the doctor?
As premature labor can sometimes be stopped, it’s important that you contact your healthcare provider immediately if you’re having any of the signs and symptoms listed above. Even if you’re unsure of what you’re experiencing, it’s always best to reach out to your doctor as soon as possible.
Treatment for Preterm Labor
When you arrive either at your doctor’s office or at the hospital, your provider may do a pelvic exam or a transvaginal ultrasound to check if your cervix has begun to dilate. You also may be hooked up to a monitor to check the strength and regularity of your contractions.
If you are in premature labor, there are several treatment options available, according to Stanford Children’s Health 4 :
Antenatal corticosteroids, which work to mature baby’s lungs in case of an early delivery
Antibiotics to treat infection
Tocolytics to stop or slow contractions
“[These treatments] give the baby a better chance of thriving when they’re born early,” explains Bradlea. “We want baby to be as ready as possible when delivery happens.”
Other treatments include progesterone, bed rest or a cerclage 5 , which is a stitch in your cervix to help keep it closed.
Can You Prevent Preterm Labor?
When it comes to preventing preterm labor, there are several things you can do to reduce your risks. The Minnesota Department of Health 6 recommends the following:
Maintaining a healthy weight
Trying to manage stress
Avoiding drugs and alcohol
Getting regular prenatal care in order to stay on top of any health conditions that may develop throughout your pregnancy
“If you’re a smoker or you use other drugs, you need to be brave and talk about it with your doctor,” Bradlea says. “They need to know about it so they can monitor you more closely.”
There’s help available too. “Your doctor can also connect you to other resources or outpatient programs to help manage all the other risks those substances come alongside with,” Bradlea says.
Preterm labor can be an overwhelming thing to think about when you’re pregnant, but knowing the signs, risks and prevention and treatment options can help you feel a little more in control.
