What Are the Signs of Preterm Labor?
Labor before 37 weeks of pregnancy is considered preterm
Labor before 37 weeks of pregnancy is considered preterm
Key Takeaways
- Know the signs of preterm labor before 37 weeks.
- Regular contractions, pelvic pressure and fluid leakage can be warning signs.
- Call your OB-GYN right away if you think you may be in preterm labor.
Most pregnancies last about 40 weeks, but labor can sometimes start earlier. Preterm labor occurs when contractions cause the cervix to begin changing before 37 weeks of pregnancy. If a baby is born before then, it is considered a preterm birth.
Preterm labor does not always lead to an early birth, but it is important to know the warning signs. Babies born prematurely may face a higher risk of health problems, especially when they are born very early.
“Recognizing the signs of preterm labor is important because the earlier a baby is born, the more likely they are to need specialized care," says Sean Daneshmand, MD, an OB-GYN and maternal-fetal medicine specialist at Scripps Clinic. “If you think you may be in labor before 37 weeks, call your OB-GYN right away so you can be evaluated."
Who is at risk for preterm labor?
Preterm labor can happen in any pregnancy, but certain factors may increase the risk, including:
- Previous preterm birth
- Short cervix
- Previous procedures or surgery involving the cervix
- Twins, triplets or other multiples
- Vaginal bleeding or certain infections during pregnancy
- Other pregnancy complications
- Low body weight before pregnancy
- Smoking during pregnancy
A previous preterm birth is one of the strongest risk factors for another. If you have had one before, let your OB-GYN know so your care team can determine whether you need additional monitoring.
“Having any of these risk factors does not mean you will have preterm labor,” Dr. Daneshmand says. “But knowing your risks can help your care team monitor your pregnancy more closely and recommend steps that may help reduce the chance of an early birth.”
If you have a high-risk pregnancy or are planning a pregnancy, talk with your OB-GYN about your individual risks. A preconception visit can also help identify potential concerns before pregnancy begins.
“Preconception counseling gives us a chance to review your medical and pregnancy history, including any prior complications or procedures that could affect a future pregnancy,” Dr. Daneshmand says. “That information can help us plan care early and address risk factors for preterm labor and preterm birth.”
What are the symptoms of preterm labor?
Symptoms of preterm labor include:
- Regular or frequent contractions or tightening, with or without pain
- Pressure in the pelvis or lower abdomen
- A constant, dull lower backache
- Mild abdominal cramps, with or without diarrhea
- A change or increase in vaginal discharge, especially watery, bloody or mucus-like discharge
- A gush or trickle of fluid from the vagina, which may mean your water has broken
If you notice any of these symptoms before 37 weeks of pregnancy, don’t wait to see if they go away. Call your OB-GYN right away or go to your hospital’s labor and delivery unit.
Learn about other pregnancy symptoms that may require medical attention.
How can you tell preterm labor from Braxton Hicks contractions?
Braxton Hicks contractions, sometimes called practice contractions, are usually irregular. They may ease with rest, a change in position or fluids.
Labor contractions are more likely to follow a regular pattern. They become stronger or more frequent and continue despite resting or changing positions.
If you are less than 37 weeks pregnant and have regular or frequent contractions or are not sure whether you may be in labor, call your OB-GYN right away.
How is preterm labor diagnosed?
If you have symptoms of preterm labor, your OB-GYN will check whether contractions are causing changes to your cervix. Your care team may monitor how often contractions occur and perform a pelvic exam to see whether the cervix is thinning or opening.
A transvaginal ultrasound may also be used to measure cervical length and look for signs that the cervix is changing. In some cases, additional tests may be used to help determine whether your water has broken or whether you are likely to deliver early.
Your care team may also monitor your baby’s heart rate and evaluate your overall health to determine whether treatment or additional observation is needed.
Can preterm labor be prevented?
There is no sure way to prevent preterm labor or preterm birth, but regular prenatal care can help find risk factors early.
If you are at higher risk, your OB-GYN may recommend closer monitoring, including ultrasound to measure cervical length. For some women with a short cervix, vaginal progesterone may help lower the risk of preterm birth.
Depending on your history and cervical length, your doctor may also consider cervical cerclage, a procedure that helps keep the cervix closed.
Talk with your OB-GYN about which prevention options may be appropriate for you.
Bed rest is not recommended to prevent preterm birth, and it may carry its own health risks.
How is preterm labor treated?
If labor continues, treatment will depend on how far along you are in your pregnancy, whether your water has broken and the health of you and your baby.
Doctors may use medication to delay delivery for a short time or help prepare your baby for an early birth. Corticosteroids may be given when preterm delivery is likely to help the baby’s lungs and other organs mature. In some situations, other medications may be used to reduce certain risks to the baby or briefly delay delivery.
What happens if your baby is born early?
If your baby is born early, the care they need will depend on how premature they are and their overall health. Some babies may need specialized care in a neonatal intensive care unit (NICU). This may include help with breathing, feeding, maintaining body temperature and monitoring vital signs.
“Depending on how early your baby is born, he or she may be transferred to a NICU with the technology and expertise to provide specialized care,” Dr. Daneshmand says.
Premature babies may also need treatment for infections or other complications. They may also need close monitoring as their lungs and organs continue to develop. Babies born very early or with complex medical needs may need a higher level of neonatal care.
Why does your choice of hospital matter?
Most pregnancies do not require NICU care, but complications can sometimes arise during labor or after delivery. When choosing a hospital, consider what maternity and newborn services are available, if your baby needs specialized care.
This is especially important if you have a high-risk pregnancy or increased risk of preterm delivery. Giving birth at a hospital with the appropriate level of neonatal care may help your baby receive treatment quickly and avoid a transfer.
Talk with your OB-GYN about what level of care may be appropriate for your pregnancy.
At Scripps, NICUs provide specialized care for premature and medically fragile newborns in partnership with Rady Children's Hospital San Diego, with access to higher-level neonatal care when needed.