A full-term pregnancy lasts about 40 weeks. Preterm labor occurs when contractions begin to open your cervix before 37 weeks of pregnancy.
If preterm labor can't be stopped, your baby will be born early. The earlier premature birth happens, the greater the health risks for your baby. Many premature babies (preemies) need special care in the neonatal intensive care unit. Preemies can also have long-term mental and physical disabilities. In addition, giving birth prematurely increases your risk of preterm labor in future pregnancies.
While the specific cause of preterm labor often isn't clear, certain risk factors can increase the risk of preterm labor. Find out if you're at risk of preterm labor and what you can do to prevent it.
For some women, the signs and symptoms of preterm labor are unmistakable. For others, they're more subtle. During pregnancy, be on the lookout for:
If you're concerned about what you're feeling — especially if you have vaginal bleeding accompanied by abdominal cramps or pain — contact your health care provider right away. Don't worry about mistaking false labor for the real thing. Everyone will be pleased if it's a false alarm.
Research doesn't support the benefits of home uterine monitoring as a routine practice, but it's sometimes recommended as a precaution. If your health care provider asks you to monitor yourself for contractions, lie on your side and place your fingertips on your lower abdomen. If you feel a firm tightening over the surface of your uterus, you might be having contractions. If you feel contractions, monitor yourself for an hour. Record when each contraction starts, how long it lasts and how many you have in an hour. While some uterine activity before 37 weeks of pregnancy is normal, contact your health care provider if you have four contractions every 20 minutes or eight contractions in an hour.
Preterm labor can affect any pregnancy and many women who have preterm labor have no known risk factors. Many factors can increase the risk of preterm labor, however, including:
Also, having a short cervical length or the presence of fetal fibronectin — a substance that acts like a glue between the fetal sac and the lining of the uterus — in your vaginal discharge might be linked to an increased risk of preterm labor. If you have risk factors for preterm labor, your health care provider might use ultrasounds to measure the length of your cervix at prenatal appointments.
While some research suggests that gum disease might be linked with premature birth, treatment of periodontal disease during pregnancy hasn't been proved to reduce the risk of premature birth.
If you're at risk of preterm labor or premature birth, you might be referred to a specialist.
Many women treated for preterm labor deliver at or near term. Sometimes, however, preterm labor can't be stopped — or an infection or other complications make an early delivery safer for mother or baby.
If preterm labor can't be stopped, your baby will be born prematurely. This could pose various health concerns, such as low birth weight, breathing difficulties, underdeveloped organs and vision problems. Children who are born prematurely also have a higher risk of learning disabilities and behavioral problems. The risks are greatest for babies born before 32 weeks of pregnancy.
Preparing for your appointment
If you develop any signs or symptoms of preterm labor, contact your health care provider right away. Depending on the circumstances, you might need immediate medical care.
Here's some information to help you get ready for your appointment, as well as what to expect from your health care provider.
What you can do
Below are some basic questions to ask your health care provider about preterm labor. If any additional questions occur to you during your visit, don't hesitate to ask.
What to expect from your health care provider
Tests and diagnosis
To help diagnose preterm labor, your health care provider will document your signs and symptoms. If you're experiencing regular, painful contractions and your cervix has begun to soften, thin and open before 37 weeks of pregnancy, you'll likely be diagnosed with preterm labor.
Tests and procedures to diagnose preterm labor include:
If you're in preterm labor, your health care provider will explain the risks and benefits of trying to stop your labor. Keep in mind that preterm labor sometimes stops on its own.
Treatments and drugs
For some women, a surgical procedure known as cervical cerclage can help prevent premature birth. During this procedure, the cervix is stitched closed with strong sutures. Typically, the sutures are removed when the baby is considered full term — during week 37 of pregnancy. If necessary, the sutures can be removed earlier. Cervical cerclage might be recommended if you're less than 24 weeks pregnant, you have a history of early premature birth and an ultrasound shows that your cervix is opening. However, cervical cerclage isn't recommended if you're in active preterm labor.
If you're less than 34 weeks pregnant and in active preterm labor, your health care provider might recommend hospitalization. In addition, your health care provider might give you medications to temporarily halt preterm labor or promote your baby's readiness for birth, including:
If you're not hospitalized, you might need to schedule weekly visits with your health care provider so he or she can monitor signs and symptoms of preterm labor.
Aside from starting too early, preterm labor typically resembles normal labor. If relaxation and breathing techniques aren't enough to control the pain, ask for relief. Your health care provider might recommend an epidural block, a spinal block or other options.
Lifestyle and home remedies
If you're having contractions that you think might be a symptom of preterm labor, try walking, resting or changing your position. This might halt false labor contractions. If you're in true preterm labor, however, your contractions will continue. Keep in mind that preterm contractions are common and don't necessarily mean that your cervix will begin to open.
Sometimes bed rest and drinking fluids are recommended, but neither is a proven remedy for halting preterm labor or preventing premature birth.
Coping and support
If you're at risk of preterm labor or premature birth, you might feel scared or anxious about your pregnancy. This might be especially true if you have a history of preterm labor or premature birth. You might be reluctant to think about the future and constantly be on the lookout for signs and symptoms of preterm labor. In addition, prenatal visits might make you particularly nervous — for fear that you'll hear bad news.
Unfortunately, anxiety can affect your health and your baby's health. Consult your health care provider about healthy ways to relax and stay calm. Some studies suggest that certain techniques — such as imagining pleasant objects or experiences or listening to music — can reduce anxiety during pregnancy.
If you give birth prematurely, it won't affect your physical recovery from childbirth. However, the common stresses after delivery could be magnified by your baby's condition. Preemies often need intensive medical care after birth, sometimes requiring lengthy hospital stays. You might be worried about the possible long-term effects for your baby. As the parent of a premature newborn, you might feel that you did something to cause the premature birth or that you could have done more to prevent it. Try to let go of any feelings of guilt about your baby's premature birth by talking about them with your baby's care providers, your partner and other loved ones. Focus your energy on caring for and getting to know your child.
You might not be able to prevent preterm labor — but there's much you can do to promote a healthy, full-term pregnancy. For example:
If your health care provider determines that you're at increased risk of preterm labor, he or she might recommend taking additional steps to reduce your risk, such as:
If you have a history of preterm labor or premature birth, you're at risk of a subsequent preterm labor. Work with your health care provider to manage any risk factors and respond to early warning signs and symptoms.
Last Updated: 2012-02-24
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