What is Preterm Labor? Symptoms, Causes, & Treatment

Preterm labor happens when your body starts preparing for delivery before your baby has reached full term. This means contractions begin and your cervix starts to change before 37 weeks of pregnancy.

While this can feel scary, understanding what's happening helps you recognize the signs early. Many women who experience preterm labor go on to have healthy pregnancies and babies with proper medical care.

What is preterm labor?

Preterm labor occurs when regular contractions start causing your cervix to open before 37 weeks of pregnancy. Your cervix is the lower part of your uterus that stays closed during pregnancy to keep your baby safe inside.

During preterm labor, these contractions happen at least every 10 minutes and cause your cervix to thin out and dilate. This process is your body's way of preparing for delivery, but it's happening too early.

The key difference from normal pregnancy discomfort is that preterm labor contractions are regular, persistent, and progressive. They don't go away when you rest or change positions like Braxton Hicks contractions do.

What are the symptoms of preterm labor?

Recognizing preterm labor symptoms early gives you and your healthcare team the best chance to help your pregnancy continue safely. These signs can develop gradually or appear suddenly.

• Regular contractions that feel like menstrual cramps or a tightening sensation across your belly
• Lower back pain that comes and goes or stays constant
• Pelvic pressure that feels like your baby is pushing down
• Changes in vaginal discharge, including more fluid than usual or bloody discharge
• Abdominal cramping that may come with diarrhea
• A feeling that something just isn't right with your pregnancy

Some women experience subtle symptoms that are easy to dismiss as normal pregnancy discomfort. Trust your instincts if something feels different from your usual pregnancy experience.

What causes preterm labor?

The exact cause of preterm labor often remains unknown, which can feel frustrating when you're looking for answers. However, several factors can increase the likelihood of early labor starting.

Infections in your reproductive system or elsewhere in your body can trigger preterm labor. Your immune system's response to fighting infection can sometimes cause contractions to begin.

Problems with your cervix, such as having a short cervix or previous cervical surgery, can make preterm labor more likely. Your cervix might not be able to stay closed under the growing weight and pressure of your baby.

Issues with your placenta, like placental abruption where it separates from your uterine wall, can cause preterm labor. Problems with amniotic fluid levels, either too much or too little, can also trigger early contractions.

Carrying multiples like twins or triplets puts extra strain on your uterus and can lead to preterm labor. Chronic conditions such as diabetes, high blood pressure, or autoimmune disorders may also play a role.

When to see a doctor for preterm labor?

Contact your healthcare provider immediately if you experience regular contractions before 37 weeks, especially if they're coming every 10 minutes or less. Don't wait to see if they'll stop on their own.

Call right away if you notice any fluid leaking from your vagina, which could mean your water has broken. Even a small amount of fluid or a constant trickle needs immediate medical attention.

Seek emergency care if you have severe abdominal pain, heavy bleeding, or signs of infection like fever and chills. These symptoms combined with contractions require urgent evaluation.

When in doubt, it's always better to call your doctor or go to the hospital. Healthcare providers would rather check you and find everything is okay than miss early signs of preterm labor.

What are the risk factors for preterm labor?

Understanding your risk factors helps you and your healthcare team watch more closely for signs of preterm labor. Many women with risk factors never experience preterm labor, while others with no risk factors do.

Previous preterm birth is the strongest predictor of preterm labor in future pregnancies. If you've had one preterm baby, your risk increases significantly for subsequent pregnancies.

• Being pregnant with multiples (twins, triplets, or more)
• Having a short cervix discovered during pregnancy
• Infections, particularly urinary tract infections or sexually transmitted infections
• Chronic health conditions like diabetes, high blood pressure, or blood clotting disorders
• Being under 17 or over 35 years old
• Having less than 18 months between pregnancies
• Smoking, drinking alcohol, or using drugs during pregnancy
• High levels of stress or experiencing domestic violence

Some risk factors you can't control, like your age or previous pregnancy history. However, you can work with your healthcare team to manage controllable factors and monitor your pregnancy more closely.

What are the possible complications of preterm labor?

While the goal is always to prevent preterm birth when possible, understanding potential complications helps you make informed decisions about your care. The earlier a baby is born, the higher the risk of complications.

Babies born before 37 weeks may have difficulty breathing because their lungs aren't fully developed. They might need help breathing with special equipment or medications to help their lungs mature.

Feeding challenges are common in preterm babies because they may not have developed the coordination to suck, swallow, and breathe at the same time. Many preterm babies need feeding tubes initially.

Temperature regulation can be difficult for preterm babies since they have less body fat and immature nervous systems. They often need to stay in incubators to maintain their body temperature.

Infection risks are higher in preterm babies because their immune systems aren't fully developed. They may need antibiotics and careful monitoring for signs of infection.

Brain development continues throughout pregnancy, so babies born early may face developmental challenges. However, many preterm babies catch up to their peers with proper care and support.

How can preterm labor be prevented?

While you can't prevent all cases of preterm labor, taking good care of yourself during pregnancy can reduce your risk. Regular prenatal care is your best protection against complications.

Managing chronic health conditions before and during pregnancy helps reduce preterm labor risk. Work with your healthcare team to keep conditions like diabetes and high blood pressure well-controlled.

Avoiding smoking, alcohol, and drugs during pregnancy significantly reduces your risk of preterm labor. If you need help quitting, your healthcare provider can connect you with resources and support.

Treating infections promptly, especially urinary tract infections, helps prevent them from triggering preterm labor. Don't ignore symptoms like burning during urination or pelvic pain.

If you have a history of preterm birth, your doctor might recommend progesterone supplements or cervical cerclage (a stitch to help keep your cervix closed) to reduce your risk.

How is preterm labor diagnosed?

Diagnosing preterm labor involves examining both your symptoms and physical changes to your cervix. Your healthcare provider will ask about your contractions and perform a physical exam.

A pelvic exam allows your doctor to check if your cervix has started to thin out or open. They'll measure how dilated your cervix is and assess other changes that indicate labor is progressing.

Monitoring your contractions with a device placed on your belly helps determine if they're regular and strong enough to be considered true labor. This monitoring can continue for several hours if needed.

Special tests might be used if the diagnosis isn't clear. A fetal fibronectin test checks for a protein that's released when labor might start soon. Transvaginal ultrasound can measure your cervical length to assess preterm labor risk.

Your doctor might also check for infections through urine tests or vaginal cultures, since infections can trigger preterm labor and need immediate treatment.

What is the treatment for preterm labor?

Treatment for preterm labor focuses on stopping contractions when possible and preparing your baby for birth if delivery can't be delayed. The approach depends on how far along you are and your specific situation.

Medications called tocolytics can sometimes slow or stop contractions temporarily. These medicines buy time for other treatments to help your baby, but they don't work for everyone and can't stop labor indefinitely.

Corticosteroids are often given to help speed up your baby's lung development if delivery seems likely. These medications can significantly improve your baby's breathing and reduce other complications if given before birth.

Magnesium sulfate may be administered if you're at risk of delivering before 32 weeks. This medication can help protect your baby's brain and nervous system development.

Antibiotics might be prescribed if you have an infection that could be triggering preterm labor. Treating the infection can sometimes help stop contractions and prevent them from returning.

In some cases, hospitalization and bed rest allow for closer monitoring and immediate treatment if your condition changes. This helps ensure you and your baby receive the best possible care.

How to take care of yourself during preterm labor?

Taking care of yourself when experiencing preterm labor means following your healthcare team's instructions carefully while staying as calm as possible. This situation requires medical supervision, so don't try to manage it alone.

Rest is crucial during this time, though complete bed rest isn't always necessary. Your doctor will tell you what level of activity is safe for your situation.

Stay hydrated by drinking plenty of water, as dehydration can sometimes worsen contractions. Avoid caffeine and alcohol, which can interfere with medications and aren't safe during pregnancy.

Monitor your symptoms closely and keep track of contractions if your healthcare provider asks you to. Note their frequency, duration, and intensity to help guide your treatment.

Follow medication instructions exactly as prescribed. Don't skip doses or stop taking medications without talking to your doctor first, even if you feel better.

Reach out for emotional support from family, friends, or support groups. Experiencing preterm labor can be stressful, and having support helps you cope better.

How should you prepare for your doctor appointment?

Preparing for your doctor appointment when dealing with preterm labor helps ensure you get the information and care you need. Bring a list of all your symptoms and when they started.

Write down your questions beforehand so you don't forget important concerns during your appointment. Include questions about your treatment options, what to expect, and when to seek emergency care.

Bring your complete medical history, including any previous pregnancies, surgeries, or chronic conditions. This information helps your doctor make the best treatment decisions for your situation.

List all medications and supplements you're currently taking, including dosages. Some medications can interact with preterm labor treatments, so complete information is important.

Consider bringing a support person with you to appointments. They can help you remember information and provide emotional support during this stressful time.

Prepare for the possibility of hospitalization by having a bag ready with essentials like comfortable clothes, toiletries, and phone chargers. Having these items ready reduces stress if you need to stay in the hospital.

What's the key takeaway about preterm labor?

The most important thing to remember about preterm labor is that early recognition and prompt medical care can make a significant difference in outcomes for both you and your baby. Trust your instincts if something feels wrong.

While preterm labor can be frightening, many women who experience it go on to have healthy pregnancies and babies with proper medical care. Advances in medical treatment have greatly improved outcomes for preterm babies.

Don't hesitate to contact your healthcare provider if you have concerns about preterm labor symptoms. It's always better to be checked and reassured than to wait and potentially miss important early signs.

Remember that experiencing preterm labor doesn't mean you did anything wrong. This condition can happen to anyone, regardless of how well you've taken care of yourself during pregnancy.