Preterm labor or premature labor happens when your body starts getting ready for birth too early in your pregnancy. Your baby is premature if he arrives before you are 37 weeks pregnant.
Most premature babies arrive after 32 weeks of pregnancy and have a good chance of surviving and growing up to be healthy. Generally, the further on in your pregnancy you are, the more likely it is that your baby will do well. His/her organs will be more mature, his/her lungs better prepared for breathing, and he/she will have more strength for sucking and feeding. Also, intensive care for extremely early babies has improved dramatically, and survival rates are much better than they used to be. However, there can sometimes be long-lasting effects for babies arriving very early, including cerebral palsy and learning difficulties.
According to studies, in nearly 40 percent of premature births, the cause is unknown, but they suggest four main causes of spontaneous premature labor.
Studies suggest that premature labor is often triggered by the body's natural immune response to certain bacterial infections, such as those involving the genital and urinary tracts and fetal membranes. Even infections far away from the reproductive organs, such as periodontal disease, may contribute to premature delivery.
The uterus may bleed because of problems such as placental abruption (i.e., the placenta peels away, partially or almost completely, from the uterine wall before delivery). Bleeding triggers the release of various proteins involved in blood clotting, which also appear to stimulate uterine contractions.
The uterus may become overstretched by the presence of two or more babies, excessive amounts of amniotic fluid, or uterine or placental abnormalities, leading to the release of chemicals that stimulate uterine contractions.
Maternal or fetal stress
If an expecting mother experiences ongoing stress, or the fetus experiences physical stress (such as insufficient blood flow from the placenta), the fetus may produce a stress-related hormone called corticotrophin-releasing hormone (CRH). CRH may stimulate production of a cascade of other hormones that trigger uterine contractions and premature birth.
Many different things can increase your risk of premature labor. Some of them are:
- Being very overweight or underweight before pregnancy
- Not getting good prenatal care
- Drinking alcohol or using street drugs during pregnancy
- Having health conditions, such as high blood pressure, preeclampsia, diabetes, blood clotting disorders, or infections
- Being pregnant with a baby that has certain birth defects
- Being pregnant with a baby from in vitro fertilization
- Being pregnant with twins or other multiples
- A family or personal history of premature labor
- Getting pregnant too soon after having a baby
To stop premature labor, you need to know the warning signs. Call your doctor right away if you have the following symptoms.
- Backache, which usually will be in your lower back. This may be constant or come and go, but it won’t ease even if you change positions or do something else for comfort.
- Contractions every 10 minutes or more often
- Cramping in your lower abdomen or menstrual-like cramps. These can feel like gas pains that may come with diarrhea.
- Fluid leaking from your vagina
- Flu-like symptoms such as nausea, vomiting, or diarrhea. Call your doctor even about mild cases. If you can’t tolerate liquids for more than 8 hours, you must see your doctor.
- Increased pressure in your pelvis or vagina
- Increased vaginal discharge
- Vaginal bleeding, including light bleeding
Checking for Contractions
Checking for contractions is a key way of spotting early labor.
Place your fingertips on your abdomen. If you feel your uterus tightening and softening, that’s a contraction.
Time your contractions. Write down the time when a contraction starts, and write down the time at the start of the next contraction.
Try to stop the contractions. Get off your feet. Change your position. Relax. Drink two or three glasses of water.
Call your doctor if you continue to have contractions every 10 minutes or more often, if any of your symptoms get worse, or if you have pain that is severe and doesn’t go away.
You need to be aware that many women have harmless false labor called Braxton Hicks contractions. These are usually erratic, don't get closer together, and stop when you move around or rest. They are not part of labor. If you are not sure about the type of contractions you are feeling, get medical advice.
You might not be able to prevent preterm labor, but there is much you can do to promote a healthy, full-term pregnancy.
- Seek regular prenatal care. Prenatal visits can help your health care provider monitor your health and your baby's health. Mention any signs or symptoms that concern you, even if they seem silly or unimportant.
- Eat a healthy diet. During pregnancy, you will need more folic acid, calcium, iron and other essential nutrients.
- Gain weight wisely. Gaining the right amount of weight can support your baby's health and makes it easier to shed the extra pounds after delivery. A weight gain of 25 to 35 pounds (about 11 to 16 kilograms) is often recommended for women who have a healthy weight before pregnancy. Work with your health care provider to determine what is right for you.
- Avoid risky substances. If you smoke, quit. Smoking might trigger preterm labor. Alcohol and illicit drugs are off-limits, too. In addition, medications of any type — even those available over-the-counter — deserve caution. Get your doctor’s consent before taking any medications or supplements.
- Be cautious when using assisted reproductive technology (ART). If you are planning to use ART to get pregnant, consider how many embryos will be implanted. Multiple pregnancies carry a higher risk of preterm labor.
- Restricting sexual activity. If you have a history of preterm labor or experience signs or symptoms of preterm labor, you might need to restrict sexual activity and monitor yourself for contractions after sex.
- Limiting certain physical activities. If you are at risk of preterm labor or develop signs or symptoms of preterm labor, your doctor might suggest avoiding heavy lifting or spending too much time on your feet. Sometimes it makes sense to scale back other physical activities, such as certain exercises and travel, too.
- Managing chronic conditions. Certain conditions, such as diabetes and high blood pressure, increase the risk of preterm labor. Work with your doctor to keep any chronic conditions under control.