Signs of Preterm Labour
Most parents expect pregnancy to last about 40 weeks, but sometimes labor starts early. Preterm labour means the body begins preparing for birth before 37 weeks. It matters because babies born too soon can face serious health problems, especially with their lungs and other organs.
Knowing the signs, like regular contractions or changes in discharge, makes all the difference. Catching these changes early helps you get the right care fast and protect your baby’s health. This post explains what to watch for and what to do if those signs start before your due date.
What Is Preterm Labour?
Preterm labour happens when the body starts to get ready for birth before 37 weeks of pregnancy. This early delivery is more common than you might think—over 13 million babies are born too soon every year. Preterm birth isn’t just about timing; it brings real health challenges for newborns, especially if they arrive very early. Let’s break down what preterm labour means, how often it happens, why it occurs, and who faces the biggest risks.
Photo by Duda Oliveira
The Definition of Preterm Labour
Preterm labour refers to when contractions and changes in the cervix (opening of the uterus) start before 37 completed weeks of pregnancy. Doctors sort preterm birth into three groups based on how early labor starts:
- Extremely preterm: Less than 28 weeks
- Very preterm: 28 to 32 weeks
- Moderate to late preterm: 32 to 37 weeks
Any birth before 37 weeks is considered preterm, but the earlier it happens, the higher the risk of complications.
How Common Is Preterm Labour?
Globally, just over 1 in 10 babies is born preterm. In some areas, the numbers are even higher due to healthcare differences. In wealthier countries, most babies born very early survive and grow up healthy, but that’s less likely in places where neonatal care is limited. Preterm birth is the leading cause of death for children under five.
Common Causes of Preterm Labour
There isn’t a single reason for most cases of preterm labour. It can happen spontaneously or because doctors decide early delivery is safer. Here are the main causes:
- Spontaneous labor: Starts on its own, sometimes with water breaking early (called PPROM).
- Medical reasons: Sometimes, doctors induce labor or perform a C-section early for health reasons, such as high blood pressure (pre-eclampsia), slow growth in the baby, or certain chronic illnesses in the mother.
- Multiple pregnancies: Twins or triplets make early birth more likely.
Researchers believe inflammation, infections, physical issues with the uterus or placenta, and even genetics can play a part.
Who’s at Risk? Key Risk Factors
Certain people face a higher risk of going into preterm labour. Recognizing these factors can help with prevention and early care:
- Previous preterm birth: One of the strongest predictors is a past early birth.
- Short cervix or weak cervix: More likely to open too soon.
- Infections: Especially urinary or vaginal infections.
- Low body weight: Underweight mothers have a higher risk.
- Chronic health conditions: Diabetes, high blood pressure, or autoimmune diseases.
- Multiple pregnancies: Carrying twins, triplets, or more.
- Lifestyle habits: Smoking, using some drugs, or not getting enough prenatal care.
Community and social factors play a role, too. People with less access to health care or certain racial and ethnic backgrounds (such as Black mothers in the US) face higher rates. Stress, physical violence, and little support can also nudge up the risk.
Knowing what preterm labour is and who’s more likely to experience it helps you and your healthcare team take steps early—keeping both you and your baby safer.
Key Signs and Symptoms of Preterm Labour
When you’re pregnant, it’s easy to second-guess every little ache or twinge. But some symptoms mean it’s time to pay attention. Preterm labour often starts with warning signs that can seem mild or confusing at first, but knowing what stands out from the “norm” is critical. Let’s break down the most recognized signs of preterm labour so you can spot them early and act fast when it counts.
Regular Uterine Contractions Before 37 Weeks: How to Recognize Abnormal Contractions
Contractions are the main sign that the body is gearing up for labour, but what makes them “preterm”? Early in pregnancy, it’s common to have occasional Braxton Hicks contractions—these are mild, irregular, and usually go away with rest. Preterm labour contractions, on the other hand:
- Feel like your belly is tightening or hardening.
- Happen regularly—six or more in one hour is a red flag.
- May be painless or feel like strong menstrual cramps.
- Don’t improve with changing positions, rest, or drinking water.
You can monitor them by lying down, keeping a hand on your belly, and timing the frequency. If you notice these patterns before 37 weeks, it’s important to call your doctor.
Changes in Vaginal Discharge: What to Watch For
A change in vaginal discharge is often the first visible sign something isn’t right. During preterm labour, discharge may:
- Become watery (like leaking urine)—this could be amniotic fluid.
- Look mucus-like or sticky, possibly tinged with pink or brown.
- Turn bloody or streaked with blood.
- Increase in amount or change in consistency.
These changes matter because watery or bloody discharge can mean your membranes have ruptured or your cervix is changing early. If you notice any of these, don’t wait—reach out to your healthcare provider for advice.
Pelvic Pressure and Abdominal Cramps: When It’s More Than Discomfort
Pregnancy comes with plenty of odd twinges, but pressure or pain that feels different or intense can signal early labour. Signs to pay attention to include:
- Pelvic pressure: It may feel like the baby is pushing down.
- Abdominal cramps: Similar to period cramps, and may come and go or be constant.
- Dull backache: That doesn’t go away with normal comfort measures.
Unlike common pregnancy pains, these symptoms often don’t ease up or might even get worse. Listen to your body, especially if these sensations are new or you feel them along with contractions or discharge changes.
Other Warning Signs: Ruptured Membranes, Bleeding, and More
Some symptoms mean you need care right away. Don’t wait if you have:
- A sudden gush of fluid or steady leaking from your vagina (possible ruptured membranes).
- Bright red vaginal bleeding.
- Severe abdominal pain.
- A sudden decrease in how often your baby moves, or if you stop feeling movement altogether.
- Fever, chills, or feeling very unwell.
These signs go beyond normal discomfort and could mean your baby or you are at risk. If any of these happen, call your doctor or go to the hospital for immediate care. Early action can make a difference for both you and your baby.
What To Do If You Notice Signs of Preterm Labour
Spotting the first signs of preterm labour can feel overwhelming and scary. Quick action helps both you and your baby. Knowing what to do at home while you wait for medical advice, understanding what to tell your healthcare provider, and having a sense of what could happen at the hospital removes some of the fear and confusion.
Immediate Actions at Home
If you think you’re going into labour before 37 weeks, pause and take a few key steps to protect your health and your baby’s. Here’s what you should do until you can talk to your doctor or midwife:
- Stop what you’re doing and sit or lie down on your left side. Resting can sometimes slow contractions.
- Hydrate. Drink water or a clear fluid—sometimes dehydration can trigger contractions.
- Time your contractions. Use your phone or a clock. Jot down how long each one lasts and how often they come.
- Avoid self-intervention. Don’t try to stop labour on your own or insert anything into your vagina.
- Empty your bladder. A full bladder can make contractions worse.
- Stay calm. Stress won’t help, and focusing on your breathing or distraction can keep anxiety down.
These steps won’t stop true preterm labour, but they give you a safe waiting period while you seek guidance from your care team.
When and How to Contact Your Healthcare Provider
Calling your doctor or midwife quickly is key. Be ready to share a few important details so they can give you the best directions right away:
- Describe your symptoms clearly: Note all new pains, tightening, changes in discharge, leaking fluid, or bleeding.
- Count contractions: Tell them how many you’ve had in the last hour, how long they last, and if they are regular.
- Share your week of pregnancy (gestational age) and mention any known risks or past preterm labours.
- Mention other problems: Include fever, chills, strong pressure, or if the baby’s movement has changed.
- Ask about next steps: Listen to their advice carefully and follow instructions—don’t drive yourself if you feel unsafe.
Go straight to hospital if:
- You have a gush or steady leak of fluid.
- You’re bleeding.
- You can’t feel the baby moving.
- Your contractions are five minutes apart or less and very strong.
- You’re feeling faint, confused, or very unwell.
What Might Happen at the Hospital or Clinic
Once at the hospital or clinic, doctors and nurses will act quickly. Here’s what usually comes next, so you know what to expect:
Photo by Jozemara Friorili Lemes
- Cervical exam: They’ll check if your cervix is dilating or thinning.
- Fetal monitoring: A belt around your belly tracks the baby’s heartbeat and checks for contractions.
- Ultrasound: This looks at your baby’s health, position, and the length of your cervix.
- Possible lab tests: Swabs for infection, urine samples, or special tests for proteins linked to labour (like fetal fibronectin).
- IV fluids or medications: To prevent dehydration, slow contractions, or speed up your baby’s lung development if needed.
Doctors may recommend a short stay for more observation or treatment. They’ll explain what they find and what the next steps may be, such as medications, rest, or—if needed—delivery planning. Most who arrive with preterm labour get careful monitoring and care tailored to their baby’s needs and their own health.
Prevention and Long-Term Management for At-Risk Pregnancies
Pregnancy is different for everyone, but some people face higher chances of going into labor early. Good news—there are steps you can take to lower your risk, no matter if you’ve had a preterm birth before or just want to keep things on track. Preventing preterm labor is a team effort: healthy habits at home, regular check-ins with your care team, and, in some cases, special medical treatments. The goal is always the same: keep both you and your baby as healthy as possible until your due date.
Lifestyle Modifications and Monitoring: Everyday Choices That Matter
Photo by Matilda Wormwood
Small changes add up. Healthy daily choices hold real power for reducing the risk of early labor, especially when combined with careful self-monitoring and regular care. Try these proven strategies:
- Quit smoking and avoid alcohol or street drugs. Smoking increases the risk of preterm birth, while alcohol and other substances can raise your chances for complications.
- Treat infections quickly. Any infection—urinary, vaginal, flu-like—can kickstart contractions. Always finish antibiotics as prescribed and call your doctor for new symptoms.
- Keep up with all prenatal visits. Regular check-ins let your provider catch small problems before they grow. Early ultrasounds, cervical length checks, and lab tests are especially important if you’ve had a preterm baby before.
- Eat well and manage stress. Aim for a balanced diet rich in iron, folic acid, and protein. Even a short daily walk or a few minutes with your favorite music can help drop stress levels.
- Monitor your body. Know the signs of preterm labor. Keep track of contractions and discharge, and never ignore new pain, fluid leaks, or bleeding.
- Prevent spacing pregnancies too close. Giving your body at least 18 months between pregnancies lowers risk for both mother and baby.
Consistent routines build confidence. Whether you’re tracking fetal movement or avoiding certain foods, what you do every day truly counts.
Medical Interventions for Prevention and Delay
In some cases, lifestyle changes alone aren’t enough. Medical options are available to help prevent or delay preterm labor in people with clear risks or new symptoms. Here’s a look at the main tools:
- Vaginal progesterone:
For people with a short cervix or a history of preterm birth, vaginal progesterone can help keep the cervix from opening too soon. It’s usually started in the second trimester and used daily until late in pregnancy. Studies show it lowers the risk of early delivery. - Cervical cerclage:
This is a minor surgical procedure. A doctor places a strong stitch around the cervix to help keep it closed if it’s weak or has started to open early in a past pregnancy. Cerclage can make a big difference, particularly for people with cervical insufficiency. - Steroids:
If labor looks likely before 34 weeks, doctors can give steroid shots to speed up your baby’s lung development. This doesn’t stop labor but gives your baby a better start if born early. - Tocolytic medications:
These drugs temporarily slow or stop contractions. Tocolytics can buy precious time—usually a day or two—so steroid treatment works or you can be moved to a hospital with a special care nursery. - Treat underlying problems:
Managing chronic health problems like high blood pressure, diabetes, or infections can also help prevent preterm labor from starting in the first place.
Every person’s situation is unique, so your healthcare team will explain which (if any) of these steps are right for you. Together, you can make a plan for a safer pregnancy—because every extra day your baby stays inside matters.
Potential Outcomes and the Importance of Early Action
Preterm labour is more than just an early delivery—it brings serious risks for both babies and their families. Outcomes depend on how early the baby is born and what steps are taken in those first crucial hours. Early detection and fast care reshape the future for preterm babies and give parents the best tools to face the unexpected.
Photo by Alex P
Neonatal Risks of Preterm Birth
Babies coming early have less time to fully develop inside the womb. The earlier the birth, the greater the risk. Even a few extra weeks inside can make a huge difference. Some of the most common risks preterm babies face include:
- Breathing problems: Immature lungs may lead to respiratory distress syndrome. Some need help to breathe or extra oxygen for days, weeks, or longer.
- Brain injuries: The brain is fragile in early birth. Some babies face bleeding or damage that can lead to cerebral palsy, learning issues, or motor delays.
- Feeding and growth challenges: Early babies often struggle to suck, swallow, and gain weight.
- Temperature control: Lack of body fat makes it hard to keep warm.
- Vision and hearing loss: Problems like retinopathy can impact eyesight, and hearing loss is more likely.
- Infections: Immature immune systems mean even a mild infection can quickly turn serious.
- Long-term health effects: Some children have learning disabilities, speech delays, lung problems (like asthma), or even heart concerns as they grow.
These risks aren’t just statistics—they’re real and can affect families for years. But early action makes a big difference.
The Benefits of Early Detection and Treatment
Spotting preterm labour signs early changes everything. You and your care team can act fast, and the baby gets a stronger start. Here’s what early action can do:
- Delay birth: Prompt hospital care and medicines can sometimes pause labour for a day or two (or more). Every hour your baby stays inside helps organs mature.
- Steroid treatment: Doctors can give steroid shots to speed up your baby’s lung development, sharply cutting the risk of severe breathing problems.
- Specialized care: Babies at risk get transferred to facilities with advanced neonatal units—places designed for early arrivals.
- Better planning: Doctors can prepare for birth, order the right tests, and get equipment ready.
- Protect the brain: Medicines like magnesium sulphate may be used to cut the risk of cerebral palsy if delivery is expected.
Research shows survival and long-term outcomes improve when preemie babies come into the world with a team prepared and a plan in place.
Advances in Neonatal Care: Reason for Hope
Preterm birth isn’t as dire as it once was. Advances in neonatal intensive care have given even the tiniest babies a fighting chance. Today:
- Survival rates have risen sharply, even for babies born before 28 weeks.
- Many hospitals have dedicated teams just for high-risk births, with therapy and family support.
- Modern ventilators and medicines protect fragile lungs and brains.
- Early intervention services start before the baby ever leaves the hospital, working to catch delays or issues early.
Families who face preterm birth aren’t alone—science and support have come a long way. With early action and strong medical teams, every week and every minute matter for the smallest patients.
Conclusion
Knowing the signs of preterm labour gives you the power to protect your baby’s health. Acting on warning signs—like regular contractions or sudden changes in discharge—helps you get fast care if you need it. Every day counts, and reaching out early can make all the difference for you and your baby.
Trust your instincts and never hesitate to call for help. The sooner you speak up, the sooner your care team can take action. Staying informed and aware, while keeping up with good prenatal habits, is a strong step toward a healthy birth.
Thank you for reading. If you found this guide helpful or have a question, share your thoughts below—your story could help someone else.
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