What is preterm labour?
Going into labour before your 37th week of pregnancy is called preterm labour, or premature labour. Preterm labour can cause your baby to be born too soon. This can lead to a number of health problems that may affect your baby.
Symptoms of preterm labour
If you believe you are having preterm labour, get medical help right away. If in doubt, get checked early. Once labour is established it is very difficult to stop. Contractions alone do not mean you are in preterm labour, however. What matters more are the changes in your cervix (the lower end of your uterus). Symptoms of preterm labour include:
- 4 or more contractions per hour;
- strong contractions;
- constant menstrual-like cramping;
- low back pain;
- pelvic presure (feeling that the baby is pushing down;
- watery, mucous, or bloody vaginal discharge; or
- bleeding or blood spotting after 3 months into your pregnancy.
Evaluating preterm labour
Your doctor or obstetrician will try to find out whether you are in preterm labour or whether you are just having contractions. They may keep watch on you for a few hours. The following tests may be done:
- pelvic exam to see if your cervix has effaced (thinned) and dilated (opened);
- uterine activity monitoring to detect contractions; or
- fetal monitoring to check the health of your baby.
In addition, there is a biochemical test that can identify women at risk of preterm delivery. The test involves the measurement of fetal fibronectin, a type of glue created by the body to help the pregnancy bind to the inside lining of the uterus. This substance leaks through the cervix early in the process of preterm labour, and can be detected in vaginal fluid using a simple swab test.
The fetal fibronectin test is not 100 per cent reliable, but if you are experiencing symptoms of preterm labour it can help determine your risk of delivering the baby in the next one to 2 weeks.
Caring for yourself at home
If you have contractions preterm but your cervix is still thick and closed, your doctor or obstetrician may ask you to do the following at home:
- do fewer activities, including heavy lifting; or
- rest in bed, lying on your side.
If you need hospital care
Preterm labour often requires hospital care and complete bed rest. You may need an intravenous line through which fluids are given. You may also be given pills or an injection to help prevent contractions.
Are you at risk?
Any pregnant woman can have preterm labour. It may start for no reason. But these risk factors can increase your chances:
- previous preterm labour or early birth;
- some abnormalities of the baby, cervix, uterus or placenta;
- a lack of prenatal medical care;
- some infections, such as urinary tract infections or vaginal infections (e.g. bacterial vaginosis);
- having certain medical problems, such as diabetes, high blood pressure or clotting disorders;
- being underweight or overweight before becoming pregnant;
- being under 17 or over 35 years old;
- smoking, drug or alcohol use during pregnancy; or
- multiple fetuses (twins or more).
The dangers of preterm birth
A baby born too soon may have health problems. This is because the baby did not have enough time to mature. The baby is then at risk of a variety of problems, such as:
- not breastfeeding well;
- having immature lungs, and not being able to breathe on their own;
- bleeding in the brain;
- life-threatening infections;
- inflammation of the bowel;
- long-term health problems, such as cerebral palsy; or
Your goal is to get as close to term (40 weeks) as you can before giving birth. The closer you get to term, the greater your chances of having a healthy baby. Work with your doctor or obstetrician. Together you can take steps to keep you from giving birth too early.
2. MayoClinic.com. Vaginitis [updated 2009, Feb 6; accessed 2009, Aug 7]. Available at: http://www.mayoclinic.com/health/vaginitis/DS00255
3. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Use of cervical fetal fibronectin as a screening test for preterm birth [published 2008, Nov; accessed 2009, Aug 7]. Available at: http://www.ranzcog.edu.au/publications/statements/C-obs26.pdf