Most pregnancies (or about xc percent of them, roughly speaking) final to term — which is at to the lowest degree week 37 of pregnancy (though that'south at present called "early term"; full-term babies are built-in between 39 weeks of pregnancy and calendar week xl of pregnancy). But sometimes, babe unexpectedly arrives sooner. Here's why premature labor happens — and what you can do to assist preclude it.

What is considered preterm labor?

Preterm, or premature, labor occurs after calendar week 20 of pregnancy and before calendar week 37.

The latest inquiry from the March of Dimes shows that the number of cases of premature labor is on the rise for the fifth year in a row, and around 10 percent of moms observe their expected ix months of pregnancy turns into an unexpected seven or viii because they go into labor too soon.

What might cause preterm labor?

While no 1 knows for sure what causes preterm labor, experts point to a number of factors that could play a role in triggering your uterus to begin contracting and your cervix dilating earlier your infant is ready to come out:

  • Smoking, alcohol and drug use: Not only exercise these increase your risk of miscarriage, they too increase your baby's risk of being born early or at a low birth weight (toxins that cross the placenta can keep your babe from getting the necessary oxygen she needs to grow). If there'due south e'er a reason to quit, pregnancy is it.
  • Short interval between pregnancies: Getting pregnant sooner than xviii months after giving birth to your last child increases your risk of preterm nativity. And the longer you lot can look, the less y'all're at risk: A large recent study found that 20 percent of women who wait less than a year between pregnancies give nascency earlier 37 weeks; the rate drops to 10 percent amid women who wait a yr to xviii months and is less than eight per centum in those who wait more than 18 months to conceive over again.
  • Uterine and vaginal infections: Infections — both those in the genital tract, such as bacterial vaginosis (BV) and sexually transmitted diseases (STDs) like trichomoniasis, along with infections in the uterus and amniotic fluid — are thought to be responsible for nearly half of all preterm births. Experts suspect they cause inflammation, which in turn leads to the release of prostaglandins — the same substance that initiates labor when yous're total-term. Untreated urinary-tract infections can have the same effect.
  • Pregnancy complications: Complications (such as gestational diabetes, preeclampsia and excessive amniotic fluid) as well equally problems with the placenta (such as placenta previa or placental abruption) can make an early on commitment more than likely.
  • Structural anomalies of the uterus and/or neck: A uterus that is extremely large or has other structural abnormalities can brand it more than difficult to deport a baby to term, every bit tin issues with the cervix (such equally having a short cervical length or an incompetent cervix — when the cervix doesn't stay closed the way it'south supposed to during pregnancy).
  • Gum infections: Pregnancy hormones make expectant moms more susceptible to periodontal affliction, which in turn has been linked to preterm labor. Some experts suspect that the bacteria that crusade inflammation in the gums can actually become into mom'south bloodstream, achieve the fetus and initiate early on delivery. Other research proposes another possibility: The bacteria that cause inflammation in the gums can also trigger the immune organization to produce inflammation in the cervix and uterus, triggering early on labor.
  • Stress levels: Researchers conjecture that severe emotional stress — not the kind caused past those raging hormones or a bad twenty-four hours, but the kind that's related to a traumatic experience — tin can lead to the release of hormones that in turn trigger labor contractions.
  • Occupational factors: Extreme physical stress on the task has also been linked to preterm labor. Researchers have found that women who stand for long periods of fourth dimension (more than five hours a 24-hour interval) or who take jobs that are extremely physically exhausting are more probable to evangelize early.
  • Carrying multiples: Multiples are more than probable than singletons to arrive early on.
  • Maternal historic period: Women younger than 17 and older than 35 are more than likely than their younger counterparts to deliver prematurely.
  • A previous preterm birth: If you've given nativity early previously, you're at an increased risk of having a subsequent preterm nascency.
  • If yous were preterm yourself. A large 2015 study establish that women who were born prematurely themselves are at a college risk of giving birth prematurely (though those odds are still low, at 14.two per centum or less depending on how early you were born).

Almost of import to call up, however, is that having 1 of these gamble factors doesn't mean that y'all'll necessarily become into preterm labor. Similarly, non having any of the hazard factors doesn't hateful that y'all won't (some women do for other reasons — or for no known reason at all).

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Is there anything you can do to prevent preterm labor?

While medical advances have fabricated it possible to successfully treat even the tiniest of premature babies, medical interventions to forbid preterm labor have been elusive, in big role because doctors still don't empathize it plenty to be able to develop effective ways to treat it.

But that doesn't mean there'due south nothing y'all as a concerned mom-to-be can do. Fifty-fifty if you lot're not at risk for preterm labor (and especially if you are), there are plenty of ways to help keep your baby put until he or she is completely gear up for a salubrious and timely inflow:

  • Aim for xviii months between pregnancies. Your rate of preterm labor drops significantly if you wait at least a year — and optimally 18 months — between when you concluding gave nascency and when you conceive again.
  • See your doctor. Getting early and regular prenatal care can help your doc pinpoint and assistance you treat any take a chance factors for preterm labor and ensure y'all have the healthiest pregnancy possible.
  • Control what you lot tin can. Smoking, drinking, using drugs not prescribed by your doc or having untreated diabetes tin all pb to preterm labor. Eliminate any that use to you.
  • Accept your prenatal vitamins. A daily prenatal supplement enhances your overall wellness, improving the odds that you'll carry to term. In fact, inquiry suggests that folic acid (which already does so much proficient for your baby) may also lower the risk of placental abruption (the placenta separating from the uterine wall) and preeclampsia, two weather condition that are responsible for a good percent of early on deliveries.
  • Swallow well. Getting all the nutrients your body needs from a healthy, counterbalanced pregnancy diet non merely results in a healthier baby but likewise 1 that arrives at the right fourth dimension. Adequate intake of certain omega-three fatty acids (plant in salmon, DHA eggs, walnuts and flax seed) has been shown to reduce preterm labor (and boosts your baby'due south encephalon development). Other studies have shown that vitamin C (citrus, berries, bong peppers) and calcium (milk and other dairy products or fortified juices) tin as well be helpful in preventing preterm labor.
  • Eat often. Enquiry suggests that information technology'south not enough to ship your baby all the right nutrients — you lot should besides make those shipments as regular as possible. Pregnant women who consume at least 5 times a mean solar day (3 meals and 2 snacks, or v smaller meals, for example) are less likely to deliver prematurely.
  • Drink upwardly. Drinking enough water (more if you lot're exercising or it's very hot) will keep yous hydrated. And staying hydrated increases your odds of keeping baby put, since dehydration can pb to premature contractions.
  • Exist good to your gums. Preventative dental care is one of your first (and best, and easiest) lines of defense in preventing preterm labor, since information technology tin be triggered by mucilage disease. So brush, floss and visit your dentist at least once during your pregnancy — not just for your regular cleaning, merely likewise to take intendance of any little problems before they become big ones.
  • Get when you gotta go. Belongings in your urine, besides being uncomfortable, tin can inflame your bladder — which in turn could irritate your uterus and set up off contractions. Not going when you gotta go could also lead to a urinary tract infection, another cause of preterm contractions. And then make a habit of peeing when you've got the urge to go.
  • Care for it. If you're considered high-risk because you have BV, ask your practitioner if an oral antibiotic is correct for yous. Some studies prove that symptomatic women with BV who are treated with antibiotics have a reduced risk of preterm commitment. Other studies, though, have disputed those findings, saying that there is no reduction in the charge per unit of premature commitment even if the infection (both BV and other STDs) is treated. Your practitioner will be able to guide you.
  • Explore your options. If you've already had one preterm labor, recent research has found that the hormone progesterone (given as a shot or a gel during weeks sixteen through 36) reduces the chance for preterm nativity in women with a prior history — and so enquire your practitioner if information technology might aid you.

How to Tell if You're in Labor

Screenings for preterm labor take a chance

Unfortunately, in that location are no universal screening tests for preterm labor adventure. Just for high-risk patients, cervical length measurement between sixteen to 22 weeks may be useful in predicting whether you're at chance for preterm nativity. If there are any signs that your cervix is shortening or opening, your practitioner may take some steps to forestall early labor — such equally putting y'all on bed residuum, prescribing vaginal progesterone or perhaps stitching your neck closed, chosen cerclage.

How to recognize preterm labor

A full eighty per centum of women who have symptoms of preterm labor will non deliver early. And while information technology's likely y'all'll never have to put this knowledge to use, information technology's good to have in your back pocket: The earlier yous recognize that you're in labor, the earlier you lot'll be able to seek handling. Call your practitioner correct abroad if yous are experiencing these labor signs:

  • Regular contractions: That is, those that come every 10 minutes (or more than often) and do not subside when you change position (effort lying down on your side). These are not to exist dislocated with Braxton Hicks contractions that you've perhaps already begun to feel, which are practice contractions that are no cause for concern (they're irregular, don't intensify and subside when you change position). If yous're non certain, call your practitioner anyway.
  • Modify in vaginal belch: Look for blood-streaked discharge ("bloody show") or vaginal bleeding.
  • Fluid leaking from your vagina: It could be a sign your h2o has broken. Accept a sniff examination: If it smells similar ammonia, information technology's urine. If information technology doesn't, it could be amniotic fluid.
  • Period-like cramps: Strong cramps you feel in your lower abdomen or lower back could exist a sign of labor.
  • Back pain: A constant low, irksome back pain may be a sign of labor.
  • Increased pelvic pressure: If you lot feel a significant increase in pressure level in your pelvic expanse, call your doctor.

Keep in mind that you can have some or all of these symptoms and not exist in labor (near pregnant women feel pelvic pain/pressure or lower dorsum pain at some betoken). But only your practitioner can tell for sure, so pick up the phone and phone call. Later all, better safe than sorry.

What to await if you experience preterm labor

If you lot're experiencing any symptoms of preterm labor, your practitioner volition desire to appraise you — either in the role or the hospital. Here's what to await:

Tests for preterm labor: You lot'll starting time exist hooked upward to a fetal monitor to check for contractions and to brand sure the babe is non in whatever distress. Your cervix volition exist examined to determine if any dilation or effacement has begun, and your practitioner volition probably use a vaginal swab to test for signs of infection and possibly fetal fibronectin. You might likewise receive an ultrasound to assess the corporeality of amniotic fluid and to confirm the size and gestational age of your baby. If these tests and exams testify that you aren't in labor, you'll be sent domicile, often with instructions to take it easy — or peradventure to go on modified bed rest.

If your practitioner thinks yous're in preterm labor: Because each day a babe remains in the womb improves the chances of survival and good health, your doctor'southward main goal will exist property off labor for as long as possible. He or she may put y'all on bed rest. Or, depending on how far along in the pregnancy you are and what other complications you lot may be having, she may acknowledge you lot to the hospital, where you may receive whatsoever or all of the following:

  • Intravenous fluids: The better hydrated y'all are, the lower the chances of connected contractions.
  • Antibiotics: You may receive antibiotics, peculiarly if infection is believed to accept triggered labor. And if you lot haven't even so been tested for Group B strep (the examination is usually performed later on 35 weeks), you'll be given IV antibiotics to prevent possible transmission of the bacteria to your baby in case you are indeed a carrier.
  • Tocolytic agents: Your doctor may requite yous medications (like magnesium sulfate) to relax the uterus and, in theory, temporarily end contractions. These are unremarkably only dispensed if you're less than 34 weeks pregnant and if your baby's lungs are deemed also immature for delivery.
  • Corticosteroids: If your baby's lungs are still underdeveloped, y'all'll receive these medications to speed upwards fetal lung maturity. Doctors have long brash that women betwixt 24 and 34 weeks significant who are expected to go into imminent preterm labor have corticosteroids administered. In 2017, the American College of Obstetricians and Gynecologists (ACOG) issued new recommendations suggesting that sure women at risk of preterm birth too be given antenatal corticosteroids during the late preterm nascence menses, or between 34 and 37 weeks of pregnancy. ACOG also says that women could consider starting the corticosteroid treatment at 23 weeks if they're at risk of a preterm delivery within 7 days. The drugs help fast-rail the growth of the fetus' lungs 2 to vii days afterward they're taken, boosting the chances that baby volition successfully office and thrive without help exterior the womb.

If at any point your practitioner determines that the chance to yous or your infant outweighs the take chances of preterm birth, he or she will not try to postpone delivery. The good news is that for almost 30 percent of women, preterm labor stops on its own, and only nigh 10 per centum of women who get into preterm labor requite nascence within the adjacent 7 days.

Your premature infant'southward health

A baby built-in before 34 weeks will near always need to stay in the neonatal intensive care unit (NICU) for the get-go few days, weeks or, in some cases, months of his or her life.

Babies born betwixt 34 and 37 weeks of gestation who have no other health problems by and large practise fine — and often just need a brusk stay in the NICU before they head home.