Most pregnancies (or about 90 percent of them, roughly speaking) terminal to term — which is at least week 37 of pregnancy (though that'southward at present chosen "early term"; full-term babies are born between 39 weeks of pregnancy and week forty of pregnancy). Only sometimes, baby unexpectedly arrives sooner. Here'due south why premature labor happens — and what you can do to help prevent information technology.

What is considered preterm labor?

Preterm, or premature, labor occurs later on week 20 of pregnancy and before week 37.

The latest research from the March of Dimes shows that the number of cases of premature labor is on the ascent for the fifth yr in a row, and around ten percent of moms find their expected nine months of pregnancy turns into an unexpected seven or eight because they go into labor besides shortly.

What might cause preterm labor?

While no one knows for certain what causes preterm labor, experts point to a number of factors that could play a function in triggering your uterus to brainstorm contracting and your cervix dilating before your baby is set up to come up out:

  • Smoking, alcohol and drug use: Not only do these increase your risk of miscarriage, they also increase your baby'south risk of being born early or at a low nascence weight (toxins that cantankerous the placenta tin keep your baby from getting the necessary oxygen she needs to grow). If there's ever a reason to quit, pregnancy is information technology.
  • Curt interval between pregnancies: Getting meaning sooner than 18 months after giving birth to your terminal child increases your risk of preterm birth. And the longer yous can await, the less you're at risk: A large recent study institute that 20 percent of women who wait less than a year between pregnancies give nascence before 37 weeks; the rate drops to x pct among women who look a yr to 18 months and is less than 8 percent in those who wait more than 18 months to conceive 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 almost 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 you're total-term. Untreated urinary-tract infections tin take the same effect.
  • Pregnancy complications: Complications (such as gestational diabetes, preeclampsia and excessive amniotic fluid) too as bug with the placenta (such as placenta previa or placental abruption) can make an early delivery more likely.
  • Structural anomalies of the uterus and/or neck: A uterus that is extremely big or has other structural abnormalities can brand it more difficult to carry a baby to term, as tin can problems with the cervix (such equally having a short cervical length or an incompetent cervix — when the neck doesn't stay airtight the manner it's supposed to during pregnancy).
  • Mucilage infections: Pregnancy hormones brand expectant moms more susceptible to periodontal disease, which in turn has been linked to preterm labor. Some experts suspect that the bacteria that cause inflammation in the gums tin can actually go into mom's bloodstream, reach the fetus and initiate early delivery. Other research proposes another possibility: The bacteria that cause inflammation in the gums can also trigger the immune system to produce inflammation in the cervix and uterus, triggering early labor.
  • Stress levels: Researchers conjecture that severe emotional stress — not the kind caused by those raging hormones or a bad day, but the kind that's related to a traumatic experience — can lead to the release of hormones that in plough trigger labor contractions.
  • Occupational factors: Extreme concrete stress on the job has also been linked to preterm labor. Researchers have found that women who represent long periods of time (more than v hours a mean solar day) or who have jobs that are extremely physically exhausting are more than probable to deliver 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 likely than their younger counterparts to deliver prematurely.
  • A previous preterm birth: If y'all've given birth early previously, you're at an increased hazard of having a subsequent preterm nascency.
  • If y'all were preterm yourself. A big 2015 study institute that women who were built-in prematurely themselves are at a higher risk of giving birth prematurely (though those odds are still low, at 14.2 percent or less depending on how early yous were born).

Most important to remember, all the same, is that having one of these gamble factors doesn't hateful that you'll necessarily become into preterm labor. Similarly, not having any of the chance factors doesn't mean that you won't (some women do for other reasons — or for no known reason at all).

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Is there anything y'all tin 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 prevent preterm labor take been elusive, in large part because doctors still don't understand it enough to be able to develop effective ways to treat it.

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

  • Aim for 18 months betwixt pregnancies. Your rate of preterm labor drops significantly if you lot look at to the lowest degree a yr — and optimally xviii months — between when you final gave nascency and when you excogitate again.
  • Come across your dr.. Getting early and regular prenatal care can assistance your physician pinpoint and assistance you treat any adventure factors for preterm labor and ensure you lot take the healthiest pregnancy possible.
  • Control what you tin can. Smoking, drinking, using drugs not prescribed by your doctor or having untreated diabetes can all lead to preterm labor. Eliminate any that apply to you lot.
  • Accept your prenatal vitamins. A daily prenatal supplement enhances your overall health, improving the odds that y'all'll behave to term. In fact, research suggests that folic acid (which already does and so much expert for your infant) may as well lower the adventure of placental abruption (the placenta separating from the uterine wall) and preeclampsia, two weather that are responsible for a skilful per centum of early deliveries.
  • Eat well. Getting all the nutrients your body needs from a salubrious, balanced pregnancy nutrition not only results in a healthier baby but also one that arrives at the correct time. Acceptable intake of certain omega-3 fatty acids (found in salmon, DHA eggs, walnuts and flax seed) has been shown to reduce preterm labor (and boosts your baby's brain development). Other studies have shown that vitamin C (citrus, berries, bong peppers) and calcium (milk and other dairy products or fortified juices) can also be helpful in preventing preterm labor.
  • Eat frequently. Enquiry suggests that it's non enough to transport your baby all the right nutrients — you should as well make those shipments as regular as possible. Meaning women who consume at least five times a 24-hour interval (three meals and ii snacks, or five smaller meals, for instance) are less likely to deliver prematurely.
  • Drink upward. Drinking enough water (more than if you're exercising or information technology'southward very hot) will keep yous hydrated. And staying hydrated increases your odds of keeping babe put, since aridity can pb to premature contractions.
  • Be practiced to your gums. Preventative dental intendance is one of your first (and best, and easiest) lines of defence force in preventing preterm labor, since information technology can be triggered by gum disease. So castor, floss and visit your dentist at least in one case during your pregnancy — not just for your regular cleaning, merely besides to take care of any little issues earlier they go big ones.
  • Go when you gotta go. Property in your urine, besides beingness uncomfortable, can inflame your bladder — which in turn could irritate your uterus and prepare off contractions. Not going when you gotta become could too atomic number 82 to a urinary tract infection, another cause of preterm contractions. And then make a habit of peeing when you've got the urge to get.
  • Treat information technology. If y'all're considered high-hazard considering you have BV, ask your practitioner if an oral antibody is right for you. Some studies evidence that symptomatic women with BV who are treated with antibiotics have a reduced run a risk of preterm delivery. Other studies, though, have disputed those findings, saying that there is no reduction in the rate of premature delivery even if the infection (both BV and other STDs) is treated. Your practitioner will be able to guide yous.
  • Explore your options. If y'all've already had one preterm labor, contempo inquiry has establish that the hormone progesterone (given as a shot or a gel during weeks 16 through 36) reduces the risk for preterm nativity in women with a prior history — 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, there are no universal screening tests for preterm labor risk. But for high-risk patients, cervical length measurement between 16 to 22 weeks may be useful in predicting whether you're at run a risk for preterm nativity. If there are any signs that your neck is shortening or opening, your practitioner may take some steps to prevent early labor — such as putting you on bed rest, prescribing vaginal progesterone or perhaps stitching your cervix airtight, called cerclage.

How to recognize preterm labor

A full lxxx percent of women who take symptoms of preterm labor will non deliver early on. And while it'due south likely you lot'll never have to put this knowledge to use, it's expert to have in your back pocket: The before you lot recognize that you're in labor, the earlier you'll exist able to seek treatment. Call your practitioner correct away if you are experiencing these labor signs:

  • Regular contractions: That is, those that come every 10 minutes (or more often) and do not subside when you change position (try lying down on your side). These are not to exist dislocated with Braxton Hicks contractions that yous've possibly already begun to feel, which are exercise contractions that are no cause for concern (they're irregular, don't intensify and subside when yous change position). If you're not certain, call your practitioner anyway.
  • Modify in vaginal discharge: Await for blood-streaked discharge ("bloody show") or vaginal haemorrhage.
  • Fluid leaking from your vagina: Information technology could exist a sign your water has cleaved. Take a sniff test: If it smells similar ammonia, it'southward urine. If information technology doesn't, it could exist amniotic fluid.
  • Catamenia-like cramps: Strong cramps you lot feel in your lower belly or lower dorsum could exist a sign of labor.
  • Back pain: A constant low, dull dorsum pain may be a sign of labor.
  • Increased pelvic pressure level: If you feel a significant increment in pressure in your pelvic expanse, phone call your md.

Keep in mind that y'all can accept some or all of these symptoms and not be in labor (well-nigh meaning women experience pelvic hurting/pressure or lower dorsum pain at some betoken). Merely only your practitioner tin tell for sure, so pick up the phone and call. Later all, ameliorate prophylactic than sorry.

What to expect if you lot experience preterm labor

If you're experiencing any symptoms of preterm labor, your practitioner will want to appraise you — either in the office or the hospital. Here'due south what to expect:

Tests for preterm labor: You'll first be hooked up to a fetal monitor to check for contractions and to make sure the baby is not in any distress. Your neck will be examined to determine if any dilation or effacement has begun, and your practitioner will probably employ a vaginal swab to test for signs of infection and maybe fetal fibronectin. You might besides receive an ultrasound to assess the amount of amniotic fluid and to confirm the size and gestational historic period of your baby. If these tests and exams show that you aren't in labor, you lot'll exist sent habitation, frequently with instructions to take it easy — or perhaps to go on modified bed rest.

If your practitioner thinks you're in preterm labor: Because each day a infant remains in the womb improves the chances of survival and adept wellness, your doctor's main goal will be holding off labor for as long as possible. He or she may put yous on bed rest. Or, depending on how far along in the pregnancy you are and what other complications you may be having, she may admit you lot to the hospital, where you may receive any or all of the post-obit:

  • Intravenous fluids: The better hydrated yous are, the lower the chances of continued contractions.
  • Antibiotics: Yous may receive antibiotics, specially if infection is believed to have triggered labor. And if you lot oasis't yet been tested for Group B strep (the test is usually performed after 35 weeks), you'll exist given 4 antibiotics to preclude possible transmission of the bacteria to your infant in case you are indeed a carrier.
  • Tocolytic agents: Your doctor may give you medications (similar magnesium sulfate) to relax the uterus and, in theory, temporarily end contractions. These are commonly only dispensed if you're less than 34 weeks pregnant and if your babe'southward lungs are deemed too immature for delivery.
  • Corticosteroids: If your baby's lungs are notwithstanding underdeveloped, you'll receive these medications to speed upwards fetal lung maturity. Doctors have long brash that women between 24 and 34 weeks meaning who are expected to get into imminent preterm labor have corticosteroids administered. In 2017, the American College of Obstetricians and Gynecologists (ACOG) issued new recommendations suggesting that certain women at hazard of preterm birth besides be given antenatal corticosteroids during the tardily preterm nativity period, 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 hazard of a preterm delivery inside 7 days. The drugs help fast-track the growth of the fetus' lungs two to seven days after they're taken, boosting the chances that baby will successfully function and thrive without help outside the womb.

If at any indicate your practitioner determines that the take a chance to you or your baby outweighs the risk of preterm birth, he or she volition not attempt to postpone commitment. The proficient news is that for about 30 percent of women, preterm labor stops on its own, and just about ten percent of women who become into preterm labor give nativity within the next seven days.

Your premature baby'southward wellness

A infant born before 34 weeks will almost always need to stay in the neonatal intensive intendance unit (NICU) for the first few days, weeks or, in some cases, months of his or her life.

Babies built-in between 34 and 37 weeks of gestation who have no other health problems generally exercise fine — and often just need a brusk stay in the NICU before they head home.