Preterm labor can occur at any point after the fetus is viable, meaning that it is capable of surviving outside of the womb. Prior to viability, a fetus or embryo can be ejected prematurely from the uterus, but we call that a spontaneous abortion (or a threatened abortion if it appears there is a high risk of imminent embryonic or fetal death), rather than ‘labor”. 40 weeks gestational age marks full-term pregnancy and a birth is considered premature if it occurs prior to about 38 weeks, and there is some wiggle room here. Some obstetricians will use 37 weeks as the cut-off point for full- versus pre-term. When you get down below 36 weeks, that’s when doctors are concerned about health effects. When an infant is born at 28 weeks or younger, that’s when you are looking at a scenario of heavy life-support equipment and all the trimmings of a modern neonatology unit. If you are having twins, it’s fairly normal to give birth around 36 weeks, but otherwise obstetricians will try to extend your pregnancy toward full term, unless there is a medical reason to deliver early. This means that, if you find yourself in early labor, you could call your doctor and go to the delivery room immediately for treatment that may stop the labor.
What are the Warnings for Preterm Labor?
Here are a few signs and symptoms:
- Contractions – Your belly will start becoming tight after every 10 minutes, or more often than that. It’s possible that these will turn out to be Braxton-Hicks contractions, known commonly as false labor. If that’s the case, they’ll send you back home.
- Discharge – You will see a change in the discharge from your vagina. It could be a leaking fluid and, in some cases, bleeding from the vagina too.
- Pressure – You will feel a strong pressure on your pelvic area, as if the baby were pushing down and is ready to come out. You will also have lower back pain, which may be severe.
- Cramps – If you start having cramps, as if you were menstruating, this indicates that you are going into labor.
- Diarrhea – Sometimes you may develop diarrhea.
What to do?
The first thing to do is to call for help; contact a doctor. If you are in pain, you can ask your partner or anyone around you to drive you to the hospital for support. If your pain stops after a while, drink water and breathe. Sit down for a while and then you can head to a hospital for further assistance.
What can cause preterm labor?
You may never know the cause of your preterm labor, but here are some common risk factors:
- Smoking, Drugs, Alcohol – These substances can provoke not only premature delivery, but also early pregnancy loss, as well as birth defects and low birth weight.
- Short interval pregnancy – This means getting pregnant sooner than 16 to 18 months subsequent to delivering your previous baby. It’s not a major risk factor, but it’s possible.
- Infections – If you have sexually transmitted diseases (STDs) or, if the uterus or vagina is otherwise infected, this too can provoke premature birth. Any untreated urinary tract infection (UTI) or even a minor vaginal infection can factor into the health of your pregnancy and future child.
- High blood pressure – This is not really a risk factor for prematurity, but rather a sign of a condition called preeclampsia, which puts your pregnancy in jeopardy. Risk for preeclampsia is elevated in mothers who are very young (under 18 years) or old (over 40 years), those with a history of preeclampsia, or with a family history of preeclampsia, those carrying their first pregnancy, those carrying a multiple pregnancy, and those with an organ transplant. Medical conditions that increase the preeclampsia risk include obesity, autoimmune disorders, sickle cell disease, high blood pressure, kidney disease, and polycystic ovarian syndrome. In vitro fertilization also elevates the preeclampsia risk.