Signs of Preterm Labor in a Pregnancy With Twins or Multiples

Pregnant woman holding her belly while sitting on a couch
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From the moment you found out you were having twins or more, the term "preterm labor" started hovering in your consciousness. It's true that multiples are at risk of being preterm. More than half of twins are born early, with more than ten percent born very preterm, before 32 weeks.

According to the March of Dimes, you are six times more likely to deliver early with twins than with one baby. With triplets, quadruplets and other higher-order multiples, the odds are higher, nearly 100 percent.

Before you get panicked at the inevitability of preterm labor, let's break down the statistics. If you are having "just" twins, you are likely to have full-term, healthy twins within the last few weeks of the third trimester. Of the 70 percent that were reportedly born early, many were born within a few weeks of their due date. Fewer are born severely prematurely at 24-28 weeks.

Educate Yourself About Warning Signs of Preterm Labor

You can increase your odds by maintaining a healthy pregnancy. Rather than fretting about the possibility of preterm labor, prepare for a positive outcome by educating yourself about the warning signs.

Tune in to your body's cues. Although not every woman knows in advance that she's going into labor, sometimes there are signals that can prompt you to get medical attention. Timely action can make a big difference for your babies.

Signs of Preterm Labor

Here are the common signs of preterm labor. Contact your doctor if you have any concerns about your pregnancy.

  • More than four or five contractions per hour
  • Regular contractions that increase in frequency
  • Rhythmic or persistent pelvic pressure
  • Cramps, similar to menstrual cramping
  • Backache
  • Diarrhea or upset stomach
  • A change in vaginal discharge
  • Vaginal bleeding
  • Uneasy or urgent sense that something is wrong

A Word From Verywell

It's important for all expectant mothers of multiples to be aware of the risks, as well as the signs of preterm labor. However, don't let fear take the joy out of your pregnancy.

Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  • Martin, Joyce A., et al. ”Births: Final Data for 2013.” National Vital Statistics Reports.
  • ”What are the signs and symptoms of preterm labor and what should I do if I have any of them?” The American College of Obstetricians and Gynecologists.

By Pamela Prindle Fierro
 Pamela Prindle Fierro is the author of several parenting books and the mother of twin girls.