What to Do If You Think You Are in Preterm Labor

Pregnant woman feeling sick and faint

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Preterm labor is one of the most serious things that can occur in a pregnancy. Although not very likely, serious health issues or even an increased risk of death can occur when a baby is born a few weeks before its due date. Sometimes, the effects of preterm labor and birth can last a lifetime for a baby.

It is important to know the signs of preterm labor during pregnancy. Your midwife or doctor should go over the signs with you at a prenatal visit early in your pregnancy. This is particularly true if you are considered high risk for preterm labor.

Some reasons that you may be considered high risk for preterm labor (labor before 37 weeks of pregnancy) include:

  • You are carrying more than one baby
  • You have a history of preterm labor 
  • You have had previous surgery on your cervix
  • You have certain infections

Even if you have none of the risk factors for preterm labor, you can experience labor before a full-term pregnancy. Any signs and symptoms of preterm labor prior to 37 weeks of pregnancy should be reported immediately to your doctor or midwife.

The signs and symptoms include a backache that does not stop, more than five contractions in one hour, a release of your bag of water, cramping, bleeding, any lower abdominal or back pain, and anything else that you find concerning.

Here are five things that you need to do if you believe you are in preterm labor:

  1. Lay down with a clock or watch handy. Start timing your contractions and making note of when they start, when they stop, and when the next one begins. This will be vital information for your practitioner.
  2. Have someone bring you something to drink, preferably water, but anything that is not caffeinated is okay. The goal is to ensure that you are hydrated, as being dehydrated is one of the most common causes of contractions before your baby is due.
  3. Call your practitioner. Be sure to give a report of all of your signs and symptoms, including any contractions that you're having, how long they last, and how far apart they are.
  4. If you are alone, ask your partner to come home or have a friend come over. It is important that you have someone with you should you need to report to the practitioner's office or the emergency room. This person can also help with any other children that you might have at home or other things that may need to be coordinated while you are lying down. 
  5. If you were unable to reach your practitioner or your signs and symptoms increase, go to the emergency room. If you are prior to 20 weeks they may treat you in the emergency department, but if you're over 20 weeks pregnant they will usually send you to the labor and delivery unit for care. 

It is always better to be safe than sorry in this situation. If it is during office hours and your practitioner is open, you may be seen at that point. Some practitioners have this as a standard operating procedure, while others will ask you to go immediately to the emergency room. This may depend on your length of gestation, your previous history, and/or what symptoms you are experiencing.

Whatever you do, don't delay in seeking treatment. Preterm labor can sometimes be halted or delayed. Every day you remain pregnant is a positive one, buying time for treatments to prepare your baby for a preterm birth or by staving off labor until you are full term. 

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  • Gabbe SG, Niebyl JR, Simpson JL, Galan H, Goetzl L, Jauniaux ER, Landon M. Obstetrics: Normal and Problem Pregnancies (6th ed.). Churchill Livingstone, 2012.

By Robin Elise Weiss, PhD, MPH
Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.