Preterm Labor

Preterm labor, also known as premature labor, is a condition in which your body begins to prepare for birth too early in the pregnancy. Labor is considered to be premature if it begins more than three weeks before the due date. Preterm labor leads to an early birth, but doctors can do a great deal to delay early delivery. The longer a baby can grow inside the mother, the less likely it is that they will suffer problems after birth, so it is important to determine what can be done if you are experiencing preterm labor.

Risks of Preterm Labor

There are a variety of conditions that increase your chances of experiencing preterm labor. Some include:

  • Smoking
  • Failing to get adequate prenatal care
  • Being very underweight or overweight during pregnancy
  • Having health conditions including preeclampsia, high blood pressure, diabetes, infections or blood clotting disorders
  • Being pregnant from in vitro fertilization
  • Being pregnant with a baby with certain defects
  • Getting pregnant too soon after a previous pregnancy
  • A personal or family history of preterm labor

What to Do If I Am at High Risk for Preterm Labor

If you are at risk for preterm labor, strive to get plenty of rest and eat a proper diet. Start prenatal care as soon as possible and work to eliminate any unhealthy habits like smoking that could be increasing your risk. Work to manage your stress level as well. Your doctor may recommend you see a high-risk specialist to ensure that you are getting the care you need.

If you have experienced preterm rupture of the membranes or spontaneous preterm labor that caused a baby to be born before 34 weeks of pregnancy and are carrying a single baby, ask about whether Makena, a progesterone compound, could be helpful for your condition. Studies suggest that weekly injections of Makena that begin around 16-20 weeks of pregnancy and move through 36 weeks can help to lower the risk of preterm delivery for those that have experienced this condition in the past.

As you progress through your pregnancy you will need to note the changes your body is experiencing. Take some time by yourself each day to learn about your child’s movements and watch for any unusual sensations or pressure. Be familiar with the signs of preterm labor and let your doctor know if you experience any of them right away. Some doctors suggest bed rest for those at risk of preterm labor, but some studies have suggested that this could be detrimental in some cases.

One of the most important developments in the treatment of preterm labor is the development of corticosteroids that will speed the development of the baby’s lungs before birth. The sooner you realize you are in preterm labor, the more likely it is that this treatment will help you and your child.

Signs of Preterm Labor

It is important to know the warning signs of preterm labor so you can stop it. Acting quickly in the event of preterm labor can make a vast difference in the outcome. Call your doctor or midwife immediately if you notice:

  • Contractions every 10 minutes or sooner
  • Backaches, often in the lower back. This ache may come and go but will not improve with comfort-seeking measures or changing positions.
  • Fluid leaking from the vagina
  • Cramping similar to menstrual cramps in the abdomen. These may also feel like gas pains that come alongside diarrhea.
  • Increased pressure in the vagina or pelvis
  • Increased vaginal discharge
  • Vaginal bleeding, even if it is light
  • Flu-like symptoms including diarrhea, nausea or vomiting. You should call your doctor even if these symptoms are mild, especially if you cannot tolerate or hold liquids for more than 8 hours.

It may be difficult to tell some of these symptoms apart from the normal symptoms of pregnancy, but it is important to be extra cautious if you are at risk. If you are worried, get checked for any symptoms you are experiencing.

An important way to check for early labor is to check for contractions. To do this, place your fingertips on the abdomen. A contraction feels light a tightening and softening of the uterus. Time the contractions by writing down when it starts followed by the start time of the next contraction. Try to stop the contractions by relaxing, drinking a few glasses of water or getting off your feet. If you continue to have contractions every 10 minutes or sooner, call your doctor or midwife. This is especially important if you have pain that will not fade or other symptoms.

Many women have false labor pains, known as Braxton Hicks. These contractions are harmless and usually erratic. They should not get closer together and will stop if you rest or move around. Braxton Hicks contractions are not a part of labor. If you are concerned about the type of contractions you are feeling, consult with your doctor.

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What Will Happen if I Start to have Preterm Labor?

If you start to have signs of preterm labor or you are leaking amniotic fluid you should call your medical practitioner right away. They will likely have you go to the hospital so your condition can be examined. Your contractions and baby’s heart rate will be monitored and your doctor will check to see if your membranes have ruptured. You will also be checked for any signs of infection.

If your water has not broken your doctor may perform an exam to determine the state of your cervix or an abnormal ultrasound to check the amount of amniotic fluid and the gestational age, position and growth of your baby. If these tests come back negative, your cervix does not dilate and your contractions subside you will be sent home if you and your baby appear to be healthy. Each practitioner will handle this situation differently.

If you are less than 34 weeks along, show no signs of infection, your membranes are intact and your baby’s heart rate is steady your doctor will likely attempt to delay the delivery. This process will start with an IV of antibiotics to the baby in case you are a carrier of group B streptococcal infection. You may also be given medication to stop your contractions and corticosteroids to speed the development of your child’s lungs.

If the water breaks before 37 weeks of pregnancy, but you are not having contractions your doctor will determine if you should wait until your child matures further or if labor needs to be induced. This will vary based on any signs of infection and the development level of the child. If you are at 34 weeks or farther in your pregnancy your doctor may perform a cesarean section.

If you are 32-34 weeks pregnant and your child’s lungs are not mature you may need to wait to deliver unless there is a compelling reason to proceed. This will give your child more time to develop, but it may increase your child’s risk of infection. You may be given medication in order to quicken lung development and hold off delivery. You will need to be carefully monitored during this waiting period to watch for signs of infection. If this appears or your baby is failing to thrive, your doctor will likely deliver your baby via C-section. If you are not yet at 24 weeks of pregnancy, corticosteroids or GBS prevention is not recommended. Your doctor will let you know about your baby’s prognosis and your options.

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