Preterm labor: Prevention is key

No one knows exactly what causes preterm labor. Learn who's at risk of preterm labor — and what you can do about it.

Most pregnancies last 38 to 42 weeks. Preterm labor refers to contractions that begin to open the cervix before week 37.

No one knows exactly what causes preterm labor. It's a scary possibility, but that's not the end of the story. Taking good care of yourself can go a long way toward preventing preterm labor — and delivering a healthy baby.

Why is preterm labor a concern?

If preterm labor can't be stopped, your baby will be born too early. Survival is possible for babies born as early as 24 to 27 weeks, but these preemies may face a lifetime of health problems. Even preemies born later may face serious complications — including low birth weight, breathing and digestive difficulties, underdeveloped organs, learning disabilities and developmental problems.

Who's at risk of preterm labor?

The most common risk factor for preterm labor is a previous preterm labor or preterm birth. Other risk factors may include:

Smoking cigarettes or using illicit drugs
Some infections, particularly of the amniotic fluid and lower genital tract
Some chronic conditions, such as high blood pressure and diabetes
Being underweight before pregnancy
Pregnancy with twins, triplets or other multiples
Problems with the uterus, cervix or placenta
Stressful life events, such as the death of a loved one or domestic violence
Multiple miscarriages or abortions

But preterm labor can happen to anyone. In fact, only half the women who have preterm labor have a known risk factor.

Can preterm labor be prevented?

There are no guarantees — but there's much you can do to nurture a healthy, full-term pregnancy.

Seek regular prenatal care. Prenatal visits can help your health care provider monitor your health and your baby's health. Mention any signs or symptoms that concern you, even if they seem silly or unimportant.
Eat healthy foods. During pregnancy, you'll need more folic acid, calcium, iron, protein and other essential nutrients. A daily prenatal vitamin that contains at least 1 milligram of folic acid — ideally starting a few months before conception — can help fill any gaps.
Manage chronic conditions. Diseases such as diabetes and high blood pressure increase the risk of preterm labor. Work with your health care provider to keep any chronic conditions under control.
Follow your doctor's guidelines for activity. If you develop signs or symptoms of preterm labor, your health care provider may suggest working fewer hours or spending less time on your feet. Sometimes it makes sense to scale back other physical activities, too.
Avoid risky substances. If you smoke, quit. Smoking may trigger preterm labor. Alcohol and recreational drugs are off-limits, too. Even prescription and over-the-counter medications deserve caution. Get your health care provider's OK before taking any medications or supplements.
Ask your health care provider about sex. It's not a concern for women who have healthy pregnancies. But sex may be off-limits if you have certain complications, such as vaginal bleeding or problems with your cervix or placenta.
Limit stress. Set reasonable limits — and stick to them. Set aside some quiet time every day. Ask for help when you need it.
Take care of your teeth. Brush and floss daily, and visit your dentist for regular cleanings and dental care. Gum disease may be associated with preterm birth.

If you have a history of preterm birth or significant risk factors for preterm birth, your health care provider may suggest weekly shots of the hormone progesterone to help prevent preterm labor.

What are the signs and symptoms of preterm labor?

For some women, the clues of preterm labor are unmistakable. For others, the signs and symptoms are more subtle. Be on the lookout for:

Contractions that occur more than six times each hour (You'll feel a tightening sensation in your abdomen, often reminiscent of menstrual cramps.)
Low, dull backache
A sensation of pelvic pressure
Diarrhea
Vaginal spotting or bleeding
Watery vaginal discharge

If you're concerned about what you're feeling — especially if you have vaginal bleeding accompanied by abdominal cramps or pain — contact your health care provider. Don't worry about mistaking false labor for the real thing. Everyone will be pleased to find out it was a false alarm!

Can preterm labor be stopped?

In some cases, drinking lots of fluids and lying down — usually on your left side to improve circulation to your uterus — can halt contractions. Sometimes bed rest is recommended, although bed rest isn't a proven remedy for preventing pregnancy complications or preterm birth.

If you're admitted to the hospital, you may be given fluids through an intravenous (IV) tube. Your health care provider may use a uterine monitor to measure your contractions and an ultrasound to evaluate your cervix. You may be given medication to stop the contractions.

What if the contractions continue?

Many women treated for one episode of preterm labor deliver at or near term. Often, however, advanced preterm labor can't be stopped — or an infection or other complications make an early delivery safer for mother or baby.

If you're between weeks 23 and 34, your health care provider may recommend two treatments. To temporarily stop labor, you may be given a medication such as magnesium sulfate — either intravenously or by injection. To speed your baby's lung maturity, you'll get an injection of potent steroids. After week 34, steroids may not be needed because fetal lung development is more advanced.

What can I expect during labor?

Aside from starting too early, preterm labor typically resembles normal labor. If relaxation and breathing techniques aren't enough to control the pain, ask for relief. Your health care provider may recommend narcotic analgesics, an epidural block or other options.

A team of pediatric experts will likely be on hand for the delivery to evaluate your baby and meet any special needs.

What about recovery and future pregnancies?

Preterm labor won't affect your physical recovery from childbirth. However, the common stresses after delivery may be magnified by your baby's condition. Preemies often need intensive medical care after birth — sometimes requiring lengthy hospital stays. This time will be busy and stressful. Surround yourself with supportive loved ones and friends. Accept their help in caring for your baby or older children.

After one preterm birth, you're at risk of a subsequent preterm birth. To boost the odds, work with your health care provider to manage any risk factors and respond to early warning signs.