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Preterm Labor

Preterm Labor

labor breathing

What is preterm labor?

  • Full term of a pregnancy is 40 weeks.
  • Labor usually begins between 37 and 42 weeks.
  • Going into labor before 37 weeks is considered preterm (accounting for about 1 in 10 babies born in the United States).

How does labor start?

The process of labor begins when you start to feel regular contractions of the uterus. This causes the walls of the cervix to thin and begins to open up (dilate) in order for the baby to enter the birth canal. The biggest trigger that beings labor is a surge of hormones released by the fetus.

What can happen if my baby is born too early?

Because the fetus has not finished fully growing and developing, preterm labor can cause serious problems or death for the infant. Most newborn deaths are due to preterm labor. For proper development, the longer the fetus remains inside the uterus, the better.

  • Premature babies tend to grow slower than full term babies, and may have problems with their eyes, ears, breathing, and nervous system.
  • Learning disabilities and behavioral problems are also more common to arise with premature babies.

What factors increase the risk of preterm labor?

Many factors increase the risk of preterm labor including:

  • Preterm labor in a previous pregnancy
  • Smoking or drug use
  • Multiple pregnancy (twins, triplets)
  • Abnormal cervix or uterus
  • Short cervical length
  • Problems with the placenta
  • Abdominal surgery during pregnancy
  • Excess amniotic fluid
  • Infection during pregnancy
  • Being underweight
  • Bleeding during the second or third trimester
  • Receiving little or no prenatal care
  • Already having a child with chromosomal disorders
  • Having an increased amount of the protein, fetal fibronectin, in vaginal discharge
  • Having a mother or grandmother who took DES while pregnant (a medication given to pregnancy women in the 1950’s-60’s).

What are the signs and symptoms of preterm labor?

What are the signs and symptoms of preterm labor?

  • Changes in type of vaginal discharge
  • Pelvic or low abdominal pressure or cramps
  • Dull ache in the lower back
  • Regular or frequent contractions
  • Rupturing membranes (water break).

How can preterm labor be diagnosed?

  • Preterm labor will be diagnosed if you begin having regular contractions and your cervix begins to change or dilate.

To help diagnose preterm labor, these tests can be done:

  • Ultrasonography
  • Fetal fibronectin
  • Fetal monitoring
  • You may also receive a pelvic exam to check for changes.

If I am at risk of preterm labor, what can I do?

  • It is important to receive early prenatal care.
  • Your healthcare provider may require frequent exams and tests.
  • If you’ve had a previous preterm delivery, you may be given dosages of the hormone progesterone.
  • Smoking and drug use increase the risk of preterm births, so stop immediately if you do either. 
  • Avoid heavy lifting or extra tiring tasks.
  • If you are attending childbirth preparation classes, let your teacher know you are at risk for preterm delivery.
  • Limit your travel.
  • You may be advised to limit sexual activity.

How do I monitor myself for contractions?

You can begin to monitor yourself for contractions after about 20 weeks.

To do so:

  • Lie on your side and feel your entire lower abdominal region with your fingers.
  • Feel for firmness or tightening over your uterus (these are usually not painful).
  • If you begin to feel contractions, continue to monitor for the next hour.
  • Be sure to keep track of how many contractions occur within the hour and how long each one is.

It is normal to experience some uterine activity before 37 weeks.

You may be in preterm labor if you have 4 contractions within 20 minutes (8 contractions in 1 hour). Call your healthcare provider if this is the case.

Will my health care provider try to stop labor?

If you and your baby are not in any danger of complications, and it has been detected early enough, your doctor may try to stop labor.

What medications are used to slow or stop preterm labor?

  • Tocolytics are medications that stop contractions.
  • Tocolytics may have side effects, but each woman responds to it differently.
  • You may talk to your doctor about the possible side effects that come with taking tocolytics.
  • If it appears you are going to have a preterm labor, your doctor may give you a medication called corticosteroid, which helps the baby’s lungs develop.

In what cases might my baby be delivered preterm?

The baby will be delivered premature if it is too far along to stop.

It may be safer to be delivered early for these reasons:

  • High blood pressure
  • Infection
  • Bleedings
  • Any signs that the fetus is having issues.

What are the special needs of preterm babies?

  • Premature babies often need special care to continue their development and to eat, breath, and stay warn.
  • They may be kept in a neonatal intensive care unit (NICU) for a couple of weeks or months. If this is needed, you could potentially have to be moved to a different hospital that is able to provide this type of care.
  • The extent of special care each baby needs depends on how early they were delivered.
  • Preterm babies have the potential to have long-term physical and mental disabilities (most likely in infants born before 32 weeks).
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