One of the most common concerns of pregnant women is premature labor, which occurs in approximately 12% of pregnancy. Understanding the symptoms and risks of premature labor can help to ease the anxiety of a premature birth and lower the chances that premature labor will occur.
Premature Labor Defined
A full term pregnancy lasts 40 weeks, so labor that begins before the 37th week is considered premature. If the labor cannot be halted, then the baby will be born premature, which can put them at risk for health problems after they are born, or later in life. Luckily there have been many advances in technology and medicine which make the health risk to premature babies much lower than it used to be.
Risk Factors For Premature Labor
What specifically causes premature labor is unknown, however researchers have found that certain factors will result in a higher risk of premature labor. If you have any of these risk factors, it does not necessarily mean that you will go into premature labor, but it does mean that you should learn what premature labor feels like so you can identify it early on.
Risk factors include:
- Twins or multiples
- History of premature birth in previous pregnancy
- Specific uterine or cervical abnormalities
- Frequent bladder or kidney infections
- Other infections including urinary tract infection and sexually transmitted infections
- Infection with a high fever during pregnancy
- Vaginal bleeding after 20 weeks gestation
- Certain chronic illnesses like high blood pressure, kidney disease or diabetes
- More than one first trimester abortions or one or more abortions during the second trimester
- Underweight or overweight prior to pregnancy
- Clotting disorder
- In vitro fertilization resulting in one fetus
- Start of pregnancy is relatively close to the last birth (6-9 months)
Other risks include:
- Lack of prenatal care
- Smoking, drinking alcohol or using recreational drugs
- Domestic violence
- Little social support
- High stress levels
- Low income
- Standing on feet for long periods of time
Symptoms Of Premature Labor
If you can identify the signs or premature labor and contact your health care provider you will have a better chance of controlling the labor and perhaps stopping it for the time being. Symptoms can include:
- Contractions that are 10 minutes apart, or 5 or more contractions per hour
- Water leaking from vagina (indicating your membranes have ruptured)
- Cramping in lower abdomen
- Low backache, can be constant or come and go
- Pressure on the pelvis as baby pushes down
- Change or increase in vaginal discharge
Preterm Labor – How It Feels
When the muscles in your uterus contract your abdomen will harden, then soften as the contraction passes. This is unlike Braxton-Hicks contractions, where only portions of your uterus will tighten. If the tightening of your muscles become regular over the course of an hour then they may be enough to cause the cervix to open, and you should contact your health practitioner immediately.
Feeling For Contractions
In order to detect whether you are having contractions, lay comfortably on a bed or couch and then gently feel your uterus to detect whether it tightens or softens. If you are having actual contractions your abdomen will become hard all over, not just in one place.
What To Do
If you think that you are having premature labor you should at least call your health practitioner to talk it over with them. At the very least they can save to a trip to the hospital by determining whether you are in labor or not. In the meantime you can help yourself by doing the following:
- Empty your bladder
- Lie down or your left side, and avoid lying on your back
- Avoid becoming dehydrated as this can cause contractions or make them worse
- Keep track of contractions for one hour, calculating the time that pass from the beginning of one contraction to the next
If the contractions become closer together or more intense, or are still occurring regularly after one hour then you should call your health care provider and tell them that you suspect premature labor. The only test for premature labor is to measure the cervix to see if it is starting to efface or dilate.
Treatment For Premature Labor
The following are possible treatments for women in premature labor:
- Magnesium Sulphate can be administered by IV for 12-24 hours to help slow or stop the contractions. It can cause nausea.
- Corticosteriod medication is given 24 hours prior to birth, if labor cannot be stopped in order to speed up the development of the baby’s lungs and brain.
- Oral medication can be used to decrease contractions, and help the mother feel better.
Impact Of Premature Labor On Pregnancy
The risks of premature labor depend on whether the labor can be halted, and how mature the fetus is. Premature babies have a higher risk for neurological problems, as well as difficulties with breathing and digestion. What complications occur depend on how early the baby is born, and can also involve developmental delays.
Babies born after 32 weeks gestation have a very good chance of survival with little in the way of long term complications, while those born before 24 weeks have a 50% chance of pulling through with little or no effect, while the other half may die or have long-term problems. Babies who have access to a neonatal intensive care unit (NICU) have a much better chance of survival.
