Does your doctor suggest preterm delivery, leaving you confused? This is one situation you may have to face while nearing the end of nine months of pregnancy.
Do not worry as premature labor happens in 12 out of 100 pregnancies. But, it is good to understand the symptoms and avoid certain risk factors, to ensure that you are not among those 12.
What Is Preterm Labor?
Preterm or premature labor occurs when contractions begin to open the cervix before you reach 37 weeks of pregnancy. A complete full-term pregnancy lasts for 40 weeks. If you cannot stop preterm labor, your baby is born early.
Preterm labor is the primary cause of neonatal death, and it can cause health problems like chronic lung disease, developmental delays, and cerebral palsy. These health issues can be the reasons for financial and emotional toll on your family.
The rate of premature births has been increasing tremendously. According to the US National Center for Health Statistics, there is one preterm labor in every eight births. Experts state that it can be because of the increased use of fertility treatments and giving birth at an older age.
Modern treatment methods have made significant progress in treating preterm babies, but there are also advances being made in preventing preterm labor.
Risk Factors For Preterm Labor:
Specific causes of preterm labor are not clearly known, but according to experts, several factors play a role in causing contractions in the cervix even before the baby is ready for delivery.
There is no single risk factor that can be identified as the reason for premature labor. You can also experience premature labor for no particular reason.
You can be at a higher risk of preterm labor if:
- You are pregnant with multiples – Multiples are likely to arrive earlier than single babies.
- You have had premature labor previously – If you have already had early labor, you may be at higher risk of another preterm labor.
- You have any cervical or uterine abnormalities – Large uterus or any structural abnormalities can make it difficult for you to hold the baby. The same is the case if the cervix is incompetent or short.
- You were also born preterm – A study says that women who are born prematurely are at a greater risk of having preterm labor.
- Age – Women who are below 17 and above 35 are at greater risk for preterm labor. This is one of the reasons health experts say older women have a high risk of preterm pregnancy.
- Short interval between pregnancies – Becoming pregnant anytime before 18 months of last delivery can increase the possibility of preterm labor. The more the gap, the lower the risk.
There are medical factors as well:
- Vaginal infections and STDs infections are a cause for nearly half of all preterm labors. The inflammation releases prostaglandins, the substance that causes labor when you reach preterm. Untreated urinary infections also have the same infection.
- Chronic illness such as kidney disease, high blood pressure, diabetes and placental problems.
- Infections related to fever higher than 101 degrees during pregnancy.
- Vaginal bleeding after 20 weeks of pregnancy.
- Multiple abortions in the first or second trimester.
- Overweight or underweight before you get pregnant.
- Thrombophilia (clotting disorder).
- Being pregnant after in-vitro fertilization.
- Anemia, i.e., red blood cell deficiency during early pregnancy.
- Any fetal birth defects.
- Pregnancy complications like preeclampsia.
- Excess amniotic fluid, a condition called polyhydramnios.
Lifestyle risk factors for preterm labor include:
- Smoking, boozing and illegal drugs – All these habits increase the risk of premature labor or a low birth weight baby. The toxins from smoking, drugs and alcohol prevent the supply of oxygen to your baby.
- Gum diseases – Hormones released during pregnancy are likely to increase the chances of periodontal disease, which, in turn, is linked to preterm labor. The bacteria which is responsible for gum infections gets into the bloodstream, enters the fetus and causes an early labor. The bacteria cal also trigger the immune system to cause inflammation in the uterus and cervix causing early contractions.
- High stress levels – Severe emotional stress that is related to traumatic experiences can cause hormonal release, triggering early contractions.
- Long hours of standing – Women who stand for long hours or who work under physically challenging conditions are at a higher risk.
- Domestic violence that includes sexual, emotional or physical abuse.
- Little or zero prenatal care.
- Low income.
- Lack of social support.
- Fetal Fibronectin – A glue-like substance present in between fetal sac and uterus lining, Fetal Fibronectin is also responsible for premature labor.
Signs And Symptoms Of Premature Labor:
You should see your health care provider immediately after you notice the following preterm labor symptoms:
- Back pain – Backache, especially in the lower part, that is constant and will not allow you to change positions.
- Cramping – Cramps like the ones you get during your menstrual period or in the lower abdomen.
- Contractions – Five or more contractions per hour.
- Flu symptoms – Nausea, diarrhea or vomiting even if they are mild.
- Fluid leakage – Vaginal bleeding, discharge, or leakage that could be a sign of water break.
- Increased pressure in the vagina or pelvis making you feel as if your baby is pushing down.
How Can You Check For Contractions?
- Place fingertips on your abdomen
- If you think that your uterus is softening or tightening, it is a contraction.
- Note down your contractions. Write the time between the starting of one contraction to the beginning of the next.
- Get off your feet, change position so as to stop contractions. Relax and drink two to three glasses of water.
- Go to your healthcare provider if you notice contractions every 10 minutes or quite often. If you have severe pain or symptoms get worse, check with a doctor immediately.
Most of the women have harmless false labor contractions known as Braxton Hicks contractions. They are not regular and will not open your cervix. But if they become more frequent or regular, like one in 10 – 12 minutes, they can be preterm contractions that will lead to the cervical opening. You should check with your healthcare provider when you experience these.
What Can You Do If You Experience Preterm Labor?
If you are showing all the above symptoms of preterm labor, you should check with your doctor. It is natural to be anxious, but by taking the below steps, you can prevent preterm birth.
- Empty your bladder
- Lie down towards your left side. It will reduce the signs and symptoms.
- Do not lie flat on the back as it can increase contractions.
- Drink as much water as you can since dehydration can lead to contractions.
- Look out for contractions for one hour and count the minutes.
If symptoms do not disappear even after an hour, you should check with your doctor. Make sure you tell your doctor about all the symptoms.
The only way to know if you are in preterm labor is by examining your cervix. If cervix opens up, preterm labor can be the cause.
Preparing For Doctor’s Appointment:
The following information will help you get ready for the appointment.
Pre-appointment restrictions – In most of the cases, you will be treated immediately. You should ask whether you have to restrict any activity when you are waiting for the appointment.
Ask your partner or friend to join you – It is understandable that you will be anxious about the possibility of premature delivery. Therefore, taking someone along with you can help in remembering all the instructions your doctor gives you.
Note down questions to ask your doctor – This way, you will not forget anything important that you have to ask and can get most of the information from your doctor.
What You Can Expect From Healthcare Provider:
You may come across the following questions by your healthcare provider:
- How many contractions did you notice in one hour?
- When did you notice the first symptoms?
- Do you have any infections or a fever?
- Are you experiencing any vaginal discharge or bleeding?
- Do you smoke?
- Any previous pregnancies, uterine or cervical surgeries, or miscarriages?
Diagnostic Tests For Preterm Labor:
Your healthcare provider will check your signs and symptoms. Preterm labor test for diagnosing the pattern include:
Pelvic Examination – Your doctor will check the tenderness and firmness of your uterus and your baby’s size and location. She might perform a pelvic exam to check if the cervix has opened if waters have broken and for placental previa (placenta does not cover cervix).
Ultrasound – She will perform an ultrasound to measure the length of the cervix and determine your baby’s age, weight, position and size. You will be monitored for some time and then have another one later.
Monitoring Uterus – A uterine monitor measures the spacing and duration of your labor contractions.
Laboratory tests – Your doctor may check for the presence of any infections or fibronectin by taking a swab of your vaginal discharge. This is not reliable enough to assess the risk of premature labor.
Amniocentesis – In this test, amniotic fluid will be taken to check for your baby’s lung maturity. It can also be used to detect infection in the amniotic fluid.
Your healthcare provider will then explain the risks associated and how you can prevent preterm labor. Sometimes, preterm labor will stop on its own.
Treatments For Preterm Labor:
Your healthcare provider’s aim is to hold the labor as long as possible.
It is a surgical treatment that can prevent preterm labor. It is usually recommended if you experience preterm labor signs before 24 weeks of pregnancy. In this method, your cervix is stitched with strong sutures. These sutures will be removed when your baby reaches full term, likely around 37 weeks. Sometimes, the stitches will be removed earlier as well.
The more fluids you take to prevent dehydration, the lower are the chances of contractions.
If any infection triggers labor, then you will receive a dosage of antibiotics. If you are not tested for Group B strep, you will also receive antibiotics to avoid any bacterial transmission to your fetus.
If you in 24th to 34th week of pregnancy, you will be given potent steroid injections to aid the lung maturity of your fetus. After the 34th week, your baby’s lungs will be mature enough for labor.
This medication will reduce the risk of cerebral palsy (damage to the brain) in babies who are born before 32 weeks of pregnancy.
Tocolytic stops contractions temporarily. They prolong preterm labor for a few days as they will not address any underlying cause. It is not recommended if you have pregnancy-induced hypertension.
With the above treatments, preterm labor stops for about 30% of pregnant women while 10% will go into preterm labor within the next one week.
Prevention Of Preterm Labor:
Though there are high end treatments to treat premature babies, there are medical interventions to prevent preterm labor. There are ways to hold the labor until your baby is completely ready.
1. 18 months gap between pregnancies:
The risk of preterm labor reduces if you wait for 18 months from the previous pregnancy. The period is between the last birth and the next conception.
2. Check with your doctor:
Getting regular and early prenatal care can help your healthcare provider treat any risk factors and makes sure you will have a healthy pregnancy.
3. Control certain lifestyle factors:
Avoid smoking, boozing and taking drugs as they can cause preterm labor.
4. Check your weight:
Gaining excess weight will increase the chances of preeclampsia and gestational diabetes, both of which can cause preterm labor. Too little weight is also risky. The correct weight will improve the likelihood of a full-term.
5. Prenatal vitamins:
Taking a prenatal supplement will enhance your overall health. Research states that folic acid supplements will reduce the risk of placental abruption that is responsible for early labor.
6. Eat well:
Having a healthy balanced diet will not only give you a healthy baby but also helps you deliver at the right time. Intake of foods rich in omega 3 fatty acids (walnuts, flax seeds, salmon, DHA eggs) is known to reduce the risk of preterm labor. Vitamin C foods (berries, citrus, bell peppers) and calcium-rich foods also help.
7. Eat at frequent intervals:
Pregnant women who eat at least five meals a day (five smaller, or three meals and two snacks) are at a lower risk of premature labor.
Drink as much water as you can to keep yourself hydrated.
9. Dental care:
Preventing gum diseases is one of the ways to avoid preterm labor. You need to check with your dentist, and brush and floss regularly.
10. Do not hold urine:
Holding your urine, can cause bladder inflammation, and irritates the uterus leading to contractions. It can also lead to urinary infections, which are also the causes of preterm contractions.
11. Get the flu shot:
It can reduce the risk of preterm labor. Flu is a serious problem that can affect your baby growth. It can cause preterm labor and birth defects in babies.
12. Rest and Relax:
Get rid of stress, depression and anxiety since psychological factors can affect your baby’s growth. If you remain anxious for a long period, your health gets affected and as a result, your baby may be born with low weight. Balance your life with exercise, diet, work and rest for physical and mental health.
13. Practice polar bear position:
Experts say that practicing polar bear pose for 15 minutes, four times a day will take off the pressure from the cervix. By doing so, the baby moves away from the cervix and goes closer to mom’s lungs. This way, the baby will be comfortable, and it prevents preterm labor. It also eases labor.
What Happens If Your Baby Is Born Early?
Premature babies are at a higher risk of brain and neurological disorders, and digestive and breathing problems as well. Some babies have learning difficulties and developmental delays.
- Babies born before 24 weeks of pregnancy have fewer chances of survival. Only 50% can survive, and another 50% will either have permanent problems or die.
- Babies born before 34 weeks of pregnancy require neonatal intensive care unit (NICU) for the first few days or weeks or months.
- Babies born in 34 to 37 weeks will do well and have no health issues. They just require a short stay in NICU before heading home.
Hope this article helps you in understanding preterm labor and addressing it properly. The earlier you respond to the warning signs, the more you can hold off your labor. Wish you a safe and healthy pregnancy!