Experiencing labor pains but not yet full term? 7 warning signs of pre-term labor

Are you already feeling contractions but you're not near your due date yet? Learn about the possible causes of preterm labor here.

All pregnancies have a due date. It is reassuring for the mother-to-be to know when she will give birth and finally get to meet her new son or daughter. But things do not always go as planned.

Sometimes, pregnancies have a surprise or two (or more) for the expectant mum, like when labor begins early and the baby seems to want to come out way before the ideal 40-week period. This is called premature or preterm labor.

What is preterm labor?

"Preterm labor is having labor pains or uterine contractions that lead to the opening up of the cervix between 20 weeks and less than 37 completed weeks of pregnancy," said Dr. Katleen del Prado, an obstetrician-gynecologist based in Lucena City.

According to Mayo Clinic, Early labor could result in delivery and having a premature baby. And the earlier it happens, the greater the health risks are for your baby. A lot of premature babies usually need special care in neonatal intensive care units. Some of them also develop long-term mental and physical activities.

Preterm labor is something that moms-to-be should be careful with. For this reason, we've come up with a list of things that pregnant women should know about preterm labor.

11 noteworthy facts about preterm labor

1. Preterm labor is not life-threatening to the mother.

The premature birth that usually results from it, however, is the leading cause of death for neonates or newborns all around the world, shared Dr. del Prado.

According to the World Health Organization (WHO), an estimated 15 million babies are born too early every year, and about one million die annually due to complications of preterm birth. WHO also reported that globally, prematurity is the leading cause of death in children under the age of five.

2. Being pregnant with twins, triplets, or more increases the risk of preterm labor.

This is because carrying more than one baby can overstretch the uterus.

Other risk factors are:

• having medical conditions like high blood pressure, preeclampsia, diabetes, anemia, and blood clotting disorders
• having a premature baby in the past
• being pregnant after in vitro fertilization (IVF)
• having a baby with birth defects
• having problems with your uterus, cervix or placenta
• getting pregnant too soon (less than six months) after giving birth
• lack of or no prenatal care
• being overweight or underweight before pregnancy
• smoking, drinking alcohol or taking illegal drugs while pregnant
• chronic stress

According to the American Pregnancy Association, premature labor occurs in about 12% of all pregnancies. But mothers-to-be are at the greatest risk for it if they have these three simultaneously:

• multiple babies (carrying triplets or more)
• a previous premature birth
• certain uterine or cervical abnormalities

3. Pregnant women with no known risk factors can experience preterm labor.

Conversely, having one or several risk factors does not automatically mean you will go into early labor. However, there are other things that might contribute to a pregnant woman going into preterm labor.

4. Pre-term labor causes to watch out for

According to Dr. del Prado,

“The most common causes are urinary tract infection (UTI) and cervico-vaginal infections, but infections elsewhere, like in the lungs for pneumonia or in the mouth for periodontal disease, can trigger preterm labor as well.”

Other possible preterm labor causes are:

• Uterine stretch or conditions that stretch the uterus, like when there is too much fluid or the baby is too big. Uncontrolled diabetes mellitus for instance, can increase the amniotic fluid.
• Cervical incompetence or the opening up of the cervix even if without uterine contractions. “This is actually not under the classification of preterm labor but is a very significant cause of preterm delivery,” explained Dr. del Prado.
• Spontaneous preterm birth, which causes about two-thirds of all premature births, is when labor happens on its own and/or the pregnant woman’s water breaks early.

“There are many causes of preterm labor,” said Dr. del Prado. “We must understand how labour works. Labour happens because of uterine contractions and opening up of the cervix. The basic mechanism is that of inflammation, muscle stretch, and opening of the cervix either spontaneously or secondary to the contractions,” she added.

Meanwhile, Dr. Patricia Kho, an OB-Gynecologist from Makati Medical Center, believes that stress can be one of the factors and possible causes of preterm labor.

"If the woman is stressed and doesnt take care of herself, it can take its toll on her baby. If she is not eating well or having a balanced diet, or if she is too stressed that she smokes, drinks alcohol or takes drugs, it can affect her unborn child. These things might cause a miscarriage, a very small baby or preterm labor and delivery," she said in Filipino.

5. SEVEN warning signs and symptoms of preterm labor

It's important for a pregnant woman to know when she is going into preterm labor so she can get immediate medical attention. Call your doctor right away if you have not reached 37 weeks of pregnancy and experience any of these symptoms:

1. regular or frequent contractions (five or more in an hour) that feel like menstrual cramps or could be painless
2. a dull, low backache that is constant or may come and go
3. watery fluid leaking from your vagina (a gush or a trickle) to show that your bag of water or amniotic sac has broken
4. pelvic or lower abdominal pressure
5. vaginal spotting or bleeding
6. increase or change in vaginal discharge (it may be watery, bloody or include mucus)
7. nausea, diarrhea or intestinal upset

According to Dr. del Prado, the woman going into preterm labor can feel labor pains, like any other laboring woman in full-term. She explains in detail what it may also feel like:

“The contractions usually happen hourly, then the interval in between shortens, until it becomes every two to three minutes. The pain is like the pain we feel during menses in the lower belly and radiates to the lower back. There is watery or a bloody-mucoid type of vaginal discharge. There are contractions of the uterus and opening up of the cervix upon digital internal examination by the doctor.”

6. Doctors can stop or slow down early labor.

Medications can be given, for example, to stop contractions and to delay delivery or keep the baby in the womb as long as possible.

“Choice of medications is highly individualized because these are not without side effects, and hence, cannot be overly prolonged. Response to these medications depends also on the patient, who may or may not be admitted depending on the case,” said Dr. del Prado.

7. Sometimes, preterm labor stops on its own.

This happens in three out of 10 pregnant women, said the American College of Obstetrics and Gynecology (ACOG). The Centers for Disease Control and Prevention (CDC) likewise reported that up to 50% of women who experience preterm labor go on to have their babies at 37 weeks or later.

8. Preterm labor can be scheduled.

Yes, this type of labor is not always surprising or unexpected. According to the National Health Service (NHS), certain cases call for planned and induced premature labor because it is safer for the baby to be born at an earlier time. An example is when the expectant mother has a high blood pressure disorder like preeclampsia.

9. A pelvic exam is done by the doctor to confirm preterm labor.

Your doctor will check your cervix for changes and monitor your contractions. Examples of these changes are effacement (the cervix thins out) and dilation (the cervix opens so that the fetus can enter the birth canal).

Your doctor may need to examine you repeatedly as your labor progresses in the next few hours. He/she could do other tests too, like a transvaginal ultrasound, to check the length of the cervix, and to determine if specialized care or hospitalization is needed.

10. Management of preterm labor is highly individualized.

Women have different histories, risk factors, and pregnancy experiences. Not all who go into early labor, for example, will need a cervical cerclage or a cervical stitch. This is a treatment for cervical weakness (when the cervix starts to shorten and open too early during pregnancy) and could help prevent a late miscarriage or premature birth.

You might receive one or more treatments and medications from your doctor to stop or delay early labor, hasten your baby's development, or help you feel better. It is important to have professional medical care throughout your pregnancy.

"Those with previous preterm birth/s must be managed by obstetricians and deliver their babies in the hospital," stressed Dr. del Prado.

11. You can reduce the risk of preterm labor by dealing with treatable risk factors.

Start by getting very early prenatal care with a perinatologist or a high-risk pregnancy expert, even if you have yet to conceive, Dr. del Prado recommended. This way, you can plan your pregnancy well, control chronic conditions effectively, and make the necessary lifestyle changes to improve your health.

For those already pregnant, consult with an obstetrician regularly, and at the earliest stage of pregnancy as possible.

Here are other steps you can take to reduce the risk of preterm labor and have a healthier pregnancy:

• Eat a well-balanced diet and take vitamins/supplements if needed.
• Strive to reach your ideal weight before getting pregnant, especially if you need to lose or gain several pounds.
• Avoid all products and substances that could harm you and your baby like tobacco, illegal drugs, and alcohol.
• Work with your doctor to manage medical conditions such as high blood pressure and diabetes.
• Seek treatment for all infections. Ideally, this should be done before pregnancy.
• Get enough rest and sleep.
• Minimize stressful situations, strenuous activities, and long periods of standing.
• Discuss pregnancy spacing and birth control options with your doctor.
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Republished with permission from theAsianparent Singapore

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