Preterm Labor & Premature Birth

Preterm and premature mean the same thing—early. Preterm labor is labor that begins early, before 37 weeks of pregnancy. Labor is the process your body goes through to give birth to your baby. Preterm labor can lead to premature birth. Premature birth is when your baby is born early, before 37 weeks of pregnancy. Your baby needs about 40 weeks in the womb to grow and develop before birth. About 1 in 10 babies is born prematurely each year in the United States.

The earlier in pregnancy a baby is born, the more likely he or she is to have health problems. Some premature babies have to spend time in a hospital’s neonatal intensive care unit (also called NICU). This is the part of a hospital that takes care of sick newborns. But thanks to advances in medical care, even babies born very prematurely are more likely to survive today than ever before. Premature babies may need to stay in the hospital longer than babies born later. They also may have long-term health problems that can affect their whole lives.

There are major risk factors that can increase the risk for premature delivery. They are having a history of premature delivery in the past, being pregnant with multiples, and having problems with the uterus or cervix during pregnancy or in the past. Some of the lesser risk factors can include being underweight or overweight before pregnancy, getting pregnant again too soon after having a baby, getting late or no prenatal care, not gaining enough weight during pregnancy, bleeding from the vagina in the second or third trimester, having certain health conditions or infections such as high blood pressure, preeclampsia, diabetes or thrombophilias, being pregnant after in vitro fertilization, and being pregnant with a baby who has certain birth defects.

In addition, there are some risk factors that occur in our everyday life that can cause preterm labor and premature birth. Smoking, drinking alcohol, using street drugs or abusing prescription drugs, having a lot of stress in your life, low income, being unemployed or having little support from family and friends, being single, domestic violence whether it is physical, sexual or emotional abuse, working long hours or having to stand a lot, and being exposed to harmful chemicals. Most of these risk factors can be managed or changed in order to reduce the risk of preterm labor.

Others, such as age and race, can increase our chances of having preterm labor and premature birth. Being younger than 17 or older than 35 makes you more likely than other women to give birth early. In the United States, black women are more likely to give birth early. Almost 17 percent of black babies are born prematurely each year. Just more than 10 percent of Native American and Hispanic babies are born early, and fewer than 10 percent of white and Asian babies. We don’t know why race plays a role in premature birth. Researchers are working to learn more about it.

You can reduce your risk for preterm labor and premature birth by not smoking, drinking alcohol, using street drugs, or abusing prescription drugs. Make sure to go to your first prenatal care checkup as soon as you think you are pregnant. Going to all of your prenatal visits even if you are feeling fine is important. It helps your provider make sure that you and your baby are healthy. Get treated for chronic health conditions, like high blood pressure, diabetes, depression, and thyroid problems. Protect yourself from infections by washing hands with soap and water after using the bathroom or blowing your nose, avoid eating raw meat, raw fish or raw eggs, have safe sex, and don’t change the cat litter box. Get to a healthy weight before pregnancy and gain the right amount of weight during pregnancy. Reduce your stress. Eat healthy foods and do something active every day. And finally, wait at least 18 months between giving birth and getting pregnant again.

What are the signs and symptoms of preterm labor? Change in your vaginal discharge (watery, mucus, or bloody) or more vaginal discharge than usual, pressure in your pelvis or lower belly, like your baby is pushing down, constant low, dull backache, belly cramps with or without diarrhea, regular or frequent contractions that make your belly tighten like a fist, or your water breaks. If you experience any of these symptoms before 37 weeks of pregnant, you should contact your health care provider.

There are treatments that can help stop preterm labor. Progesterone injections weekly from 16 to 36 weeks and sometimes vaginal suppositories can stop/reduce preterm labor. Chemicals called tocolytics may also help slow or stop preterm labor. They are given in a hospital setting. When you see your provider, he or she may do a pelvic exam or an ultrasound to see if your cervix has started to thin out and open for labor. If you’re having contractions, your provider monitors them to see how strong and far apart they are. You may get other tests to help your provider find out if you really are in labor.

The best treatment for preterm labor and premature delivery is preventing it. Make sure you contact your provider if you have any changes during your pregnancy. Early diagnosis and early intervention could have positive effects on stopping or slowing preterm labor and premature delivery.

Melissa Waddell, WHNP, is a nurse practitioner at Atlantic Ob/Gyn located in Va. Beach and Chesapeake. Visit www.atlanticobgyn.com.

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