Preterm Labor

Labor that begins anytime before the 37th week of pregnancy is preterm labor (or “premature labor”). Ideally, pregnancies (under normal circumstances), last for approximately 40 weeks from the first day of the last menstrual period, give or take 2 weeks. Most babies are considered “full-term” if they are born after the 37th week of pregnancy. If you have contractions sufficient enough in strength and frequency to start to efface (thin out) and dilate (open up) your cervix or if your water breaks (preterm premature rupture of the membranes or “PPROM”) between 20-37 weeks along, you’d be considered in preterm labor.

It is estimated that as many as 10-12% of pregnant women in the U.S. will suffer from preterm labor, not including twin or triplet pregnancies. Approximately 60% of twins and about 90% of triplets are born preterm. Overall, the rate of preterm births are rising, mainly due to the large numbers of multiple births in recent years. Twins and other multiples are six times more likely to be preterm than single birth babies. The rate of premature single births is slightly increasing each year. Between 1992 and 2002, the rate of babies born before 37 weeks increased almost 13%. In 2002, there were over 480,000 preterm births (about 1 in 9 live births). The preterm birth rate was highest for black babies (over 17%), followed by Native American babies (almost 13%), Hispanic babies (over 11%), Caucasian babies (over 10%) and lowest for Asian babies (over 9%).

Early detection of preterm labor is very important, so steps can be taken to stop labor from progressing and to prevent preterm delivery. Being informed and aware of early warnings signs can make all the difference. The early signs of labor can be subtle and hard to detect; some women experience preterm labor without noticing any uterine contractions at all. Don”t hesitate to call your doctor or midwife immediately if you think you are experiencing any symptoms of labor and you are less than 37 weeks along. Always call if you have any reason to suspect you might have preterm labor or you are confused or concerned about what you are feeling. Some symptoms can be especially confusing, because they may occur normally as typical pregnancy discomforts (including pelvic pressure and lower backache).

Symptoms of preterm labor that you want to watch for include: uterine contractions that are fairly regular (whether they are painless or not) that occur 4 times or more within an hour and abdominal menstrual-like cramping (constant or occasional), with or without diarrhea. It may be difficult to tell the difference between Braxton-Hicks (or “practice”) contractions and the real thing. Monitor your contractions, by timing them (from beginning of one to the beginning of the next) and writing down your results. More than 4 in an hour, especially accompanied by other symptoms definitely warrants a call to your doctor or midwife, to be on the safe side. Other common preterm labor symptoms include: persistent, lower back pain (especially if you don’t typically have back pain), sudden increase in vaginal discharge (particularly gushes or a trickle of watery, mucus-like or blood-tinged fluid), any vaginal bleeding or spotting (some spotting is common after pelvic exams), persistent and/or increased pelvic pressure (painless or not) and frequent diarrhea.

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