You’re minding your own business when suddenly a vice-like grip seizes your stomach, causing you to immediately perk up. Could it be an early start to labor? Or just some practice contractions called Braxton Hicks? True labor contractions and practice contractions can be difficult to discern. Here are some signs of preterm labor, and what to do if you experience them.

Pregnant woman having contractions - How to Know You're in Pre-Term Labor

Shutterstock/Tomsickova Tatyana

What is preterm labor?

The signs and symptoms of preterm labor are the same as regular labor. The difference is timing. The American College of Obstetricians and Gynecologists says preterm labor is “defined as regular contractions of the uterus resulting in changes in the cervix that start before 37 weeks of pregnancy[1]“Preterm Labor and Birth,” American College of Obstetricians and Gynecologists, January 2019, https://www.acog.org/patient-resources/faqs/labor-delivery-and-postpartum-care/preterm-labor-and-birth.” Those changes could either be the thinning of the cervix or the dilation.

You will not know if you are having changes to your cervix, so it is important to pay attention to the signs of labor and report them to your provider.

Even still, knowing if you are in labor can be a little tricky. Every mom at some point in pregnancy has moments of, “Is this IT?” Even if you’ve labored before, no two pregnancies are identical, and your body can interpret labor differently. This means it can be difficult at times to know if you are in labor without being checked by a medical professional.

Signs and symptoms of preterm labor.

Here are some reasons that you can suspect you might be in preterm labor. And these warrant a call to your doctor, especially if you are not yet 37 weeks pregnant.

  • Mild cramping (that may cause diarrhea). This can feel like menstrual cramps or like gastrointestinal cramps.
  • Pressure on your pelvic floor or diffuse feeling of abdominal pressure.
  • Dull backache. A backache associated with labor will not ease or go away even when you change positions or take other measures to relieve the pain.
  • Change in discharge. It could be watery, have mucus, or blood in it.
  • Breaking of your water. This isn’t always dramatic. It can be a slow leak or a big gush.
  • Increase in discharge.
  • Regular or frequent contractions that may be painless. Frequent means every 10 minutes or more often[2]“Preterm Birth,” Centers for Disease Control and Prevention, October 21, 2019, https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pretermbirth.htm. Regular means they are timeable – there is a pattern to them, and you can generally anticipate when the next contraction will come based on that pattern.
  • Flu-like symptoms, such as nausea, vomiting, or diarrhea. Call your doctor even for mild symptoms. If you cannot keep water down for more than 8 hours, you need to be seen[3]“Premature Labor,” WebMD, https://www.webmd.com/baby/guide/premature-labor#1.

How to know if you are at risk of preterm labor.

The March of Dimes says the most common risk factors for preterm labor are[4]“Signs and Symptoms of Preterm Labor,” March of Dimes, August 2017, >https://www.marchofdimes.org/complications/signs-and-symptoms-of-preterm-labor.aspx:

  • A pregnancy history of premature birth.
  • A pregnancy with multiple babies.
  • Current problems with uterus or cervix or problems in the past.

Other common risk factors are smoking or substance abuse and not having prenatal care. Statistically in America, black women have 50% more risk of preterm birth than white women[5]“Preterm Birth,” Centers for Disease Control and Prevention, October 21, 2019, https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pretermbirth.htm. (We have strong feelings about the additional risks black women wrongfully face in pregnancy. We wish this were not true.) Age is important as well. Teens and women over 35 are at an increased risk of preterm labor. As are women with low income. Health issues, such as infections or preeclampsia, can also put you at higher risk.

Does preterm labor always mean preterm birth?

Only about 1 in 10 women who have preterm labor will give birth within the next 7 days[6]“Preterm Labor and Birth,” American College of Obstetricians and Gynecologists, January 2019, https://www.acog.org/patient-resources/faqs/labor-delivery-and-postpartum-care/preterm-labor-and-birth. However, you should always take threatened preterm labor seriously. The greatest risks of health complications for babies happen at 34 weeks and under. But even if a woman is between 34-37 weeks, her baby can still have complications.

The earlier a woman receives intervention for preterm labor, the higher the likelihood they can get the labor to stop or slow. And the more likely they can intervene for baby, such as giving corticosteroids to speed up growth. While not all preterm labor can be stopped, getting immediate care gives your baby the best chance of a good outcome.

What to do if you have signs or symptoms of preterm labor?

If you have any of the above signs of preterm labor, it is important you immediately contact your on-call doctor to let them know what you are experiencing and to find out what they recommend. If your doctor recommends you go to the hospital, go immediately unless your doctor says you have time to pack a bag. You can always send someone to your house to pack a bag for you and bring it to the hospital if you are admitted.

If you are having cramps or contractions, it can be helpful to tell the doctor how frequent they are and how long you’ve been having them. (If you’re not sure how to time contractions, this article is helpful. It also explains the difference between labor contractions and Braxton Hicks contractions.)

If you have a change in discharge or believe your water has broken, when you call your doctor, be sure to report if your discharge or water is clear or murky, or if it has mucus or blood in it.

If the signs of labor are progressing quickly, get immediate medical attention by going to Labor & Delivery. Call an ambulance if you have no way to get to the hospital safely or if you think you cannot make it to the hospital in time.

Thinking you might be in preterm labor can be stressful – but your diligence can help.

Understanding your risks and the signs and symptoms to watch out for can make a difference in your outcome if you have preterm labor. If you are concerned at all that you may be in labor before 37 weeks, call your doctor or go in. This is one of those things you can’t be too cautious about.

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